==============================
EXAM TITLE: HESI PN OB & Peds Practice Exam Questions | 100%
Correct Answers with Detailed Rationales (2026/2027 Edition)
Practical Nursing HESI Practice Examination – Obstetric and Pediatric Nursing
==============================
SECTION 1: Antepartum Nursing
Question 1
A practical nurse is caring for a client at 32 weeks gestation who has been diagnosed
with gestational diabetes mellitus (GDM). The client asks why she needs to monitor her
blood glucose levels. Which response by the practical nurse is most accurate?
A. "Monitoring is only necessary to prevent you from gaining too much weight during
pregnancy."
B. "Elevated blood glucose increases the risk of fetal macrosomia, birth trauma, and
neonatal hypoglycemia, so control is essential."
C. "Blood glucose monitoring is required because gestational diabetes always
progresses to type 2 diabetes after delivery."
D. "Your blood sugar only needs to be checked once per week since GDM is not a
serious condition."
Correct Answer: B
,Rationale: Gestational diabetes mellitus increases the risk of fetal macrosomia (birth
weight greater than 4,000 g), which can lead to birth trauma, shoulder dystocia, and
cesarean delivery. Neonatal hypoglycemia is also a significant risk due to fetal
hyperinsulinemia. The practical nurse must educate the client that blood glucose
monitoring and control are essential to reduce these complications. GDM does not
always progress to type 2 diabetes, and monitoring frequency is typically more than
once weekly.
Question 2
A client at 24 weeks gestation reports a severe headache, visual disturbances, and right
upper quadrant pain. Her blood pressure is 158/96 mmHg, and she has 2+ proteinuria.
Based on these findings, the practical nurse should recognize these symptoms as
indicative of which condition?
A. Normal physiological changes of pregnancy
B. Mild preeclampsia
C. Severe preeclampsia
D. Gestational hypertension without proteinuria
Correct Answer: C
Rationale: Severe preeclampsia is characterized by blood pressure of 160/110 mmHg or
higher (or a significant rise), proteinuria, and symptoms including severe headache,
visual disturbances (blurred vision, scotomata), and right upper quadrant or epigastric
pain (indicating liver involvement). This client presents with all these hallmark
,symptoms. The practical nurse must immediately notify the registered nurse or provider,
as severe preeclampsia requires urgent intervention to prevent progression to
eclampsia.
Question 3
A practical nurse is reviewing the prenatal record of a client at 16 weeks gestation. The
client's rubella titer indicates she is non-immune. Which action by the practical nurse is
most appropriate?
A. Administer the rubella vaccine immediately to protect the fetus.
B. Document the finding and instruct the client to avoid contact with individuals who
have rubella; plan for postpartum vaccination.
C. Inform the client that rubella immunity is not important during pregnancy.
D. Recommend the client take oral acyclovir to prevent rubella infection.
Correct Answer: B
Rationale: The rubella vaccine is a live attenuated vaccine and is contraindicated during
pregnancy due to the risk of congenital rubella syndrome. The practical nurse should
document the non-immune status, educate the client to avoid exposure to individuals
with rubella, and plan for postpartum vaccination. Acyclovir is an antiviral medication
used for herpes simplex virus, not rubella.
Question 4
, A client at 28 weeks gestation is Rh-negative and has a negative antibody screen. She
experienced a minor fall and reports mild abdominal tenderness. Which intervention
should the practical nurse anticipate?
A. Administration of Rh immune globulin (RhoGAM) within 72 hours of the traumatic
event.
B. Immediate delivery of the fetus to prevent hemolytic disease.
C. No intervention is needed since the client is only 28 weeks gestation.
D. Administration of a tetanus toxoid vaccine only.
Correct Answer: A
Rationale: Any potential fetomaternal hemorrhage event in an Rh-negative client,
including trauma, amniocentesis, or abdominal injury, requires administration of Rh
immune globulin (RhoGAM) within 72 hours to prevent sensitization. The standard dose
is 300 mcg, which covers up to 30 mL of fetal whole blood exposure. Failure to
administer RhoGAM can result in alloimmunization and hemolytic disease of the fetus
and newborn in subsequent pregnancies.
Question 5
A practical nurse is assessing a client at 20 weeks gestation who reports vaginal
bleeding. The client states the bleeding began suddenly, is bright red, and she has no
pain. Her fundal height measures 22 cm, and fetal heart tones are present. Based on
these findings, the practical nurse should suspect which condition?
