HESI RN Maternity Exam 7n

Extract:

Question 1 of 5

The nurse is evaluating the growth and development of a 3-year-old child. Which speech and language skills should the nurse identify as normal developmental milestones for this child?

Correct Answer: C

Rationale: By age 3, children typically speak in simple sentences with four or more words. Gestures with 1-2 word sentences and single-word sentences are milestones for younger children, and recognizing letters/numbers is expected around age 4-5.

Question 2 of 5

A 17-year-old student arrives at the emergency department (ED) complaining of severe abdominal pain and cramping that has worsened since the morning. Her mother suspects a urinary tract infection due to her daughter's frequent and urgent urination, or possibly appendicitis. What signs would indicate that a healthy psychosocial adaptation is taking place? Select all that apply.

A. Both mother and daughter are shedding tears of joy and gratitude. B. The mother expresses her full support for her daughter. C. The mother appears sad. D. The patient gives birth to a healthy baby boy. E. Mother commends her daughter. F. Mother and daughter stroke baby's cheek.

Correct Answer: B,E

Rationale: Maternal support and commendation indicate healthy psychosocial adaptation by fostering coping and self-efficacy. Tears of joy, sadness, childbirth, and touching a baby are not directly relevant to psychosocial adaptation in this context.

Question 3 of 5

The nurse finds that an infant admitted for surgical repair of an inguinal hernia voids a urinary stream from the ventral surface of the penis. What action should the nurse take?

A. Assess for bladder distention. B. Listen for bowel sounds. C. Document the observation. D. Check the scrotum for testicular descent.

Correct Answer: C

Rationale: Voiding from the ventral penis suggests hypospadias, a congenital condition. Documenting this finding ensures it is reported and addressed appropriately.

Question 4 of 5

A client at 28-weeks gestation whose hemoglobin level is 10.7 g/dL (107 g/L) and hematocrit is 32.3% (0.323 volume fraction), tells the nurse that she eats plenty of green vegetables. When the client asks the nurse how the pregnancy might affect the laboratory findings, which information should the nurse provide?

A. Increasing intake of protein might improve these values. B. Plasma volume increases, making the blood count appear low. C. Almost all women at 28-weeks gestation have anemia. D. It might be necessary to take an iron supplement twice daily.

Correct Answer: B

Rationale: Pregnancy increases plasma volume, diluting red blood cells and causing physiological anemia, explaining the low hemoglobin and hematocrit.

Question 5 of 5

The nurse is caring for a child who has had a unilateral long-leg cast applied for the correction of club foot. What is the most important action for the nurse to perform?

A. Monitor the capillary refill of the toes. B. Compare the temperature of both legs. C. Observe for spontaneous movement. D. Check the femoral pulses.

Correct Answer: A

Rationale: Monitoring capillary refill assesses circulation, critical to prevent complications like tissue necrosis from cast compression.