HESI PN OB & PEDS
Enhanced Master Study Guide
2025 Practice-Exam Focus • Obstetrics / Maternal-Newborn • Pediatrics
Purpose: A comprehensive, original exam-preparation guide built from the public preview/topic structure of the referenced
Stuvia listing and current HESI/Elsevier review structure. It is not an official HESI exam, and the Stuvia seller’s “verified” or
“actual” claims are not treated as official exam evidence.
Source snapshot: The referenced listing is a 10-page 2024/2025 document. Its public preview describes 50 questions
split evenly between 25 obstetric/maternal-newborn and 25 pediatric questions, using MCQ and SATA formats.
EXAM MINDSET
Think like a safe entry-level nurse: recognize instability first, identify the highest-risk finding, choose the least invasive
appropriate assessment before treatment when the client is stable, and protect the patient/fetus/newborn when
deterioration is possible.
ROADMAP
• Part I — HESI-style clinical judgment and prioritization
• Part II — Antepartum and high-risk pregnancy
• Part III — Labor, fetal monitoring, and intrapartum complications
• Part IV — Postpartum and newborn care
• Part V — Pediatric growth, development, safety, and common disorders
• Part VI — 30 original practice questions with rationales
• Part VII — Rapid-review tables, memory tricks, and final checklist
HESI PN OB & Peds — Enhanced Study Guide Page 1
, PART I — CLINICAL JUDGMENT
Priority hierarchy. In many HESI-style questions, unstable airway/breathing/circulation findings outrank routine teaching.
In maternity and pediatrics, add fetal/newborn oxygenation, severe bleeding, seizures, altered consciousness, and signs of
shock to the immediate-priority list.
Question cue What to do first
“Priority” / “first” Find the immediate threat; assess or intervene accordingly.
“Requires immediate intervention”
Choose the dangerous abnormality, not the expected finding.
Stable client + uncertain diagnosis
Assess before administering a treatment that assumes the diagnosis.
SATA Judge each option independently; do not choose based on a pattern.
Teaching question Pick the statement that best prevents harm or demonstrates correct technique.
A powerful elimination rule: expected ≠ priority. A normal postpartum change, normal pediatric behavior, or a mild side
effect is usually less urgent than a new sign of hypoxia, hemorrhage, infection, neurologic change, or perfusion failure.
PART II — OBSTETRICS / MATERNAL-NEWBORN
1. Antepartum essentials
Fetal movement: A meaningful decrease from the fetus’s usual activity pattern deserves assessment. Kick-count
instructions can help quantify movement in a stable outpatient client; persistent or marked reduction may require fetal
surveillance.
Preterm labor: Regular contractions with cervical change before term are concerning. Do not assume that hydration alone
rules out labor. Assessment of contractions, fetal status, cervical change, membranes, and gestational age guides
management.
Gestational diabetes: Key nursing priorities include glucose monitoring, nutrition education, activity as prescribed,
medication adherence when needed, and surveillance for maternal/fetal complications. Avoid advice that promotes
uncontrolled hyperglycemia.
Preeclampsia: Watch blood pressure, headache, visual symptoms, epigastric/RUQ pain, hyperreflexia/clonus, pulmonary
symptoms, urine output, and laboratory evidence of organ involvement. Magnesium sulfate is used for seizure prophylaxis
in appropriate patients; monitor for toxicity.
Magnesium safety memory: “REFLEX–RESPIRATION–RENAL.” Check deep-tendon reflexes, respiratory status, and
urine output; toxicity can cause loss of reflexes and respiratory depression.
2. Labor and fetal surveillance
Oxytocin: Its purpose is to improve labor progress, but excessive uterine stimulation can compromise fetal oxygenation. A
concerning fetal heart-rate pattern or excessive uterine activity should prompt rapid intrauterine resuscitation and
evaluation according to protocol.
Prolonged deceleration: Treat as potentially serious. Reposition laterally, stop/reduce uterotonic stimulation when
indicated, assess maternal status and uterine activity, and escalate promptly. Oxygen is not a reflexive substitute for
correcting maternal positioning or other reversible causes.
FHR interpretation: Baseline, variability, accelerations, and decelerations are interpreted together. Variable decelerations
commonly suggest cord compression; late decelerations suggest uteroplacental insufficiency; prolonged deceleration
requires urgent evaluation.
