Maternity HESI Test bank Exam Questions
and Correct Answers
Question 1
A newborn infant, diagnosed with developmental dysplasia of the hip (DDH), is being
prepared for discharge. Which nursing intervention should be included in this infant's
discharge teaching plan?
A.Observe the parents applying a Pavlik harness.
B.Provide a referral for an orthopedic surgeon.
C.Schedule a physical therapy follow-up home visit.
D.Teach the parents to check for hip joint mobility.
Correct Answer
A.Observe the parents applying a Pavlik harness.
Rationale: It is important that the hips of infants with hip dysplasia are maintained in
an abducted position, which can be accomplished by using the Pavlik harness; this
keeps the hips and knees flexed, the hips abducted, and the femoral head in the
acetabulum. Early treatment often negates the need for surgery, and option B is not
indicated until approximately 6 months of age. Option C is not indicated for hip
dysplasia. It is best for the pediatrician to monitor hip joint mobility, and teaching
the parents to perform this technique is likely to increase their anxiety.
Question 2
Which action should the nurse implement when preparing to measure the fundal
height of a pregnant client?
A. have the client empty her bladder
B. request the client lie on her left side
C. Perform Leopold's maneuvers first
D. Give the client some cold juice to drink
Correct Answer
A. have the client empty her bladder
Page 1 of 93
,Question 3
A 4 week old premature infant has been receiving epoetin alfa (Epogen) for the last 3
weeks. Which assessment finding indicates to the nurse that the drug is effective?
A. slowly increasing urinary output over the last week
B. respiratory rate changes from the 40s to the 60s.
C. changes in apical heart rate from the 180s to the 140s
D. change in indirect bilirubin from 12 mg/dl to 8 mg/dl
Correct Answer
A. slowly increasing urinary output over the last week
Question 4
Which findings are of most concern to the nurse when caring for a woman in the first
trimester of pregnancy? (Select all that apply.)
A.Cramping with bright red spotting
B.Extreme tenderness of the breast
C.Lack of tenderness of the breast
D.Increased amounts of discharge
E.Increased right-side flank pain
Correct Answer
A.Cramping with bright red spotting
C.Lack of tenderness of the breast
E.Increased right-side flank pain
Rationale: Options A and C are signs of a possible miscarriage. Cramping with bright
red bleeding is a sign that the client's menstrual cycle is about to begin. A decrease
of tenderness in the breast is a sign that hormone levels have declined and that a
miscarriage is imminent. Option E could be a sign of an ectopic pregnancy, which
could be fatal if not discovered in time before rupture. Options B and D are normal
signs during the first trimester of a pregnancy.
Page 2 of 93
,Question 5
A full term infant is transferred to the nursery from labor and delivery. Which
information is most important for the nurse to receive when planning immediate care
for the newborn?
A. length of labor and method of delivery
B. infant's condition at birth and treatment received
C. feeding method chosen by the parents
D. history of drugs given to the mother during labor
Correct Answer
B. infant's condition at birth and treatment received
Question 6
A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when
she could use a home pregnancy test to diagnose pregnancy. Which response is
appropriate?
A. "A home pregnancy test can be used right after your first missed period."
B. "These tests are most accurate after you have missed your second period."
C. "Home pregnancy tests often give false positives and should not be trusted."
D. "The test can provide accurate information when used right after ovulation."
Correct Answer
A. "A home pregnancy test can be used right after your first missed period."
Question 7
A 30 year old gravida, 2 para 1 client is admitted to the hospital at 26 weeks gestation
in preterm labor. She is started on an IV solution of terbutaline (Brethine). Which
assessment is the highest priority for the nurse to monitor during the administration
of this drug?
A. maternal blood pressure and respirations
B. maternal and fetal heart rates
C. hourly urinary output
D. deep tendon reflexes
Correct Answer
B. maternal and fetal heart rates
Page 3 of 93
, Question 8
A 24-hour old newborn has a pink papular rash with vesicles superimposed on the
thorax, back and abdomen. What action should the nurse implement?
A. notify the healthcare provider
B. move the newborn to an isolation nursery
C. document the finding in the infant's record
D. obtain a culture of the vesicles
Correct Answer
C. document the finding in the infant's record. Erythema Toxicum (or erythema
neonatorium) is a newborn rash that is commonly referred to as "flea bites." but is a
normal finding that is documented in the infant's record and requires no further
action.
Question 9
An expectant father tells the nurse he fears that his wife is "losing her mind." He states
that she is constantly rubbing her abdomen and talking to the baby and that she
actually reprimands the baby when it moves too much. Which recommendation
should the nurse make to this expectant father?
A.Suggest that his wife seek professional counseling to deal with her symptoms.
B.Explain that his wife is exhibiting ambivalence about the pregnancy.
C. Ask him to report similar abnormal behaviors at the next prenatal visit.
D.Reassure him that normal maternal-fetal bonding is occurring.
Correct Answer
D) Reassure him that normal maternal-fetal bonding is occurring.
Rationale:
These behaviors are positive signs of maternal-fetal bonding and do not reflect
ambivalence. No intervention is needed. Quickening, the first perception of fetal
movement, occurs at 17 to 20 weeks of gestation and begins a new phase of
prenatal bonding during the second trimester. Options A and C are not necessary
because the behaviors displayed are normal.
