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HESI MATERNITY OB EXAM VERSION 2
ACTUAL EXAM PREP 2026 ALL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES |TOP RATED VERSION FOR
2026 BY EXPERTS |NEW AND REVISED
1. A client at 36 weeks gestation is admitted with a diagnosis of
preeclampsia with severe features. The nurse notes that the client's blood
pressure is 168/110 mm Hg, and she reports a persistent headache and
epigastric pain. The provider orders magnesium sulfate. Which
assessment finding indicates the need for the nurse to discontinue the
magnesium sulfate infusion?
A. Urine output of 35 mL/hour
B. Respiratory rate of 16 breaths per minute
C. Deep tendon reflexes of 3+
D. Serum magnesium level of 11 mg/dL
Correct Answer: D
Rationale: A serum magnesium level of 11 mg/dL indicates
magnesium toxicity (therapeutic range is 4.8-9.6 mg/dL). Signs of
toxicity include respiratory depression (<12 breaths/minute), absent
deep tendon reflexes, and oliguria (<30 mL/hour). The infusion
should be discontinued, and calcium gluconate administered. Urine
output of 35 mL/hour, respiratory rate of 16, and DTRs of 3+ are
within acceptable ranges.
2. A client at 40 weeks gestation is in active labor. The fetal heart rate
tracing shows recurrent variable decelerations with a "W" shape. The
nurse should implement which intervention first?
A. Administer oxygen at 10 L/min via face mask
B. Place the client in a knee-chest position
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C. Perform a sterile vaginal exam to assess for cord prolapse
D. Discontinue oxytocin if infusing
Correct Answer: C
Rationale: Variable decelerations are caused by umbilical cord
compression. A "W" shape indicates more significant cord
compression. The priority action is to perform a sterile vaginal exam to
rule out cord prolapse. While position changes and oxygen may be
beneficial, cord prolapse is an emergency requiring immediate
intervention. Oxytocin discontinuation is not the first step unless
hyperstimulation is present.
3. A postpartum client who delivered via cesarean section 24 hours ago
reports sudden, sharp chest pain and shortness of breath. The nurse notes
that the client's oxygen saturation is 88% on room air. What is the
priority nursing action?
A. Administer oxygen via non-rebreather mask and notify the healthcare
provider
B. Encourage the client to take deep breaths and cough
C. Apply sequential compression devices to the lower extremities
D. Administer a prescribed anticoagulant
Correct Answer: A
Rationale: Sudden onset of chest pain and shortness of breath with
hypoxia suggests a pulmonary embolism, which is a medical
emergency. The priority action is to administer oxygen and
immediately notify the healthcare provider. Deep breathing, SCDs, and
anticoagulants are not the immediate priority in an acute, life-
threatening situation.
4. A client at 34 weeks gestation with preterm labor is prescribed
magnesium sulfate for neuroprotection. The nurse understands that the
primary purpose of this medication is to:
A. Stop uterine contractions
B. Reduce the risk of cerebral palsy in the preterm infant
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C. Promote fetal lung maturity
D. Lower maternal blood pressure
Correct Answer: B
Rationale: Magnesium sulfate is administered for neuroprotection in
preterm labor (before 32 weeks gestation) to reduce the risk of cerebral
palsy in the preterm infant. It is not a tocolytic (those stop
contractions), does not promote lung maturity (corticosteroids do that),
and while it lowers blood pressure in preeclampsia, that is not its
primary purpose in preterm labor.
5. A client at 38 weeks gestation with gestational diabetes is admitted for
induction of labor. The nurse anticipates that the newborn will be at risk
for which complication immediately after birth?
A. Hyperglycemia
B. Hypoglycemia
C. Hyperbilirubinemia
D. Respiratory distress syndrome
Correct Answer: B
Rationale: Infants of mothers with gestational diabetes are at risk for
hypoglycemia after birth due to fetal hyperinsulinemia. The abrupt
cessation of maternal glucose supply at birth results in neonatal
hypoglycemia. Hyperglycemia is less common; hyperbilirubinemia and
respiratory distress are not directly related to gestational diabetes
unless the infant is preterm.
