HESI LPN
HESI Maternal Newborn
1. A newborn nursery protocol includes a prescription for ophthalmic erythromycin 5% ointment to both eyes upon a newborn's admission. What action should the nurse take to ensure adequate installation of the ointment?
- A. Instill a thin ribbon into each lower conjunctival sac
- B. Occlude the inner canthus after retracting the eyelids
- C. Mummy wrap the infant before instilling the ointment
- D. Stabilize the instilling hand on the neonate's head
Correct answer: A
Rationale: To ensure adequate installation of the ophthalmic erythromycin 5% ointment in a newborn, the nurse should instill a thin ribbon into each lower conjunctival sac. This method helps to ensure proper distribution and effectiveness of the medication to prevent neonatal conjunctivitis. Choices B, C, and D are incorrect. Occluding the inner canthus after retracting the eyelids, mummy wrapping the infant, or stabilizing the instilling hand on the neonate's head are not appropriate actions for ensuring the proper installation of the ointment.
2. A mother spontaneously delivers a newborn infant in the taxicab while on the way to the hospital. The emergency room nurse reported the mother has active herpes (HSV II) lesions on the vulva. Which intervention should the nurse implement first when admitting the neonate to the nursery?
- A. Document the newborn's temperature on the flow sheet.
- B. Place the newborn in the isolation area of the nursery.
- C. Obtain a blood specimen for a serum glucose level.
- D. Administer the vitamin K injection.
Correct answer: B
Rationale: Newborns exposed to active herpes lesions are at high risk for neonatal herpes, which can be severe. Placing the newborn in isolation is crucial as it helps prevent the spread of the virus and allows for close monitoring. Documenting the newborn's temperature, obtaining a blood specimen for a serum glucose level, and administering the vitamin K injection are important interventions but are not the priority when dealing with a potential infectious risk like neonatal herpes.
3. _____ is a type of estrogen, prescribed in the 1940s and 1950s to pregnant women, that is said to have caused testicular, vaginal, and cervical cancer in some offspring.
- A. Androsterone
- B. Adiponectin
- C. Progestin
- D. Diethylstilbestrol
Correct answer: D
Rationale: Diethylstilbestrol (DES) is a synthetic estrogen that was prescribed to pregnant women in the 1940s and 1950s to prevent miscarriages. However, it was later discovered that DES exposure in utero could lead to health issues in offspring, including an increased risk of testicular, vaginal, and cervical cancer. Choice A, Androsterone, is a steroid hormone produced in small amounts in humans and unlikely to be associated with the adverse effects described. Choice B, Adiponectin, is a protein hormone that plays a role in regulating glucose levels and fatty acid breakdown, not related to the adverse effects mentioned. Choice C, Progestin, is a synthetic form of progesterone used in birth control and hormone therapy, not linked to the specific health concerns associated with DES exposure.
4. As women reach the end of their childbearing years, does ovulation become more regular?
- A. TRUE
- B. FALSE
- C. Rarely
- D. Always
Correct answer: B
Rationale: The correct answer is B: FALSE. As women age and reach the end of their childbearing years, ovulation becomes less regular due to hormonal changes associated with menopause. This can result in irregular ovulation patterns or even the cessation of ovulation entirely. Choice A is incorrect because ovulation does not become more regular with age. Choices C and D are also incorrect as they do not accurately reflect the changes in ovulation patterns that occur as women approach the end of their childbearing years.
5. Which of the following statements is true of sickle-cell anemia?
- A. It is typically managed with treatments such as pain relief medications.
- B. It is caused by a mutation in the beta-globin gene.
- C. It leads to the obstruction of small blood vessels and decreased oxygen delivery.
- D. It is more prevalent in individuals of African, Mediterranean, Middle Eastern, and Indian descent.
Correct answer: C
Rationale: The correct answer is C. Sickle-cell anemia results from a mutation in the beta-globin gene, causing red blood cells to become sickle-shaped. These misshapen cells can obstruct small blood vessels, leading to reduced oxygen delivery to tissues. Choices A, B, and D are incorrect because sickle-cell anemia is typically managed with treatments such as pain relief medications, hydration, and in severe cases, blood transfusions. It is caused by a specific mutation in the beta-globin gene, not by the inability to metabolize phenylalanine. Additionally, sickle-cell anemia is more prevalent in individuals of African, Mediterranean, Middle Eastern, and Indian descent, not exclusive to any specific gender.
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