HESI LPN
HESI Focus on Maternity Exam
1. The healthcare provider is preparing to administer phytonadione (vitamin K) to a newborn. Which statement made by the parents indicates understanding why the healthcare provider is administering this medication?
- A. Improve insufficient dietary intake
- B. Stimulate the immune system
- C. Help an immature liver
- D. Prevent hemorrhagic disorders
Correct answer: D
Rationale: The correct answer is D because phytonadione (vitamin K) is administered to newborns to prevent hemorrhagic disease due to their low levels of vitamin K, which is essential for blood clotting. Choice A is incorrect as vitamin K administration is not related to improving dietary intake. Choice B is incorrect as vitamin K doesn't stimulate the immune system. Choice C is incorrect as vitamin K is not given to help an immature liver, but rather to prevent hemorrhagic disorders.
2. A newborn with a respiratory rate of 40 breaths per minute at one minute after birth is demonstrating cyanosis of the hands and feet. What action should a nurse take?
- A. Assess bowel sounds.
- B. Continue to monitor.
- C. Assist with intubation.
- D. Rub the infant's back.
Correct answer: B
Rationale: Cyanosis of the hands and feet, known as acrocyanosis, is common in newborns shortly after birth and usually resolves on its own. It is not indicative of a need for immediate intervention. Therefore, the appropriate action is to continue monitoring the newborn's condition. Assessing bowel sounds (Choice A) is not relevant to the presenting issue of cyanosis and respiratory rate. Assisting with intubation (Choice C) is an invasive procedure that is not warranted based on the information provided. Rubbing the infant's back (Choice D) is not necessary for acrocyanosis and could potentially disturb the newborn.
3. What is the primary rationale for thoroughly drying the infant immediately after birth?
- A. Stimulates crying and lung expansion.
- B. Removes maternal blood from the skin surface.
- C. Reduces heat loss from evaporation.
- D. Increases blood supply to the hands and feet.
Correct answer: C
Rationale: The primary rationale for thoroughly drying the infant immediately after birth is to reduce heat loss from evaporation. This helps maintain the infant's body temperature and prevent hypothermia. Choice A (Stimulates crying and lung expansion) is incorrect because drying the infant is not primarily done to stimulate crying but rather to prevent heat loss. Choice B (Removes maternal blood from the skin surface) is incorrect as the main reason is to prevent heat loss, not to remove maternal blood. Choice D (Increases blood supply to the hands and feet) is also incorrect as drying the infant is not intended to increase blood supply but rather to regulate body temperature.
4. A new mother who is a lacto-ovo vegetarian plans to breastfeed her infant. Which information should the nurse provide prior to discharge?
- A. Continue prenatal vitamins with B12 while breastfeeding
- B. Avoid using Lanolin-based nipple cream or ointment
- C. Offer iron-fortified supplemental formula daily
- D. Weigh the baby weekly to evaluate the newborn's growth
Correct answer: A
Rationale: The correct answer is A: 'Continue prenatal vitamins with B12 while breastfeeding.' Vitamin B12 is crucial for lacto-ovo vegetarian mothers to prevent deficiencies in both the mother and the infant. Choice B is incorrect as Lanolin-based nipple cream is safe for use during breastfeeding. Choice C is not necessary unless there are specific indications for iron supplementation. Choice D, weighing the baby weekly, is important for monitoring growth but not specifically related to the mother's diet.
5. Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand?
- A. Stress on the heart is greatest in the first trimester and the last 2 weeks before labor.
- B. Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms.
- C. Women with class III cardiac disease should get 8 to 10 hours of sleep every day and limit housework, shopping, and exercise.
- D. Women with class I cardiac disease need bed rest through most of the pregnancy and face the possibility of hospitalization near term.
Correct answer: B
Rationale: Class II cardiac disease is symptomatic with ordinary activity. Women in this category need to avoid heavy exertion and limit regular activities as symptoms dictate. Stress is greatest between weeks 28 and 32 of gestation, when hemodynamic changes reach their maximum. Class III cardiac disease is symptomatic with less-than-ordinary activity. These women need bed rest most of the day and face the possibility of hospitalization near term. Class I cardiac disease is asymptomatic at normal levels of activity. These women can perform limited normal activities with discretion, although they still need a good amount of sleep.
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