HESI LPN
HESI Maternal Newborn
1. Which of the following statements about Rh incompatibility is true?
- A. Rh incompatibility occurs most commonly during a woman’s first pregnancy.
- B. Rh incompatibility is an untreatable condition that leaves a woman infertile for the rest of her life.
- C. Rh incompatibility is an abnormality that is transmitted from generation to generation and carried by a sex chromosome.
- D. Rh incompatibility occurs due to antibodies transmitted to a fetus during subsequent deliveries causing brain damage or death.
Correct answer: D
Rationale: Rh incompatibility occurs when the mother's antibodies attack the fetus's red blood cells, leading to serious complications, usually in subsequent pregnancies. Choice A is incorrect because Rh incompatibility often occurs in subsequent pregnancies, not necessarily the first one. Choice B is incorrect as Rh incompatibility does not render a woman infertile but can lead to complications during pregnancies. Choice C is incorrect as Rh incompatibility is not carried by a sex chromosome but involves the Rh factor on red blood cells.
2. Which of the following illnesses causes degeneration of the central nervous system?
- A. Tay-Sachs disease
- B. Cystic fibrosis
- C. Turner syndrome
- D. Klinefelter syndrome
Correct answer: A
Rationale: Tay-Sachs disease is a genetic disorder that causes a progressive degeneration of the central nervous system, particularly in infants. Choice B, Cystic fibrosis, is a genetic disorder that primarily affects the lungs and digestive system, not the central nervous system. Choices C and D, Turner syndrome and Klinefelter syndrome, are chromosomal disorders that do not directly involve degeneration of the central nervous system.
3. The healthcare provider is planning care for a client at 30 weeks gestation who is experiencing preterm labor. Which medication is most important in preventing this fetus from developing respiratory distress syndrome?
- A. Ampicillin 1 gram IV push every 8 hours
- B. Betamethasone 12 mg deep IM
- C. Terbutaline 0.25 mg subcutaneously every 15 minutes for 3 doses
- D. Butorphanol tartrate 1 mg IV push every 2 hours as needed
Correct answer: B
Rationale: Betamethasone is a corticosteroid given to stimulate fetal lung maturity and reduce the risk of respiratory distress syndrome in preterm infants. Ampicillin (Choice A) is an antibiotic and does not prevent respiratory distress syndrome. Terbutaline (Choice C) is a tocolytic used to inhibit contractions and does not directly prevent respiratory distress syndrome. Butorphanol tartrate (Choice D) is an opioid analgesic and does not have a role in preventing respiratory distress syndrome in preterm infants.
4. What determines a child’s sex?
- A. Presence of teratogens at the time of conception.
- B. Sex chromosome received from the mother.
- C. Presence of teratogens at the time of ovulation.
- D. Sex chromosome received from the father.
Correct answer: D
Rationale: The correct answer is the sex chromosome received from the father. The father contributes either an X or Y chromosome, which determines the child's sex. This occurs at the moment of fertilization when the sperm carrying either an X (resulting in a female) or Y (resulting in a male) chromosome fertilizes the egg. Choices A, B, and C are incorrect because the presence of teratogens at the time of conception or ovulation does not determine the child's sex. While the sex chromosome received from the mother is important, it is the father's contribution that ultimately determines the child's sex.
5. A newborn is 24 hours old, and a healthcare provider is caring for them. Which of the following laboratory findings should the healthcare provider report to the provider?
- A. Hgb 20 g/dL
- B. Bilirubin 2 mg/dL
- C. Platelets 200,000/mm3
- D. WBC count 32,000/mm3
Correct answer: D
Rationale: The correct answer is D: WBC count 32,000/mm3. A WBC count of 32,000/mm3 is significantly elevated in a newborn and could indicate an infection, which needs immediate attention and intervention. High white blood cell counts in newborns can be concerning as they may suggest an ongoing infection or other underlying issues that require prompt medical evaluation and treatment. Choices A, B, and C are within normal ranges for a newborn and would not typically warrant immediate reporting to the provider. Hgb levels of 20 g/dL (Choice A) are high for newborns, but this is not as concerning as a significantly elevated WBC count. Bilirubin levels of 2 mg/dL (Choice B) are within normal limits for a newborn and do not indicate immediate issues. Platelet count of 200,000/mm3 (Choice C) is also within the normal range for a newborn and would not require immediate reporting.
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