HESI LPN
HESI Focus on Maternity Exam
1. A healthcare professional is caring for a client who is 14 weeks of gestation. At which of the following locations should the healthcare professional place the Doppler device when assessing the fetal heart rate?
- A. Midline 2 to 3 cm (0.8 to 1.2 in) above the symphysis pubis
- B. Left Upper Abdomen
- C. Two fingerbreadths above the umbilicus
- D. Lateral at the Xiphoid Process
Correct answer: A
Rationale: At 14 weeks of gestation, the uterus is still relatively low in the abdomen. Placing the Doppler midline 2 to 3 cm above the symphysis pubis is appropriate for assessing the fetal heart rate. This location allows for better detection of the fetal heart tones as the uterus is at a lower position during this stage of pregnancy. Placing the Doppler on the left upper abdomen would not be ideal at 14 weeks gestation as the uterus is not yet at that level. Placing it two fingerbreadths above the umbilicus or lateral at the xiphoid process would also not be accurate for locating the fetal heart rate at this stage of gestation.
2. _________ are problems that stem from the interaction of heredity and environmental factors.
- A. Multifactorial problems
- B. Cognitive problems
- C. Horizon problems
- D. Coronal problems
Correct answer: A
Rationale: Multifactorial problems are conditions that result from the interplay of genetic and environmental factors. These conditions, such as diabetes or heart disease, are not solely determined by genetics or environment but are influenced by a combination of both factors. Choice B, cognitive problems, refers to difficulties related to thinking, learning, and memory and are not specifically linked to genetic and environmental interactions. Choices C and D, horizon problems and coronal problems, are nonsensical terms and do not relate to the interaction of heredity and environmental factors.
3. A client with preeclampsia is receiving magnesium sulfate by continuous IV infusion. Which finding should the nurse report to the provider?
- A. Blood pressure 148/94 mm Hg
- B. Respiratory rate 14/min
- C. Urinary output 20 mL/hr
- D. 2+ deep tendon reflexes
Correct answer: C
Rationale: In a client with preeclampsia receiving magnesium sulfate, a urinary output of 20 mL/hr is a concerning finding as it may indicate renal impairment or magnesium toxicity. Adequate urinary output is crucial for eliminating excess magnesium and preventing toxicity. The nurse should report this finding to the provider for further evaluation. A blood pressure of 148/94 mm Hg is elevated but expected in a client with preeclampsia. A respiratory rate of 14/min is within the normal range. 2+ deep tendon reflexes are a common finding in clients receiving magnesium sulfate and are not a cause for concern unless they progress to hyperreflexia or clonus.
4. A client who delivered a healthy newborn an hour ago asked the nurse when she can go home. Which information is most important for the nurse to provide the client?
- A. After the baby no longer demonstrates acrocyanosis
- B. After the baby receives the vitamin K injection
- C. When ambulating to avoid causing dizziness
- D. When there is no significant vaginal bleeding
Correct answer: D
Rationale: The most critical information for the nurse to provide the client is ensuring that there is no significant vaginal bleeding before discharge. This is vital to prevent complications such as postpartum hemorrhage. Options A, B, and C are important aspects of postpartum care, but assessing and managing vaginal bleeding takes precedence due to its potential seriousness.
5. A client is experiencing preterm labor and has a prescription for 4 doses of dexamethasone 6 mg IM every 12 hours. The available concentration is dexamethasone 10 mg/mL. How many mL of dexamethasone should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use trailing zero.)
- A. 0.6 mL
- B. ---
- C. ---
- D. ---
Correct answer: A
Rationale: Calculation: (6 mg/dose) / (10 mg/mL) = 0.6 mL per dose. The correct answer is 0.6 mL. This calculation is obtained by dividing the dose needed (6 mg) by the concentration available (10 mg/mL). The resulting value is 0.6 mL per dose. Choices B, C, and D are not applicable as the correct answer has been calculated accurately.
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