HESI Maternal-Newborn 2026/2027: 200 Practice
Questions with Answers & Rationales | Exam Prep
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1. A client at 32 weeks’ gestation reports painless vaginal bleeding. Which condition
should the nurse suspect?
A) Placenta previa ✅
B) Abruptio placentae
C) Preterm labor
D) Ectopic pregnancy
Rationale: 👀*** Painless bright red bleeding in the third trimester is characteristic of
placenta previa. Abruptio placentae usually presents with painful bleeding.
2. A pregnant client at 28 weeks’ gestation has a fundal height of 24 cm. What should
the nurse suspect?
A) Normal growth
B) Intrauterine growth restriction (IUGR) ✅
C) Gestational diabetes
D) Polyhydramnios
Rationale: 👀*** Fundal height should roughly match gestational age in cm. Lower
measurements may indicate IUGR.
3. A client with preeclampsia has 3+ proteinuria. Which additional assessment is
priority?
A) Deep tendon reflexes ✅
B) Temperature
C) Heart rate
D) Respiratory rate
,Rationale: 👀*** Hyperreflexia may indicate worsening preeclampsia and risk for seizures.
4. A newborn has a respiratory rate of 65/min, nasal flaring, and grunting. The nurse
suspects:
A) Normal newborn breathing
B) Transient tachypnea of the newborn
C) Respiratory distress syndrome ✅
D) Meconium aspiration
Rationale: 👀*** Signs of respiratory distress in a newborn include tachypnea, grunting,
and nasal flaring.
5. A woman in labor is at 4 cm dilation and requests pain relief. Which is safest at this
stage?
A) Epidural analgesia ✅
B) General anesthesia
C) Narcotics intravenously at full dose
D) Spinal anesthesia
Rationale: 👀*** Epidural analgesia is preferred during active labor. Spinal anesthesia is
usually reserved for cesarean delivery.
6. The nurse is teaching a client about Rh incompatibility. Which statement indicates
understanding?
A) “I need Rh immunoglobulin only if my baby is Rh-negative.”
B) “I need Rh immunoglobulin if I am Rh-negative and my baby is Rh-positive.” ✅
C) “It is needed for every pregnancy.”
D) “It prevents preterm labor.”
Rationale: 👀*** Rh immunoglobulin is given to Rh-negative mothers with an Rh-positive
fetus to prevent hemolytic disease of the newborn.
,7. During postpartum assessment, the nurse notes a boggy uterus. The first action
should be:
A) Notify the physician
B) Massage the uterus ✅
C) Administer oxytocin immediately
D) Assess vital signs
Rationale: 👀*** A boggy uterus indicates uterine atony. Fundal massage is the first
intervention to stimulate contraction.
8. A newborn is jittery, has a high-pitched cry, and poor feeding. Which lab should be
checked first?
A) CBC
B) Glucose ✅
C) Bilirubin
D) Calcium
Rationale: 👀*** These signs indicate neonatal hypoglycemia.
9. A pregnant client at 36 weeks’ gestation reports regular contractions every 10
minutes. The nurse should:
A) Encourage ambulation
B) Assess contraction pattern and fetal status ✅
C) Prepare for immediate delivery
D) Administer tocolytics
Rationale: 👀*** At term, assessing contractions and fetal well-being helps determine if
labor is progressing.
10. Which vaccination is contraindicated during pregnancy?
, A) Tdap
B) Influenza inactivated
C) MMR ✅
D) Hepatitis B
Rationale: 👀*** MMR is a live vaccine and contraindicated during pregnancy.
11. A primigravida at 20 weeks’ gestation reports severe right lower quadrant pain.
Which condition is most concerning?
A) Appendicitis ✅
B) Round ligament pain
C) Braxton Hicks contractions
D) Urinary tract infection
Rationale: 👀*** Severe, localized abdominal pain in the second trimester may indicate
appendicitis, which requires prompt evaluation.
12. Which sign indicates magnesium sulfate toxicity in a preeclamptic client?
A) Diaphoresis
B) Respiratory depression ✅
C) Bradycardia
D) Increased reflexes
Rationale: 👀*** Respiratory depression and absent reflexes are signs of magnesium
toxicity.
