HESI LPN
HESI Maternal Newborn
1. A 17-year-old client gave birth 12 hours ago. She states that she doesn't know how to care for her baby. To promote parent-infant attachment behaviors, which intervention should the nurse implement?
- A. Ask if she has help to care for the baby at home
- B. Provide a video on newborn safety and care
- C. Explore the basis of fears with the client
- D. Encourage rooming in while in the hospital
Correct answer: D
Rationale: Encouraging rooming in while in the hospital is the most appropriate intervention to promote parent-infant attachment behaviors. Rooming in allows the mother to stay with her baby continuously, facilitating bonding and providing the opportunity for the mother to learn how to care for her baby with the nurse's support. Asking if she has help at home (Choice A) does not directly address promoting attachment behaviors. Providing a video on newborn safety and care (Choice B) may offer information but does not actively facilitate immediate bonding. Exploring the basis of fears (Choice C) is important but may not directly address promoting attachment behaviors as effectively as encouraging rooming in.
2. 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.
3. In the structure of deoxyribonucleic acid (DNA), which of the following bases combines with thymine?
- A. Cytosine
- B. Adenine
- C. Rhodamine
- D. Serine
Correct answer: B
Rationale: The correct answer is B: Adenine. In the structure of DNA, adenine pairs with thymine through hydrogen bonding, forming one of the complementary base pairs that make up the double helix structure of DNA. Cytosine pairs with guanine, not thymine. Rhodamine and serine are not DNA bases and do not participate in DNA base pairing. Therefore, choices A, C, and D are incorrect.
4. Why is a client with gestational diabetes being scheduled for an amniocentesis when the fetus has an estimated weight of eight pounds (3629 grams) at 36 weeks gestation? What information is the amniocentesis seeking to obtain?
- A. Presence of a neural tube defect.
- B. Chromosomal abnormalities.
- C. Gender of the fetus.
- D. Fetal lung maturity.
Correct answer: D
Rationale: An amniocentesis in this scenario is most likely being performed to assess fetal lung maturity. This is necessary when considering early delivery due to macrosomia (large fetal size), which is a common concern in gestational diabetes. Evaluating fetal lung maturity is crucial to determine if the fetus's lungs are developed enough to support breathing independently outside the womb. The presence of a neural tube defect and chromosomal abnormalities are not typically assessed through amniocentesis in this situation, and determining the gender of the fetus is not the primary purpose of the procedure here.
5. The nurse is planning discharge teaching for four mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period?
- A. A primiparous woman who has recently migrated to the US with her spouse
- B. A multiparous client who lives with her husband and his family members
- C. A multiparous female with a large family living in a community
- D. A primiparous adolescent living at home with her parents and significant other
Correct answer: A
Rationale: A primiparous woman who has recently migrated to the US with her spouse is at the highest risk for psychological difficulties during the postpartum period. Recent migration and adjustment to a new environment can increase the risk of postpartum depression, especially when combined with the challenges of being a new mother. Choice B, a multiparous client living with her husband and his family, may have social support from family members, which can be protective against psychological difficulties. Choice C, a multiparous female with a large family living in a community, also indicates potential social support. Choice D, a primiparous adolescent living at home with her parents and significant other, may have a support system in place with her family and significant other.
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