HESI RN
HESI RN Maternal Newborn I Questions
Question 1 of 5
The nurse is caring for a child with a unilateral long-leg cast applied for the correction of club foot. Which action is most important for the nurse to perform?
Correct Answer: C
Rationale: Monitoring capillary refill ensures adequate circulation in the casted limb, detecting complications like compartment syndrome.
Question 2 of 5
The nurse receives a newborn within the first minutes after a vaginal delivery and intervenes to establish adequate respirations. Which priority issue should the nurse address to ensure the newborn's survival?
Correct Answer: A
Rationale: Preventing heat loss avoids cold stress, which can lead to respiratory distress and metabolic issues, critical for newborn survival.
Question 3 of 5
A 7-year-old child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's mother, the recent occurrence of which illness is most significant?
Correct Answer: D
Rationale: A recent untreated Group A Streptococcus sore throat is the primary risk factor for acute rheumatic fever, triggering an autoimmune response.
Question 4 of 5
A multiparous client with active herpes lesions is admitted to the unit with spontaneous rupture of membranes. Which action should the nurse take?
Correct Answer: C
Rationale: Cesarean section prevents neonatal herpes transmission during delivery with active lesions.
Extract:
History and Physical
Nurses' Notes
Flow Sheet
Vital signs
The client is a 9-month-old male who was born by cesarean section at 32 weeks gestation. He has been hospitalized once with respiratory syncytial virus at 2 months of age. He is up to date on vaccines.
Exhibits
Review H and P, nurse's note, and flow sheet.
Question 5 of 5
Complete the diagram by specifying which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
| Remove some of the baby's clothing |
| Clean the area with warm water |
| Alert child protective services |
| Swab the area and send for a culture |
| Hold the vaccines |
| Temperature |
| Parent's understanding of education |
Correct Answer: A,B
Rationale: Miliaria, caused by overdressing, is addressed by removing clothing and cleaning with warm water. Monitoring temperature and parental education prevents recurrence.