HESI PN OB & Peds — Enhanced Study Guide Page 2
Enhanced Master Study Guide
2025 Practice-Exam Focus • Obstetrics / Maternal-Newborn • Pediatrics
Purpose: A comprehensive, original exam-preparation guide built from the public preview/topic structure of the referenced
Stuvia listing and current HESI/Elsevier review structure. It is not an official HESI exam, and the Stuvia seller’s “verified” or
“actual” claims are not treated as official exam evidence.
Source snapshot: The referenced listing is a 10-page 2024/2025 document. Its public preview describes 50 questions
split evenly between 25 obstetric/maternal-newborn and 25 pediatric questions, using MCQ and SATA formats.
EXAM MINDSET
Think like a safe entry-level nurse: recognize instability first, identify the highest-risk finding, choose the least invasive
appropriate assessment before treatment when the client is stable, and protect the patient/fetus/newborn when
deterioration is possible.
ROADMAP
• Part I — HESI-style clinical judgment and prioritization
• Part II — Antepartum and high-risk pregnancy
• Part III — Labor, fetal monitoring, and intrapartum complications
• Part IV — Postpartum and newborn care
• Part V — Pediatric growth, development, safety, and common disorders
• Part VI — 30 original practice questions with rationales
• Part VII — Rapid-review tables, memory tricks, and final checklist
HESI PN OB & Peds — Enhanced Study Guide Page 1
, PART I — CLINICAL JUDGMENT
Priority hierarchy. In many HESI-style questions, unstable airway/breathing/circulation findings outrank routine teaching.
In maternity and pediatrics, add fetal/newborn oxygenation, severe bleeding, seizures, altered consciousness, and signs of
shock to the immediate-priority list.
Question cue What to do first
“Priority” / “first” Find the immediate threat; assess or intervene accordingly.
“Requires immediate intervention”
Choose the dangerous abnormality, not the expected finding.
Stable client + uncertain diagnosis
Assess before administering a treatment that assumes the diagnosis.
SATA Judge each option independently; do not choose based on a pattern.
Teaching question Pick the statement that best prevents harm or demonstrates correct technique.
A powerful elimination rule: expected ≠ priority. A normal postpartum change, normal pediatric behavior, or a mild side
effect is usually less urgent than a new sign of hypoxia, hemorrhage, infection, neurologic change, or perfusion failure.
PART II — OBSTETRICS / MATERNAL-NEWBORN
1. Antepartum essentials
Fetal movement: A meaningful decrease from the fetus’s usual activity pattern deserves assessment. Kick-count
instructions can help quantify movement in a stable outpatient client; persistent or marked reduction may require fetal
surveillance.
Preterm labor: Regular contractions with cervical change before term are concerning. Do not assume that hydration alone
rules out labor. Assessment of contractions, fetal status, cervical change, membranes, and gestational age guides
management.
Gestational diabetes: Key nursing priorities include glucose monitoring, nutrition education, activity as prescribed,
medication adherence when needed, and surveillance for maternal/fetal complications. Avoid advice that promotes
uncontrolled hyperglycemia.
Preeclampsia: Watch blood pressure, headache, visual symptoms, epigastric/RUQ pain, hyperreflexia/clonus, pulmonary
symptoms, urine output, and laboratory evidence of organ involvement. Magnesium sulfate is used for seizure prophylaxis
in appropriate patients; monitor for toxicity.
Magnesium safety memory: “REFLEX–RESPIRATION–RENAL.” Check deep-tendon reflexes, respiratory status, and
urine output; toxicity can cause loss of reflexes and respiratory depression.
2. Labor and fetal surveillance
Oxytocin: Its purpose is to improve labor progress, but excessive uterine stimulation can compromise fetal oxygenation. A
concerning fetal heart-rate pattern or excessive uterine activity should prompt rapid intrauterine resuscitation and
evaluation according to protocol.
Prolonged deceleration: Treat as potentially serious. Reposition laterally, stop/reduce uterotonic stimulation when
indicated, assess maternal status and uterine activity, and escalate promptly. Oxygen is not a reflexive substitute for
correcting maternal positioning or other reversible causes.
FHR interpretation: Baseline, variability, accelerations, and decelerations are interpreted together. Variable decelerations
commonly suggest cord compression; late decelerations suggest uteroplacental insufficiency; prolonged deceleration
requires urgent evaluation.
HESI PN OB & Peds — Enhanced Study Guide Page 2
