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2025 OB Maternity HESI Exit Exam –
Versions 1 & 2 Actual Exam Test Bank |
NextGen Format | 100% Verified
Questions & Guaranteed A+ Score
Version 1
1. A primigravida at 37 weeks gestation reports leaking fluid for 12 hours. The nurse
notes a fetal heart rate (FHR) of 140 bpm and irregular contractions. Which action
should the nurse take first?
A) Administer oxygen at 10 L/min via face mask
B) Assess cervical dilation
C) Perform a nitrazine test
D) Notify the healthcare provider
Correct Answer: C) Perform a nitrazine test
Rationale: Leaking fluid suggests possible rupture of membranes (ROM). A nitrazine
test confirms amniotic fluid by detecting pH changes, guiding further management.
Assessing dilation or notifying the provider is premature without confirming ROM.
Oxygen is unnecessary with a normal FHR.
2. A client at 39 weeks gestation is in active labor with contractions every 3 minutes.
The nurse observes a late deceleration on the FHR monitor. Which intervention is
priority?
A) Reposition the client to the left lateral position
B) Increase IV fluid rate
C) Prepare for an emergency cesarean section
D) Administer terbutaline subcutaneously
Correct Answer: A) Reposition the client to the left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning to the
left lateral position improves placental perfusion, addressing the immediate cause. IV
fluids or cesarean may follow if unresolved, and terbutaline is inappropriate.
3. A multiparous client at 38 weeks gestation presents with bright red vaginal bleeding
and no pain. The nurse suspects which condition?
A) Abruptio placentae
B) Placenta previa
C) Bloody show
D) Cervical laceration
Correct Answer: B) Placenta previa
Rationale: Painless bright red bleeding in the third trimester is characteristic of placenta
previa, where the placenta covers the cervix. Abruptio placentae typically involves pain,
bloody show is minimal, and cervical laceration is less common.
, 2
4. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia.
Which finding requires immediate intervention?
A) Blood pressure 140/90 mmHg
B) Deep tendon reflexes absent
C) Respiratory rate 16 breaths/min
D) Urine output 40 mL/hr
Correct Answer: B) Deep tendon reflexes absent
Rationale: Absent deep tendon reflexes indicate magnesium toxicity, a life-threatening
complication requiring immediate cessation of the infusion and antidote administration
(calcium gluconate). Other findings are within expected ranges for preeclampsia
management.
5. A postpartum client 4 hours after cesarean delivery has a saturated perineal pad
within 15 minutes. Which action should the nurse implement first?
A) Notify the healthcare provider
B) Perform fundal massage
C) Assess vital signs
D) Encourage the client to void
Correct Answer: B) Perform fundal massage
Rationale: A saturated pad suggests postpartum hemorrhage, often due to uterine atony.
Fundal massage stimulates uterine contraction to control bleeding. Assessing vitals or
notifying the provider follows, and voiding is less urgent.
6. A client at 30 weeks gestation reports decreased fetal movement for 24 hours. The
nurse notes an FHR of 60 bpm. Which action is priority?
A) Administer betamethasone
B) Prepare for an ultrasound
C) Notify the healthcare provider
D) Initiate a non-stress test
Correct Answer: C) Notify the healthcare provider
Rationale: An FHR of 60 bpm indicates severe fetal distress requiring immediate
intervention. Notifying the provider ensures rapid escalation, likely for emergency
delivery. Other actions delay critical care.
7. A newborn’s assessment reveals a soft, edematous swelling over the parietal scalp
crossing suture lines. The nurse documents this as:
A) Caput succedaneum
B) Cephalhematoma
C) Hydrocephalus
D) Microcephaly
Correct Answer: A) Caput succedaneum
Rationale: Caput succedaneum is a soft, edematous swelling crossing suture lines due to
pressure during delivery. Cephalhematoma is confined by sutures, hydrocephalus
involves increased intracranial fluid, and microcephaly is a small head size.
8. A client in labor requests an epidural. Which assessment is most important before
administration?
A) Cervical dilation
B) Maternal blood pressure
C) Fetal station
, 3
D) Contraction frequency
Correct Answer: B) Maternal blood pressure
Rationale: Epidural anesthesia can cause hypotension, risking maternal and fetal
compromise. Assessing blood pressure ensures stability before administration. Other
assessments are relevant but secondary.
