a woman gave birth to a 7 pound 6 ounce infant girl 1 hour ago the birth was vaginal and the estimated blood loss ebl was 1500 ml when evaluating the

HESI LPN

HESI Maternal Newborn

1. A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When evaluating the woman’s vital signs, which finding would be of greatest concern to the nurse?

A. Temperature 37.9°C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and blood pressure 90/50 mm Hg.
B. Temperature 37.4°C, heart rate 88 bpm, respirations 36 breaths per minute, and blood pressure 126/68 mm Hg.
C. Temperature 38°C, heart rate 80 bpm, respirations 16 breaths per minute, and blood pressure 110/80 mm Hg.
D. Temperature 36.8°C, heart rate 60 bpm, respirations 18 breaths per minute, and blood pressure 140/90 mm Hg.

Correct answer: A

Rationale: An estimated blood loss (EBL) of 1500 ml following a vaginal birth is significant and can lead to hypovolemia. The vital signs provided in option A (Temperature 37.9°C, heart rate 120 bpm, respirations 20 breaths per minute, and blood pressure 90/50 mm Hg) indicate tachycardia and hypotension, which are concerning signs of hypovolemia due to excessive blood loss. Tachycardia is the body's compensatory mechanism to maintain cardiac output in response to decreased blood volume, and hypotension indicates inadequate perfusion. Options B, C, and D do not exhibit the same level of concern for hypovolemia. Option B shows tachypnea, which can be a result of pain or anxiety postpartum. Option C and D have vital signs within normal limits, which are not indicative of the body's response to significant blood loss.

2. When should a nurse on a labor and delivery unit instruct a newly licensed nurse to don gloves for a procedure?

A. Assisting a mother with breastfeeding
B. Performing a newborn's initial bath
C. Administering the measles, mumps, rubella vaccine
D. Performing umbilical cord care

Correct answer: B

Rationale: The correct answer is B: Performing a newborn's initial bath. Gloves should be worn during this procedure to protect against exposure to body fluids, such as amniotic fluid or blood. Assisting a mother with breastfeeding (Choice A) does not typically require gloves unless there are specific reasons for infection control. Administering vaccines (Choice C) and performing umbilical cord care (Choice D) are procedures that may require hand hygiene but not necessarily gloves, unless there is active bleeding or potential exposure to body fluids. The initial bath involves direct contact with body fluids, making it crucial to wear gloves for protection.

3. What causes cystic fibrosis?

A. Sex-linked abnormality.
B. Abnormality in the 21st pair of chromosomes.
C. Recessive gene.
D. Single segment found only on the Y chromosome.

Correct answer: C

Rationale: Cystic fibrosis is a genetic disorder caused by inheriting two copies of a recessive gene, one from each parent. This means that both parents must carry at least one copy of the faulty gene for a child to inherit the condition. Choice A is incorrect because cystic fibrosis is not linked to the sex chromosomes. Choice B is incorrect as cystic fibrosis is not caused by an abnormality in the 21st pair of chromosomes but by a specific gene mutation. Choice D is also incorrect as cystic fibrosis is not related to the Y chromosome, which is specific to males.

4. Which of the following statements is true of Down’s syndrome?

A. Down’s syndrome is usually caused by an extra copy of chromosome 21 in an individual.
B. The symptoms of Down’s syndrome are similar to those of sickle-cell anemia.
C. Down’s syndrome is caused by a sexually transmitted infection (STI) during conception.
D. The probability of having a child with Down’s syndrome increases with the age of the parents.

Correct answer: D

Rationale: The correct answer is D. The likelihood of having a child with Down’s syndrome increases as the age of the parents increases, particularly the mother's age. Choice A is incorrect because Down’s syndrome is caused by an extra copy of chromosome 21, not a defect in the sex chromosomes. Choice B is incorrect as the symptoms of Down’s syndrome and sickle-cell anemia are different. Choice C is also incorrect as Down’s syndrome is not caused by a sexually transmitted infection during conception.

5. Does the probability of having a child with Down’s syndrome increase with the age of the parents?

A. TRUE
B. FALSE
C. Sometimes
D. Never

Correct answer: A

Rationale: The correct answer is A: TRUE. Advanced parental age, particularly maternal age, is associated with an increased risk of Down's syndrome in offspring. As parents get older, the likelihood of having a child with Down's syndrome increases. Choices B, C, and D are incorrect because the risk of Down's syndrome is known to rise with parental age, especially maternal age, due to the increased likelihood of chromosomal abnormalities during egg formation.