HESI LPN
HESI Maternity 55 Questions
1. According to a survey by Adhikari and Liu in the year 2013, at birth, women have:
- A. close to 100,000 ova.
- B. around 300,000 to 400,000 ova.
- C. around 100 to 200 ova.
- D. only 500 ova.
Correct answer: B
Rationale: Women are born with approximately 300,000 to 400,000 ova, which gradually decrease in number as they age. Choice A ('close to 100,000 ova.') is incorrect as the actual number is much higher. Choice C ('around 100 to 200 ova.') is incorrect as it underestimates the quantity significantly. Choice D ('only 500 ova.') is incorrect as it greatly underestimates the number of ova present at birth.
2. A client who is 5 days postpartum is being taught about signs of effective breastfeeding. Which information should the nurse include in the teaching?
- A. Feeling a tugging sensation when the baby is sucking
- B. Expecting the baby to have two to three wet diapers in a 24-hour period
- C. The baby’s urine should appear dark and concentrated
- D. The breast should stay firm after the baby breastfeeds
Correct answer: A
Rationale: Feeling a tugging sensation while the baby is sucking indicates an effective latch and milk transfer during breastfeeding. This sensation means that the baby is effectively drawing milk from the breast. Choice B is incorrect because infants should ideally have six to eight wet diapers in a 24-hour period to show adequate hydration. Choice C is incorrect as a dark and concentrated urine may indicate dehydration, which is not a sign of effective breastfeeding. Choice D is incorrect as the breast should soften after the baby breastfeeds, indicating that the baby has effectively emptied the breast of milk.
3. The nurse is providing care for a newborn who was delivered vaginally assisted by forceps. The nurse observes red marks on the head with swelling that does not cross the suture line. Which condition should the nurse document in the medical record?
- A. Caput succedaneum
- B. Hydrocephalus
- C. Cephalhematoma
- D. Microcephaly
Correct answer: C
Rationale: The correct answer is Cephalhematoma. Cephalhematoma is a collection of blood between the skull bone and periosteum that does not cross the suture line. It often occurs due to birth trauma, such as forceps delivery, leading to localized swelling. Caput succedaneum (Choice A) is diffuse swelling of the scalp that may cross suture lines and is typically present at birth. Hydrocephalus (Choice B) is an abnormal accumulation of cerebrospinal fluid within the brain's ventricles. Microcephaly (Choice D) is a condition characterized by a smaller than average head size and may be present at birth or develop later in infancy.
4. A 30-year-old primigravida delivers a nine-pound (4082 gram) infant vaginally after a 30-hour labor. What is the priority nursing action for this client?
- A. Assess the blood pressure for hypertension.
- B. Gently massage fundus every four hours.
- C. Observe for signs of uterine hemorrhage.
- D. Encourage direct contact with the infant.
Correct answer: C
Rationale: After a prolonged labor and delivery of a large infant, the client is at an increased risk for uterine atony and postpartum hemorrhage, making observation for signs of bleeding a priority. Assessing the blood pressure for hypertension (Choice A) is not the priority in this situation as the immediate concern is postpartum hemorrhage. Gently massaging the fundus every four hours (Choice B) is a routine postpartum care activity but is not the priority in this scenario. Encouraging direct contact with the infant (Choice D) is important for bonding but does not address the immediate risk of uterine hemorrhage after delivery.
5. A pregnant client mentions in her history that she changes the cat's litter box daily. Which test should the nurse anticipate the healthcare provider to prescribe?
- A. Biophysical profile
- B. Fern test
- C. Amniocentesis
- D. TORCH screening
Correct answer: D
Rationale: The correct answer is D, TORCH screening. TORCH screening is done to detect infections such as toxoplasmosis, which can be contracted from handling cat litter and is harmful during pregnancy. Biophysical profile (choice A) is a prenatal ultrasound evaluation. Fern test (choice B) is used to assess for amniotic fluid leakage. Amniocentesis (choice C) involves taking a sample of amniotic fluid to test for genetic abnormalities and certain infections, not specifically related to toxoplasmosis from cat litter.
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