HESI OB PEDS EXIT EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Antepartum Nursing Care
Intrapartum Nursing Care
Postpartum Nursing Care
Newborn Assessment and Transition
Pediatric Growth and Development
Common Pediatric Illnesses and Management
Pharmacology in Maternal-Child Nursing
Family-Centered Care and Ethics
Delegation and Prioritization in Nursing
Introduction
This comprehensive examination is designed to assess the essential knowledge, critical thinking, and clinical
judgment skills required for success in maternal-child nursing. The test covers key areas across the obstetric and
pediatric spectrum, from prenatal care and high-risk pregnancy management to newborn transition and the care
of children with acute and chronic conditions. Through a series of multiple-choice questions and realistic scenarios,
this assessment emphasizes the application of evidence-based practice, safety principles, and professional
standards. It challenges students to make sound clinical decisions, prioritize care, and effectively manage complex
,situations encountered in the maternal-child healthcare setting. This exam is an indispensable tool for evaluating
readiness for the HESI exit exam and for safe, competent nursing practice.
SECTION ONE: QUESTIONS 1–100
1. A 16-year-old primigravida at 38 weeks' gestation is admitted to the labor and delivery unit with
contractions every 4 minutes. Her prenatal record indicates she has received no prenatal care. She appears
anxious and states she is afraid of the pain. What is the nurse's priority action?
A. Administer a prescribed dose of morphine for pain relief.
B. Assess the client's understanding of the labor process.
C. Obtain a detailed medical history from the client.
D. Continue to monitor and prepare for immediate delivery.
🟢B
🔴 RATIONALE: The priority action when a client presents with no prenatal care is to build trust and assess her
baseline understanding and support system. The client's anxiety indicates a need for education and emotional
support. Obtaining a medical history is important but not the immediate priority over addressing the client's
emotional state. Administering pain medication could mask complications and should not be the first step
before assessing the patient. While delivery is imminent, preparation should be efficient and not overshadow
the client's immediate psychological needs.
2. A nurse is performing an initial newborn assessment. The newborn's heart rate is 150 bpm, respiratory rate
is 45 breaths/min, and the infant has a strong cry. The infant exhibits some flexion of the extremities, with
acrocyanosis noted. Which Apgar score should the nurse assign at 1 minute?
,A. 7
B. 8
C. 9
D. 10
🟢B
🔴 RATIONALE: The Apgar score assesses heart rate (2 points for >100 bpm), respiratory effort (2 points for a
strong cry), muscle tone (1 point for some flexion), reflex irritability (2 points for a vigorous cry), and color (0
points for acrocyanosis). The total score is 2+2+1+2+0=8. An acrocyanosis is a normal finding in the newborn,
giving a score of 0 for color.
3. A 2-year-old child is admitted with a diagnosis of acute epiglottitis. Which assessment finding requires the
nurse to take immediate action?
A. The child is drooling and leaning forward to breathe.
B. The child's oxygen saturation is 92% on room air.
C. The child has a fever of 102.2°F (39°C).
D. The child's mother states, "He is very irritable."
🟢A
🔴 RATIONALE: Drooling and leaning forward to breathe (tripod position) are classic signs of acute epiglottitis
and indicate a critical airway obstruction. The child is at risk for complete airway closure. This assessment
finding is the highest priority and requires immediate intervention, such as preparing for intubation. While fever,
low oxygen saturation, and irritability are concerning, the risk of respiratory failure is the most immediate threat.
, 4. The nurse is preparing a client for a scheduled non-stress test (NST) at 34 weeks' gestation. Which of the
following is the most appropriate client teaching?
A. "You will need to have a full bladder for this test."
B. "This test will measure how your baby's heart rate responds to its own movements."
C. "This test is performed to evaluate the strength of your contractions."
D. "You will need to fast for 8 hours prior to this test."
🟢B
🔴 RATIONALE: A non-stress test (NST) assesses fetal well-being by evaluating the fetal heart rate's response to
fetal movement. A reactive NST is associated with fetal movement and accelerations in the heart rate. The test
does not require a full bladder (this is for an ultrasound). It does not measure the strength of contractions (this
is done with an internal monitor or by palpation). Fasting is not required for an NST.
5. A 6-year-old child is being admitted to the pediatric unit for a tonsillectomy. What is the most appropriate
nursing intervention to prepare the child for the procedure?
