HESI MATERNAL NEWBORN – COMPLETE
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Exam
SECTION 1: ANTEPARTUM (Prenatal Care) – Questions 1–40
1. A client at 12 weeks gestation reports nausea and vomiting.
Which instruction is most helpful?
a) Eat three large meals daily
b) Drink fluids with meals
c) Eat dry crackers before getting out of bed
d) Lie flat after eating
Answer: c) Eat dry crackers before getting out of bed
Rationale: Morning sickness is often helped by small, frequent, dry
carbohydrates before rising; avoid large meals and lying flat after
eating.
2. A client at 10 weeks gestation has a rubella titer drawn. The result
shows non-immune status (1:8). When should the client receive the
rubella vaccine?
,a) Immediately now
b) After 12 weeks gestation
c) In the postpartum period
d) Never – contraindicated
Answer: c) In the postpartum period
Rationale: Rubella vaccine is a live virus and contraindicated during
pregnancy; given postpartum before discharge.
3. A client at 28 weeks gestation screens positive for gestational
diabetes. Which test is used for definitive diagnosis?
a) Fasting blood glucose
b) 1-hour glucose challenge test (GCT)
c) 3-hour oral glucose tolerance test (OGTT)
d) Hemoglobin A1C
Answer: c) 3-hour oral glucose tolerance test (OGTT)
Rationale: Abnormal GCT (≥140 mg/dL) requires confirmatory 3-
hour OGTT for GDM diagnosis.
4. A client at 32 weeks gestation reports headache, blurred vision,
and epigastric pain. Vital signs: BP 160/100, HR 90. What should the
nurse suspect?
a) Normal pregnancy symptoms
b) Gestational hypertension
c) Severe preeclampsia
d) Placenta previa
,Answer: c) Severe preeclampsia
Rationale: Headache, visual changes, epigastric pain, and BP
≥160/110 indicate severe features of preeclampsia.
5. A client at 36 weeks gestation reports decreased fetal movement.
What is the priority action?
a) Tell the client to drink orange juice and rest
b) Instruct the client to count kicks for 2 hours
c) Advise the client to come to L&D for evaluation
d) Schedule a non-stress test in 3 days
Answer: c) Advise the client to come to L&D for evaluation
Rationale: Decreased fetal movement requires immediate evaluation
(NST, BPP).
6. A client at 20 weeks gestation is Rh-negative and has an indirect
Coombs test negative. She asks about Rh immune globulin
(RhoGAM). When should it be given?
a) Only after delivery
b) At 28 weeks and within 72 hours after delivery
c) Only if the baby is Rh-negative
d) Only after an amniocentesis
Answer: b) At 28 weeks and within 72 hours after delivery
Rationale: RhoGAM at 28 weeks and again postpartum if newborn is
Rh-positive prevents sensitization.
, 7. A client at 16 weeks gestation has a maternal serum alpha-
fetoprotein (MSAFP) level that is elevated. What condition is
associated with this finding?
a) Down syndrome
b) Neural tube defect (e.g., spina bifida)
c) Gestational diabetes
d) Placenta previa
Answer: b) Neural tube defect (e.g., spina bifida)
Rationale: Elevated MSAFP suggests open neural tube defects; low
MSAFP suggests aneuploidy.
8. A client at 8 weeks gestation reports bright red vaginal bleeding
without pain. What condition should the nurse suspect?
a) Abruptio placentae
b) Ectopic pregnancy
c) Spontaneous abortion (miscarriage)
d) Placenta previa
Answer: c) Spontaneous abortion (miscarriage)
Rationale: Painless bleeding in first trimester often indicates
threatened or inevitable abortion; placenta previa is painless
bleeding but occurs in 2nd/3rd trimester.
