HESI LPN
HESI Focus on Maternity Exam
1. Do neural tube defects cause an elevation in the alpha-fetoprotein (AFP) level in the mother’s blood?
- A. Yes
- B. No
- C. Possibly
- D. Never
Correct answer: A
Rationale: Yes, neural tube defects can cause an elevation in AFP levels in the mother’s blood. AFP levels are often used as a screening marker during pregnancy to detect neural tube defects. Choice B is incorrect because an elevation in AFP levels can indeed occur in the presence of neural tube defects. Choice C is not the best option as it leaves room for uncertainty when the relationship between neural tube defects and AFP elevation is well-established. Choice D is incorrect as neural tube defects are known to influence AFP levels in the maternal blood.
2. The mother of a breastfeeding 24-hour old infant is very concerned about the techniques involved in breastfeeding. She calls the nurse with each feeding to seek reassurance that she is doing it right. She tells the nurse, "Now my daughter is not getting enough to eat." Which response would be best for the nurse to make?
- A. Feed your baby hourly until you feel confident that your child is receiving enough milk.
- B. Don't worry, soon your milk will come in, and you will feel how full your breasts are.
- C. Since you are so concerned, you should probably supplement breastfeeding with formula.
- D. If your baby's urine is straw-colored, she's getting enough milk.
Correct answer: D
Rationale: Reassuring the mother that the baby's urine color can be an indicator of adequate hydration can help her feel more confident in her breastfeeding.
3. A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse?
- A. Blood pressure (BP) increased to 138/86 mm Hg.
- B. Weight gain of 0.5 kg during the past 2 weeks.
- C. Dipstick value of 3+ for protein in her urine.
- D. Pitting pedal edema at the end of the day.
Correct answer: C
Rationale: The correct answer is C. Proteinuria, indicated by a dipstick value of 3+ in the urine, is a significant concern in a patient being monitored for preeclampsia. Proteinuria is a key diagnostic criterion for preeclampsia, and a value of 3+ signifies a substantial amount of protein in the urine, warranting further evaluation. While an increase in blood pressure to 138/86 mm Hg is slightly elevated, it does not meet the diagnostic threshold for severe hypertension in preeclampsia. A weight gain of 0.5 kg over 2 weeks is within normal limits and not as concerning as significant rapid weight gain. Pitting pedal edema, though common in pregnancy, is not a specific indicator of preeclampsia and is considered a less concerning finding compared to significant proteinuria.
4. A nurse is planning to teach a group of clients who are breastfeeding after returning to work. Which of the following instructions should the nurse include in the teaching?
- A. “Thawed breast milk can be refrigerated for up to 24 hours.â€
- B. “Breast milk can be stored in a deep freezer for 12 months.â€
- C. “Breast milk can be stored at room temperature for up to 4 hours.â€
- D. “Thawed breast milk that is unused cannot be refrozen.â€
Correct answer: B
Rationale: The correct answer is B: “Breast milk can be stored in a deep freezer for 12 months.†This instruction is important for mothers returning to work to ensure a long-term storage option for breast milk. Choice A is incorrect because thawed breast milk should be used within 24 hours if stored in the refrigerator. Choice C is incorrect as breast milk can be kept at room temperature for only up to 4 hours. Choice D is incorrect as thawed breast milk that is unused should not be refrozen due to safety concerns.
5. A client who is pregnant and follows a vegan diet asks a nurse for guidance on foods high in calcium. Which of the following foods has the highest amount of calcium?
- A. ½ cup cubed avocado
- B. 1 large banana
- C. 1 medium potato
- D. 1 cup cooked broccoli
Correct answer: D
Rationale: The correct answer is D: 1 cup of cooked broccoli. Broccoli is an excellent source of calcium, making it a suitable choice for a vegan diet. Avocado (Choice A), banana (Choice B), and potato (Choice C) are not significant sources of calcium compared to broccoli. Avocado and banana are primarily sources of other nutrients like healthy fats and potassium, respectively. Potato is a good source of vitamin C and potassium but not calcium. Therefore, for a pregnant client following a vegan diet and seeking calcium-rich foods, cooked broccoli is the most appropriate choice.
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