HESI LPN
Maternity HESI Practice Questions
1. What is the most critical action in caring for the newborn immediately after birth?
- A. Keeping the airway clear.
- B. Fostering parent-newborn attachment.
- C. Drying the newborn and wrapping the infant in a blanket.
- D. Administering eye drops and vitamin K.
Correct answer: A
Rationale: The most critical action in caring for the newborn immediately after birth is keeping the airway clear. This is essential to ensure that the newborn can breathe effectively and prevent any respiratory distress. Fostering parent-newborn attachment, although important, is not the most critical action immediately after birth. Drying the newborn and wrapping the infant in a blanket is important for temperature regulation but is not as critical as maintaining a clear airway. Administering eye drops and vitamin K is typically done later and is not the most critical action immediately after birth.
2. 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.
3. The nurse is caring for a multiparous client who is 8 centimeters dilated, 100% effaced, and the fetal head is at 0 station. The client is shivering and states extreme discomfort with the urge to bear down. Which intervention should the nurse implement?
- A. Administer IV pain medication
- B. Perform a vaginal exam
- C. Reposition to side-lying
- D. Encourage pushing with each contraction
Correct answer: C
Rationale: Repositioning the client to a side-lying position is the most appropriate intervention in this scenario. This position can help relieve pressure on the cervix and reduce the urge to push prematurely, allowing the cervix to continue dilating. Administering IV pain medication may not address the underlying cause of the discomfort, and pushing prematurely can lead to cervical trauma. Performing a vaginal exam is not necessary at this point as the client is already 8 centimeters dilated, and the fetal head is at 0 station.
4. Is a low sperm count or lack of sperm the most common infertility problem in men?
- A. TRUE
- B. FALSE
- C. Rarely
- D. Never
Correct answer: A
Rationale: A low sperm count or lack of sperm is indeed one of the most common causes of infertility in men. Factors such as hormonal imbalances, genetic issues, reproductive anatomy problems, and lifestyle factors can also contribute to male infertility. Choice B is incorrect because a low sperm count is a prevalent issue among men facing infertility, making it a common problem. Choices C and D are incorrect as they do not accurately reflect the prevalence of low sperm count as a cause of infertility in men.
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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