HESI MATERNITY OB
COMPREHENSIVE EXAM 2026/2027
QUESTIONS AND CORRECT ANSWERS
1. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
assessment finding should the nurse report immediately to the healthcare provider?
A. Feeling of warmth and flushing
B. Urine output of 40 mL per hour
C. Respiratory rate of 14 breaths per minute
D. Absence of deep tendon reflexes
Answer: D
Conceptual Explanation: Loss of deep tendon reflexes is an early sign of magnesium
toxicity. A urine output of 40 mL/hr is adequate (>30 mL/hr), and a respiratory rate of 14
is within normal limits. Flushing is a common side effect, not a toxic effect.
2. Which fetal heart rate pattern should the nurse prioritize for immediate intervention
during labor?
A. Early decelerations during a contraction
B. Late decelerations with every contraction
C. Accelerations of 15 bpm above baseline
,D. Moderate variability between 6-25 bpm
Answer: B
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency and are
a non-reassuring sign that requires immediate action, such as repositioning the mother or
administering oxygen. Early decelerations are usually due to head compression and are
benign.
3. A postpartum client who delivered 2 hours ago has a fundus that is boggy and displaced to
the right. What is the nurse’s first action?
A. Administer oxytocin as ordered
B. Massage the fundus until firm
C. Assist the client to the bathroom to void
D. Notify the healthcare provider
Answer: C
Conceptual Explanation: A fundus displaced to the right is a classic sign of a full bladder,
which prevents the uterus from contracting. Emptying the bladder is the priority to allow
the fundus to return to the midline and firm up.
4. A nurse is caring for a client in the first stage of labor. The electronic fetal monitor shows
variable decelerations. What is the most likely cause of this finding?
A. Umbilical cord compression
, B. Head compression
C. Uteroplacental insufficiency
D. Fetal hypoxia
Answer: A
Conceptual Explanation: Variable decelerations are caused by cord compression. Early
decelerations are caused by head compression, and late decelerations are caused by
uteroplacental insufficiency.
5. A client at 32 weeks gestation presents with painless, bright red vaginal bleeding. Which
procedure is contraindicated for this client?
A. External fetal monitoring
B. Vaginal examination
C. Abdominal ultrasound
D. Monitoring maternal vital signs
Answer: B
Conceptual Explanation: Painless bright red bleeding is indicative of placenta previa. A
vaginal exam is contraindicated because it can cause placental abruption and life-
threatening hemorrhage.
COMPREHENSIVE EXAM 2026/2027
QUESTIONS AND CORRECT ANSWERS
1. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
assessment finding should the nurse report immediately to the healthcare provider?
A. Feeling of warmth and flushing
B. Urine output of 40 mL per hour
C. Respiratory rate of 14 breaths per minute
D. Absence of deep tendon reflexes
Answer: D
Conceptual Explanation: Loss of deep tendon reflexes is an early sign of magnesium
toxicity. A urine output of 40 mL/hr is adequate (>30 mL/hr), and a respiratory rate of 14
is within normal limits. Flushing is a common side effect, not a toxic effect.
2. Which fetal heart rate pattern should the nurse prioritize for immediate intervention
during labor?
A. Early decelerations during a contraction
B. Late decelerations with every contraction
C. Accelerations of 15 bpm above baseline
,D. Moderate variability between 6-25 bpm
Answer: B
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency and are
a non-reassuring sign that requires immediate action, such as repositioning the mother or
administering oxygen. Early decelerations are usually due to head compression and are
benign.
3. A postpartum client who delivered 2 hours ago has a fundus that is boggy and displaced to
the right. What is the nurse’s first action?
A. Administer oxytocin as ordered
B. Massage the fundus until firm
C. Assist the client to the bathroom to void
D. Notify the healthcare provider
Answer: C
Conceptual Explanation: A fundus displaced to the right is a classic sign of a full bladder,
which prevents the uterus from contracting. Emptying the bladder is the priority to allow
the fundus to return to the midline and firm up.
4. A nurse is caring for a client in the first stage of labor. The electronic fetal monitor shows
variable decelerations. What is the most likely cause of this finding?
A. Umbilical cord compression
, B. Head compression
C. Uteroplacental insufficiency
D. Fetal hypoxia
Answer: A
Conceptual Explanation: Variable decelerations are caused by cord compression. Early
decelerations are caused by head compression, and late decelerations are caused by
uteroplacental insufficiency.
5. A client at 32 weeks gestation presents with painless, bright red vaginal bleeding. Which
procedure is contraindicated for this client?
A. External fetal monitoring
B. Vaginal examination
C. Abdominal ultrasound
D. Monitoring maternal vital signs
Answer: B
Conceptual Explanation: Painless bright red bleeding is indicative of placenta previa. A
vaginal exam is contraindicated because it can cause placental abruption and life-
threatening hemorrhage.
