HESI LPN
HESI Focus on Maternity Exam
1. A newborn who was born post-term is being assessed by a nurse. Which of the following findings should the nurse expect?
- A. A Rh-negative mother who has an Rh-positive infant
- B. A Rh-positive mother who has an Rh-negative infant
- C. A Rh-positive mother who has an Rh-positive infant
- D. A Rh-negative mother who has an Rh-negative infant
Correct answer: A
Rationale: The correct answer is A: 'A Rh-negative mother who has an Rh-positive infant.' In cases where the newborn is born post-term, the mismatched Rh factor between the mother (Rh-negative) and the infant (Rh-positive) can lead to hemolytic disease of the newborn. This condition occurs when maternal antibodies attack fetal red blood cells, causing hemolysis. This can result in jaundice, anemia, and other serious complications for the infant. Choices B, C, and D are incorrect because they do not reflect the mismatched Rh factor scenario that poses a risk for hemolytic disease of the newborn.
2. 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.
3. As women reach the end of their childbearing years, does ovulation become more regular?
- A. TRUE
- B. FALSE
- C. Rarely
- D. Always
Correct answer: B
Rationale: The correct answer is B: FALSE. As women age and reach the end of their childbearing years, ovulation becomes less regular due to hormonal changes associated with menopause. This can result in irregular ovulation patterns or even the cessation of ovulation entirely. Choice A is incorrect because ovulation does not become more regular with age. Choices C and D are also incorrect as they do not accurately reflect the changes in ovulation patterns that occur as women approach the end of their childbearing years.
4. When reviewing the electronic medical record of a postpartum client, which of the following factors places the client at risk for infection?
- A. Meconium-stained amniotic fluid
- B. Placenta previa
- C. Midline episiotomy
- D. Gestational hypertension
Correct answer: C
Rationale: The correct answer is C: Midline episiotomy. An episiotomy is a surgical incision made during childbirth to enlarge the vaginal opening. This procedure increases the risk of infection in the postpartum period due to the incision site being a potential entry point for pathogens. Meconium-stained amniotic fluid (choice A) is a risk factor for fetal distress but does not directly increase the mother's risk of infection. Placenta previa (choice B) is a condition where the placenta partially or completely covers the cervix, leading to potential bleeding issues but not necessarily an increased risk of infection. Gestational hypertension (choice D) is a hypertensive disorder that affects some pregnant women but is not directly associated with an increased risk of infection in the postpartum period.
5. Twenty-year-old Jack is extremely tall and has very thick facial hair. Most of his male secondary sex characteristics are also more pronounced than men of his age. In this scenario, Jack is most likely:
- A. an XYY male.
- B. diagnosed with Klinefelter syndrome.
- C. an XXY male.
- D. diagnosed with Down syndrome.
Correct answer: A
Rationale: The correct answer is A: an XYY male. Individuals with XYY syndrome often exhibit increased height and more pronounced secondary male characteristics, such as thick facial hair. Choice B, Klinefelter syndrome (XXY), typically presents with less prominent male secondary sex characteristics due to the presence of an extra X chromosome. Choice C, XXY male, refers to Klinefelter syndrome, which does not align with the description of Jack having more pronounced male secondary sex characteristics. Choice D, Down syndrome, is caused by a trisomy of chromosome 21 and is not associated with the physical characteristics described in the scenario.
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