HESI MATERNITY OB PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS
1. A nurse is monitoring a client receiving Magnesium Sulfate for preeclampsia. Which finding
should the nurse report to the provider immediately?
A. Deep tendon reflexes of 2+
B. Blood pressure of 150/95 mmHg
C. Respiratory rate of 14/min
D. Urine output of 20 mL/hr
Answer: D
Conceptual Explanation: Magnesium sulfate is excreted by the kidneys. A urine output of
less than 30 mL/hr can lead to magnesium toxicity. Decreased reflexes and respiratory
depression are also signs of toxicity, but 2+ reflexes and 14/min respiration are within
normal/acceptable limits.
2. A client at 32 weeks gestation presents with painless, bright red vaginal bleeding. Which of
the following is the priority nursing action?
A. Perform a sterile vaginal exam to check dilation
B. Administer oxytocin to control bleeding
C. Assess fetal heart rate and maternal vital signs
,D. Prepare the client for immediate vaginal delivery
Answer: C
Conceptual Explanation: Painless bright red bleeding is indicative of placenta previa.
Vaginal exams are contraindicated as they can cause hemorrhage. The priority is to assess
the status of the mother and fetus.
3. Following a precipitous delivery, the nurse notes the client’s fundus is boggy and displaced
to the right. What is the nurse’s first action?
A. Assist the client to the bathroom to void
B. Administer methylergonovine IM
C. Massage the fundus until firm
D. Notify the healthcare provider
Answer: A
Conceptual Explanation: A fundus displaced to the right usually indicates a full bladder. A
full bladder prevents the uterus from contracting effectively, leading to atony. Emptying the
bladder is the first step to allow the fundus to return to the midline and contract.
4. A nurse is caring for a client in the transition phase of labor. The client screams, ‘I can’t do
this anymore!’ and is extremely irritable. Which action is most appropriate?
A. Offer the client a sedative to help her relax
B. Provide firm, short instructions and support
, C. Encourage the client to use slow, deep chest breathing
D. Tell the client that the baby will be here in a few hours
Answer: B
Conceptual Explanation: During the transition phase (8-10 cm), clients often experience
loss of control, irritability, and nausea. Firm, direct communication and coaching are
necessary to help the client stay focused.
5. Which of the following findings in a newborn should the nurse report to the provider?
A. Acrocyanosis in the hands and feet
B. Chest retractions and nasal flaring
C. Small white papules on the bridge of the nose
D. A heart rate of 140 beats per minute
Answer: B
Conceptual Explanation: Chest retractions and nasal flaring are signs of respiratory
distress in a newborn and require immediate intervention. Acrocyanosis and milia (white
papules) are normal findings.
6. A client’s last menstrual period (LMP) began on November 10. Using Naegele’s rule, what is
the estimated date of birth (EDB)?
A. August 17
B. August 3
QUESTIONS AND CORRECT ANSWERS
1. A nurse is monitoring a client receiving Magnesium Sulfate for preeclampsia. Which finding
should the nurse report to the provider immediately?
A. Deep tendon reflexes of 2+
B. Blood pressure of 150/95 mmHg
C. Respiratory rate of 14/min
D. Urine output of 20 mL/hr
Answer: D
Conceptual Explanation: Magnesium sulfate is excreted by the kidneys. A urine output of
less than 30 mL/hr can lead to magnesium toxicity. Decreased reflexes and respiratory
depression are also signs of toxicity, but 2+ reflexes and 14/min respiration are within
normal/acceptable limits.
2. A client at 32 weeks gestation presents with painless, bright red vaginal bleeding. Which of
the following is the priority nursing action?
A. Perform a sterile vaginal exam to check dilation
B. Administer oxytocin to control bleeding
C. Assess fetal heart rate and maternal vital signs
,D. Prepare the client for immediate vaginal delivery
Answer: C
Conceptual Explanation: Painless bright red bleeding is indicative of placenta previa.
Vaginal exams are contraindicated as they can cause hemorrhage. The priority is to assess
the status of the mother and fetus.
3. Following a precipitous delivery, the nurse notes the client’s fundus is boggy and displaced
to the right. What is the nurse’s first action?
A. Assist the client to the bathroom to void
B. Administer methylergonovine IM
C. Massage the fundus until firm
D. Notify the healthcare provider
Answer: A
Conceptual Explanation: A fundus displaced to the right usually indicates a full bladder. A
full bladder prevents the uterus from contracting effectively, leading to atony. Emptying the
bladder is the first step to allow the fundus to return to the midline and contract.
4. A nurse is caring for a client in the transition phase of labor. The client screams, ‘I can’t do
this anymore!’ and is extremely irritable. Which action is most appropriate?
A. Offer the client a sedative to help her relax
B. Provide firm, short instructions and support
, C. Encourage the client to use slow, deep chest breathing
D. Tell the client that the baby will be here in a few hours
Answer: B
Conceptual Explanation: During the transition phase (8-10 cm), clients often experience
loss of control, irritability, and nausea. Firm, direct communication and coaching are
necessary to help the client stay focused.
5. Which of the following findings in a newborn should the nurse report to the provider?
A. Acrocyanosis in the hands and feet
B. Chest retractions and nasal flaring
C. Small white papules on the bridge of the nose
D. A heart rate of 140 beats per minute
Answer: B
Conceptual Explanation: Chest retractions and nasal flaring are signs of respiratory
distress in a newborn and require immediate intervention. Acrocyanosis and milia (white
papules) are normal findings.
6. A client’s last menstrual period (LMP) began on November 10. Using Naegele’s rule, what is
the estimated date of birth (EDB)?
A. August 17
B. August 3
