HESI MATERNAL MOCK EXAM WITH ANSWER
RATIONALES 2026
◉ A client at 25-weeks gestation tells the nurse that she dropped a
cooking utensil last week and her baby jumped in response to the
noise. What information should the nurse provide?
1. This is a demonstration of the fetus's acoustical reflex.
2. The fetus can respond to sound by 24-weeks gestation.
3. It is a coincidence the fetus responded at the same time.
4. Report the fetus's behavior to the healthcare provider.. Answer; 2.
The fetus can respond to sound by 24-weeks gestation.
At 24-weeks gestation, the fetus's ability to hear loud environment
sounds can illicit a startle response (B). Acoustic stimulations can
evoke a fetal heart rate response and fetal movement, but (A and C)
are inaccurate. (D) is not indicated.
◉ A client at 28-weeks gestation experiences blunt abdominal
trauma. Which parameter should the nurse assess first for signs of
internal hemorrhage?
1. Vaginal bleeding.
,2. Complaints of abdominal pain.
3. Changes in fetal heart rate patterns.
4. Alteration in maternal blood pressure. Answer; 3. Changes in fetal
heart rate patterns.
Hypoperfusion of the fetus may be present before the onset of
clinical signs of maternal compromise or shock in a pregnant
woman, so the external fetal monitor tracings should be assessed
first to determine signs of fetal hypoxia due to internal bleeding in
the mother. (A, B, and D) are not the first findings of internal
hemorrhage in the pregnant client.
◉ The nurse assesses a male newborn and determines that he has
the following vital signs: axillary temperature 95.1 F, heart rate 136
beats/minute and a respiratory rate 48 breaths/minute. Based on
these findings, which action should the nurse take first?
1. Check the infant's arterial blood gases.
2. Notify the pediatrician of the infant's vital signs.
3. Assess the infant's blood glucose level.
4. Encourage the infant to take the breast or sugar water.. Answer; 3.
Assess the infant's blood glucose level.
The nurse should first assess the infant's blood glucose level (C),
because the infant is displaying signs of hypothermia (normal
,newborn axillary temperature is 96 to 98 F) and hypoglycemia may
occur as glucose is metabolized in an effort to meet cellular energy
demands. The infant's respiratory and heart rates are within normal
limits, so (A) is not a priority. (B and D) would be implemented after
information regarding the blood sugar level has been obtained.
◉ A client at 29-weeks gestation with possible placental
insufficiency is being prepared for prenatal testing. Information
about which diagnostic study should the nurse provide information
to the client?
1. Amniocentesis.
2. Ultrasonography.
3. Chorionic villus sampling.
4. Maternal serum alpha-fetoprotein.. Answer; 2. Ultrasonography.
Gestational age, fetal growth, and the status and position of the
placenta are monitored by ultrasound.
◉ A multigravida client at 40+ weeks gestation is induced using
oxytocin (Pitocin). An intrauterine pressure catheter (IUPC) is in
place when the client's membranes rupture after 5 hours of active
labor. Which finding should require the nurse to implement further
action?
, 1. Labor has progressed at 1 cm/hr dilation.
2. Intensity of contractions is 130 mm Hg.
3. Contractions are lasting 60 to 80 seconds.
4. Oxytocin is infusing at a rate ot 30 mU/min.. Answer; 2. Intensity
of contractions is 130 mm Hg.
The goal of induction of labor with oxytocin is to produce an
effective labor, which can be measured by an IUPC reading of 40 to
90 mm Hg for contractions when giving oxytocin, so (B) requires
further intervention. (A, C, and D) are goals for induction of labor
using oxytocin.
◉ Which finding in the medical history of a post-partum client
should the nurse withhold the administration of a routine standing
order for methylergonovine maleate (Methergine)?
1. Pregnancy induced hypertension.
2. Placenta previa.
3. Gestational diabetes.
4. Postpartum hemorrhage.. Answer; 1. Pregnancy induced
hypertension.
