HESI LPN
Maternity HESI Test Bank
1. After a mother was diagnosed with gonorrhea immediately after delivery, what is an important goal of the nurse when providing care for her baby?
- A. Prevent the development of ophthalmia neonatorum.
- B. Lubricate the eyes.
- C. Prevent the development of infection.
- D. Teach about the risks of breastfeeding with gonorrhea.
Correct answer: A
Rationale: The correct answer is A: Prevent the development of ophthalmia neonatorum. When a mother has gonorrhea, the baby can be infected during delivery, leading to ophthalmia neonatorum, which can cause permanent blindness. Therefore, it is crucial for the nurse to prevent this condition by treating the baby's eyes with an antibiotic prophylactically after birth. Choice B, lubricating the eyes, is not the primary goal in this situation as preventing infection takes precedence. Choice C, preventing the development of infection, is too broad and does not specifically address the potential complication of ophthalmia neonatorum. Choice D, teaching about the risks of breastfeeding with gonorrhea, is important but not the immediate goal in this scenario where preventing ophthalmia neonatorum and potential blindness is the priority.
2. Are babies with fetal alcohol syndrome (FAS) often larger than normal, and so are their brains?
- A. TRUE
- B. FALSE
- C. Sometimes
- D. Always
Correct answer: B
Rationale: The correct answer is B: FALSE. Babies with fetal alcohol syndrome (FAS) are typically smaller than normal, with smaller brains and developmental issues. Choice A is incorrect because babies with FAS are not larger than normal. Choice C is incorrect as it does not accurately reflect the typical characteristics of babies with FAS. Choice D is incorrect as babies with FAS are not always larger than normal.
3. What nursing action should the nurse implement for a 3-hour-old male infant who presents with cyanotic hands and feet, an axillary temperature of 96.5°F (35.8°C), a respiratory rate of 40 breaths per minute, and a heart rate of 165 beats per minute?
- A. Administer oxygen by mouth at 2L/min
- B. Gradually warm the infant under a radiant heat source
- C. Notify the pediatrician of the infant's vital signs
- D. Perform a heel-stick to maintain blood glucose levels
Correct answer: B
Rationale: The correct nursing action is to gradually warm the infant under a radiant heat source. The infant is presenting with signs of cold stress, indicated by cyanotic extremities and a low body temperature. Gradual warming is crucial to stabilize the infant's temperature and prevent further complications. Administering oxygen, notifying the pediatrician, or performing a heel-stick are not the priority actions in this scenario and may not address the immediate need to raise the infant's body temperature.
4. 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.
5. If an individual receives a recessive gene for eye color from both parents, the:
- A. gender of the child will not determine the expression of that trait.
- B. recessive trait will be expressed in the child.
- C. recessive trait will be expressed in all the offspring.
- D. recessive trait will be suppressed, and the dominant trait will not be expressed.
Correct answer: B
Rationale: When an individual inherits a recessive gene for eye color from both parents, the recessive trait will be expressed in the child. This is because having two copies of the recessive gene overrides the presence of any dominant gene. Choice A is incorrect because the expression of the trait is determined by the genetic makeup, not the gender of the child. Choice C is incorrect as the expression of the recessive trait is certain when both parents pass on the recessive gene, but it does not mean that all offspring will express the trait. Choice D is incorrect because if both parents provide a recessive gene, the dominant trait will not be expressed in the child, but it does not mean it will be suppressed; rather, the recessive trait will be expressed.
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