HESI OB EXAM QUESTIONS AND ANSWERS

HESI OB EXAM QUESTIONS AND ANSWERS 

What nursing action should be implemented when intermittently gavage-feeding a
preterm infant?
Allow formula to flow by gravity.
Avoid letting infant suck on tube.
Insert feeding tube through
nares.Apply steady pressure to
syringe.Rationale
Gavage feeding is commonly used to feed preterm infants who are born at less
than 32-weeks gestation, infants who weigh less than 1500 grams, or infants who
are unable to tolerate oral feedings. The feeding should flow by gravity (A) to
avoid over-distention and a sudden sensation of fullness that may cause vomiting.
Allowing the infant to suck on the tube, not (B), permits observation of the sucking
response. The feeding tube should be inserted orally, since nasal insertion (C)
impedes obligatory nose breathing and may irritate delicate nasal mucosa. (D) can
result in vomiting if the rate of administration is too fast. A
client is receiving an oxytocin infusion for induction of labor. When the client
begins active labor, the fetal heart rate (FHR) slows at the onset of several
contractions with subsequent return to baseline before each contraction ends.
What action should the nurse implement?
Insert an internal monitor
device.Change the woman's
position.
Discontinue the oxytocin infusion.
Document the finding in the client
record.Rationale
Early FHR decelerations are a normal finding during active labor that occurs due to
fetal head compression, so the finding should be documented in the client record
(D). Although the client's status should be monitored continuously, this is a
reassuring FHR pattern, so (A, B, and C) are not indicated.
The nurse is teaching a new mother about diet and breastfeeding. Which
instruction is most important to include in the teaching plan?
Avoid alcohol because it is excreted in breast milk.
Avoid spicy foods to prevent infant colic.
Increase caloric intake by approximately 500 calories/day.
Double prenatal milk intake to improve Vitamin D transfer to the infant.
Rationale
Alcohol should be avoided while breastfeeding because, when consumed by the
mother, it is excreted in breast milk (A). It also adversely effects the milk ejection
HESI OB 2026/2027 EXAM QUESTIONS AND
ANSWERS
reflex. While (B) may cause some gastric upset in some babies, it does not cause
colic. (C) should also be included in diet teaching for a breastfeeding mother, but
because it does not involve safety to the infant it does not have the same degree
of importance as (A). Recent research has shown that infants receive very little
Vitamin D via the breastmilk and some sources recommend Vitamin D
supplementation in exclusively breastfed babies to prevent rickets.
An infant born at 37-weeks gestation, weighing 4.1 kg (9.02 pounds) is 2 hours
old and appears large for gestational age, flushed, and tremulous. What
procedure should the nurse follow to implement a glucose screening? (Arrange
the examination process from first on top to last on the bottom.)
Correct Answer:
• 1.
Wrap the infant's foot with a heel warmer for 5 minutes.
• 2.
Collect a spring-loaded automatic puncture device.
• 3.
Restrain the newborn's foot with your free hand.
• 4.
Cleanse puncture site on the lateral aspect of the heel.
Rationale
Obtaining capillary blood for the glucose screening for a infant that is macrosomic
and at risk for hypoglycemia should begin with wrapping the infant'sfoot with a
heel warmer for 5 to 10 minutes to facilitate vasodilation to obtain an adequate
blood sample volume. Next, a spring loaded automatic puncture device should be
obtained to puncture the skin because it is less traumatic than a manual lancet.
Then, the nurse's hand is used to restrain the foot as the puncture site on the
lateral aspect of the heel is cleansed.
The nurse observes a male newborn who is displaying a rigid posture with his eyes
tightly closed and grimacing as he is crying after an invasive procedure. Thebaby's
blood pressure is elevated on the Dinamap display. What action should the nurse
implement?
Obtain a serum glucose level.
Give the infant medication for
pain. Feed the newborn 1 ounce of
formula. Request a genetic
consultation.
Rationale
A cry face (or crying with the eyes squeezed or closed tightly), a rigid posture,
and an increase in blood pressure are indicative of pain in the neonate, so
analgesia should be given for pain (B). The symptoms of hypoglycemia (A) are
jitteriness and mottling. The signs of hunger include rooting, tongue extrusion
and possibly crying (C). A high-pitched shrill cry is associated with neurologic and
genetic anomalies (D).
The nurse assesses a high-risk neonate under a radiant warmer who has an
umbilical catheter and identifies that the neonate's feet are blanched. What
nursing action should be implemented?
Place socks on infant.
Elevate feet 15 degrees.
Wrap feet loosely in prewarmed blanket.
Report findings to the healthcare provider.
Rationale
Vasoconstriction of peripheral vessels, which can seriously impair circulation, is
triggered by arterial vasospasm caused by the presence of the catheter, the
infusion of fluids, or the injection of medication. Blanching of the buttocks,
genitalia, or the legs or feet is an indication of vasospasm and should be reported
immediately to the healthcare provider (D). (A, B, and C) do not provide effective
resolution of this potentially serious complications. A
gravid client develops maternal hypotension following regional anesthesia.
What intervention(s) should the nurse implement? (Select all that apply.)
Select all that apply
Some correct answers were not selected
Administer oxygen.
Increase IV fluids.
Perform a vaginal examination.
Assist client to a sitting
position.
Place the client in a lateral position.
Monitor fetal status.
Rationale
Correct selections are (A, B, E, and F). Oxygen (A), fluids (B), lateral position (E),
and evaluating fetal response (F) effectively manage maternal hypotension
following regional anesthesia. Placing the client in a sitting position (D) does not
facilitate venous return to the heart and limits perfusion of the fetus. A sterile
vaginal examination (C) does not increase blood flow and oxygenation to the
placenta and fetus.

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