a multiparous client at 36 hours postpartum reports increased bleeding and cramping on examination the nurse finds the uterine fundus 2 centimeters ab
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HESI Focus on Maternity Exam

1. A multiparous client at 36 hours postpartum reports increased bleeding and cramping. On examination, the nurse finds the uterine fundus 2 centimeters above the umbilicus. Which action should the nurse take first?

Correct answer: C

Rationale: Encouraging the client to void is the priority action in this scenario. A distended bladder can prevent the uterus from contracting properly, leading to increased bleeding and a high uterine fundus. By encouraging the client to void, the nurse can help the uterus contract effectively, reducing bleeding. Increasing intravenous fluids or administering ibuprofen would not address the immediate concern of a distended bladder affecting uterine contraction. While it may be necessary to involve the healthcare provider, addressing the bladder distention promptly is crucial to prevent further complications.

2. Individuals with Klinefelter syndrome produce:

Correct answer: B

Rationale: Individuals with Klinefelter syndrome have an extra X chromosome (XXY), leading to reduced production of testosterone, the primary male sex hormone. This deficiency can result in various physical and developmental characteristics associated with the syndrome. Estrogen levels may actually be relatively elevated due to the imbalance between testosterone and estrogen. Choices C and D are incorrect as adenine and thymine are nucleotide bases found in DNA and are not related to hormone production.

3. When both alleles' effects are shown, there is said to be:

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.

4. A client has experienced a fetal demise following a vaginal delivery at term. What should the nurse advise the client?

Correct answer: A

Rationale: After a fetal demise, allowing the parents to bathe and dress their baby can offer them a sense of closure and help them in their grieving process. This act can provide a tangible way for the parents to bond with their baby and create lasting memories. Option B is incorrect because each individual may have different emotional needs and holding the baby may not be appropriate or helpful for everyone. Option C, while well-intentioned, may not be suitable for all parents as naming the baby could be emotionally challenging. Option D is insensitive as it overlooks the grieving process of losing a baby by suggesting a replacement.

5. What is the structure of deoxyribonucleic acid (DNA)?

Correct answer: B

Rationale: The correct answer is B: double helix. DNA is structured as a double helix, resembling a twisted ladder made up of two strands of nucleotides. Choice A, single spiral, is incorrect as DNA is not a single spiral structure. Choice C, sphere, is incorrect as DNA does not form a spherical shape. Choice D, cube, is incorrect as DNA does not have a cubic structure. Understanding the double helix structure of DNA is essential as it allows for the storage and transmission of genetic information in living organisms.

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