HESI LPN
HESI Maternal Newborn
1. When obtaining a health history from a client, a nurse in a woman’s health clinic should identify which of the following findings as increasing the client’s risk for developing pelvic inflammatory disease (PID)?
- A. Recurrent Cystitis
- B. Frequent Alcohol Use
- C. Use of Oral Contraceptives
- D. Chlamydia Infection
Correct answer: D
Rationale: Chlamydia infection is a significant risk factor for developing pelvic inflammatory disease (PID). PID is often caused by untreated sexually transmitted infections (STIs) like Chlamydia and Gonorrhea that ascend from the vagina to the upper reproductive organs. Recurrent cystitis (choice A) is more related to urinary tract infections, frequent alcohol use (choice B) is not directly linked to PID, and the use of oral contraceptives (choice C) does not increase the risk of developing PID.
2. A primiparous woman presents in labor with the following labs: hemoglobin 10.9 g/dL, hematocrit 29%, hepatitis surface antigen positive, Group B Streptococcus positive, and rubella non-immune. Which intervention should the nurse implement?
- A. Transfuse 2 units of packed red blood cells.
- B. Give measles, mumps, rubella vaccine 0.5 mL.
- C. Administer ampicillin 2 grams intravenously.
- D. Inject hepatitis B immune globulin 0.5 milliliters.
Correct answer: C
Rationale: The correct intervention in this scenario is to administer ampicillin 2 grams intravenously. This is crucial to prevent Group B Streptococcus infection in the newborn during delivery. Option A, transfusing packed red blood cells, is not indicated based on the hemoglobin and hematocrit levels provided. Option B, giving measles, mumps, rubella vaccine, is not necessary at this time. Option D, injecting hepatitis B immune globulin, is not appropriate for the conditions presented in the question.
3. Which of the following most accurately describes the function of genes?
- A. They regulate the development of traits.
- B. They prevent foreign particles from entering the body.
- C. They work together with lutein to influence development.
- D. They transfer oxygen from the bloodstream to other parts of the body.
Correct answer: A
Rationale: The correct answer is A: 'They regulate the development of traits.' Genes play a crucial role in regulating the development of traits by encoding proteins that control various bodily functions and characteristics. This process involves gene expression and the production of proteins that ultimately determine an individual's traits. Choice B is incorrect because genes do not have a direct role in preventing foreign particles from entering the body; this function is primarily carried out by the immune system. Choice C is incorrect as genes do not specifically work with lutein to influence development; genes operate independently to regulate trait expression. Choice D is incorrect as genes are not responsible for transferring oxygen in the bloodstream; this function is carried out by red blood cells and hemoglobin.
4. During a prenatal visit, for which of the following clients should the nurse auscultate the fetal heart rate?
- A. A client who has an ultrasound confirming a molar pregnancy
- B. A client who has a crown-rump length corresponding to 7 weeks gestation
- C. A client who has a positive urine pregnancy test 1 week after missed menses
- D. A client who has felt quickening for the first time
Correct answer: D
Rationale: The correct answer is D because feeling quickening typically occurs around 18-20 weeks of gestation, indicating fetal movement. This is an appropriate time to auscultate the fetal heart rate. Choice A is incorrect because a molar pregnancy is not a viable pregnancy, and auscultating the fetal heart rate in this case is not applicable. Choice B is incorrect because a crown-rump length of 7 weeks gestation is too early for fetal heart rate auscultation. Choice C is incorrect because a positive urine pregnancy test alone does not indicate the appropriate timing for fetal heart rate auscultation.
5. Why is a client with gestational diabetes being scheduled for an amniocentesis when the fetus has an estimated weight of eight pounds (3629 grams) at 36 weeks gestation? What information is the amniocentesis seeking to obtain?
- A. Presence of a neural tube defect.
- B. Chromosomal abnormalities.
- C. Gender of the fetus.
- D. Fetal lung maturity.
Correct answer: D
Rationale: An amniocentesis in this scenario is most likely being performed to assess fetal lung maturity. This is necessary when considering early delivery due to macrosomia (large fetal size), which is a common concern in gestational diabetes. Evaluating fetal lung maturity is crucial to determine if the fetus's lungs are developed enough to support breathing independently outside the womb. The presence of a neural tube defect and chromosomal abnormalities are not typically assessed through amniocentesis in this situation, and determining the gender of the fetus is not the primary purpose of the procedure here.
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