9. A client at 34 weeks gestation with placenta previa has sudden,
painless vaginal bleeding. Which action should the nurse take first?
a) Assess fetal heart rate
TEST BANK | Questions And Answers Plus
Rationales | Instant Pdf Download 2026
Exam
SECTION 1: ANTEPARTUM (Prenatal Care) – Questions 1–40
1. A client at 12 weeks gestation reports nausea and vomiting.
Which instruction is most helpful?
a) Eat three large meals daily
b) Drink fluids with meals
c) Eat dry crackers before getting out of bed
d) Lie flat after eating
Answer: c) Eat dry crackers before getting out of bed
Rationale: Morning sickness is often helped by small, frequent, dry
carbohydrates before rising; avoid large meals and lying flat after
eating.
2. A client at 10 weeks gestation has a rubella titer drawn. The result
shows non-immune status (1:8). When should the client receive the
rubella vaccine?
,a) Immediately now
b) After 12 weeks gestation
c) In the postpartum period
d) Never – contraindicated
Answer: c) In the postpartum period
Rationale: Rubella vaccine is a live virus and contraindicated during
pregnancy; given postpartum before discharge.
3. A client at 28 weeks gestation screens positive for gestational
diabetes. Which test is used for definitive diagnosis?
a) Fasting blood glucose
b) 1-hour glucose challenge test (GCT)
c) 3-hour oral glucose tolerance test (OGTT)
d) Hemoglobin A1C
Answer: c) 3-hour oral glucose tolerance test (OGTT)
Rationale: Abnormal GCT (≥140 mg/dL) requires confirmatory 3-
hour OGTT for GDM diagnosis.
4. A client at 32 weeks gestation reports headache, blurred vision,
and epigastric pain. Vital signs: BP 160/100, HR 90. What should the
nurse suspect?
a) Normal pregnancy symptoms
b) Gestational hypertension
c) Severe preeclampsia
d) Placenta previa
,Answer: c) Severe preeclampsia
Rationale: Headache, visual changes, epigastric pain, and BP
≥160/110 indicate severe features of preeclampsia.
5. A client at 36 weeks gestation reports decreased fetal movement.
What is the priority action?
a) Tell the client to drink orange juice and rest
b) Instruct the client to count kicks for 2 hours
c) Advise the client to come to L&D for evaluation
d) Schedule a non-stress test in 3 days
Answer: c) Advise the client to come to L&D for evaluation
Rationale: Decreased fetal movement requires immediate evaluation
(NST, BPP).
6. A client at 20 weeks gestation is Rh-negative and has an indirect
Coombs test negative. She asks about Rh immune globulin
(RhoGAM). When should it be given?
a) Only after delivery
b) At 28 weeks and within 72 hours after delivery
c) Only if the baby is Rh-negative
d) Only after an amniocentesis
Answer: b) At 28 weeks and within 72 hours after delivery
Rationale: RhoGAM at 28 weeks and again postpartum if newborn is
Rh-positive prevents sensitization.
, 7. A client at 16 weeks gestation has a maternal serum alpha-
fetoprotein (MSAFP) level that is elevated. What condition is
associated with this finding?
a) Down syndrome
b) Neural tube defect (e.g., spina bifida)
c) Gestational diabetes
d) Placenta previa
Answer: b) Neural tube defect (e.g., spina bifida)
Rationale: Elevated MSAFP suggests open neural tube defects; low
MSAFP suggests aneuploidy.
8. A client at 8 weeks gestation reports bright red vaginal bleeding
without pain. What condition should the nurse suspect?
a) Abruptio placentae
b) Ectopic pregnancy
c) Spontaneous abortion (miscarriage)
d) Placenta previa
Answer: c) Spontaneous abortion (miscarriage)
Rationale: Painless bleeding in first trimester often indicates
threatened or inevitable abortion; placenta previa is painless
bleeding but occurs in 2nd/3rd trimester.
9. A client at 34 weeks gestation with placenta previa has sudden,
painless vaginal bleeding. Which action should the nurse take first?
a) Assess fetal heart rate