A. Placental abruption
EXAM TITLE: HESI PN OB & Peds Practice Exam Questions | 100%
Correct Answers with Detailed Rationales (2026/2027 Edition)
Practical Nursing HESI Practice Examination – Obstetric and Pediatric Nursing
==============================
SECTION 1: Antepartum Nursing
Question 1
A practical nurse is caring for a client at 32 weeks gestation who has been diagnosed
with gestational diabetes mellitus (GDM). The client asks why she needs to monitor her
blood glucose levels. Which response by the practical nurse is most accurate?
A. "Monitoring is only necessary to prevent you from gaining too much weight during
pregnancy."
B. "Elevated blood glucose increases the risk of fetal macrosomia, birth trauma, and
neonatal hypoglycemia, so control is essential."
C. "Blood glucose monitoring is required because gestational diabetes always
progresses to type 2 diabetes after delivery."
D. "Your blood sugar only needs to be checked once per week since GDM is not a
serious condition."
Correct Answer: B
,Rationale: Gestational diabetes mellitus increases the risk of fetal macrosomia (birth
weight greater than 4,000 g), which can lead to birth trauma, shoulder dystocia, and
cesarean delivery. Neonatal hypoglycemia is also a significant risk due to fetal
hyperinsulinemia. The practical nurse must educate the client that blood glucose
monitoring and control are essential to reduce these complications. GDM does not
always progress to type 2 diabetes, and monitoring frequency is typically more than
once weekly.
Question 2
A client at 24 weeks gestation reports a severe headache, visual disturbances, and right
upper quadrant pain. Her blood pressure is 158/96 mmHg, and she has 2+ proteinuria.
Based on these findings, the practical nurse should recognize these symptoms as
indicative of which condition?
A. Normal physiological changes of pregnancy
B. Mild preeclampsia
C. Severe preeclampsia
D. Gestational hypertension without proteinuria
Correct Answer: C
Rationale: Severe preeclampsia is characterized by blood pressure of 160/110 mmHg or
higher (or a significant rise), proteinuria, and symptoms including severe headache,
visual disturbances (blurred vision, scotomata), and right upper quadrant or epigastric
pain (indicating liver involvement). This client presents with all these hallmark
,symptoms. The practical nurse must immediately notify the registered nurse or provider,
as severe preeclampsia requires urgent intervention to prevent progression to
eclampsia.
Question 3
A practical nurse is reviewing the prenatal record of a client at 16 weeks gestation. The
client's rubella titer indicates she is non-immune. Which action by the practical nurse is
most appropriate?
A. Administer the rubella vaccine immediately to protect the fetus.
B. Document the finding and instruct the client to avoid contact with individuals who
have rubella; plan for postpartum vaccination.
C. Inform the client that rubella immunity is not important during pregnancy.
D. Recommend the client take oral acyclovir to prevent rubella infection.
Correct Answer: B
Rationale: The rubella vaccine is a live attenuated vaccine and is contraindicated during
pregnancy due to the risk of congenital rubella syndrome. The practical nurse should
document the non-immune status, educate the client to avoid exposure to individuals
with rubella, and plan for postpartum vaccination. Acyclovir is an antiviral medication
used for herpes simplex virus, not rubella.
Question 4
, A client at 28 weeks gestation is Rh-negative and has a negative antibody screen. She
experienced a minor fall and reports mild abdominal tenderness. Which intervention
should the practical nurse anticipate?
A. Administration of Rh immune globulin (RhoGAM) within 72 hours of the traumatic
event.
B. Immediate delivery of the fetus to prevent hemolytic disease.
C. No intervention is needed since the client is only 28 weeks gestation.
D. Administration of a tetanus toxoid vaccine only.
Correct Answer: A
Rationale: Any potential fetomaternal hemorrhage event in an Rh-negative client,
including trauma, amniocentesis, or abdominal injury, requires administration of Rh
immune globulin (RhoGAM) within 72 hours to prevent sensitization. The standard dose
is 300 mcg, which covers up to 30 mL of fetal whole blood exposure. Failure to
administer RhoGAM can result in alloimmunization and hemolytic disease of the fetus
and newborn in subsequent pregnancies.
Question 5
A practical nurse is assessing a client at 20 weeks gestation who reports vaginal
bleeding. The client states the bleeding began suddenly, is bright red, and she has no
pain. Her fundal height measures 22 cm, and fetal heart tones are present. Based on
these findings, the practical nurse should suspect which condition?
A. Placental abruption
