HESI MATERNAL NEWBORN (OB) PRACTICE EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Pregnancy, Birth Risk Factors, and Complications
- Maternal Postpartum Assessment, Management, and Education
- Newborn Assessment and Management
- Maternal Postpartum Complications
- Newborn Complications
- Pharmacology in Maternal-Newborn Care
- Ethics, Legal Compliance, and Professional Standards in OB Nursing
- Lactation and Neonatal Nutrition
This comprehensive assessment evaluates the knowledge and clinical decision-making skills essential for safe,
effective nursing care during the prenatal, perinatal, and postpartum periods. The exam consists of 100
multiple-choice and scenario-based questions that test foundational theory, applied professional knowledge,
regulatory and legal compliance, ethics, and real-world clinical judgment. Each question presents authentic
clinical situations requiring critical thinking, prioritization, and evidence-based interventions. The primary
purpose is to prepare nursing students and professionals for high-stakes certification by emphasizing real-
world application, patient safety, and professional accountability in maternal-newborn healthcare settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is assessing a 28-year-old woman at 32 weeks gestation who reports sudden, painless bright red vaginal
bleeding. Which condition should the nurse suspect first?
,A. Placenta previa
B. Placental abruption
C. Vasa previa
D. Cervical incompetence
🟢 Correct answer: A
🔴 RATIONALE: Painless bright red vaginal bleeding in the third trimester is the classic presentation of
placenta previa, where the placenta covers the cervical opening. Placental abruption typically presents with
painful bleeding and uterine tenderness. Vasa previa involves fetal blood vessel rupture and causes fetal
distress. Cervical incompetence does not typically cause bleeding.
Question 2
After delivery, a newborn exhibits grunting, nasal flaring, and subcostal retractions. The respiratory rate is 68
breaths/min. What is the nurse's priority intervention?
A. Administer oxygen via nasal cannula
B. Prepare for intubation
C. Obtain a capillary blood gas
D. Place the newborn in a warm incubator
🟢 Correct answer: A
,🔴 RATIONALE: The newborn is showing signs of respiratory distress (grunting, nasal flaring, retractions,
tachypnea). Initial management includes providing supplemental oxygen to maintain adequate oxygenation.
Intubation is reserved for severe cases. Blood gas confirms severity but is not the priority. Warmth is important
but not the immediate priority for respiratory distress.
Question 3
A patient at 36 weeks gestation presents with severe headache, visual disturbances, and epigastric pain. Her
blood pressure is 168/110 mmHg. Which medication should the nurse anticipate administering?
A. Magnesium sulfate
B. Hydralazine
C. Furosemide
D. Methyldopa
🟢 Correct answer: A
🔴 RATIONALE: These symptoms indicate severe preeclampsia with risk for eclampsia (seizures). Magnesium
sulfate is the anticonvulsant of choice to prevent seizures in severe preeclampsia. Hydralazine treats
hypertension but does not prevent seizures. Furosemide is not typically used in preeclampsia. Methyldopa is for
chronic hypertension, not acute management.
Question 4
Which finding in a postpartum patient at 24 hours after delivery requires immediate nursing intervention?
, A. Lochia rubra with moderate amount
B. Temperature of 38.2°C (100.8°F)
C. Urine output of 20 mL/hr
D. Breast engorgement
🟢 Correct answer: C
🔴 RATIONALE: Urine output of 20 mL/hr indicates oliguria (normal is ≥30 mL/hr), which may signal
hypovolemia, kidney dysfunction, or postpartum hemorrhage complications. This requires immediate
assessment and intervention. Lochia rubra is normal at 24 hours. Temperature up to 38°C can be normal
postpartum. Breast engorgement typically occurs later (days 3-5).
Question 5
A newborn born at 34 weeks gestation is at risk for which complication due to immature lung development?
A. Hypoglycemia
B. Respiratory distress syndrome
C. Jaundice
D. Polycythemia
🟢 Correct answer: B
🔴 RATIONALE: Respiratory distress syndrome (RDS) occurs in preterm infants due to insufficient surfactant
production, leading to alveolar collapse and impaired gas exchange. Hypoglycemia, jaundice, and polycythemia
are also concerns in preterm infants but are not directly related to lung immaturity.
