HESI MATERNAL-CHILD NURSING
Actual Exam QUESTIONS AND ANSWERS
2025 | 55 Questions | Pass Guaranteed - A+
Graded
Combined OB/Pediatrics/Maternity Exam
Version 4
55 Questions and Answers
2025 New Update
Section 1: Antepartum Care
Questions 1-8
Question 1
A 28-year-old G1P0 at 32 weeks gestation presents with complaints of severe headache, blurred
vision, and right upper quadrant pain. Her blood pressure is 168/112 mmHg, and urine dipstick
shows 3+ protein. Which intervention is the nurse's priority?
A. Administer prescribed oral labetalol immediately
B. Insert an indwelling urinary catheter for strict intake and output monitoring
C. Initiate magnesium sulfate infusion per protocol [CORRECT]
D. Prepare the patient for immediate cesarean section
Correct Answer: C
Rationale: This patient exhibits classic signs of severe preeclampsia: severe hypertension
(≥160/110 mmHg), proteinuria (3+), and symptoms of end-organ involvement (headache, visual
disturbances, epigastric/RUQ pain indicating hepatic involvement). Magnesium sulfate is the
first-line anticonvulsant for seizure prophylaxis in severe preeclampsia and eclampsia, with a
loading dose of 4-6g IV over 20-30 minutes followed by maintenance infusion. While
antihypertensives (A) are indicated for severe range pressures, seizure prevention takes priority
as eclampsia can occur without warning. Urinary catheterization (B) may be necessary for
monitoring but is not the immediate priority. Delivery (D) is the definitive treatment for severe
preeclampsia, but stabilization with magnesium and blood pressure control precedes delivery
,unless there is fetal compromise or eclampsia has occurred. The 2026 ACOG guidelines
emphasize that magnesium sulfate reduces seizure risk by 50% and should be administered
promptly when severe features are present.
Question 2
A pregnant client at 28 weeks gestation has a 1-hour glucose challenge test result of 158 mg/dL.
What is the most appropriate nursing action?
A. Counsel the client on gestational diabetes management and initiate dietary modifications
B. Schedule a 3-hour oral glucose tolerance test (OGTT) for definitive diagnosis [CORRECT]
C. Notify the provider to begin insulin therapy immediately
D. Reassure the client that this is a normal finding requiring no follow-up
Correct Answer: B
Rationale: The 1-hour glucose challenge test is a screening tool, not diagnostic. Values between
140-199 mg/dL are abnormal and require follow-up with a 100g 3-hour OGTT for definitive
diagnosis of gestational diabetes mellitus (GDM). Two or more abnormal values on the 3-hour
test confirm GDM. Initiating management (A) or insulin (C) based solely on screening is
premature and inappropriate. Values ≥200 mg/dL may indicate overt diabetes and require
different management. The nurse should schedule the diagnostic test promptly, ideally within one
week, and provide preliminary education about carbohydrate consistency while awaiting results.
Early diagnosis and management of GDM reduce risks of macrosomia, birth trauma, neonatal
hypoglycemia, and future type 2 diabetes.
Question 3
A client at 10 weeks gestation reports persistent nausea and vomiting that improves with eating
small amounts but worsens with an empty stomach. Which evidence-based recommendation
should the nurse provide?
A. "Avoid eating until the nausea subsides completely"
B. "Keep dry crackers or toast at your bedside and eat before rising" [CORRECT]
C. "Drink large amounts of water with meals to dilute stomach acid"
D. "Take your prenatal vitamin on an empty stomach each morning"
Correct Answer: B
Rationale: Morning sickness affects 70-85% of pregnancies and results from elevated hCG and
progesterone. Eating dry, bland carbohydrates (crackers, toast) before rising minimizes gastric
acidity and hypoglycemia, which exacerbate nausea. Small, frequent meals throughout the day
,maintain blood glucose and prevent gastric overdistention. Avoiding food (A) worsens nausea
and increases risk of ketosis. Large fluid volumes with meals (C) distend the stomach and trigger
vomiting; fluids should be consumed between meals. Prenatal vitamins (D), particularly iron,
often worsen nausea and should be taken with food or at bedtime. If hyperemesis gravidarum
(persistent vomiting with weight loss >5%, ketonuria, electrolyte imbalance) develops, medical
intervention with IV fluids, antiemetics (doxylamine-pyridoxine, ondansetron), and thiamine
supplementation is necessary to prevent Wernicke encephalopathy.
