HESI LPN
HESI Focus on Maternity Exam
1. A new parent is receiving discharge teaching about car seat safety from a nurse. Which statement by the parent indicates an understanding of the teaching?
- A. “I should position my baby’s car seat at a 45-degree angle in the car.”
- B. “I should place the car seat rear-facing until my baby is 12 months old.”
- C. “I should place the harness snugly in a slot above my baby’s shoulders.”
- D. “I should position the retainer clip at the top of my baby’s abdomen.”
Correct answer: A
Rationale: The correct answer is A. Positioning the car seat at a 45-degree angle is crucial to prevent the baby's head from falling forward, which can obstruct the airway. Choice B is incorrect because the recommendation is to keep the car seat rear-facing until the baby reaches the height or weight limit set by the car seat manufacturer, typically beyond 12 months. Choice C is incorrect as the harness should be snugly placed at or below the baby's shoulders, not above. Choice D is incorrect as the retainer clip should be positioned at armpit level to secure the harness straps properly.
2. The nurse places one hand above the symphysis while massaging the fundus of a multiparous client whose uterine tone is boggy 15 minutes after delivering a 7-pound, 10-ounce (3220-gram) infant. Which information should the nurse provide to the client about these findings?
- A. The uterus should be firm to prevent an intrauterine infection.
- B. Both the lower uterine segment and the fundus must be massaged.
- C. A firm uterus prevents the endometrial lining from being sloughed.
- D. Clots may form inside a boggy uterus and need to be expelled.
Correct answer: D
Rationale: After childbirth, a boggy uterus indicates poor uterine tone, which can lead to the formation of clots. Massaging the fundus helps the uterus contract and expel clots, reducing the risk of postpartum hemorrhage. Choices A, B, and C are incorrect because the main concern with a boggy uterus is the risk of clot formation and postpartum hemorrhage, not solely preventing intrauterine infection, massaging the lower uterine segment, or preventing the endometrial lining from sloughing.
3. A healthcare provider is assessing a newborn upon admission to the nursery. Which of the following should the provider expect?
- A. Bulging Fontanels
- B. Nasal Flaring
- C. Length from head to heel of 40 cm (15.7 in)
- D. Chest circumference 2 cm (0.8 in) smaller than the head circumference
Correct answer: D
Rationale: Upon admission to the nursery, a healthcare provider should expect the newborn's chest circumference to be slightly smaller than the head circumference. This is a normal finding in newborns due to their physiological development. Bulging fontanels (Choice A) can indicate increased intracranial pressure, which is abnormal. Nasal flaring (Choice B) is a sign of respiratory distress and is also an abnormal finding. While a length from head to heel of 40 cm (15.7 in) (Choice C) falls within the normal range for newborns, it is not a specific expectation upon admission to the nursery. Therefore, the correct expectation for a newborn upon admission is for the chest circumference to be slightly smaller than the head circumference.
4. A client has bacterial vaginosis. Which of the following medications should the nurse expect to administer?
- A. Metronidazole
- B. Fluconazole
- C. Acyclovir
- D. Clindamycin
Correct answer: A
Rationale: Metronidazole is the correct choice for treating bacterial vaginosis as it is the first-line medication recommended for this condition. Metronidazole works by disrupting the DNA structure of bacteria, making it an effective treatment. Choice B, Fluconazole, is an antifungal medication primarily used for treating fungal infections, not bacterial vaginosis. Choice C, Acyclovir, is an antiviral medication used to treat viral infections, not bacterial vaginosis. Choice D, Clindamycin, is also used to treat bacterial infections but is not the first-line treatment for bacterial vaginosis, making it an incorrect choice in this scenario.
5. A woman who is 38 weeks gestation is receiving magnesium sulfate for severe preeclampsia. Which assessment finding warrants immediate intervention by the nurse?
- A. Dizziness while standing
- B. Sinus tachycardia
- C. Lower back pain
- D. Absent patellar reflexes
Correct answer: D
Rationale: The correct answer is D: Absent patellar reflexes. Absent patellar reflexes can indicate magnesium toxicity, a serious condition that requires immediate intervention to prevent respiratory depression or cardiac arrest. Dizziness while standing (choice A) is common in pregnancy but does not specifically indicate magnesium toxicity. Sinus tachycardia (choice B) can be a normal response to magnesium sulfate but does not indicate toxicity. Lower back pain (choice C) is common in pregnancy and not specifically associated with magnesium toxicity.
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