HESI Maternity Nursing Study Guide 2026 – Comprehensive Maternal
Health Review Notes, Practice Questions & Exam Prep
1. A 38-week primigravida who works as a secretary and sits at a computer for 8
hours each day tells the nurse that her feet have begun to swell. Which
instruction would be most effective in preventing pooling of blood in the lower
extremities?
Move about every hour
Pooling of blood in the lower extremities results from the enlarged uterus
exerting pressure on the pelvic veins. Moving about every hour will
straighten out thepelvic veins and increase venous return.
2. A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks
gestationin preterm labor. She is given 3 doses of terbutaline sulfate (Brethine)
0.25 mg subcutaneously to stop her labor contractions. The nurse plans to
monitor for which primary side effect of terbutaline sulfate?
Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates beta-
adrenergicreceptors in the uterine muscle to stop contractions. The beta-
adrenergic agonist properties of the drug may cause tachycardia, increased
cardiac output, restlessness, headache, and a feeling of "nervousness".
3. When do the anterior and posterior fontanels close?
anterior fontanel closes at 12 to 18 months and the posterior by the end of
thesecond month.
4. When assessing a client who is at 12-weeks gestation, the nurse
recommends that she and her husband consider attending childbirth
preparation classes. When is the best time for the couple to attend these
classes?
30 weeks gestation
at 30 weeks gestation is closest (of the options) to the time parents would be
ready for such classes. Learning is facilitated by an interested pupil! The
couple is most interested in childbirth toward the end of the pregnancy when
they are psychologically ready for the termination of the pregnancy, and the
birth of their childis an immediate concern.
5. The nurse should encourage the laboring client to begin pushing
19
, when...the cervix is completely dilated.
Pushing begins with the second stage of labor, i.e., when the cervix is completely
dilatedat 10 cm (C). If pushing begins before the cervix is completely dilated the
cervix can become edematous and may never completely dilate, necessitating an
operativedelivery. Many primigravida’s begin active labor 100%and
theneffacedproceed todilate.
6. The nurse instructs a laboring client to use accelerated-blow breathing. The
client begins to complain of tingling fingers and dizziness. What action should
the nurse take?
Have the client breathe into her cupped hands
Tingling fingers and dizziness are signs of hyperventilation (blowing off too
much carbon dioxide). Hyperventilation is treated by retaining carbon dioxide.
This can befacilitated by breathing into a paper bag or cupped hands.
7. Twenty-four hours after admission to the newborn nursery, a full-term male
infant develops localized edema on the right side of his head. The nurse
knows that, in thenewborn, an accumulation of blood between the periosteum
and skull which does not cross the suture line is a newborn variation known
as...
a cephalohematoma, caused by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn, usually arises
within the first 24 hours after delivery. Trauma from delivery causes capillary
bleeding between theperiosteum and the skull.
8. When does the head return to its normal
shape? 7-10 days
9. What did Nurse theorist Reva Rubin describe?
The initial postpartum period as the "taking-in phase," which is characterized by
maternal reliance on others to satisfy the needs for comfort, rest, nourishment,
andcloseness to families and the newborn.
10. A couple, concerned because the woman has not been able to conceive, is
referred toa healthcare provider for a fertility workup and a
hysterosalpingography is scheduled. Which post procedure complaint
indicates that the fallopian tubes are patent?
Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from a sub
19
, diaphragmatic collection of peritoneal dye/gas.
11. Which nursing intervention is most helpful in relieving postpartum uterine
contractionsor "afterpains?"
Lying prone with a pillow on the abdomen
Lying prone keeps the fundus contracted and is especially useful with
multiparas,who commonly experience afterpains due to lack of uterine tone.
12. Which maternal behavior is the nurse most likely to see when a new mother
receives her infant for the first time?
Her arms and hands receive the infant and she then traces the infant's profile
withher fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate
behaviorsdescribed in during the first visit with the newborn, which may be at
delivery or later.
13. A client at 32-weeks gestation is hospitalized with severe pregnancy-
induced hypertension (PIH), and magnesium sulfate is prescribed to control
the symptoms.Which assessment finding indicates the therapeutic drug
level has been achieved?
A decreased in respiratory rate from 24 to 16
Magnesium sulfate, a CNS depressant, helps prevent seizures. A decreased
respiratory rate indicates that the drug is effective. (Respiratory rate below 12
indicatestoxic effects.)
14. Urinary output must be monitored when administering magnesium sulfate and
should be at least 30 ml per hour. (The therapeutic level of magnesium sulfate
for a PIH clientis 4.8 to 9.6 mg/dl.) What is the therapeutic level of magnesium
sulfate?
