HESI Maternal Newborn

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The nurse is planning discharge teaching for four mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period?

  • A. A primiparous woman who has recently migrated to the US with her spouse
  • B. A multiparous client who lives with her husband and his family members
  • C. A multiparous female with a large family living in a community
  • D. A primiparous adolescent living at home with her parents and significant other
Correct Answer: A

Rationale: A primiparous woman who has recently migrated to the US with her spouse is at the highest risk for psychological difficulties during the postpartum period. Recent migration and adjustment to a new environment can increase the risk of postpartum depression, especially when combined with the challenges of being a new mother. Choice B, a multiparous client living with her husband and his family, may have social support from family members, which can be protective against psychological difficulties. Choice C, a multiparous female with a large family living in a community, also indicates potential social support. Choice D, a primiparous adolescent living at home with her parents and significant other, may have a support system in place with her family and significant other.

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Which drug was marketed in the 1960s to pregnant women and caused birth defects such as missing or stunted limbs in infants?

  • A. Progestin
  • B. Estrogen
  • C. Thalidomide
  • D. Oxytocin
Correct Answer: C

Rationale: Thalidomide is the correct answer. Thalidomide was a drug marketed in the 1960s to pregnant women as a sedative and anti-nausea medication but tragically led to severe birth defects, including limb deformities, when taken during pregnancy. Progestin (Choice A) and Estrogen (Choice B) are hormones that are not associated with causing birth defects like Thalidomide. Oxytocin (Choice D) is a hormone that plays a role in labor and breastfeeding and is not known to cause birth defects like Thalidomide.

What is the typical sex chromosome pattern for females?

  • A. XX
  • B. XYY
  • C. XY
  • D. XXY
Correct Answer: A

Rationale: The typical sex chromosome pattern for females is XX. Females have two X chromosomes, which is represented as XX. Choice B (XYY) is incorrect as it represents the sex chromosome pattern for males with an extra Y chromosome. Choice C (XY) is the sex chromosome pattern for males. Choice D (XXY) represents a genetic disorder known as Klinefelter syndrome, where males have an extra X chromosome.

During a prenatal visit, for which of the following clients should the nurse auscultate the fetal heart rate?

  • A. A client who has an ultrasound confirming a molar pregnancy
  • B. A client who has a crown-rump length corresponding to 7 weeks gestation
  • C. A client who has a positive urine pregnancy test 1 week after missed menses
  • D. A client who has felt quickening for the first time
Correct Answer: D

Rationale: The correct answer is D because feeling quickening typically occurs around 18-20 weeks of gestation, indicating fetal movement. This is an appropriate time to auscultate the fetal heart rate. Choice A is incorrect because a molar pregnancy is not a viable pregnancy, and auscultating the fetal heart rate in this case is not applicable. Choice B is incorrect because a crown-rump length of 7 weeks gestation is too early for fetal heart rate auscultation. Choice C is incorrect because a positive urine pregnancy test alone does not indicate the appropriate timing for fetal heart rate auscultation.

A client at 27 weeks of gestation with preeclampsia is being assessed by a nurse. Which of the following findings should the nurse report to the provider?

  • A. Urine protein concentration of 200 mg/24 hr.
  • B. Creatinine level of 0.8 mg/dL
  • C. Hemoglobin level of 14.8 g/dL
  • D. Platelet count of 60,000/mm3
Correct Answer: D

Rationale: A platelet count of 60,000/mm3 is significantly low and can indicate HELLP syndrome, a severe complication of preeclampsia that involves hemolysis, elevated liver enzymes, and low platelet count. HELLP syndrome requires prompt medical intervention to prevent serious maternal and fetal complications. The other findings listed are within normal limits or not directly related to the severe condition associated with HELLP syndrome.

What causes Down's syndrome?

  • A. Alcohol abuse by the mother at the time of conception.
  • B. Sex-linked chromosomal abnormalities.
  • C. An extra chromosome on the 21st pair.
  • D. Drug abuse by the mother during pregnancy.
Correct Answer: C

Rationale: Down's syndrome, also known as trisomy 21, is caused by the presence of an extra chromosome on the 21st pair. Choice A is incorrect as alcohol abuse is not the cause of Down's syndrome. Choice B is incorrect because Down's syndrome is not related to sex-linked chromosomal abnormalities. Choice D is also incorrect as drug abuse by the mother during pregnancy is not the cause of Down's syndrome.

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