HESI LPN
HESI Focus on Maternity Exam
1. Which synthetic hormone is used to prevent miscarriages and can cause masculinization of the fetus?
- A. Testosterone
- B. Estrogen
- C. Progestin
- D. Oxytocin
Correct answer: C
Rationale: Progestin is the synthetic hormone used to prevent miscarriages. While it is beneficial in maintaining pregnancy, in some cases, it can lead to masculinization of the fetus. Testosterone (Choice A) and estrogen (Choice B) are not typically used to prevent miscarriages and do not cause masculinization of the fetus in this context. Oxytocin (Choice D) is a hormone involved in labor and breastfeeding, but it is not used to prevent miscarriages nor does it cause masculinization of the fetus.
2. When both alleles' effects are shown, there is said to be:
- A. codominance.
- B. preponderance.
- C. ascendance.
- D. concurrence.
Correct answer: A
Rationale: The correct answer is A: codominance. Codominance refers to a genetic scenario where both alleles in a gene pair are fully expressed, leading to a phenotype that displays traits from both alleles equally. This is distinct from incomplete dominance where the traits blend. Choices B, C, and D are incorrect. Preponderance does not specifically relate to the expression of alleles. Ascendance and concurrence do not describe the genetic concept of codominance where both alleles are fully expressed.
3. A healthcare provider is assessing a newborn upon admission to the nursery. Which of the following should the provider expect?
- A. Bulging Fontanels
- B. Nasal Flaring
- C. Length from head to heel of 40 cm (15.7 in)
- D. Chest circumference 2 cm (0.8 in) smaller than the head circumference
Correct answer: D
Rationale: Upon admission to the nursery, a healthcare provider should expect the newborn's chest circumference to be slightly smaller than the head circumference. This is a normal finding in newborns due to their physiological development. Bulging fontanels (Choice A) can indicate increased intracranial pressure, which is abnormal. Nasal flaring (Choice B) is a sign of respiratory distress and is also an abnormal finding. While a length from head to heel of 40 cm (15.7 in) (Choice C) falls within the normal range for newborns, it is not a specific expectation upon admission to the nursery. Therefore, the correct expectation for a newborn upon admission is for the chest circumference to be slightly smaller than the head circumference.
4. A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured. What is the nurse’s highest priority in this situation?
- A. Prepare the woman for imminent birth.
- B. Notify the woman’s primary healthcare provider.
- C. Document the characteristics of the fluid.
- D. Assess the fetal heart rate (FHR) and pattern.
Correct answer: D
Rationale: The correct answer is to assess the fetal heart rate (FHR) and pattern (Choice D). When a multiparous woman's membranes rupture after 8 hours of labor, the nurse's priority is to assess the fetal well-being. Rupture of membranes can lead to potential complications such as umbilical cord prolapse. Monitoring the fetal heart rate and pattern immediately after the rupture of membranes is crucial to ensure the fetus is not in distress. This assessment helps in determining the need for immediate interventions to safeguard the fetus. Documenting the characteristics of the fluid (Choice C) may be necessary but is of lower priority compared to assessing fetal well-being. While preparing the woman for imminent birth (Choice A) is important, assessing the fetal heart rate takes precedence to ensure the fetus is not compromised. Notifying the woman's primary healthcare provider (Choice B) is also important but not the highest priority at this moment.
5. A newborn's head circumference is 12 inches (30.5 cm) and his chest measurement is 13 inches (33 cm). The nurse notes that this infant has no molding, and it was a breech presentation delivered by cesarean section. What action should the nurse take based on this data?
- A. No action needs to be taken, it is normal for an infant born by cesarean section to have a small head circumference.
- B. Notify the pediatrician immediately. These signs support the possibility of hydrocephalus.
- C. Call these findings to the attention of the pediatrician. The head/chest ratio is abnormal.
- D. Record the findings on the chart. They are within normal limits.
Correct answer: D
Rationale: Head and chest circumference measurements are within normal limits for a newborn, especially for those delivered by cesarean section, so no immediate action is required beyond documentation.
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