Question 4
During prenatal education, which client statement indicates understanding of danger signs
requiring immediate medical attention during pregnancy?
A. "I should call if I notice mild ankle swelling at the end of the day"
B. "Occasional Braxton Hicks contractions are normal and expected"
C. "Severe headache with visual changes requires immediate evaluation" [CORRECT]
D. "Increased vaginal discharge is always normal in pregnancy"
Correct Answer: C
Rationale: Severe headache with visual disturbances (scotomata, blurred vision) is a cardinal
symptom of severe preeclampsia and requires immediate evaluation to prevent eclampsia, stroke,
or hepatic rupture. Mild dependent edema (A) is common in pregnancy due to increased fluid
volume and venous compression; however, facial edema or rapid weight gain (>2 lbs/week)
suggests pathological fluid retention. Braxton Hicks contractions (B) are irregular, painless
uterine contractions that are normal after 28 weeks. While increased leukorrhea is normal (D),
discharge with odor, pruritus, color change, or bleeding is abnormal. Other danger signs include
vaginal bleeding, rupture of membranes, decreased fetal movement after 28 weeks, persistent
vomiting, fever >100.4°F, and epigastric pain. The 2026 ACOG guidelines emphasize patient
education on these warning signs to reduce maternal morbidity.
Question 5
A pregnant client at 16 weeks gestation asks about prenatal screening for chromosomal
abnormalities. Which information should the nurse provide regarding cell-free DNA testing?
A. "It is only available to women over age 35 with high-risk pregnancies"
B. "It can be performed any time during pregnancy with equal accuracy"
C. "It analyzes fetal DNA from maternal blood with high detection rates for trisomies 21, 18, and
13" [CORRECT]
D. "It replaces the need for diagnostic testing like amniocentesis in all cases"
, Correct Answer: C
Rationale: Cell-free DNA (cfDNA) or non-invasive prenatal testing (NIPT) analyzes fragments
of placental DNA (fetal origin) circulating in maternal blood, with detection rates >99% for
Down syndrome (trisomy 21), 97% for trisomy 18, and 90% for trisomy 13, with false positive
rates <0.1%. It can be performed from 10 weeks gestation onward. It is available to all women
regardless of age or risk status (A is outdated; 2026 guidelines support offering to all). Accuracy
varies by gestational age and fetal fraction (B is incorrect; optimal 10-22 weeks). Positive
predictive value varies by condition and maternal age; diagnostic testing (amniocentesis or CVS)
is recommended to confirm positive screen results (D is incorrect). cfDNA also screens for sex
chromosome aneuploidies and can determine fetal sex. The nurse should emphasize that cfDNA
is a screening test, not diagnostic, and discuss options for confirmatory testing if results are
positive.
Question 6
A client at 24 weeks gestation with type 1 diabetes asks about fetal surveillance. Which test is
typically initiated at this gestational age for diabetic pregnancies?
A. Weekly non-stress tests (NST)
B. Biophysical profile (BPP) scoring twice weekly
C. Fetal kick counts and growth ultrasounds every 4 weeks [CORRECT]
D. Contraction stress testing (CST) weekly
Correct Answer: C
Rationale: For pregestational diabetes, antenatal surveillance begins at 32-34 weeks (or earlier
with complications) with twice-weekly NSTs or BPPs. At 24 weeks, management focuses on
fetal kick counts (daily maternal perception of 10 movements within 2 hours) and serial growth
ultrasounds every 4 weeks to monitor for macrosomia or intrauterine growth restriction. Diabetic
pregnancies have increased risk of congenital anomalies (if glycemic control poor in first
trimester), macrosomia, polyhydramnios, and stillbirth. Tight glycemic control (fasting <95
mg/dL, 1-hour postprandial <140 mg/dL, 2-hour <120 mg/dL) reduces complications. Weekly
NSTs (A) and CST (D) begin later in pregnancy. BPP twice weekly (B) is excessive at 24 weeks
and reserved for third trimester or specific concerns. The nurse should teach kick count technique
and ensure the patient understands the importance of glycemic monitoring.
Question 7
A pregnant client at 35 weeks gestation with placenta previa (complete) is admitted with painless
vaginal bleeding. Which nursing intervention is priority?
