HESI LPN
Maternity HESI Practice Questions
1. During the client’s initial prenatal visit, which of the following would indicate a need for further assessment?
- A. History of diabetes for 6 years.
- B. Exercises three times a week.
- C. Occasional use of over-the-counter pain relievers.
- D. Maternal age 30 years.
Correct answer: A
Rationale: A history of diabetes for 6 years indicates a pre-existing medical condition that can significantly impact both the mother and the developing fetus during pregnancy. This necessitates further assessment and monitoring to manage potential complications. Regular exercise (Choice B) is generally beneficial during pregnancy and does not raise immediate concerns. Occasional use of over-the-counter pain relievers (Choice C) is common and does not necessarily indicate a need for further assessment during the initial visit. Maternal age of 30 years (Choice D) falls within the normal range for childbearing and is not a standalone factor requiring immediate further assessment.
2. Which FHR finding is the most concerning to the nurse providing care to a laboring client?
- A. Accelerations with fetal movement.
- B. Early decelerations.
- C. Average FHR of 126 beats per minute.
- D. Late decelerations.
Correct answer: D
Rationale: Late decelerations are caused by uteroplacental insufficiency, resulting in fetal hypoxemia. They are considered ominous if persistent, indicating compromised oxygen supply to the fetus. Accelerations with fetal movement (Choice A) are reassuring signs of fetal well-being. Early decelerations (Choice B) are typically benign, associated with head compression during contractions. An average FHR of 126 beats per minute (Choice C) falls within the normal range for fetal heart rate and is not concerning. Therefore, the most concerning FHR finding in a laboring client is late decelerations (Choice D).
3. 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.
4. A woman has experienced iron deficiency anemia during her pregnancy. She had been taking iron for 3 months before the birth. The client gave birth by cesarean 2 days earlier and has been having problems with constipation. After assisting her back to bed from the bathroom, the nurse notes that the woman’s stools are dark (greenish-black). What should the nurse’s initial action be?
- A. Perform a guaiac test and record the results.
- B. Recognize the finding as abnormal and report it to the primary health care provider.
- C. Recognize the finding as a normal result of iron therapy.
- D. Check the woman’s next stool to validate the observation.
Correct answer: C
Rationale: The nurse should recognize that dark stools are a common side effect in clients who are taking iron replacement therapy. Dark stools are a known, expected result of iron supplementation and are not indicative of a complication unless other symptoms of GI bleeding are present. A guaiac test would be necessary if there were concerns about gastrointestinal bleeding. Recognizing dark stools as a consequence of iron therapy is an essential nursing assessment skill and does not require immediate reporting. Checking the next stool to confirm the observation is unnecessary as the presence of dark stools in this context is already an expected outcome of iron supplementation.
5. Which neonatal complications are associated with hypertension in the mother?
- A. Intrauterine growth restriction (IUGR) and prematurity.
- B. Seizures and cerebral hemorrhage.
- C. Hepatic or renal dysfunction.
- D. Placental abruption and DIC.
Correct answer: A
Rationale: Neonatal complications associated with maternal hypertension are primarily due to placental insufficiency. The correct answer is A, which includes Intrauterine Growth Restriction (IUGR) and prematurity. These complications arise from inadequate blood flow to the fetus, leading to growth restriction and premature birth. Choices B, seizures, and cerebral hemorrhage are more commonly maternal complications rather than neonatal ones. Choice C, hepatic or renal dysfunction, pertains to maternal complications of hypertensive disorders in pregnancy, not neonatal issues. Choice D, placental abruption, and Disseminated Intravascular Coagulation (DIC) are conditions linked to maternal morbidity and mortality, not neonatal complications.
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