HESI LPN
HESI Maternal Newborn
1. What causes Down's syndrome?
- A. Alcohol abuse by the mother at the time of conception.
- B. Sex-linked chromosomal abnormalities.
- C. An extra chromosome on the 21st pair.
- D. Drug abuse by the mother during pregnancy.
Correct answer: C
Rationale: Down's syndrome, also known as trisomy 21, is caused by the presence of an extra chromosome on the 21st pair. Choice A is incorrect as alcohol abuse is not the cause of Down's syndrome. Choice B is incorrect because Down's syndrome is not related to sex-linked chromosomal abnormalities. Choice D is also incorrect as drug abuse by the mother during pregnancy is not the cause of Down's syndrome.
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 nurse is caring for an infant who has signs of neonatal abstinence syndrome. Which of the following actions should the nurse take?
- A. Provide a calm environment
- B. Monitor blood glucose levels every hour
- C. Initiate seizure precautions
- D. Place the infant on their back with legs extended
Correct answer: C
Rationale: Initiating seizure precautions is crucial when caring for an infant with neonatal abstinence syndrome due to the increased risk of seizures. Providing a calm environment (Choice A) is important to reduce stimulation as these infants may be irritable. Monitoring blood glucose levels (Choice B) is not typically a priority in neonatal abstinence syndrome unless specific signs or symptoms suggest the need for this assessment. Placing the infant on their back with legs extended (Choice D) does not directly address the potential complications associated with neonatal abstinence syndrome, such as seizures.
4. A nurse on an antepartum unit is reviewing the medical records for four clients. Which of the following clients should the nurse assess first?
- A. A client who has diabetes mellitus and an HbA1c of 5.8%
- B. A client who has preeclampsia and a creatinine level of 1.1 mg/dL
- C. A client who has hyperemesis gravidarum and a sodium level of 110 mEq/L
- D. A client who has placenta previa and a hematocrit of 36%
Correct answer: C
Rationale: A sodium level of 110 mEq/L is critically low and can indicate severe dehydration and electrolyte imbalance, requiring immediate intervention.
5. A primigravida at 36 weeks gestation who is RH-negative experienced abdominal trauma in a motor vehicle collision. Which assessment finding is most important for the nurse to report to the healthcare provider?
- A. Fetal heart rate at 162 beats per minute
- B. Mild contractions every 10 minutes
- C. Trace of protein in the urine
- D. Positive fetal hemoglobin testing
Correct answer: D
Rationale: The correct answer is 'Positive fetal hemoglobin testing' (D). Positive fetal hemoglobin testing (Kleihauer-Betke test) indicates fetal-maternal hemorrhage, which is critical in an RH-negative mother due to the risk of isoimmunization. This condition can lead to sensitization of the mother's immune system against fetal blood cells, potentially causing hemolytic disease of the newborn in subsequent pregnancies. Reporting this finding promptly is crucial for appropriate management and interventions. Choices A, B, and C are not as critical in this scenario. While monitoring fetal heart rate and contractions is important, the detection of fetal-maternal hemorrhage takes precedence due to the serious implications it poses for the current and future pregnancies of an RH-negative mother.
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