The therapeutic level of magnesium sulfate for a PIH client is 4.8 to 9.6
mg/dl. What does it help prevent? helps prevent seizures
What indicates toxic levels? 3
Respiratory rate below 12 indicates toxic
effects.Urine output of less than 100 ml/4
hours
Absent DTRs
15. Twenty minutes after a continuous epidural anesthetic is administered, a laboring
client'sblood pressure drops from 120/80 to 90/60. What action should the nurse
take?
19
, Place woman in a lateral position
The nurse should immediately turn the woman to a lateral position, place a
pillow orwedge under the right hip to deflect the uterus, increase the rate of
the main line IVinfusion, and administer oxygen by face mask at 10-12 L/min. If
the blood pressure remains low, especially if it further decreases, the
anesthesiologist/healthcare provider should be notified immediately.
16. A client at 28-weeks gestation calls the antepartum clinic and states that she
is experiencing a small amount of vaginal bleeding which she describes as
bright red. She further states that she is not experiencing any uterine
contractions or abdominalpain. What instruction should the nurse provide?
Come to the clinic today for an ultrasound
Third trimester painless bleeding is characteristic of a placenta previa. Bright
red bleeding may be intermittent, occur in gushes, or be continuous. Rarely is
the first incidence life-threatening, nor cause for hypovolemic shock.
Diagnosis is confirmedby transabdominal ultrasound.
17. An off-duty nurse finds a woman in a supermarket parking lot delivering an
infant while her husband is screaming for someone to help his wife. Which
intervention hasthe highest priority?
Put the newborn to breast
Putting the newborn to breast will help contract the uterus and prevent a
postpartum hemorrhage--this intervention has the highest priority.
18. A pregnant client with mitral stenosis Class III is prescribed complete bedrest.
The clientasks the nurse, "Why must I stay in bed all the time?" Which response
is best for the nurse to provide this client?
Complete bedrest decreases oxygen needs and demands on the heart muscle tissue.
To help preserve cardiac reserves, the woman may need to restrict her
activitiesand complete bedrest is often prescribed.
19. The nurse is teaching care of the newborn to a group of prospective parents
and describes the need for administering antibiotic ointment into the eyes of
the newborn.Which infectious organism will this treatment prevent from
harming the infant?
Gonorrhea
Erythromycin ointment is instilled into the lower conjunctiva of each eye within 2
hoursafter birth to prevent ophthalmic neonatorum, an infection caused by
gonorrhea, and inclusion conjunctivitis, an infection caused by chlamydia. The
infant may be exposedto these bacteria when passing through the birth canal.
19
Health Review Notes, Practice Questions & Exam Prep
1. A 38-week primigravida who works as a secretary and sits at a computer for 8
hours each day tells the nurse that her feet have begun to swell. Which
instruction would be most effective in preventing pooling of blood in the lower
extremities?
Move about every hour
Pooling of blood in the lower extremities results from the enlarged uterus
exerting pressure on the pelvic veins. Moving about every hour will
straighten out thepelvic veins and increase venous return.
2. A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks
gestationin preterm labor. She is given 3 doses of terbutaline sulfate (Brethine)
0.25 mg subcutaneously to stop her labor contractions. The nurse plans to
monitor for which primary side effect of terbutaline sulfate?
Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates beta-
adrenergicreceptors in the uterine muscle to stop contractions. The beta-
adrenergic agonist properties of the drug may cause tachycardia, increased
cardiac output, restlessness, headache, and a feeling of "nervousness".
3. When do the anterior and posterior fontanels close?
anterior fontanel closes at 12 to 18 months and the posterior by the end of
thesecond month.
4. When assessing a client who is at 12-weeks gestation, the nurse
recommends that she and her husband consider attending childbirth
preparation classes. When is the best time for the couple to attend these
classes?
30 weeks gestation
at 30 weeks gestation is closest (of the options) to the time parents would be
ready for such classes. Learning is facilitated by an interested pupil! The
couple is most interested in childbirth toward the end of the pregnancy when
they are psychologically ready for the termination of the pregnancy, and the
birth of their childis an immediate concern.
5. The nurse should encourage the laboring client to begin pushing
19
, when...the cervix is completely dilated.
Pushing begins with the second stage of labor, i.e., when the cervix is completely
dilatedat 10 cm (C). If pushing begins before the cervix is completely dilated the
cervix can become edematous and may never completely dilate, necessitating an
operativedelivery. Many primigravida’s begin active labor 100%and
theneffacedproceed todilate.
6. The nurse instructs a laboring client to use accelerated-blow breathing. The
client begins to complain of tingling fingers and dizziness. What action should
the nurse take?
Have the client breathe into her cupped hands
Tingling fingers and dizziness are signs of hyperventilation (blowing off too
much carbon dioxide). Hyperventilation is treated by retaining carbon dioxide.
This can befacilitated by breathing into a paper bag or cupped hands.