6. A client at 28 weeks gestation with a history of previous preterm birth
is prescribed progesterone supplementation. The nurse explains that the
purpose of this medication is to:
A. Prevent infection
B. Reduce the risk of preterm labor
C. Promote fetal lung maturity
D. Increase amniotic fluid volume
Correct Answer: B
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Rationale: Progesterone supplementation is used to reduce the risk of
preterm labor in women with a history of previous preterm birth. It
helps maintain uterine quiescence. It does not prevent infection,
promote lung maturity (corticosteroids do that), or increase amniotic
fluid volume.
7. A client at 39 weeks gestation is in labor. The nurse notes that the
client's cervix is 9 cm dilated, 100% effaced, and the presenting part is at
+2 station. The client reports an overwhelming urge to push. The nurse's
best response is to:
A. Instruct the client to push with each contraction
B. Encourage the client to pant or blow through the urge to push
C. Perform a sterile vaginal exam to confirm full dilation
D. Prepare for immediate delivery
Correct Answer: A
Rationale: At 9 cm dilation, the client is in the transition phase.
However, with a +2 station, the presenting part is low in the pelvis. The
urge to push indicates the client is ready to push, especially if the
cervix is fully effaced. The nurse should instruct the client to push
with contractions to facilitate delivery. Panting or blowing is
appropriate when the cervix is not fully dilated and pushing could
cause cervical edema.
8. A client at 32 weeks gestation with preeclampsia is prescribed
labetalol. The nurse should monitor for which potential side effect?
A. Tachycardia
B. Bradycardia
C. Hyperglycemia
D. Hypokalemia
Correct Answer: B
Rationale: Labetalol is a beta-blocker that can cause bradycardia. It
also lowers blood pressure. Tachycardia is not expected;
HESI MATERNITY OB EXAM VERSION 2
ACTUAL EXAM PREP 2026 ALL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES |TOP RATED VERSION FOR
2026 BY EXPERTS |NEW AND REVISED
1. A client at 36 weeks gestation is admitted with a diagnosis of
preeclampsia with severe features. The nurse notes that the client's blood
pressure is 168/110 mm Hg, and she reports a persistent headache and
epigastric pain. The provider orders magnesium sulfate. Which
assessment finding indicates the need for the nurse to discontinue the
magnesium sulfate infusion?
A. Urine output of 35 mL/hour
B. Respiratory rate of 16 breaths per minute
C. Deep tendon reflexes of 3+
D. Serum magnesium level of 11 mg/dL
Correct Answer: D
Rationale: A serum magnesium level of 11 mg/dL indicates
magnesium toxicity (therapeutic range is 4.8-9.6 mg/dL). Signs of
toxicity include respiratory depression (<12 breaths/minute), absent
deep tendon reflexes, and oliguria (<30 mL/hour). The infusion
should be discontinued, and calcium gluconate administered. Urine
output of 35 mL/hour, respiratory rate of 16, and DTRs of 3+ are
within acceptable ranges.
2. A client at 40 weeks gestation is in active labor. The fetal heart rate
tracing shows recurrent variable decelerations with a "W" shape. The
nurse should implement which intervention first?
A. Administer oxygen at 10 L/min via face mask
B. Place the client in a knee-chest position
,2|Page
C. Perform a sterile vaginal exam to assess for cord prolapse
D. Discontinue oxytocin if infusing
Correct Answer: C
Rationale: Variable decelerations are caused by umbilical cord
compression. A "W" shape indicates more significant cord
compression. The priority action is to perform a sterile vaginal exam to
rule out cord prolapse. While position changes and oxygen may be
beneficial, cord prolapse is an emergency requiring immediate
intervention. Oxytocin discontinuation is not the first step unless
hyperstimulation is present.
