HESI LPN
Maternity HESI Practice Questions
1. Which FHR finding is the most concerning to the nurse providing care to a laboring client?
- A. Accelerations with fetal movement.
- B. Early decelerations.
- C. Average FHR of 126 beats per minute.
- D. Late decelerations.
Correct answer: D
Rationale: Late decelerations are caused by uteroplacental insufficiency, resulting in fetal hypoxemia. They are considered ominous if persistent, indicating compromised oxygen supply to the fetus. Accelerations with fetal movement (Choice A) are reassuring signs of fetal well-being. Early decelerations (Choice B) are typically benign, associated with head compression during contractions. An average FHR of 126 beats per minute (Choice C) falls within the normal range for fetal heart rate and is not concerning. Therefore, the most concerning FHR finding in a laboring client is late decelerations (Choice D).
2. According to a study in the year 2013 by Fellman, if a woman is a twin, if her mother was a twin, or if she has previously borne twins, then:
- A. she will bear only monozygotic (MZ) twins.
- B. the chances of her becoming pregnant decrease.
- C. she is likely to be a healthy mother.
- D. the chances rise that she will bear twins.
Correct answer: D
Rationale: According to the study, the chances of a woman bearing twins increase if she is a twin herself, if her mother was a twin, or if she has previously borne twins. Therefore, the correct answer is D. Choice A is incorrect because the study does not specify that she will bear only monozygotic twins. Choice B is incorrect as the study does not mention any decrease in the chances of becoming pregnant. Choice C is incorrect because the study does not provide information about the woman's health status, focusing instead on the likelihood of bearing twins.
3. Which procedure is used to detect neural tube defects such as spina bifida and certain chromosomal abnormalities?
- A. Artificial insemination
- B. Amniocentesis
- C. Endometriosis
- D. Alpha-fetoprotein (AFP) assay
Correct answer: D
Rationale: The correct answer is the Alpha-fetoprotein (AFP) assay. This blood test measures the level of AFP in a pregnant woman's blood, aiding in the detection of neural tube defects and certain chromosomal abnormalities in the fetus. Choice A, artificial insemination, is a method used to facilitate fertilization and is not related to detecting fetal abnormalities. Choice B, amniocentesis, involves collecting amniotic fluid for genetic testing, not directly measuring AFP levels. Choice C, endometriosis, is a medical condition involving abnormal tissue growth and is not a procedure for detecting fetal abnormalities. Therefore, the Alpha-fetoprotein (AFP) assay is the most appropriate option for detecting neural tube defects such as spina bifida and certain chromosomal abnormalities.
4. The healthcare provider prescribes 10 units per liter of oxytocin via IV drip to augment a client's labor because she is experiencing a prolonged active phase. Which finding would cause the nurse to immediately discontinue the oxytocin?
- A. Contraction duration of 100 seconds.
- B. Four contractions in 10 minutes.
- C. Uterus is soft.
- D. Early deceleration of fetal heart rate.
Correct answer: A
Rationale: A contraction duration of 100 seconds is too long and can indicate uterine hyperstimulation, which can lead to fetal distress and other complications. This prolonged contraction duration suggests that the uterus is not relaxing adequately between contractions, potentially compromising fetal oxygenation. Choice B, 'Four contractions in 10 minutes,' is a sign of tachysystole, which is concerning but not as immediately critical as the prolonged contraction duration. Choice C, 'Uterus is soft,' is not a reason to discontinue oxytocin; in fact, it is a normal finding. Choice D, 'Early deceleration of fetal heart rate,' while indicating fetal distress, is not a direct result of the oxytocin and may require intervention but not immediate discontinuation of the medication.
5. A woman has experienced iron deficiency anemia during her pregnancy. She had been taking iron for 3 months before the birth. The client gave birth by cesarean 2 days earlier and has been having problems with constipation. After assisting her back to bed from the bathroom, the nurse notes that the woman’s stools are dark (greenish-black). What should the nurse’s initial action be?
- A. Perform a guaiac test and record the results.
- B. Recognize the finding as abnormal and report it to the primary health care provider.
- C. Recognize the finding as a normal result of iron therapy.
- D. Check the woman’s next stool to validate the observation.
Correct answer: C
Rationale: The nurse should recognize that dark stools are a common side effect in clients who are taking iron replacement therapy. Dark stools are a known, expected result of iron supplementation and are not indicative of a complication unless other symptoms of GI bleeding are present. A guaiac test would be necessary if there were concerns about gastrointestinal bleeding. Recognizing dark stools as a consequence of iron therapy is an essential nursing assessment skill and does not require immediate reporting. Checking the next stool to confirm the observation is unnecessary as the presence of dark stools in this context is already an expected outcome of iron supplementation.
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