HESI MATERNITY OB ADVANCED
PRACTICE EXAM QUESTIONS AND
CORRECT ANSWERS
1. A client at 32 weeks gestation is receiving Magnesium Sulfate for preeclampsia. Which
assessment finding should the nurse prioritize as a sign of toxicity?
A. Absence of patellar reflex
B. Urine output of 40 mL/hr
C. Presence of 2+ deep tendon reflexes
D. Blood pressure of 150/90 mmHg
Answer: A
Conceptual Explanation: The loss of deep tendon reflexes (patellar reflex) is one of the
earliest signs of Magnesium Sulfate toxicity. Other signs include respiratory depression and
cardiac arrest.
2. A nurse is caring for a client in the active phase of labor. The fetal heart rate monitor shows
late decelerations. What is the nurse’s immediate priority action?
A. Perform a vaginal examination to check for cord prolapse
B. Increase the rate of the oxytocin infusion
C. Reposition the client to the left side-lying position
,D. Administer oxygen via nasal cannula at 2 L/min
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation to the fetus by turning the mother to her side to relieve
pressure on the vena cava.
3. Which clinical finding differentiates abruptio placentae from placenta previa?
A. Painless, bright red vaginal bleeding
B. Hypotension and tachycardia
C. Rigid, board-like abdomen with severe pain
D. Decreased fetal movement
Answer: C
Conceptual Explanation: Abruptio placentae is characterized by painful vaginal bleeding
and a rigid, board-like abdomen. Placenta previa typically presents with painless bleeding.
4. A postpartum nurse is assessing a client 2 hours after delivery and finds the fundus is boggy
and displaced to the right. What should the nurse do first?
A. Massage the fundus until firm
B. Administer Methylergonovine (Methergine)
C. Assist the client to the bathroom to void
D. Call the healthcare provider immediately
, Answer: C
Conceptual Explanation: A fundus displaced to the right usually indicates a full bladder,
which prevents the uterus from contracting. Emptying the bladder is the priority to resolve
the displacement and bogginess.
5. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on May 10?
A. February 10
B. March 17
C. August 17
D. February 17
Answer: D
Conceptual Explanation: Naegele’s rule: Subtract 3 months from the first day of LMP and
add 7 days (May 10 - 3 months = Feb 10 + 7 days = Feb 17).
6. Which client should receive Rho(D) immune globulin (RhoGAM)?
A. An Rh-negative mother with an Rh-positive newborn
B. An Rh-negative mother with an Rh-negative newborn
C. An Rh-positive mother with an Rh-positive newborn
D. An Rh-positive mother with an Rh-negative newborn
Answer: A
PRACTICE EXAM QUESTIONS AND
CORRECT ANSWERS
1. A client at 32 weeks gestation is receiving Magnesium Sulfate for preeclampsia. Which
assessment finding should the nurse prioritize as a sign of toxicity?
A. Absence of patellar reflex
B. Urine output of 40 mL/hr
C. Presence of 2+ deep tendon reflexes
D. Blood pressure of 150/90 mmHg
Answer: A
Conceptual Explanation: The loss of deep tendon reflexes (patellar reflex) is one of the
earliest signs of Magnesium Sulfate toxicity. Other signs include respiratory depression and
cardiac arrest.
2. A nurse is caring for a client in the active phase of labor. The fetal heart rate monitor shows
late decelerations. What is the nurse’s immediate priority action?
A. Perform a vaginal examination to check for cord prolapse
B. Increase the rate of the oxytocin infusion
C. Reposition the client to the left side-lying position
,D. Administer oxygen via nasal cannula at 2 L/min
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
priority is to improve oxygenation to the fetus by turning the mother to her side to relieve
pressure on the vena cava.
3. Which clinical finding differentiates abruptio placentae from placenta previa?
A. Painless, bright red vaginal bleeding
B. Hypotension and tachycardia
C. Rigid, board-like abdomen with severe pain
D. Decreased fetal movement
Answer: C
Conceptual Explanation: Abruptio placentae is characterized by painful vaginal bleeding
and a rigid, board-like abdomen. Placenta previa typically presents with painless bleeding.
4. A postpartum nurse is assessing a client 2 hours after delivery and finds the fundus is boggy
and displaced to the right. What should the nurse do first?
A. Massage the fundus until firm
B. Administer Methylergonovine (Methergine)
C. Assist the client to the bathroom to void
D. Call the healthcare provider immediately
, Answer: C
Conceptual Explanation: A fundus displaced to the right usually indicates a full bladder,
which prevents the uterus from contracting. Emptying the bladder is the priority to resolve
the displacement and bogginess.
5. Using Naegele’s rule, what is the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on May 10?
A. February 10
B. March 17
C. August 17
D. February 17
Answer: D
Conceptual Explanation: Naegele’s rule: Subtract 3 months from the first day of LMP and
add 7 days (May 10 - 3 months = Feb 10 + 7 days = Feb 17).
6. Which client should receive Rho(D) immune globulin (RhoGAM)?
A. An Rh-negative mother with an Rh-positive newborn
B. An Rh-negative mother with an Rh-negative newborn
C. An Rh-positive mother with an Rh-positive newborn
D. An Rh-positive mother with an Rh-negative newborn
Answer: A