A. Show the child a video of the surgery and discuss it in detail.
B. Provide the child with a coloring book and crayons to keep busy.
C. Allow the child to play with a doll and medical equipment to practice on it.
D. Tell the child that a "big operation" will help them feel better.
🟢C
🔴 RATIONALE: Therapeutic play using a doll and medical equipment allows the child to express feelings and
gain a sense of control over the upcoming procedure. This is the most developmentally appropriate method to
reduce anxiety and prepare a 6-year-old for surgery. Showing a video or discussing details may increase anxiety
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Antepartum Nursing Care
Intrapartum Nursing Care
Postpartum Nursing Care
Newborn Assessment and Transition
Pediatric Growth and Development
Common Pediatric Illnesses and Management
Pharmacology in Maternal-Child Nursing
Family-Centered Care and Ethics
Delegation and Prioritization in Nursing
Introduction
This comprehensive examination is designed to assess the essential knowledge, critical thinking, and clinical
judgment skills required for success in maternal-child nursing. The test covers key areas across the obstetric and
pediatric spectrum, from prenatal care and high-risk pregnancy management to newborn transition and the care
of children with acute and chronic conditions. Through a series of multiple-choice questions and realistic scenarios,
this assessment emphasizes the application of evidence-based practice, safety principles, and professional
standards. It challenges students to make sound clinical decisions, prioritize care, and effectively manage complex
,situations encountered in the maternal-child healthcare setting. This exam is an indispensable tool for evaluating
readiness for the HESI exit exam and for safe, competent nursing practice.
SECTION ONE: QUESTIONS 1–100
1. A 16-year-old primigravida at 38 weeks' gestation is admitted to the labor and delivery unit with
contractions every 4 minutes. Her prenatal record indicates she has received no prenatal care. She appears
anxious and states she is afraid of the pain. What is the nurse's priority action?
A. Administer a prescribed dose of morphine for pain relief.
B. Assess the client's understanding of the labor process.
C. Obtain a detailed medical history from the client.
D. Continue to monitor and prepare for immediate delivery.
🟢B
🔴 RATIONALE: The priority action when a client presents with no prenatal care is to build trust and assess her
baseline understanding and support system. The client's anxiety indicates a need for education and emotional
support. Obtaining a medical history is important but not the immediate priority over addressing the client's
emotional state. Administering pain medication could mask complications and should not be the first step
before assessing the patient. While delivery is imminent, preparation should be efficient and not overshadow
the client's immediate psychological needs.
2. A nurse is performing an initial newborn assessment. The newborn's heart rate is 150 bpm, respiratory rate
is 45 breaths/min, and the infant has a strong cry. The infant exhibits some flexion of the extremities, with
acrocyanosis noted. Which Apgar score should the nurse assign at 1 minute?
,A. 7
B. 8
C. 9
D. 10
🟢B
🔴 RATIONALE: The Apgar score assesses heart rate (2 points for >100 bpm), respiratory effort (2 points for a
strong cry), muscle tone (1 point for some flexion), reflex irritability (2 points for a vigorous cry), and color (0
points for acrocyanosis). The total score is 2+2+1+2+0=8. An acrocyanosis is a normal finding in the newborn,
giving a score of 0 for color.
3. A 2-year-old child is admitted with a diagnosis of acute epiglottitis. Which assessment finding requires the
nurse to take immediate action?
A. The child is drooling and leaning forward to breathe.
B. The child's oxygen saturation is 92% on room air.
C. The child has a fever of 102.2°F (39°C).
D. The child's mother states, "He is very irritable."
🟢A
🔴 RATIONALE: Drooling and leaning forward to breathe (tripod position) are classic signs of acute epiglottitis
and indicate a critical airway obstruction. The child is at risk for complete airway closure. This assessment
finding is the highest priority and requires immediate intervention, such as preparing for intubation. While fever,
low oxygen saturation, and irritability are concerning, the risk of respiratory failure is the most immediate threat.
, 4. The nurse is preparing a client for a scheduled non-stress test (NST) at 34 weeks' gestation. Which of the
following is the most appropriate client teaching?
A. "You will need to have a full bladder for this test."
B. "This test will measure how your baby's heart rate responds to its own movements."
C. "This test is performed to evaluate the strength of your contractions."
D. "You will need to fast for 8 hours prior to this test."
🟢B
🔴 RATIONALE: A non-stress test (NST) assesses fetal well-being by evaluating the fetal heart rate's response to
fetal movement. A reactive NST is associated with fetal movement and accelerations in the heart rate. The test
does not require a full bladder (this is for an ultrasound). It does not measure the strength of contractions (this
is done with an internal monitor or by palpation). Fasting is not required for an NST.
5. A 6-year-old child is being admitted to the pediatric unit for a tonsillectomy. What is the most appropriate
nursing intervention to prepare the child for the procedure?
A. Show the child a video of the surgery and discuss it in detail.
B. Provide the child with a coloring book and crayons to keep busy.
C. Allow the child to play with a doll and medical equipment to practice on it.
D. Tell the child that a "big operation" will help them feel better.
🟢C
🔴 RATIONALE: Therapeutic play using a doll and medical equipment allows the child to express feelings and
gain a sense of control over the upcoming procedure. This is the most developmentally appropriate method to
reduce anxiety and prepare a 6-year-old for surgery. Showing a video or discussing details may increase anxiety