9. A primigravida at 41 weeks gestation is scheduled for induction. Which medication
is most likely to be used initially?
A) Oxytocin
B) Misoprostol
C) Dinoprostone
D) Magnesium sulfate
Correct Answer: B) Misoprostol
Rationale: Misoprostol is commonly used for cervical ripening in induction of labor,
especially in post-term pregnancies. Oxytocin follows ripening, dinoprostone is an
alternative, and magnesium sulfate is for preeclampsia or tocolysis.
10. A client at 32 weeks gestation with preterm labor is prescribed betamethasone. The
nurse explains this medication is given to:
A) Stop uterine contractions
B) Enhance fetal lung maturity
C) Prevent infection
D) Control maternal blood pressure
Correct Answer: B) Enhance fetal lung maturity
Rationale: Betamethasone is a corticosteroid that accelerates fetal lung surfactant
production, reducing the risk of respiratory distress syndrome in preterm infants. It does
not affect contractions, infection, or blood pressure.
11. A postpartum client reports severe perineal pain 24 hours after a vaginal delivery
with episiotomy. Which action should the nurse take first?
A) Administer prescribed analgesics
B) Inspect the perineum for hematoma
C) Apply an ice pack to the perineum
D) Encourage sitz baths
Correct Answer: B) Inspect the perineum for hematoma
Rationale: Severe pain suggests complications like hematoma or infection. Inspection
identifies the cause, guiding treatment. Analgesics, ice, or sitz baths may follow but do
not address the underlying issue.
12. A client at 36 weeks gestation has a positive Group B Streptococcus (GBS) culture.
Which intervention is indicated during labor?
A) Administer penicillin IV
B) Perform a cesarean section
C) Monitor FHR continuously
D) Administer oxytocin
Correct Answer: A) Administer penicillin IV
Rationale: GBS-positive clients receive intrapartum penicillin to prevent neonatal sepsis.
Cesarean is not indicated, continuous monitoring is standard, and oxytocin is unrelated to
GBS.
2025 OB Maternity HESI Exit Exam –
Versions 1 & 2 Actual Exam Test Bank |
NextGen Format | 100% Verified
Questions & Guaranteed A+ Score
Version 1
1. A primigravida at 37 weeks gestation reports leaking fluid for 12 hours. The nurse
notes a fetal heart rate (FHR) of 140 bpm and irregular contractions. Which action
should the nurse take first?
A) Administer oxygen at 10 L/min via face mask
B) Assess cervical dilation
C) Perform a nitrazine test
D) Notify the healthcare provider
Correct Answer: C) Perform a nitrazine test
Rationale: Leaking fluid suggests possible rupture of membranes (ROM). A nitrazine
test confirms amniotic fluid by detecting pH changes, guiding further management.
Assessing dilation or notifying the provider is premature without confirming ROM.
Oxygen is unnecessary with a normal FHR.
2. A client at 39 weeks gestation is in active labor with contractions every 3 minutes.
The nurse observes a late deceleration on the FHR monitor. Which intervention is
priority?
A) Reposition the client to the left lateral position
B) Increase IV fluid rate
C) Prepare for an emergency cesarean section
D) Administer terbutaline subcutaneously
Correct Answer: A) Reposition the client to the left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning to the
left lateral position improves placental perfusion, addressing the immediate cause. IV
fluids or cesarean may follow if unresolved, and terbutaline is inappropriate.
3. A multiparous client at 38 weeks gestation presents with bright red vaginal bleeding
and no pain. The nurse suspects which condition?
A) Abruptio placentae
B) Placenta previa
C) Bloody show
D) Cervical laceration
Correct Answer: B) Placenta previa
Rationale: Painless bright red bleeding in the third trimester is characteristic of placenta
previa, where the placenta covers the cervix. Abruptio placentae typically involves pain,
bloody show is minimal, and cervical laceration is less common.
, 2
4. A client at 34 weeks gestation is receiving magnesium sulfate for preeclampsia.
Which finding requires immediate intervention?