Page 4 of 93
and Correct Answers
Question 1
A newborn infant, diagnosed with developmental dysplasia of the hip (DDH), is being
prepared for discharge. Which nursing intervention should be included in this infant's
discharge teaching plan?
A.Observe the parents applying a Pavlik harness.
B.Provide a referral for an orthopedic surgeon.
C.Schedule a physical therapy follow-up home visit.
D.Teach the parents to check for hip joint mobility.
Correct Answer
A.Observe the parents applying a Pavlik harness.
Rationale: It is important that the hips of infants with hip dysplasia are maintained in
an abducted position, which can be accomplished by using the Pavlik harness; this
keeps the hips and knees flexed, the hips abducted, and the femoral head in the
acetabulum. Early treatment often negates the need for surgery, and option B is not
indicated until approximately 6 months of age. Option C is not indicated for hip
dysplasia. It is best for the pediatrician to monitor hip joint mobility, and teaching
the parents to perform this technique is likely to increase their anxiety.
Question 2
Which action should the nurse implement when preparing to measure the fundal
height of a pregnant client?
A. have the client empty her bladder
B. request the client lie on her left side
C. Perform Leopold's maneuvers first
D. Give the client some cold juice to drink
Correct Answer
A. have the client empty her bladder
Page 1 of 93
,Question 3
A 4 week old premature infant has been receiving epoetin alfa (Epogen) for the last 3
weeks. Which assessment finding indicates to the nurse that the drug is effective?
A. slowly increasing urinary output over the last week
B. respiratory rate changes from the 40s to the 60s.
C. changes in apical heart rate from the 180s to the 140s
D. change in indirect bilirubin from 12 mg/dl to 8 mg/dl
Correct Answer
A. slowly increasing urinary output over the last week
Question 4
Which findings are of most concern to the nurse when caring for a woman in the first
trimester of pregnancy? (Select all that apply.)
A.Cramping with bright red spotting
B.Extreme tenderness of the breast
C.Lack of tenderness of the breast
D.Increased amounts of discharge
E.Increased right-side flank pain
Correct Answer
A.Cramping with bright red spotting
C.Lack of tenderness of the breast
E.Increased right-side flank pain
Rationale: Options A and C are signs of a possible miscarriage. Cramping with bright
red bleeding is a sign that the client's menstrual cycle is about to begin. A decrease
of tenderness in the breast is a sign that hormone levels have declined and that a
miscarriage is imminent. Option E could be a sign of an ectopic pregnancy, which
could be fatal if not discovered in time before rupture. Options B and D are normal
signs during the first trimester of a pregnancy.
Page 2 of 93
,Question 5
A full term infant is transferred to the nursery from labor and delivery. Which
information is most important for the nurse to receive when planning immediate care
for the newborn?
A. length of labor and method of delivery
B. infant's condition at birth and treatment received
C. feeding method chosen by the parents
D. history of drugs given to the mother during labor
Correct Answer
B. infant's condition at birth and treatment received
Question 6
A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when
she could use a home pregnancy test to diagnose pregnancy. Which response is
appropriate?
A. "A home pregnancy test can be used right after your first missed period."
B. "These tests are most accurate after you have missed your second period."
C. "Home pregnancy tests often give false positives and should not be trusted."
D. "The test can provide accurate information when used right after ovulation."
Correct Answer
A. "A home pregnancy test can be used right after your first missed period."
Question 7
A 30 year old gravida, 2 para 1 client is admitted to the hospital at 26 weeks gestation
in preterm labor. She is started on an IV solution of terbutaline (Brethine). Which
assessment is the highest priority for the nurse to monitor during the administration
of this drug?
A. maternal blood pressure and respirations
B. maternal and fetal heart rates
C. hourly urinary output
D. deep tendon reflexes
Correct Answer
B. maternal and fetal heart rates
Page 3 of 93
, Question 8
A 24-hour old newborn has a pink papular rash with vesicles superimposed on the
thorax, back and abdomen. What action should the nurse implement?
A. notify the healthcare provider
B. move the newborn to an isolation nursery
C. document the finding in the infant's record
D. obtain a culture of the vesicles
Correct Answer
C. document the finding in the infant's record. Erythema Toxicum (or erythema
neonatorium) is a newborn rash that is commonly referred to as "flea bites." but is a
normal finding that is documented in the infant's record and requires no further
action.
Question 9
An expectant father tells the nurse he fears that his wife is "losing her mind." He states
that she is constantly rubbing her abdomen and talking to the baby and that she
actually reprimands the baby when it moves too much. Which recommendation
should the nurse make to this expectant father?
A.Suggest that his wife seek professional counseling to deal with her symptoms.
B.Explain that his wife is exhibiting ambivalence about the pregnancy.
C. Ask him to report similar abnormal behaviors at the next prenatal visit.
D.Reassure him that normal maternal-fetal bonding is occurring.
Correct Answer
D) Reassure him that normal maternal-fetal bonding is occurring.
Rationale:
These behaviors are positive signs of maternal-fetal bonding and do not reflect
ambivalence. No intervention is needed. Quickening, the first perception of fetal
movement, occurs at 17 to 20 weeks of gestation and begins a new phase of
prenatal bonding during the second trimester. Options A and C are not necessary
because the behaviors displayed are normal.
Page 4 of 93
