HESI LPN
HESI Maternal Newborn
1. When both of the alleles for a trait, such as hair color, are the same, the person is said to be _____ for that trait.
- A. monozygous
- B. dizygous
- C. homozygous
- D. hemizygous
Correct answer: C
Rationale: A person is homozygous for a trait when they have two identical alleles for that trait. In this case, both alleles are the same, indicating a homozygous genotype. Choice A, 'monozygous,' is incorrect as it refers to identical twins originating from a single fertilized egg. Choice B, 'dizygous,' is also incorrect as it refers to fraternal twins or individuals that develop from two separate fertilized eggs. Choice D, 'hemizygous,' is incorrect because it describes a genetic condition where only one allele is present in a diploid organism, typically related to genes on the sex chromosomes.
2. The nurse places one hand above the symphysis while massaging the fundus of a multiparous client whose uterine tone is boggy 15 minutes after delivering a 7-pound, 10-ounce (3220-gram) infant. Which information should the nurse provide to the client about these findings?
- A. The uterus should be firm to prevent an intrauterine infection.
- B. Both the lower uterine segment and the fundus must be massaged.
- C. A firm uterus prevents the endometrial lining from being sloughed.
- D. Clots may form inside a boggy uterus and need to be expelled.
Correct answer: D
Rationale: After childbirth, a boggy uterus indicates poor uterine tone, which can lead to the formation of clots. Massaging the fundus helps the uterus contract and expel clots, reducing the risk of postpartum hemorrhage. Choices A, B, and C are incorrect because the main concern with a boggy uterus is the risk of clot formation and postpartum hemorrhage, not solely preventing intrauterine infection, massaging the lower uterine segment, or preventing the endometrial lining from sloughing.
3. A client at 38 weeks of gestation has a prescription for intravaginal misoprostol. Which of the following statements should the nurse make?
- A. “You will need to stay in a side-lying position for 30 minutes after each dose.”
- B. “You will receive an IV infusion of oxytocin 1 hour after your last dose.”
- C. “You will receive a magnesium supplement immediately following therapy.”
- D. “You will need to have a full bladder before the therapy begins.”
Correct answer: A
Rationale: The correct answer is A. Instructing the client to stay in a side-lying position after receiving misoprostol intravaginally is essential. This position helps keep the medication in place, allowing for better absorption. Choice B is incorrect because oxytocin administration is not typically indicated after misoprostol use. Choice C is incorrect as magnesium supplementation is not part of the standard protocol for misoprostol administration. Choice D is incorrect as having a full bladder is not necessary before initiating misoprostol therapy.
4. Examination reveals that the laboring client's cervix is dilated to 2 centimeters, 70% effaced with the presenting part at -2 station. The client tells the nurse, 'I need my epidural now, this hurts.' The nurse's response to the client is based on which information?
- A. The client will need to be catheterized before the epidural can be administered.
- B. Administering an epidural at this point would slow down the labor process.
- C. The client should be dilated to at least 8 centimeters before receiving an epidural.
- D. The baby needs to be at a zero station before an epidural can be administered.
Correct answer: B
Rationale: Administering an epidural too early in labor, especially at 2 cm dilation, can slow down the progress of labor. It is usually recommended to wait until labor is more established. Choice A is incorrect because catheterization is not a prerequisite for epidural administration. Choice C is incorrect as waiting until 8 cm dilation is not a standard requirement for epidural administration. Choice D is incorrect because the baby's station being at zero is not a strict criterion for epidural administration.
5. What additional assessment is required for the postoperative care of a pregnant woman who undergoes abdominal surgery for appendicitis?
- A. Intake and output (I&O) and intravenous (IV) site.
- B. Signs and symptoms of infection.
- C. Vital signs and incision.
- D. Fetal heart rate (FHR) and uterine activity.
Correct answer: D
Rationale: The correct additional assessment for postoperative care of a pregnant woman requiring abdominal surgery for appendicitis is monitoring the fetal heart rate (FHR) and uterine activity. This is crucial due to the presence of the fetus. Continuous fetal and uterine monitoring should be prioritized to ensure the well-being of both the mother and the baby. While assessing I&O levels and the IV site are common postoperative care procedures, they are not specific to the unique needs of a pregnant woman. Evaluating for signs and symptoms of infection is important for any postoperative patient but is not the additional assessment required specifically for a pregnant woman in this scenario. Routine vital signs and incision evaluation are standard components of postoperative care but do not address the specific needs related to the fetus and the uterus in this case.
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