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 who delivered a healthy newborn an hour ago asked the nurse when she can go home. Which information is most important for the nurse to provide the client?
- A. After the baby no longer demonstrates acrocyanosis
- B. After the baby receives the vitamin K injection
- C. When ambulating to avoid causing dizziness
- D. When there is no significant vaginal bleeding
Correct answer: D
Rationale: The most critical information for the nurse to provide the client is ensuring that there is no significant vaginal bleeding before discharge. This is vital to prevent complications such as postpartum hemorrhage. Options A, B, and C are important aspects of postpartum care, but assessing and managing vaginal bleeding takes precedence due to its potential seriousness.
3. A client with preeclampsia is receiving magnesium sulfate by continuous IV infusion. Which finding should the nurse report to the provider?
- A. Blood pressure 148/94 mm Hg
- B. Respiratory rate 14/min
- C. Urinary output 20 mL/hr
- D. 2+ deep tendon reflexes
Correct answer: C
Rationale: In a client with preeclampsia receiving magnesium sulfate, a urinary output of 20 mL/hr is a concerning finding as it may indicate renal impairment or magnesium toxicity. Adequate urinary output is crucial for eliminating excess magnesium and preventing toxicity. The nurse should report this finding to the provider for further evaluation. A blood pressure of 148/94 mm Hg is elevated but expected in a client with preeclampsia. A respiratory rate of 14/min is within the normal range. 2+ deep tendon reflexes are a common finding in clients receiving magnesium sulfate and are not a cause for concern unless they progress to hyperreflexia or clonus.
4. The healthcare provider is preparing to administer phytonadione (vitamin K) to a newborn. Which statement made by the parents indicates understanding why the healthcare provider is administering this medication?
- A. Improve insufficient dietary intake
- B. Stimulate the immune system
- C. Help an immature liver
- D. Prevent hemorrhagic disorders
Correct answer: D
Rationale: The correct answer is D because phytonadione (vitamin K) is administered to newborns to prevent hemorrhagic disease due to their low levels of vitamin K, which is essential for blood clotting. Choice A is incorrect as vitamin K administration is not related to improving dietary intake. Choice B is incorrect as vitamin K doesn't stimulate the immune system. Choice C is incorrect as vitamin K is not given to help an immature liver, but rather to prevent hemorrhagic disorders.
5. A client comes to the clinic for her first prenatal visit and reports that July 10 was the first day of her last menstrual period. Using Nagele’s Rule, the nurse calculates the estimated date of birth for the client to be _________.
- A. 4/17.
- B. 4/10.
- C. 5/10.
- D. 5/17.
Correct answer: A
Rationale: Nagele's Rule is a common method used to estimate the due date. To calculate it, subtract 3 months and add 7 days to the first day of the last menstrual period. In this case, if the last menstrual period started on July 10, subtracting 3 months (April) and adding 7 days gives an estimated due date of April 17. This is the correct answer. Choices B, C, and D are incorrect because they do not follow the Nagele's Rule calculation method.
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