A. Perform a sterile vaginal examination to assess cervical dilation
Actual Exam QUESTIONS AND ANSWERS
2025 | 55 Questions | Pass Guaranteed - A+
Graded
Combined OB/Pediatrics/Maternity Exam
Version 4
55 Questions and Answers
2025 New Update
Section 1: Antepartum Care
Questions 1-8
Question 1
A 28-year-old G1P0 at 32 weeks gestation presents with complaints of severe headache, blurred
vision, and right upper quadrant pain. Her blood pressure is 168/112 mmHg, and urine dipstick
shows 3+ protein. Which intervention is the nurse's priority?
A. Administer prescribed oral labetalol immediately
B. Insert an indwelling urinary catheter for strict intake and output monitoring
C. Initiate magnesium sulfate infusion per protocol [CORRECT]
D. Prepare the patient for immediate cesarean section
Correct Answer: C
Rationale: This patient exhibits classic signs of severe preeclampsia: severe hypertension
(≥160/110 mmHg), proteinuria (3+), and symptoms of end-organ involvement (headache, visual
disturbances, epigastric/RUQ pain indicating hepatic involvement). Magnesium sulfate is the
first-line anticonvulsant for seizure prophylaxis in severe preeclampsia and eclampsia, with a
loading dose of 4-6g IV over 20-30 minutes followed by maintenance infusion. While
antihypertensives (A) are indicated for severe range pressures, seizure prevention takes priority
as eclampsia can occur without warning. Urinary catheterization (B) may be necessary for
monitoring but is not the immediate priority. Delivery (D) is the definitive treatment for severe
preeclampsia, but stabilization with magnesium and blood pressure control precedes delivery
,unless there is fetal compromise or eclampsia has occurred. The 2026 ACOG guidelines
emphasize that magnesium sulfate reduces seizure risk by 50% and should be administered
promptly when severe features are present.
Question 2
A pregnant client at 28 weeks gestation has a 1-hour glucose challenge test result of 158 mg/dL.
What is the most appropriate nursing action?
A. Counsel the client on gestational diabetes management and initiate dietary modifications
B. Schedule a 3-hour oral glucose tolerance test (OGTT) for definitive diagnosis [CORRECT]
C. Notify the provider to begin insulin therapy immediately
D. Reassure the client that this is a normal finding requiring no follow-up
Correct Answer: B
Rationale: The 1-hour glucose challenge test is a screening tool, not diagnostic. Values between
140-199 mg/dL are abnormal and require follow-up with a 100g 3-hour OGTT for definitive
diagnosis of gestational diabetes mellitus (GDM). Two or more abnormal values on the 3-hour
test confirm GDM. Initiating management (A) or insulin (C) based solely on screening is
premature and inappropriate. Values ≥200 mg/dL may indicate overt diabetes and require
different management. The nurse should schedule the diagnostic test promptly, ideally within one
week, and provide preliminary education about carbohydrate consistency while awaiting results.
Early diagnosis and management of GDM reduce risks of macrosomia, birth trauma, neonatal
hypoglycemia, and future type 2 diabetes.
Question 3
A client at 10 weeks gestation reports persistent nausea and vomiting that improves with eating
small amounts but worsens with an empty stomach. Which evidence-based recommendation
should the nurse provide?
A. "Avoid eating until the nausea subsides completely"
B. "Keep dry crackers or toast at your bedside and eat before rising" [CORRECT]
C. "Drink large amounts of water with meals to dilute stomach acid"
D. "Take your prenatal vitamin on an empty stomach each morning"
Correct Answer: B
Rationale: Morning sickness affects 70-85% of pregnancies and results from elevated hCG and
progesterone. Eating dry, bland carbohydrates (crackers, toast) before rising minimizes gastric
acidity and hypoglycemia, which exacerbate nausea. Small, frequent meals throughout the day
,maintain blood glucose and prevent gastric overdistention. Avoiding food (A) worsens nausea
and increases risk of ketosis. Large fluid volumes with meals (C) distend the stomach and trigger
vomiting; fluids should be consumed between meals. Prenatal vitamins (D), particularly iron,
often worsen nausea and should be taken with food or at bedtime. If hyperemesis gravidarum
(persistent vomiting with weight loss >5%, ketonuria, electrolyte imbalance) develops, medical
intervention with IV fluids, antiemetics (doxylamine-pyridoxine, ondansetron), and thiamine
supplementation is necessary to prevent Wernicke encephalopathy.
