a newborn assessment reveals spina bifida occulta which maternity factor should the nurse identify as having the greatest impact on the development of

HESI LPN

Maternity HESI Test Bank

1. What maternal factor should the nurse identify as having the greatest impact on the development of spina bifida occulta in a newborn?

A. Short interval between pregnancies
B. Folic acid deficiency
C. Preeclampsia
D. Tobacco use

Correct answer: B

Rationale: Folic acid deficiency during pregnancy is a well-known risk factor for neural tube defects, including spina bifida occulta, making supplementation critical in prenatal care. Folic acid plays a crucial role in neural tube formation during early pregnancy. Short intervals between pregnancies do not directly impact the development of spina bifida occulta. Preeclampsia is a hypertensive disorder of pregnancy and is not directly linked to spina bifida occulta. While tobacco use during pregnancy has various adverse effects, it is not the primary factor influencing the development of spina bifida occulta in newborns.

2. A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effects should the nurse include?

A. Tinnitus
B. Urinary Frequency
C. Breast Tenderness
D. Chills

Correct answer: C

Rationale: The correct answer is C: 'Breast Tenderness.' Clomiphene citrate is known to cause breast tenderness as a common side effect due to its hormonal effects on the body. Tinnitus (choice A), which is a ringing in the ears, is not typically associated with clomiphene citrate. Urinary frequency (choice B) is not a common adverse effect of this medication. Chills (choice D) are also not commonly linked to clomiphene citrate use.

3. A newborn's head circumference is 12 inches (30.5 cm) and his chest measurement is 13 inches (33 cm). The nurse notes that this infant has no molding, and it was a breech presentation delivered by cesarean section. What action should the nurse take based on this data?

A. No action needs to be taken, it is normal for an infant born by cesarean section to have a small head circumference.
B. Notify the pediatrician immediately. These signs support the possibility of hydrocephalus.
C. Call these findings to the attention of the pediatrician. The head/chest ratio is abnormal.
D. Record the findings on the chart. They are within normal limits.

Correct answer: D

Rationale: Head and chest circumference measurements are within normal limits for a newborn, especially for those delivered by cesarean section, so no immediate action is required beyond documentation.

4. Which of the following statements about Rh incompatibility is true?

A. Rh incompatibility occurs most commonly during a woman’s first pregnancy.
B. Rh incompatibility is an untreatable condition that leaves a woman infertile for the rest of her life.
C. Rh incompatibility is an abnormality that is transmitted from generation to generation and carried by a sex chromosome.
D. Rh incompatibility occurs due to antibodies transmitted to a fetus during subsequent deliveries causing brain damage or death.

Correct answer: D

Rationale: Rh incompatibility occurs when the mother's antibodies attack the fetus's red blood cells, leading to serious complications, usually in subsequent pregnancies. Choice A is incorrect because Rh incompatibility often occurs in subsequent pregnancies, not necessarily the first one. Choice B is incorrect as Rh incompatibility does not render a woman infertile but can lead to complications during pregnancies. Choice C is incorrect as Rh incompatibility is not carried by a sex chromosome but involves the Rh factor on red blood cells.

5. What is the primary role of meiosis in the production of sperm and ova?

A. To reduce the chromosome number by half
B. To increase the chromosome number
C. To create identical copies of chromosomes
D. To repair damaged chromosomes

Correct answer: A

Rationale: The correct answer is A. Meiosis is a type of cell division that reduces the chromosome number by half, resulting in the formation of sperm and ova. Choice B is incorrect because meiosis does not increase the chromosome number. Choice C is incorrect because meiosis creates genetically diverse gametes, not identical copies of chromosomes. Choice D is incorrect because meiosis does not primarily function to repair damaged chromosomes.