HESI LPN
HESI Focus on Maternity Exam
1. Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand?
- A. Stress on the heart is greatest in the first trimester and the last 2 weeks before labor.
- B. Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms.
- C. Women with class III cardiac disease should get 8 to 10 hours of sleep every day and limit housework, shopping, and exercise.
- D. Women with class I cardiac disease need bed rest through most of the pregnancy and face the possibility of hospitalization near term.
Correct answer: B
Rationale: Class II cardiac disease is symptomatic with ordinary activity. Women in this category need to avoid heavy exertion and limit regular activities as symptoms dictate. Stress is greatest between weeks 28 and 32 of gestation, when hemodynamic changes reach their maximum. Class III cardiac disease is symptomatic with less-than-ordinary activity. These women need bed rest most of the day and face the possibility of hospitalization near term. Class I cardiac disease is asymptomatic at normal levels of activity. These women can perform limited normal activities with discretion, although they still need a good amount of sleep.
2. A multiparous client at 36 hours postpartum reports increased bleeding and cramping. On examination, the nurse finds the uterine fundus 2 centimeters above the umbilicus. Which action should the nurse take first?
- A. Increase the intravenous fluid to 150 ml/hr.
- B. Call the healthcare provider.
- C. Encourage the client to void.
- D. Administer ibuprofen 800 milligrams by mouth.
Correct answer: C
Rationale: Encouraging the client to void is the priority action in this scenario. A distended bladder can prevent the uterus from contracting properly, leading to increased bleeding and a high uterine fundus. By encouraging the client to void, the nurse can help the uterus contract effectively, reducing bleeding. Increasing intravenous fluids or administering ibuprofen would not address the immediate concern of a distended bladder affecting uterine contraction. While it may be necessary to involve the healthcare provider, addressing the bladder distention promptly is crucial to prevent further complications.
3. 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.
4. What is the primary role of meiosis in the production of sperm and ova?
- A. To reduce the chromosome number by half
- B. To increase the chromosome number
- C. To create identical copies of chromosomes
- D. To repair damaged chromosomes
Correct answer: A
Rationale: The correct answer is A. Meiosis is a type of cell division that reduces the chromosome number by half, resulting in the formation of sperm and ova. Choice B is incorrect because meiosis does not increase the chromosome number. Choice C is incorrect because meiosis creates genetically diverse gametes, not identical copies of chromosomes. Choice D is incorrect because meiosis does not primarily function to repair damaged chromosomes.
5. Individuals with Klinefelter syndrome produce:
- A. less estrogen than normal males.
- B. less testosterone than normal males.
- C. less adenine than normal males.
- D. less thymine than normal males.
Correct answer: B
Rationale: Individuals with Klinefelter syndrome have an extra X chromosome (XXY), leading to reduced production of testosterone, the primary male sex hormone. This deficiency can result in various physical and developmental characteristics associated with the syndrome. Estrogen levels may actually be relatively elevated due to the imbalance between testosterone and estrogen. Choices C and D are incorrect as adenine and thymine are nucleotide bases found in DNA and are not related to hormone production.
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