HESI LPN
Maternity HESI Practice Questions
1. A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents?
- A. “Surfactant improves the ability of your baby’s lungs to exchange oxygen and carbon dioxide.”
- B. “The drug keeps your baby from requiring too much sedation.”
- C. “Surfactant is used to reduce episodes of periodic apnea.”
- D. “Your baby needs this medication to fight a possible respiratory tract infection.”
Correct answer: A
Rationale: Artificial surfactant can be administered as an adjunct to oxygen and ventilation therapy for premature infants with respiratory distress syndrome (RDS). It helps improve respiratory compliance by aiding in the exchange of oxygen and carbon dioxide until the infant can produce enough surfactant naturally. The correct explanation to the parents would be that surfactant therapy enhances the baby’s lung function by facilitating the exchange of oxygen and carbon dioxide. Choice B is incorrect because surfactant therapy does not affect sedation needs. Choice C is inaccurate as surfactant is not used to reduce episodes of periodic apnea. Choice D is incorrect as surfactant is not administered to fight respiratory tract infections; it specifically targets improving lung function in RDS.
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. A client at 30 weeks gestation reports that she has not felt the baby move in the last 24 hours. Concerned, she arrives in a panic at the obstetric clinic where she is immediately sent to the hospital. Which assessment warrants immediate intervention by the nurse?
- A. Fetal Heart rate 60 beats per minute
- B. Ruptured amniotic membrane
- C. Onset of uterine contractions
- D. Leaking amniotic fluid
Correct answer: A
Rationale: A fetal heart rate of 60 beats per minute is significantly below the normal range (110-160 bpm) and indicates fetal distress, requiring immediate intervention. This low heart rate can be a sign of fetal compromise or distress, necessitating urgent evaluation and intervention to ensure the well-being of the fetus. Choices B, C, and D do not indicate immediate fetal distress requiring urgent intervention. Ruptured amniotic membrane, onset of uterine contractions, and leaking amniotic fluid are important assessments but do not present an immediate threat to the fetus's life like a severely low fetal heart rate.
4. The nurse is caring for a multiparous client who is 8 centimeters dilated, 100% effaced, and the fetal head is at 0 station. The client is shivering and states extreme discomfort with the urge to bear down. Which intervention should the nurse implement?
- A. Administer IV pain medication
- B. Perform a vaginal exam
- C. Reposition to side-lying
- D. Encourage pushing with each contraction
Correct answer: C
Rationale: Repositioning the client to a side-lying position is the most appropriate intervention in this scenario. This position can help relieve pressure on the cervix and reduce the urge to push prematurely, allowing the cervix to continue dilating. Administering IV pain medication may not address the underlying cause of the discomfort, and pushing prematurely can lead to cervical trauma. Performing a vaginal exam is not necessary at this point as the client is already 8 centimeters dilated, and the fetal head is at 0 station.
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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