13. A newborn’s APGAR score at 1 minute is 6. Which intervention is priority?
A) Immediate intubation
B) Continue routine care
C) Provide gentle stimulation and oxygen ✅
D) Administer epinephrine
Questions with Answers & Rationales | Exam Prep
Instant PDF Download
1. A client at 32 weeks’ gestation reports painless vaginal bleeding. Which condition
should the nurse suspect?
A) Placenta previa ✅
B) Abruptio placentae
C) Preterm labor
D) Ectopic pregnancy
Rationale: 👀*** Painless bright red bleeding in the third trimester is characteristic of
placenta previa. Abruptio placentae usually presents with painful bleeding.
2. A pregnant client at 28 weeks’ gestation has a fundal height of 24 cm. What should
the nurse suspect?
A) Normal growth
B) Intrauterine growth restriction (IUGR) ✅
C) Gestational diabetes
D) Polyhydramnios
Rationale: 👀*** Fundal height should roughly match gestational age in cm. Lower
measurements may indicate IUGR.
3. A client with preeclampsia has 3+ proteinuria. Which additional assessment is
priority?
A) Deep tendon reflexes ✅
B) Temperature
C) Heart rate
D) Respiratory rate
,Rationale: 👀*** Hyperreflexia may indicate worsening preeclampsia and risk for seizures.
4. A newborn has a respiratory rate of 65/min, nasal flaring, and grunting. The nurse
suspects:
A) Normal newborn breathing
B) Transient tachypnea of the newborn
C) Respiratory distress syndrome ✅
D) Meconium aspiration
Rationale: 👀*** Signs of respiratory distress in a newborn include tachypnea, grunting,
and nasal flaring.
5. A woman in labor is at 4 cm dilation and requests pain relief. Which is safest at this
stage?
A) Epidural analgesia ✅
B) General anesthesia
C) Narcotics intravenously at full dose
D) Spinal anesthesia
Rationale: 👀*** Epidural analgesia is preferred during active labor. Spinal anesthesia is
usually reserved for cesarean delivery.
6. The nurse is teaching a client about Rh incompatibility. Which statement indicates
understanding?
A) “I need Rh immunoglobulin only if my baby is Rh-negative.”
B) “I need Rh immunoglobulin if I am Rh-negative and my baby is Rh-positive.” ✅
C) “It is needed for every pregnancy.”
D) “It prevents preterm labor.”
Rationale: 👀*** Rh immunoglobulin is given to Rh-negative mothers with an Rh-positive
fetus to prevent hemolytic disease of the newborn.
,7. During postpartum assessment, the nurse notes a boggy uterus. The first action
should be:
A) Notify the physician
B) Massage the uterus ✅
C) Administer oxytocin immediately
D) Assess vital signs
Rationale: 👀*** A boggy uterus indicates uterine atony. Fundal massage is the first
intervention to stimulate contraction.
8. A newborn is jittery, has a high-pitched cry, and poor feeding. Which lab should be
checked first?
A) CBC
B) Glucose ✅
C) Bilirubin
D) Calcium
Rationale: 👀*** These signs indicate neonatal hypoglycemia.
9. A pregnant client at 36 weeks’ gestation reports regular contractions every 10
minutes. The nurse should:
A) Encourage ambulation
B) Assess contraction pattern and fetal status ✅
C) Prepare for immediate delivery
D) Administer tocolytics
Rationale: 👀*** At term, assessing contractions and fetal well-being helps determine if
labor is progressing.
10. Which vaccination is contraindicated during pregnancy?
, A) Tdap
B) Influenza inactivated
C) MMR ✅
D) Hepatitis B
Rationale: 👀*** MMR is a live vaccine and contraindicated during pregnancy.
11. A primigravida at 20 weeks’ gestation reports severe right lower quadrant pain.
Which condition is most concerning?
A) Appendicitis ✅
B) Round ligament pain
C) Braxton Hicks contractions
D) Urinary tract infection
Rationale: 👀*** Severe, localized abdominal pain in the second trimester may indicate
appendicitis, which requires prompt evaluation.
12. Which sign indicates magnesium sulfate toxicity in a preeclamptic client?
A) Diaphoresis
B) Respiratory depression ✅
C) Bradycardia
D) Increased reflexes
Rationale: 👀*** Respiratory depression and absent reflexes are signs of magnesium
toxicity.
13. A newborn’s APGAR score at 1 minute is 6. Which intervention is priority?
A) Immediate intubation
B) Continue routine care
C) Provide gentle stimulation and oxygen ✅
D) Administer epinephrine