Methergine is used for post-partum bleeding. A client's history of
pregnancy-induced hypertension (A) is a contraindication for
RATIONALES 2026
◉ A client at 25-weeks gestation tells the nurse that she dropped a
cooking utensil last week and her baby jumped in response to the
noise. What information should the nurse provide?
1. This is a demonstration of the fetus's acoustical reflex.
2. The fetus can respond to sound by 24-weeks gestation.
3. It is a coincidence the fetus responded at the same time.
4. Report the fetus's behavior to the healthcare provider.. Answer; 2.
The fetus can respond to sound by 24-weeks gestation.
At 24-weeks gestation, the fetus's ability to hear loud environment
sounds can illicit a startle response (B). Acoustic stimulations can
evoke a fetal heart rate response and fetal movement, but (A and C)
are inaccurate. (D) is not indicated.
◉ A client at 28-weeks gestation experiences blunt abdominal
trauma. Which parameter should the nurse assess first for signs of
internal hemorrhage?
1. Vaginal bleeding.
,2. Complaints of abdominal pain.
3. Changes in fetal heart rate patterns.
4. Alteration in maternal blood pressure. Answer; 3. Changes in fetal
heart rate patterns.
Hypoperfusion of the fetus may be present before the onset of
clinical signs of maternal compromise or shock in a pregnant
woman, so the external fetal monitor tracings should be assessed
first to determine signs of fetal hypoxia due to internal bleeding in
the mother. (A, B, and D) are not the first findings of internal
hemorrhage in the pregnant client.
◉ The nurse assesses a male newborn and determines that he has
the following vital signs: axillary temperature 95.1 F, heart rate 136
beats/minute and a respiratory rate 48 breaths/minute. Based on
these findings, which action should the nurse take first?
1. Check the infant's arterial blood gases.
2. Notify the pediatrician of the infant's vital signs.
3. Assess the infant's blood glucose level.
4. Encourage the infant to take the breast or sugar water.. Answer; 3.
Assess the infant's blood glucose level.
The nurse should first assess the infant's blood glucose level (C),
because the infant is displaying signs of hypothermia (normal
,newborn axillary temperature is 96 to 98 F) and hypoglycemia may
occur as glucose is metabolized in an effort to meet cellular energy
demands. The infant's respiratory and heart rates are within normal
limits, so (A) is not a priority. (B and D) would be implemented after
information regarding the blood sugar level has been obtained.
◉ A client at 29-weeks gestation with possible placental
insufficiency is being prepared for prenatal testing. Information
about which diagnostic study should the nurse provide information
to the client?
1. Amniocentesis.
2. Ultrasonography.
3. Chorionic villus sampling.
4. Maternal serum alpha-fetoprotein.. Answer; 2. Ultrasonography.
Gestational age, fetal growth, and the status and position of the
placenta are monitored by ultrasound.
◉ A multigravida client at 40+ weeks gestation is induced using
oxytocin (Pitocin). An intrauterine pressure catheter (IUPC) is in
place when the client's membranes rupture after 5 hours of active
labor. Which finding should require the nurse to implement further
action?
, 1. Labor has progressed at 1 cm/hr dilation.
2. Intensity of contractions is 130 mm Hg.
3. Contractions are lasting 60 to 80 seconds.
4. Oxytocin is infusing at a rate ot 30 mU/min.. Answer; 2. Intensity
of contractions is 130 mm Hg.
The goal of induction of labor with oxytocin is to produce an
effective labor, which can be measured by an IUPC reading of 40 to
90 mm Hg for contractions when giving oxytocin, so (B) requires
further intervention. (A, C, and D) are goals for induction of labor
using oxytocin.
◉ Which finding in the medical history of a post-partum client
should the nurse withhold the administration of a routine standing
order for methylergonovine maleate (Methergine)?
1. Pregnancy induced hypertension.
2. Placenta previa.
3. Gestational diabetes.
4. Postpartum hemorrhage.. Answer; 1. Pregnancy induced
hypertension.
Methergine is used for post-partum bleeding. A client's history of
pregnancy-induced hypertension (A) is a contraindication for
