HESI LPN
HESI Maternal Newborn
1. Preconception counseling is crucial for the safe management of diabetic pregnancies. Which complication is commonly associated with poor glycemic control before and during early pregnancy?
- A. Frequent episodes of maternal hypoglycemia
- B. Congenital anomalies in the fetus
- C. Hydramnios
- D. Hyperemesis gravidarum
Correct answer: B
Rationale: Preconception counseling is essential as strict metabolic control before conception and in the early weeks of gestation helps reduce the risk of congenital anomalies. Frequent episodes of maternal hypoglycemia usually occur during the first trimester due to hormonal changes, affecting insulin production and use, rather than before conception. Hydramnios is more common in diabetic pregnancies, typically seen in the third trimester, not during early pregnancy. Hyperemesis gravidarum, although it may lead to hypoglycemic events, is related to decreased food intake and glucose transfer to the fetus, exacerbating hypoglycemia rather than being directly associated with poor glycemic control before and during early pregnancy.
2. When caring for a pregnant woman with cardiac problems, the nurse must be alert for the signs and symptoms of cardiac decompensation. Which critical findings would the nurse find on assessment of the client experiencing this condition?
- A. Regular heart rate and hypertension.
- B. Increased urinary output, tachycardia, and dry cough.
- C. Shortness of breath, bradycardia, and hypertension.
- D. Dyspnea, crackles, and an irregular, weak pulse.
Correct answer: D
Rationale: In pregnant women with cardiac problems, signs of cardiac decompensation include dyspnea, crackles, an irregular, weak, and rapid pulse, rapid respirations, a moist and frequent cough, generalized edema, increasing fatigue, and cyanosis of the lips and nailbeds. Choice A is incorrect as a regular heart rate and hypertension are not typically associated with cardiac decompensation. Choice B is incorrect as increased urinary output and dry cough are not indicative of cardiac decompensation, only tachycardia is. Choice C is incorrect as bradycardia and hypertension are not typically seen in cardiac decompensation; dyspnea is a critical sign instead.
3. During a prenatal visit, for which of the following clients should the nurse auscultate the fetal heart rate?
- A. A client who has an ultrasound confirming a molar pregnancy
- B. A client who has a crown-rump length corresponding to 7 weeks gestation
- C. A client who has a positive urine pregnancy test 1 week after missed menses
- D. A client who has felt quickening for the first time
Correct answer: D
Rationale: The correct answer is D because feeling quickening typically occurs around 18-20 weeks of gestation, indicating fetal movement. This is an appropriate time to auscultate the fetal heart rate. Choice A is incorrect because a molar pregnancy is not a viable pregnancy, and auscultating the fetal heart rate in this case is not applicable. Choice B is incorrect because a crown-rump length of 7 weeks gestation is too early for fetal heart rate auscultation. Choice C is incorrect because a positive urine pregnancy test alone does not indicate the appropriate timing for fetal heart rate auscultation.
4. _____ are environmental agents that can harm the embryo or fetus.
- A. Mutations
- B. Autosomes
- C. Teratogens
- D. Androgens
Correct answer: C
Rationale: Teratogens are environmental agents, such as drugs, chemicals, or infections, that can cause harm to a developing embryo or fetus. Mutations (Choice A) refer to changes in the DNA sequence and are not environmental agents. Autosomes (Choice B) are chromosomes that are not involved in determining an individual's sex and are not environmental agents that harm the embryo or fetus. Androgens (Choice D) are a group of hormones that are more related to male sexual development and function, not environmental agents that harm the embryo or fetus.
5. _________ is self-propulsion.
- A. Mitosis
- B. Meiosis
- C. Motility
- D. Mutation
Correct answer: C
Rationale: The correct answer is 'Motility.' Motility refers to the ability of cells or organisms to move by themselves, often through the use of specialized structures like flagella or cilia. Mitosis (Choice A) and Meiosis (Choice B) are processes related to cell division and genetic recombination, respectively, not self-propulsion. Mutation (Choice D) refers to changes in the DNA sequence and is not related to self-propulsion.
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