HESI MATERNITY OB FINAL 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 to the healthcare provider immediately?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 10 breaths per minute
C. Urinary output of 40 mL/hour
D. Fetal heart rate of 140 beats per minute
Answer: B
Conceptual Explanation: A respiratory rate below 12 is a sign of magnesium toxicity.
Therapeutic magnesium levels cause decreased reflexes, but a rate of 10 indicates CNS
depression requiring immediate intervention with calcium gluconate.
2. During a non-stress test (NST), the nurse observes a fetal heart rate (FHR) of 140 bpm with
two accelerations of 15 bpm lasting 15 seconds within a 20-minute period. How should the
nurse document this result?
A. Non-reactive NST
B. Reactive NST
,C. Equivocal NST
D. Positive NST
Answer: B
Conceptual Explanation: A reactive NST is defined by at least two accelerations of 15 bpm
above the baseline lasting 15 seconds over a 20-minute window, indicating fetal well-being.
3. A nurse is caring for a client in the transition phase of the first stage of labor. Which clinical
manifestation should the nurse expect to observe?
A. The client experiences nausea, vomiting, and irritability.
B. The client is talkative and eager to follow instructions.
C. The client feels a strong urge to push and bears down.
D. The cervix is dilated 4 to 5 cm.
Answer: A
Conceptual Explanation: The transition phase (8-10 cm dilation) is characterized by
intense contractions, irritability, and often physical symptoms like nausea or shivering.
4. A client at 32 weeks gestation presents with painless, bright red vaginal bleeding. Which
nursing action is contraindicated?
A. Assessing fetal heart tones via ultrasound
B. Initiating intravenous access
C. Monitoring maternal blood pressure
, D. Performing a sterile vaginal examination
Answer: D
Conceptual Explanation: Painless bright red bleeding is indicative of placenta previa. A
vaginal exam can cause placental abruption or severe hemorrhage and is strictly
contraindicated until the placental location is confirmed.
5. The nurse is reviewing the laboratory results of a client with suspected HELLP syndrome.
Which finding is consistent with this diagnosis?
A. Elevated hemoglobin and hematocrit
B. Decreased liver enzymes
C. Decreased serum creatinine
D. Platelet count of 75,000/mm3
Answer: D
Conceptual Explanation: HELLP syndrome stands for Hemolysis, Elevated Liver enzymes,
and Low Platelets. A platelet count below 100,000/mm3 is a diagnostic criterion.
6. A postpartum nurse is assessing a client 2 hours after delivery and finds the fundus is boggy
and displaced to the right of the midline. What is the nurse’s first action?
A. Massage the fundus until firm
B. Administer oxytocin as ordered
C. Assist the client to the bathroom to void
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 to the healthcare provider immediately?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 10 breaths per minute
C. Urinary output of 40 mL/hour
D. Fetal heart rate of 140 beats per minute
Answer: B
Conceptual Explanation: A respiratory rate below 12 is a sign of magnesium toxicity.
Therapeutic magnesium levels cause decreased reflexes, but a rate of 10 indicates CNS
depression requiring immediate intervention with calcium gluconate.
2. During a non-stress test (NST), the nurse observes a fetal heart rate (FHR) of 140 bpm with
two accelerations of 15 bpm lasting 15 seconds within a 20-minute period. How should the
nurse document this result?
A. Non-reactive NST
B. Reactive NST
,C. Equivocal NST
D. Positive NST
Answer: B
Conceptual Explanation: A reactive NST is defined by at least two accelerations of 15 bpm
above the baseline lasting 15 seconds over a 20-minute window, indicating fetal well-being.
3. A nurse is caring for a client in the transition phase of the first stage of labor. Which clinical
manifestation should the nurse expect to observe?
A. The client experiences nausea, vomiting, and irritability.
B. The client is talkative and eager to follow instructions.
C. The client feels a strong urge to push and bears down.
D. The cervix is dilated 4 to 5 cm.
Answer: A
Conceptual Explanation: The transition phase (8-10 cm dilation) is characterized by
intense contractions, irritability, and often physical symptoms like nausea or shivering.
4. A client at 32 weeks gestation presents with painless, bright red vaginal bleeding. Which
nursing action is contraindicated?
A. Assessing fetal heart tones via ultrasound
B. Initiating intravenous access
C. Monitoring maternal blood pressure
, D. Performing a sterile vaginal examination
Answer: D
Conceptual Explanation: Painless bright red bleeding is indicative of placenta previa. A
vaginal exam can cause placental abruption or severe hemorrhage and is strictly
contraindicated until the placental location is confirmed.
5. The nurse is reviewing the laboratory results of a client with suspected HELLP syndrome.
Which finding is consistent with this diagnosis?
A. Elevated hemoglobin and hematocrit
B. Decreased liver enzymes
C. Decreased serum creatinine
D. Platelet count of 75,000/mm3
Answer: D
Conceptual Explanation: HELLP syndrome stands for Hemolysis, Elevated Liver enzymes,
and Low Platelets. A platelet count below 100,000/mm3 is a diagnostic criterion.
6. A postpartum nurse is assessing a client 2 hours after delivery and finds the fundus is boggy
and displaced to the right of the midline. What is the nurse’s first action?
A. Massage the fundus until firm
B. Administer oxytocin as ordered
C. Assist the client to the bathroom to void
