HESI OB/Maternity – Preeclampsia, Eclampsia, and High-Risk
Pregnancy Review Exam with 300 detailed Questions and
Answers with Rationales 2026/2027 Update
Preeclampsia Fundamentals
1. A pregnant client at 32 weeks has a blood pressure of 148/94 mm Hg
on two occasions 4 hours apart. Which condition should the nurse
suspect?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia
D. Eclampsia
Answer: C. Preeclampsia
Rationale: New-onset hypertension after 20 weeks accompanied by
proteinuria or other maternal organ dysfunction is consistent with
preeclampsia.
2. Which blood pressure finding meets the diagnostic threshold for
hypertension in pregnancy?
A. 128/78
B. 134/82
C. 140/90
D. 138/86
Answer: C. 140/90
Rationale: Hypertension in pregnancy is generally defined as
systolic pressure ≥140 mm Hg or diastolic pressure ≥90 mm Hg
on appropriate repeated measurements.
,3. Preeclampsia most commonly develops after which
gestational age?
A. 8 weeks
B. 12 weeks
C. 20 weeks
D. 24 weeks
Answer: C. 20 weeks
Rationale: Preeclampsia is characterized by new-onset
hypertension after 20 weeks of pregnancy.
4. Which finding is most concerning in a client with
preeclampsia?
A. Mild ankle edema
B. Urinary frequency
C. Severe persistent headache
D. Increased appetite
Answer: C. Severe persistent headache
Rationale: A severe headache that does not respond to usual
measures may indicate cerebral involvement and progression
toward severe disease or eclampsia.
5. Which assessment finding suggests worsening preeclampsia?
A. Brisk deep-tendon reflexes
B. Increased appetite
C. Mild urinary frequency
D. Decreased fetal movement only after exercise
,Answer: A. Brisk deep-tendon reflexes
Rationale: Hyperreflexia can reflect increased neuromuscular
irritability and increased seizure risk.
6. A client with preeclampsia reports seeing flashing lights.
What is the nurse's priority response?
A. Reassure the client this is normal
B. Document the finding at the end of the shift
C. Notify the healthcare provider promptly
D. Encourage ambulation
Answer: C. Notify the healthcare provider promptly
Rationale: Visual disturbances can indicate cerebral
involvement and severe preeclampsia.
7. Which laboratory result is particularly concerning in severe
preeclampsia?
A. Platelets 250,000/mm³
B. Platelets 80,000/mm³
C. Hemoglobin 12.5 g/dL
D. WBC 8,000/mm³
Answer: B. Platelets 80,000/mm³
Rationale: Thrombocytopenia indicates significant disease and
can occur with HELLP syndrome.
8. What is the primary pathophysiologic problem associated
with preeclampsia?
A. Excess maternal insulin
B. Abnormal placental vascular development and endothelial
, dysfunction
C. Maternal dehydration alone
D. Excess fetal erythropoietin
Answer: B. Abnormal placental vascular development and
endothelial dysfunction
Rationale: Abnormal placentation contributes to systemic
maternal endothelial dysfunction, vasoconstriction, and organ
injury.
9. Which symptom should a client with preeclampsia report
immediately?
A. Mild fatigue
B. Occasional nausea during the first trimester
C. Right upper quadrant or epigastric pain
D. Mild breast tenderness
Answer: C. Right upper quadrant or epigastric pain
Rationale: Upper abdominal pain can indicate hepatic
involvement and may occur with severe preeclampsia or HELLP
syndrome.
10. Which fetal complication is associated with placental
insufficiency from preeclampsia?
A. Macrosomia
B. Fetal growth restriction
C. Post-term pregnancy only
D. Polyhydramnios in every case
Pregnancy Review Exam with 300 detailed Questions and
Answers with Rationales 2026/2027 Update
Preeclampsia Fundamentals
1. A pregnant client at 32 weeks has a blood pressure of 148/94 mm Hg
on two occasions 4 hours apart. Which condition should the nurse
suspect?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia
D. Eclampsia
Answer: C. Preeclampsia
Rationale: New-onset hypertension after 20 weeks accompanied by
proteinuria or other maternal organ dysfunction is consistent with
preeclampsia.
2. Which blood pressure finding meets the diagnostic threshold for
hypertension in pregnancy?
A. 128/78
B. 134/82
C. 140/90
D. 138/86
Answer: C. 140/90
Rationale: Hypertension in pregnancy is generally defined as
systolic pressure ≥140 mm Hg or diastolic pressure ≥90 mm Hg
on appropriate repeated measurements.
,3. Preeclampsia most commonly develops after which
gestational age?
A. 8 weeks
B. 12 weeks
C. 20 weeks
D. 24 weeks
Answer: C. 20 weeks
Rationale: Preeclampsia is characterized by new-onset
hypertension after 20 weeks of pregnancy.
4. Which finding is most concerning in a client with
preeclampsia?
A. Mild ankle edema
B. Urinary frequency
C. Severe persistent headache
D. Increased appetite
Answer: C. Severe persistent headache
Rationale: A severe headache that does not respond to usual
measures may indicate cerebral involvement and progression
toward severe disease or eclampsia.
5. Which assessment finding suggests worsening preeclampsia?
A. Brisk deep-tendon reflexes
B. Increased appetite
C. Mild urinary frequency
D. Decreased fetal movement only after exercise
,Answer: A. Brisk deep-tendon reflexes
Rationale: Hyperreflexia can reflect increased neuromuscular
irritability and increased seizure risk.
6. A client with preeclampsia reports seeing flashing lights.
What is the nurse's priority response?
A. Reassure the client this is normal
B. Document the finding at the end of the shift
C. Notify the healthcare provider promptly
D. Encourage ambulation
Answer: C. Notify the healthcare provider promptly
Rationale: Visual disturbances can indicate cerebral
involvement and severe preeclampsia.
7. Which laboratory result is particularly concerning in severe
preeclampsia?
A. Platelets 250,000/mm³
B. Platelets 80,000/mm³
C. Hemoglobin 12.5 g/dL
D. WBC 8,000/mm³
Answer: B. Platelets 80,000/mm³
Rationale: Thrombocytopenia indicates significant disease and
can occur with HELLP syndrome.
8. What is the primary pathophysiologic problem associated
with preeclampsia?
A. Excess maternal insulin
B. Abnormal placental vascular development and endothelial
, dysfunction
C. Maternal dehydration alone
D. Excess fetal erythropoietin
Answer: B. Abnormal placental vascular development and
endothelial dysfunction
Rationale: Abnormal placentation contributes to systemic
maternal endothelial dysfunction, vasoconstriction, and organ
injury.
9. Which symptom should a client with preeclampsia report
immediately?
A. Mild fatigue
B. Occasional nausea during the first trimester
C. Right upper quadrant or epigastric pain
D. Mild breast tenderness
Answer: C. Right upper quadrant or epigastric pain
Rationale: Upper abdominal pain can indicate hepatic
involvement and may occur with severe preeclampsia or HELLP
syndrome.
10. Which fetal complication is associated with placental
insufficiency from preeclampsia?
A. Macrosomia
B. Fetal growth restriction
C. Post-term pregnancy only
D. Polyhydramnios in every case
