HESI RN
Reproductive Health Exam
1. The Gravindex test is used to detect Human Chorionic Gonadotrophic hormone (HCG) in:
- A. Urine or whole blood
- B. Amniotic fluid
- C. Saliva
- D. Cervical mucus
Correct answer: A
Rationale: The correct answer is A: Urine or whole blood. The Gravindex test is designed to detect Human Chorionic Gonadotrophic hormone (HCG) in urine or whole blood samples. HCG is a hormone produced during pregnancy, and its presence in urine or blood can indicate pregnancy. Choices B, C, and D are incorrect as the Gravindex test is not intended to detect HCG in amniotic fluid, saliva, or cervical mucus. These bodily fluids are not typically used for pregnancy testing purposes.
2. The nurse is conducting an admission assessment of an 11-month-old infant with CHF who is scheduled for repair of restenosis of coarction of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. What pathophysiologic mechanisms support these findings?
- A. The aortic semilunar valve obstructs blood flow into the systemic circulation
- B. The lumen of the aorta reduces the volume of the blood flow to the lower extremities
- C. The pulmonic valve prevents adequate blood volume into the pulmonary circulation
- D. An opening in the atrial septum causes a murmur due to a turbulent left-to-right shunt
Correct answer: B
Rationale: The correct answer is B. Coarctation of the aorta causes narrowing of the aorta, reducing blood flow to the lower extremities. This narrowing results in higher blood pressure in the arms compared to the lower extremities, along with stronger brachial pulses and slightly palpable femoral pulses. Choices A, C, and D are incorrect because they do not align with the pathophysiological mechanism of coarctation of the aorta, which specifically leads to reduced blood flow to the lower extremities.
3. A client who has been receiving chemotherapy for cancer has a platelet count of 20,000/mm3. Which intervention should the nurse include in the plan of care?
- A. Apply ice packs to bruised areas.
- B. Encourage frequent oral hygiene.
- C. Avoid invasive procedures.
- D. Place the client in a private room.
Correct answer: C
Rationale: The correct intervention for a client with a platelet count of 20,000/mm3 due to chemotherapy is to avoid invasive procedures. Chemotherapy can cause a decrease in platelet count, leading to an increased risk of bleeding. By avoiding invasive procedures, the nurse helps reduce the risk of bleeding complications. Applying ice packs to bruised areas (Choice A) may further increase the risk of bleeding due to the pressure and potential trauma to the skin. Encouraging frequent oral hygiene (Choice B) is important for overall health but does not directly address the risk of bleeding associated with a low platelet count. Placing the client in a private room (Choice D) is not directly related to managing the platelet count and risk of bleeding; it is more about privacy and infection control, which are important but not the priority in this scenario.
4. In which of the following does cellular respiration take place?
- A. Golgi apparatus
- B. Mitochondrion
- C. Chloroplast
- D. Ribosome
Correct answer: B
Rationale: The correct answer is B, Mitochondrion. Cellular respiration occurs in the mitochondria, where glucose is converted into energy through a series of metabolic processes. Choice A, Golgi apparatus, is incorrect as it is involved in modifying, sorting, and packaging proteins. Choice C, Chloroplast, is incorrect as it is the site of photosynthesis in plant cells, not cellular respiration. Choice D, Ribosome, is incorrect as it is responsible for protein synthesis, not energy production through cellular respiration.
5. A 4-month-old girl is brought to the clinic by her mother because she has had a cold for 2 or 3 days and woke up this morning with a hacking cough and difficulty breathing. Which additional assessment finding should alert the nurse that the child is in acute respiratory distress?
- A. Bilateral bronchial breath sounds.
- B. Diaphragmatic breathing.
- C. A resting respiratory rate of 35 breaths per minute.
- D. Flaring of the nares.
Correct answer: D
Rationale: Flaring of the nares is a classic sign of acute respiratory distress in infants. It indicates increased work of breathing and is a visible cue that the child is struggling to breathe. This finding should alert healthcare providers to the severity of the respiratory distress and the need for prompt intervention to support the child's breathing. Choices A, B, and C are incorrect. Bilateral bronchial breath sounds are associated with conditions like pneumonia, but they do not specifically indicate acute respiratory distress. Diaphragmatic breathing is a normal breathing pattern and not a sign of distress. A resting respiratory rate of 35 breaths per minute is within the expected range for a 4-month-old infant and does not necessarily indicate acute respiratory distress.