HESI LPN
Maternity HESI Test Bank
1. During which of the following periods does the development of arms and legs occur in a pregnancy?
- A. Development of the lungs
- B. Development of the heart
- C. Development of arms and legs
- D. Development of the stomach
Correct answer: C
Rationale: The correct answer is C. The development of arms and legs occurs during the critical period of the fourth to eighth weeks of pregnancy. This timeframe is crucial for the formation of limbs and other key body parts. Choices A, B, and D are incorrect because the development of the lungs, heart, and stomach respectively occurs at different stages of fetal development and is not primarily associated with the fourth to eighth weeks of pregnancy.
2. When should the low-risk patient, who is 16 weeks pregnant, be advised to return to the prenatal clinic?
- A. 1 week.
- B. 2 weeks.
- C. 3 weeks.
- D. 4 weeks.
Correct answer: D
Rationale: The correct answer is D: 4 weeks. Low-risk pregnant patients typically have prenatal visits every 4 weeks until 28 weeks of gestation. This frequency allows for adequate monitoring of the pregnancy without being overly burdensome on the patient. Choices A, B, and C are incorrect as they do not align with the standard prenatal care schedule for low-risk pregnancies. Visits that are too frequent may cause unnecessary anxiety for the patient, while visits that are too infrequent may miss important opportunities for monitoring and intervention.
3. The nurse has received a report regarding a client in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. What is the nurse’s interpretation of this assessment?
- A. Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm above the ischial spines.
- B. Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines.
- C. Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm below the ischial spines.
- D. Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm below the ischial spines.
Correct answer: B
Rationale: The correct interpretation of the assessment provided is that the cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines. In the given assessment, the measurements are ordered as dilation, effacement, and station. Choice A is incorrect as it wrongly places the presenting part below the ischial spines. Choice C is incorrect because it places the presenting part below the ischial spines. Choice D is also incorrect as it incorrectly states that the presenting part is below the ischial spines, even though it correctly mentions the dilation and effacement of the cervix.
4. A nurse on the postpartum unit is caring for four clients. For which of the following clients should the nurse notify the provider?
- A. A client with a urinary output of 300 ml in 8 hours
- B. A client reporting abdominal cramping during breastfeeding
- C. A client receiving magnesium sulfate with absent deep tendon reflexes
- D. A client reporting lochia rubra requiring changing perineal pads every 3 hours
Correct answer: C
Rationale: The correct answer is C because in a client receiving magnesium sulfate, absent deep tendon reflexes can indicate magnesium toxicity, which requires immediate intervention to prevent serious complications. Choices A, B, and D are common postpartum occurrences that do not typically warrant immediate provider notification. A urinary output of 300 ml in 8 hours, abdominal cramping during breastfeeding, and frequent changing of perineal pads due to lochia rubra are within the expected range of postpartum recovery and do not indicate an urgent need for provider notification.
5. A 25-year-old gravida 3, para 2 client gave birth to a 9-pound, 7-ounce boy 4 hours ago after augmentation of labor with oxytocin (Pitocin). She presses her call light and asks for her nurse right away, stating 'I’m bleeding a lot.' What is the most likely cause of postpartum hemorrhage in this client?
- A. Retained placental fragments.
- B. Unrepaired vaginal lacerations.
- C. Uterine atony.
- D. Puerperal infection.
Correct answer: C
Rationale: Uterine atony is the most likely cause of bleeding 4 hours after delivery, especially after delivering a macrosomic infant and augmenting labor with oxytocin. Uterine atony is characterized by the inability of the uterine muscles to contract effectively after childbirth, leading to excessive bleeding. The other options, such as retained placental fragments (A), unrepaired vaginal lacerations (B), and puerperal infection (D), are less likely causes of postpartum hemorrhage in this scenario. Retained placental fragments can cause bleeding, but this typically presents earlier than 4 hours postpartum. Unrepaired vaginal lacerations would likely be evident sooner and not typically result in significant bleeding. Puerperal infection is not a common cause of immediate postpartum hemorrhage unless there are other signs of infection present.
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