Question 4
During prenatal education, which client statement indicates understanding of danger signs
requiring immediate medical attention during pregnancy?
A. "I should call if I notice mild ankle swelling at the end of the day"
B. "Occasional Braxton Hicks contractions are normal and expected"
C. "Severe headache with visual changes requires immediate evaluation" [CORRECT]
D. "Increased vaginal discharge is always normal in pregnancy"
Correct Answer: C
Rationale: Severe headache with visual disturbances (scotomata, blurred vision) is a cardinal
symptom of severe preeclampsia and requires immediate evaluation to prevent eclampsia, stroke,
or hepatic rupture. Mild dependent edema (A) is common in pregnancy due to increased fluid
volume and venous compression; however, facial edema or rapid weight gain (>2 lbs/week)
suggests pathological fluid retention. Braxton Hicks contractions (B) are irregular, painless
uterine contractions that are normal after 28 weeks. While increased leukorrhea is normal (D),
discharge with odor, pruritus, color change, or bleeding is abnormal. Other danger signs include
vaginal bleeding, rupture of membranes, decreased fetal movement after 28 weeks, persistent
vomiting, fever >100.4°F, and epigastric pain. The 2026 ACOG guidelines emphasize patient
education on these warning signs to reduce maternal morbidity.
Question 5
A pregnant client at 16 weeks gestation asks about prenatal screening for chromosomal
abnormalities. Which information should the nurse provide regarding cell-free DNA testing?
A. "It is only available to women over age 35 with high-risk pregnancies"
B. "It can be performed any time during pregnancy with equal accuracy"
C. "It analyzes fetal DNA from maternal blood with high detection rates for trisomies 21, 18, and
13" [CORRECT]
D. "It replaces the need for diagnostic testing like amniocentesis in all cases"
, Correct Answer: C
Rationale: Cell-free DNA (cfDNA) or non-invasive prenatal testing (NIPT) analyzes fragments
of placental DNA (fetal origin) circulating in maternal blood, with detection rates >99% for
Down syndrome (trisomy 21), 97% for trisomy 18, and 90% for trisomy 13, with false positive
rates <0.1%. It can be performed from 10 weeks gestation onward. It is available to all women
regardless of age or risk status (A is outdated; 2026 guidelines support offering to all). Accuracy
varies by gestational age and fetal fraction (B is incorrect; optimal 10-22 weeks). Positive
predictive value varies by condition and maternal age; diagnostic testing (amniocentesis or CVS)
is recommended to confirm positive screen results (D is incorrect). cfDNA also screens for sex
chromosome aneuploidies and can determine fetal sex. The nurse should emphasize that cfDNA
is a screening test, not diagnostic, and discuss options for confirmatory testing if results are
positive.
Question 6
A client at 24 weeks gestation with type 1 diabetes asks about fetal surveillance. Which test is
typically initiated at this gestational age for diabetic pregnancies?
A. Weekly non-stress tests (NST)
B. Biophysical profile (BPP) scoring twice weekly
C. Fetal kick counts and growth ultrasounds every 4 weeks [CORRECT]
D. Contraction stress testing (CST) weekly
Correct Answer: C
Rationale: For pregestational diabetes, antenatal surveillance begins at 32-34 weeks (or earlier
with complications) with twice-weekly NSTs or BPPs. At 24 weeks, management focuses on
fetal kick counts (daily maternal perception of 10 movements within 2 hours) and serial growth
ultrasounds every 4 weeks to monitor for macrosomia or intrauterine growth restriction. Diabetic
pregnancies have increased risk of congenital anomalies (if glycemic control poor in first
trimester), macrosomia, polyhydramnios, and stillbirth. Tight glycemic control (fasting <95
mg/dL, 1-hour postprandial <140 mg/dL, 2-hour <120 mg/dL) reduces complications. Weekly
NSTs (A) and CST (D) begin later in pregnancy. BPP twice weekly (B) is excessive at 24 weeks
and reserved for third trimester or specific concerns. The nurse should teach kick count technique
and ensure the patient understands the importance of glycemic monitoring.
Question 7
A pregnant client at 35 weeks gestation with placenta previa (complete) is admitted with painless
vaginal bleeding. Which nursing intervention is priority?
A. Perform a sterile vaginal examination to assess cervical dilation
