HESI LPN
HESI Focus on Maternity Exam
1. Which of the following pairs share 100% of their genes?
- A. Biovular twins
- B. Fraternal twins
- C. Dizygotic (DZ) twins
- D. Monozygotic (MZ) twins
Correct answer: D
Rationale: The correct answer is Monozygotic (MZ) twins. Monozygotic twins, also known as identical twins, share 100% of their genes because they originate from the same fertilized egg that splits into two. Fraternal twins (choice B), also known as dizygotic (DZ) twins (choice C), result from two separate fertilized eggs and share approximately 50% of their genes. Biovular twins (choice A) is not a term used in genetics and does not describe a type of twinning.
2. 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.
3. The healthcare provider prescribes 10 units per liter of oxytocin via IV drip to augment a client's labor because she is experiencing a prolonged active phase. Which finding would cause the nurse to immediately discontinue the oxytocin?
- A. Contraction duration of 100 seconds.
- B. Four contractions in 10 minutes.
- C. Uterus is soft.
- D. Early deceleration of fetal heart rate.
Correct answer: A
Rationale: A contraction duration of 100 seconds is too long and can indicate uterine hyperstimulation, which can lead to fetal distress and other complications. This prolonged contraction duration suggests that the uterus is not relaxing adequately between contractions, potentially compromising fetal oxygenation. Choice B, 'Four contractions in 10 minutes,' is a sign of tachysystole, which is concerning but not as immediately critical as the prolonged contraction duration. Choice C, 'Uterus is soft,' is not a reason to discontinue oxytocin; in fact, it is a normal finding. Choice D, 'Early deceleration of fetal heart rate,' while indicating fetal distress, is not a direct result of the oxytocin and may require intervention but not immediate discontinuation of the medication.
4. Monozygotic (MZ) twins share _________ percent of their genes.
- A. 100
- B. 75
- C. 50
- D. 25
Correct answer: A
Rationale: Monozygotic (MZ) twins share 100% of their genes because they originate from the same fertilized egg that splits into two, resulting in identical genetic material for both twins. Choice B (75%) is incorrect as it implies a partial genetic similarity, which is not the case for MZ twins. Choice C (50%) is incorrect as it suggests half of the genes are shared, which is applicable to dizygotic (DZ) twins, not MZ. Choice D (25%) is incorrect as it indicates minimal genetic sharing, which is not true for MZ twins.
5. A client is receiving an epidural block with an opioid analgesic. The nurse should monitor for which of the following findings as an adverse effect of the medication?
- A. Hypotension
- B. Polyuria
- C. Bilateral crackles
- D. Hyperglycemia
Correct answer: C
Rationale: The correct answer is C: Bilateral crackles. Bilateral crackles indicate respiratory complications, which can occur as an adverse effect of an epidural block with opioid analgesics. Hypotension (Choice A) is a common side effect of epidural opioids but is not typically monitored via crackles. Polyuria (Choice B) is excessive urination and is not directly associated with epidural blocks. Hyperglycemia (Choice D) is high blood sugar levels and is not a typical adverse effect of epidural opioids.
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