7. Twenty-four hours after admission to the newborn nursery, a full-term male
infant develops localized edema on the right side of his head. The nurse
knows that, in thenewborn, an accumulation of blood between the periosteum
and skull which does not cross the suture line is a newborn variation known
as...
a cephalohematoma, caused by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn, usually arises
within the first 24 hours after delivery. Trauma from delivery causes capillary
bleeding between theperiosteum and the skull.
8. When does the head return to its normal
shape? 7-10 days
9. What did Nurse theorist Reva Rubin describe?
The initial postpartum period as the "taking-in phase," which is characterized by
maternal reliance on others to satisfy the needs for comfort, rest, nourishment,
andcloseness to families and the newborn.
10. A couple, concerned because the woman has not been able to conceive, is
referred toa healthcare provider for a fertility workup and a
hysterosalpingography is scheduled. Which post procedure complaint
indicates that the fallopian tubes are patent?
Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from a sub
19
, diaphragmatic collection of peritoneal dye/gas.
11. Which nursing intervention is most helpful in relieving postpartum uterine
contractionsor "afterpains?"
Lying prone with a pillow on the abdomen
Lying prone keeps the fundus contracted and is especially useful with
multiparas,who commonly experience afterpains due to lack of uterine tone.
12. Which maternal behavior is the nurse most likely to see when a new mother
receives her infant for the first time?
Her arms and hands receive the infant and she then traces the infant's profile
withher fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate
behaviorsdescribed in during the first visit with the newborn, which may be at
delivery or later.
13. A client at 32-weeks gestation is hospitalized with severe pregnancy-
induced hypertension (PIH), and magnesium sulfate is prescribed to control
the symptoms.Which assessment finding indicates the therapeutic drug
level has been achieved?
A decreased in respiratory rate from 24 to 16
Magnesium sulfate, a CNS depressant, helps prevent seizures. A decreased
respiratory rate indicates that the drug is effective. (Respiratory rate below 12
indicatestoxic effects.)
14. Urinary output must be monitored when administering magnesium sulfate and
should be at least 30 ml per hour. (The therapeutic level of magnesium sulfate
for a PIH clientis 4.8 to 9.6 mg/dl.) What is the therapeutic level of magnesium
sulfate?
The therapeutic level of magnesium sulfate for a PIH client is 4.8 to 9.6
mg/dl. What does it help prevent? helps prevent seizures
What indicates toxic levels? 3
Respiratory rate below 12 indicates toxic
effects.Urine output of less than 100 ml/4
hours
Absent DTRs
15. Twenty minutes after a continuous epidural anesthetic is administered, a laboring
client'sblood pressure drops from 120/80 to 90/60. What action should the nurse
take?
19
, Place woman in a lateral position
The nurse should immediately turn the woman to a lateral position, place a
pillow orwedge under the right hip to deflect the uterus, increase the rate of
the main line IVinfusion, and administer oxygen by face mask at 10-12 L/min. If
the blood pressure remains low, especially if it further decreases, the
anesthesiologist/healthcare provider should be notified immediately.
16. A client at 28-weeks gestation calls the antepartum clinic and states that she
is experiencing a small amount of vaginal bleeding which she describes as
bright red. She further states that she is not experiencing any uterine
contractions or abdominalpain. What instruction should the nurse provide?
Come to the clinic today for an ultrasound
Third trimester painless bleeding is characteristic of a placenta previa. Bright
red bleeding may be intermittent, occur in gushes, or be continuous. Rarely is
the first incidence life-threatening, nor cause for hypovolemic shock.
Diagnosis is confirmedby transabdominal ultrasound.
17. An off-duty nurse finds a woman in a supermarket parking lot delivering an
infant while her husband is screaming for someone to help his wife. Which
intervention hasthe highest priority?
Put the newborn to breast
Putting the newborn to breast will help contract the uterus and prevent a
postpartum hemorrhage--this intervention has the highest priority.
18. A pregnant client with mitral stenosis Class III is prescribed complete bedrest.
The clientasks the nurse, "Why must I stay in bed all the time?" Which response
is best for the nurse to provide this client?
Complete bedrest decreases oxygen needs and demands on the heart muscle tissue.
To help preserve cardiac reserves, the woman may need to restrict her
activitiesand complete bedrest is often prescribed.
19. The nurse is teaching care of the newborn to a group of prospective parents
and describes the need for administering antibiotic ointment into the eyes of
the newborn.Which infectious organism will this treatment prevent from
harming the infant?
Gonorrhea
Erythromycin ointment is instilled into the lower conjunctiva of each eye within 2
hoursafter birth to prevent ophthalmic neonatorum, an infection caused by
gonorrhea, and inclusion conjunctivitis, an infection caused by chlamydia. The
infant may be exposedto these bacteria when passing through the birth canal.
19
