HESI MATERNITY OB 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 report to the healthcare provider immediately?
A. Deep tendon reflexes of 2+
B. Fetal heart rate of 140 beats per minute
C. Urine output of 40 mL per hour
D. Respiratory rate of 10 breaths per minute
Answer: D
Conceptual Explanation: Magnesium sulfate is a CNS depressant. A respiratory rate below
12 breaths per minute is a sign of magnesium toxicity and requires immediate intervention,
including stopping the infusion and potentially administering calcium gluconate.
2. A nurse is caring for a client in the active phase of labor. The fetal heart rate monitor shows
late decelerations. Which action should the nurse take first?
A. Increase the rate of the oxytocin infusion
B. Assist the client into a supine position
C. Administer oxygen via non-rebreather face mask
,D. Perform a vaginal exam to check for cord prolapse
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. Priority
actions include repositioning the client to the side, discontinuing oxytocin, and
administering oxygen to improve fetal oxygenation.
3. Which clinical finding is pathognomonic for a suspected Placental Abruption?
A. Board-like, rigid abdomen with severe pain
B. Soft, non-tender uterus
C. Painless, bright red vaginal bleeding
D. Increased fetal movement
Answer: A
Conceptual Explanation: Placental abruption (abruptio placentae) is characterized by
painful vaginal bleeding (or concealed bleeding), uterine tenderness, and a board-like, rigid
abdomen due to internal hemorrhage.
4. A postpartum client who is Rh-negative gives birth to an Rh-positive infant. When should
the nurse administer Rho(D) immune globulin (RhoGAM)?
A. At the 6-week postpartum checkup
B. Within 24 hours after birth only
C. Within 72 hours after birth
, D. Only if the Kleihauer-Betke test is negative
Answer: C
Conceptual Explanation: Rho(D) immune globulin must be administered within 72 hours
of delivery to prevent sensitization in an Rh-negative mother who has delivered an Rh-
positive infant.
5. A newborn is being evaluated for jaundice. Which finding indicates that the jaundice is
pathological rather than physiological?
A. Jaundice appearing at 48 hours of age
B. Serum bilirubin level of 8 mg/dL at 72 hours
C. Jaundice appearing within the first 24 hours of life
D. Jaundice limited to the face and sclera
Answer: C
Conceptual Explanation: Pathological jaundice occurs within the first 24 hours of life and
is often related to ABO incompatibility or Rh isoimmunization. Physiological jaundice
typically appears after 24 hours.
6. The nurse is teaching a client about the use of Methylergonovine (Methergine) for
postpartum hemorrhage. Which condition in the client’s history is a contraindication?
A. Asthma
B. Diabetes Mellitus
QUESTIONS AND CORRECT ANSWERS
1. A client at 32 weeks gestation is receiving Magnesium Sulfate for preeclampsia. Which
assessment finding should the nurse report to the healthcare provider immediately?
A. Deep tendon reflexes of 2+
B. Fetal heart rate of 140 beats per minute
C. Urine output of 40 mL per hour
D. Respiratory rate of 10 breaths per minute
Answer: D
Conceptual Explanation: Magnesium sulfate is a CNS depressant. A respiratory rate below
12 breaths per minute is a sign of magnesium toxicity and requires immediate intervention,
including stopping the infusion and potentially administering calcium gluconate.
2. A nurse is caring for a client in the active phase of labor. The fetal heart rate monitor shows
late decelerations. Which action should the nurse take first?
A. Increase the rate of the oxytocin infusion
B. Assist the client into a supine position
C. Administer oxygen via non-rebreather face mask
,D. Perform a vaginal exam to check for cord prolapse
Answer: C
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. Priority
actions include repositioning the client to the side, discontinuing oxytocin, and
administering oxygen to improve fetal oxygenation.
3. Which clinical finding is pathognomonic for a suspected Placental Abruption?
A. Board-like, rigid abdomen with severe pain
B. Soft, non-tender uterus
C. Painless, bright red vaginal bleeding
D. Increased fetal movement
Answer: A
Conceptual Explanation: Placental abruption (abruptio placentae) is characterized by
painful vaginal bleeding (or concealed bleeding), uterine tenderness, and a board-like, rigid
abdomen due to internal hemorrhage.
4. A postpartum client who is Rh-negative gives birth to an Rh-positive infant. When should
the nurse administer Rho(D) immune globulin (RhoGAM)?
A. At the 6-week postpartum checkup
B. Within 24 hours after birth only
C. Within 72 hours after birth
, D. Only if the Kleihauer-Betke test is negative
Answer: C
Conceptual Explanation: Rho(D) immune globulin must be administered within 72 hours
of delivery to prevent sensitization in an Rh-negative mother who has delivered an Rh-
positive infant.
5. A newborn is being evaluated for jaundice. Which finding indicates that the jaundice is
pathological rather than physiological?
A. Jaundice appearing at 48 hours of age
B. Serum bilirubin level of 8 mg/dL at 72 hours
C. Jaundice appearing within the first 24 hours of life
D. Jaundice limited to the face and sclera
Answer: C
Conceptual Explanation: Pathological jaundice occurs within the first 24 hours of life and
is often related to ABO incompatibility or Rh isoimmunization. Physiological jaundice
typically appears after 24 hours.
6. The nurse is teaching a client about the use of Methylergonovine (Methergine) for
postpartum hemorrhage. Which condition in the client’s history is a contraindication?
A. Asthma
B. Diabetes Mellitus