A) Blood pressure 140/90 mmHg
B) Deep tendon reflexes absent
C) Respiratory rate 16 breaths/min
D) Urine output 40 mL/hr
Correct Answer: B) Deep tendon reflexes absent
Rationale: Absent deep tendon reflexes indicate magnesium toxicity, a life-threatening
complication requiring immediate cessation of the infusion and antidote administration
(calcium gluconate). Other findings are within expected ranges for preeclampsia
management.
5. A postpartum client 4 hours after cesarean delivery has a saturated perineal pad
within 15 minutes. Which action should the nurse implement first?
A) Notify the healthcare provider
B) Perform fundal massage
C) Assess vital signs
D) Encourage the client to void
Correct Answer: B) Perform fundal massage
Rationale: A saturated pad suggests postpartum hemorrhage, often due to uterine atony.
Fundal massage stimulates uterine contraction to control bleeding. Assessing vitals or
notifying the provider follows, and voiding is less urgent.
6. A client at 30 weeks gestation reports decreased fetal movement for 24 hours. The
nurse notes an FHR of 60 bpm. Which action is priority?
A) Administer betamethasone
B) Prepare for an ultrasound
C) Notify the healthcare provider
D) Initiate a non-stress test
Correct Answer: C) Notify the healthcare provider
Rationale: An FHR of 60 bpm indicates severe fetal distress requiring immediate
intervention. Notifying the provider ensures rapid escalation, likely for emergency
delivery. Other actions delay critical care.
7. A newborn’s assessment reveals a soft, edematous swelling over the parietal scalp
crossing suture lines. The nurse documents this as:
A) Caput succedaneum
B) Cephalhematoma
C) Hydrocephalus
D) Microcephaly
Correct Answer: A) Caput succedaneum
Rationale: Caput succedaneum is a soft, edematous swelling crossing suture lines due to
pressure during delivery. Cephalhematoma is confined by sutures, hydrocephalus
involves increased intracranial fluid, and microcephaly is a small head size.
8. A client in labor requests an epidural. Which assessment is most important before
administration?
A) Cervical dilation
B) Maternal blood pressure
C) Fetal station
, 3
D) Contraction frequency
Correct Answer: B) Maternal blood pressure
Rationale: Epidural anesthesia can cause hypotension, risking maternal and fetal
compromise. Assessing blood pressure ensures stability before administration. Other
assessments are relevant but secondary.
9. A primigravida at 41 weeks gestation is scheduled for induction. Which medication
is most likely to be used initially?
A) Oxytocin
B) Misoprostol
C) Dinoprostone
D) Magnesium sulfate
Correct Answer: B) Misoprostol
Rationale: Misoprostol is commonly used for cervical ripening in induction of labor,
especially in post-term pregnancies. Oxytocin follows ripening, dinoprostone is an
alternative, and magnesium sulfate is for preeclampsia or tocolysis.
10. A client at 32 weeks gestation with preterm labor is prescribed betamethasone. The
nurse explains this medication is given to:
A) Stop uterine contractions
B) Enhance fetal lung maturity
C) Prevent infection
D) Control maternal blood pressure
Correct Answer: B) Enhance fetal lung maturity
Rationale: Betamethasone is a corticosteroid that accelerates fetal lung surfactant
production, reducing the risk of respiratory distress syndrome in preterm infants. It does
not affect contractions, infection, or blood pressure.
11. A postpartum client reports severe perineal pain 24 hours after a vaginal delivery
with episiotomy. Which action should the nurse take first?
A) Administer prescribed analgesics
B) Inspect the perineum for hematoma
C) Apply an ice pack to the perineum
D) Encourage sitz baths
Correct Answer: B) Inspect the perineum for hematoma
Rationale: Severe pain suggests complications like hematoma or infection. Inspection
identifies the cause, guiding treatment. Analgesics, ice, or sitz baths may follow but do
not address the underlying issue.
12. A client at 36 weeks gestation has a positive Group B Streptococcus (GBS) culture.
Which intervention is indicated during labor?
A) Administer penicillin IV
B) Perform a cesarean section
C) Monitor FHR continuously
D) Administer oxytocin
Correct Answer: A) Administer penicillin IV
Rationale: GBS-positive clients receive intrapartum penicillin to prevent neonatal sepsis.
Cesarean is not indicated, continuous monitoring is standard, and oxytocin is unrelated to
GBS.
