HESI LPN
HESI Focus on Maternity Exam
1. Most victims of _____ die of respiratory infections in their 20s.
- A. Tay-Sachs disease
- B. cystic fibrosis
- C. Turner syndrome
- D. Klinefelter syndrome
Correct answer: B
Rationale: Individuals with cystic fibrosis have a genetic disorder that causes mucus to be thick and sticky, leading to blockages in the lungs and digestive system. This mucus buildup makes them more susceptible to severe respiratory infections, which can ultimately result in premature death in their 20s. Tay-Sachs disease (Choice A) is a genetic disorder that affects the nervous system, not typically causing respiratory infections. Turner syndrome (Choice C) and Klinefelter syndrome (Choice D) are chromosomal disorders that do not directly lead to the respiratory issues observed in cystic fibrosis.
2. A client is experiencing preterm labor and has a prescription for 4 doses of dexamethasone 6 mg IM every 12 hours. The available concentration is dexamethasone 10 mg/mL. How many mL of dexamethasone should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use trailing zero.)
- A. 0.6 mL
- B. ---
- C. ---
- D. ---
Correct answer: A
Rationale: Calculation: (6 mg/dose) / (10 mg/mL) = 0.6 mL per dose. The correct answer is 0.6 mL. This calculation is obtained by dividing the dose needed (6 mg) by the concentration available (10 mg/mL). The resulting value is 0.6 mL per dose. Choices B, C, and D are not applicable as the correct answer has been calculated accurately.
3. A woman who is 38 weeks gestation is receiving magnesium sulfate for severe preeclampsia. Which assessment finding warrants immediate intervention by the nurse?
- A. Dizziness while standing
- B. Sinus tachycardia
- C. Lower back pain
- D. Absent patellar reflexes
Correct answer: D
Rationale: The correct answer is D: Absent patellar reflexes. Absent patellar reflexes can indicate magnesium toxicity, a serious condition that requires immediate intervention to prevent respiratory depression or cardiac arrest. Dizziness while standing (choice A) is common in pregnancy but does not specifically indicate magnesium toxicity. Sinus tachycardia (choice B) can be a normal response to magnesium sulfate but does not indicate toxicity. Lower back pain (choice C) is common in pregnancy and not specifically associated with magnesium toxicity.
4. A nurse is developing an educational program about hemolytic diseases in newborns for a group of newly licensed nurses. Which of the following genetic information should the nurse include in the program as a cause of hemolytic disease?
- A. The mother is Rh positive, and the father is Rh negative
- B. The mother is Rh negative, and the father is Rh positive
- C. The mother and the father are both Rh positive
- D. The mother and the father are both Rh negative
Correct answer: B
Rationale: The correct answer is B: 'The mother is Rh negative, and the father is Rh positive.' Hemolytic disease of the newborn occurs when an Rh-negative mother carries an Rh-positive fetus, leading to Rh incompatibility. In this scenario, the mother produces antibodies against the Rh antigen present in the fetus, which can result in hemolysis of the fetal red blood cells. Choices A, C, and D do not describe the Rh incompatibility that leads to hemolytic disease in newborns. Therefore, they are incorrect.
5. A primigravida is being monitored at the prenatal clinic for preeclampsia. Which finding is of greatest concern to the nurse?
- A. Blood pressure (BP) increased to 138/86 mm Hg.
- B. Weight gain of 0.5 kg during the past 2 weeks.
- C. Dipstick value of 3+ for protein in her urine.
- D. Pitting pedal edema at the end of the day.
Correct answer: C
Rationale: The correct answer is C. Proteinuria, indicated by a dipstick value of 3+ in the urine, is a significant concern in a patient being monitored for preeclampsia. Proteinuria is a key diagnostic criterion for preeclampsia, and a value of 3+ signifies a substantial amount of protein in the urine, warranting further evaluation. While an increase in blood pressure to 138/86 mm Hg is slightly elevated, it does not meet the diagnostic threshold for severe hypertension in preeclampsia. A weight gain of 0.5 kg over 2 weeks is within normal limits and not as concerning as significant rapid weight gain. Pitting pedal edema, though common in pregnancy, is not a specific indicator of preeclampsia and is considered a less concerning finding compared to significant proteinuria.
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