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Pregnancy, Birth Risk Factors, and Complications
- Maternal Postpartum Assessment, Management, and Education
- Newborn Assessment and Management
- Maternal Postpartum Complications
- Newborn Complications
- Pharmacology in Maternal-Newborn Care
- Ethics, Legal Compliance, and Professional Standards in OB Nursing
- Lactation and Neonatal Nutrition
This comprehensive assessment evaluates the knowledge and clinical decision-making skills essential for safe,
effective nursing care during the prenatal, perinatal, and postpartum periods. The exam consists of 100
multiple-choice and scenario-based questions that test foundational theory, applied professional knowledge,
regulatory and legal compliance, ethics, and real-world clinical judgment. Each question presents authentic
clinical situations requiring critical thinking, prioritization, and evidence-based interventions. The primary
purpose is to prepare nursing students and professionals for high-stakes certification by emphasizing real-
world application, patient safety, and professional accountability in maternal-newborn healthcare settings.
SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is assessing a 28-year-old woman at 32 weeks gestation who reports sudden, painless bright red vaginal
bleeding. Which condition should the nurse suspect first?
,A. Placenta previa
B. Placental abruption
C. Vasa previa
D. Cervical incompetence
🟢 Correct answer: A
🔴 RATIONALE: Painless bright red vaginal bleeding in the third trimester is the classic presentation of
placenta previa, where the placenta covers the cervical opening. Placental abruption typically presents with
painful bleeding and uterine tenderness. Vasa previa involves fetal blood vessel rupture and causes fetal
distress. Cervical incompetence does not typically cause bleeding.
Question 2
After delivery, a newborn exhibits grunting, nasal flaring, and subcostal retractions. The respiratory rate is 68
breaths/min. What is the nurse's priority intervention?
A. Administer oxygen via nasal cannula
B. Prepare for intubation
C. Obtain a capillary blood gas
D. Place the newborn in a warm incubator
🟢 Correct answer: A
,🔴 RATIONALE: The newborn is showing signs of respiratory distress (grunting, nasal flaring, retractions,
tachypnea). Initial management includes providing supplemental oxygen to maintain adequate oxygenation.
Intubation is reserved for severe cases. Blood gas confirms severity but is not the priority. Warmth is important
but not the immediate priority for respiratory distress.
Question 3
A patient at 36 weeks gestation presents with severe headache, visual disturbances, and epigastric pain. Her
blood pressure is 168/110 mmHg. Which medication should the nurse anticipate administering?
A. Magnesium sulfate
B. Hydralazine
C. Furosemide
D. Methyldopa
🟢 Correct answer: A
🔴 RATIONALE: These symptoms indicate severe preeclampsia with risk for eclampsia (seizures). Magnesium
sulfate is the anticonvulsant of choice to prevent seizures in severe preeclampsia. Hydralazine treats
hypertension but does not prevent seizures. Furosemide is not typically used in preeclampsia. Methyldopa is for
chronic hypertension, not acute management.
Question 4
Which finding in a postpartum patient at 24 hours after delivery requires immediate nursing intervention?
, A. Lochia rubra with moderate amount
B. Temperature of 38.2°C (100.8°F)
C. Urine output of 20 mL/hr
D. Breast engorgement
🟢 Correct answer: C
🔴 RATIONALE: Urine output of 20 mL/hr indicates oliguria (normal is ≥30 mL/hr), which may signal
hypovolemia, kidney dysfunction, or postpartum hemorrhage complications. This requires immediate
assessment and intervention. Lochia rubra is normal at 24 hours. Temperature up to 38°C can be normal
postpartum. Breast engorgement typically occurs later (days 3-5).
Question 5
A newborn born at 34 weeks gestation is at risk for which complication due to immature lung development?
A. Hypoglycemia
B. Respiratory distress syndrome
C. Jaundice
D. Polycythemia
🟢 Correct answer: B
🔴 RATIONALE: Respiratory distress syndrome (RDS) occurs in preterm infants due to insufficient surfactant
production, leading to alveolar collapse and impaired gas exchange. Hypoglycemia, jaundice, and polycythemia
are also concerns in preterm infants but are not directly related to lung immaturity.
