which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand

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 client at 27 weeks of gestation with preeclampsia is being assessed by a nurse. Which of the following findings should the nurse report to the provider?

A. Urine protein concentration of 200 mg/24 hr.
B. Creatinine level of 0.8 mg/dL
C. Hemoglobin level of 14.8 g/dL
D. Platelet count of 60,000/mm3

Correct answer: D

Rationale: A platelet count of 60,000/mm3 is significantly low and can indicate HELLP syndrome, a severe complication of preeclampsia that involves hemolysis, elevated liver enzymes, and low platelet count. HELLP syndrome requires prompt medical intervention to prevent serious maternal and fetal complications. The other findings listed are within normal limits or not directly related to the severe condition associated with HELLP syndrome.

3. A client is preparing to administer methylergonovine 0.2 mg orally to a client who is 2 hr postpartum and has a boggy uterus. For which of the following assessment findings should the nurse withhold the medication?

A. Blood pressure 142/92 mm Hg
B. Urine output 100 mL in 1 hr
C. Pulse 58/min
D. Respiratory rate 14/min

Correct answer: A

Rationale: The correct answer is A. Methylergonovine can increase blood pressure, so it should be withheld if the client has hypertension. A blood pressure reading of 142/92 mm Hg indicates hypertension and is a contraindication for administering methylergonovine. Choices B, C, and D are within normal limits and not contraindications for administering this medication. Urine output, pulse rate, and respiratory rate are not factors that determine the appropriateness of administering methylergonovine in this situation.

4. What causes sickle-cell anemia?

A. A chromosomal abnormality.
B. A single segment found only on the Y chromosome.
C. A recessive gene.
D. A decrease in estrogen levels.

Correct answer: C

Rationale: Sickle-cell anemia is a genetic disorder caused by inheriting two copies of a recessive gene, one from each parent. The correct answer is C. Choice A is incorrect because sickle-cell anemia is not primarily caused by a chromosomal abnormality. Choice B is incorrect as the condition is not linked to a single segment found only on the Y chromosome. Choice D is unrelated as it mentions a decrease in estrogen levels, which is not a cause of sickle-cell anemia.

5. Which of the following statements is true of menstruation?

A. During this time, the endometrium is shed.
B. During this time, an unfertilized egg is discharged.
C. During this time, a female can engage in sexual activity with her partner.
D. During this time, a fertilized egg implants in the uterine lining.

Correct answer: B

Rationale: The correct statement regarding menstruation is that during this time, an unfertilized egg is discharged along with the shedding of the uterine lining. Choice A is incorrect because the endometrium is shed during menstruation. Choice C is incorrect as menstruation does not prevent a female from engaging in sexual activity with her partner. Choice D is incorrect as a fertilized egg does not undergo mitosis during menstruation but rather implants in the uterine lining for further development.