3. A postpartum client who delivered via cesarean section 24 hours ago
reports sudden, sharp chest pain and shortness of breath. The nurse notes
that the client's oxygen saturation is 88% on room air. What is the
priority nursing action?
A. Administer oxygen via non-rebreather mask and notify the healthcare
provider
B. Encourage the client to take deep breaths and cough
C. Apply sequential compression devices to the lower extremities
D. Administer a prescribed anticoagulant
Correct Answer: A
Rationale: Sudden onset of chest pain and shortness of breath with
hypoxia suggests a pulmonary embolism, which is a medical
emergency. The priority action is to administer oxygen and
immediately notify the healthcare provider. Deep breathing, SCDs, and
anticoagulants are not the immediate priority in an acute, life-
threatening situation.
4. A client at 34 weeks gestation with preterm labor is prescribed
magnesium sulfate for neuroprotection. The nurse understands that the
primary purpose of this medication is to:
A. Stop uterine contractions
B. Reduce the risk of cerebral palsy in the preterm infant
,3|Page
C. Promote fetal lung maturity
D. Lower maternal blood pressure
Correct Answer: B
Rationale: Magnesium sulfate is administered for neuroprotection in
preterm labor (before 32 weeks gestation) to reduce the risk of cerebral
palsy in the preterm infant. It is not a tocolytic (those stop
contractions), does not promote lung maturity (corticosteroids do that),
and while it lowers blood pressure in preeclampsia, that is not its
primary purpose in preterm labor.
5. A client at 38 weeks gestation with gestational diabetes is admitted for
induction of labor. The nurse anticipates that the newborn will be at risk
for which complication immediately after birth?
A. Hyperglycemia
B. Hypoglycemia
C. Hyperbilirubinemia
D. Respiratory distress syndrome
Correct Answer: B
Rationale: Infants of mothers with gestational diabetes are at risk for
hypoglycemia after birth due to fetal hyperinsulinemia. The abrupt
cessation of maternal glucose supply at birth results in neonatal
hypoglycemia. Hyperglycemia is less common; hyperbilirubinemia and
respiratory distress are not directly related to gestational diabetes
unless the infant is preterm.
6. A client at 28 weeks gestation with a history of previous preterm birth
is prescribed progesterone supplementation. The nurse explains that the
purpose of this medication is to:
A. Prevent infection
B. Reduce the risk of preterm labor
C. Promote fetal lung maturity
D. Increase amniotic fluid volume
Correct Answer: B
, 4|Page
Rationale: Progesterone supplementation is used to reduce the risk of
preterm labor in women with a history of previous preterm birth. It
helps maintain uterine quiescence. It does not prevent infection,
promote lung maturity (corticosteroids do that), or increase amniotic
fluid volume.
7. A client at 39 weeks gestation is in labor. The nurse notes that the
client's cervix is 9 cm dilated, 100% effaced, and the presenting part is at
+2 station. The client reports an overwhelming urge to push. The nurse's
best response is to:
A. Instruct the client to push with each contraction
B. Encourage the client to pant or blow through the urge to push
C. Perform a sterile vaginal exam to confirm full dilation
D. Prepare for immediate delivery
Correct Answer: A
Rationale: At 9 cm dilation, the client is in the transition phase.
However, with a +2 station, the presenting part is low in the pelvis. The
urge to push indicates the client is ready to push, especially if the
cervix is fully effaced. The nurse should instruct the client to push
with contractions to facilitate delivery. Panting or blowing is
appropriate when the cervix is not fully dilated and pushing could
cause cervical edema.
8. A client at 32 weeks gestation with preeclampsia is prescribed
labetalol. The nurse should monitor for which potential side effect?
A. Tachycardia
B. Bradycardia
C. Hyperglycemia
D. Hypokalemia
Correct Answer: B
Rationale: Labetalol is a beta-blocker that can cause bradycardia. It
also lowers blood pressure. Tachycardia is not expected;
