HESI PN OB EXAM 100 ACTUAL QUESTIONS AND CORRECT
ANSWERS WITH RATIONALE LATEST 2026 ALREADY
GRADED A+
1. A nurse is caring for a client at 12 weeks gestation who reports nausea and
vomiting. Which recommendation is most appropriate?
A) Increase intake of spicy foods to stimulate digestion.
B) Lie flat for 30 minutes after eating.
C) Eat dry crackers before getting out of bed in the morning.
D) Decrease fluid intake to prevent stomach distension.
Answer: C
Rationale: Dry crackers or toast before rising helps stabilize blood sugar and settle
the stomach. Spicy foods can worsen nausea, lying flat promotes reflux, and fluid
intake should be maintained to prevent dehydration .
2. A primigravida at 38 weeks gestation with gestational diabetes is admitted for a
non-stress test (NST). The nurse notes a baseline fetal heart rate of 140 bpm with
moderate variability and two accelerations of 15 bpm above baseline lasting 15
seconds in 20 minutes. How should the nurse interpret this finding?
A) Non-reactive, needs a contraction stress test.
B) Equivocal, needs a biophysical profile.
C) Reactive, indicating fetal well-being.
D) Abnormal, indicating fetal hypoxia.
Answer: C
Rationale: A reactive NST in a term fetus is defined as two accelerations in 20
minutes, a reassuring sign of fetal well-being. A non-reactive result would require
further testing .
3. A nurse is providing education to a client at 10 weeks gestation about
recommended weight gain. The client has a pre-pregnancy BMI of 30. What
weight gain range is most appropriate?
A) 28-40 lbs
B) 25-35 lbs
C) 11-20 lbs
D) 15-25 lbs
Answer: C
,Rationale: For obese women (BMI ≥30), the recommended total weight gain is 11-
20 lbs (5-9 kg). This supports fetal growth while minimizing risks like gestational
hypertension and macrosomia .
4. A nurse is assessing a client at 36 weeks gestation who reports a sudden gush of
fluid from the vagina. The fluid is clear and the fetal heart rate is 155 bpm. What is
the priority nursing action?
A) Assess for cervical dilation.
B) Check the pH of the fluid with nitrazine paper.
C) Administer an oral analgesic for pain.
D) Prepare for immediate cesarean section.
Answer: B
Rationale: Confirming rupture of membranes is the priority. Nitrazine paper turns
blue if amniotic fluid is present (pH 7.1-7.3). Vaginal exams should be limited to
prevent infection if membranes are ruptured .
5. A client with Rh-negative blood at 28 weeks gestation has just received Rho(D)
immune globulin (RhoGAM). The client asks why this is necessary. What is the
best response by the nurse?
A) It prevents the development of Rh antibodies in case of fetal-maternal blood
mixing.
B) It treats anemia in the fetus.
C) It prevents preterm labor.
D) It reduces the risk of gestational diabetes.
Answer: A
Rationale: RhoGAM prevents Rh isoimmunization by binding to Rh-positive fetal
RBCs, preventing maternal antibody formation. It does not treat fetal anemia,
prevent preterm labor, or affect gestational diabetes .
6. A nurse is assessing a client with preeclampsia who is receiving IV magnesium
sulfate. Which finding indicates magnesium toxicity?
A) Respiratory rate of 16 breaths/minute.
B) Urine output of 40 mL/hr.
C) Absent deep tendon reflexes.
D) Serum magnesium level of 5 mEq/L.
Answer: C
Rationale: Absent deep tendon reflexes (areflexia) is a sign of magnesium toxicity.
Other signs include respiratory depression (<12/min) and oliguria (<30 mL/hr). A
level of 5 mEq/L is within therapeutic range (4-7 mEq/L) .
, 7. A client in active labor has received epidural analgesia. The nurse notes the
client's blood pressure is 90/50 mmHg and the fetal heart rate shows late
decelerations. What is the priority nursing action?
A) Administer a fluid bolus and reposition the client.
B) Increase the epidural infusion rate.
C) Prepare for immediate cesarean section.
D) Document the findings as normal.
Answer: A
Rationale: Hypotension from epidural analgesia can compromise uteroplacental
perfusion, causing late decelerations. A fluid bolus and repositioning (lateral) are
the first-line interventions to improve blood pressure and fetal oxygenation .
8. A client in the transition phase of labor (8-10 cm dilation) is assessed. Which
finding is expected?
A) A strong urge to push and bloody show.
B) Irritability, feelings of loss of control, and intense contractions every 2-3
minutes.
C) Contractions lasting 30 seconds with intervals of 5-7 minutes.
D) Cervical dilation of 4 cm.
Answer: B
Rationale: Transition is 8-10 cm dilation, characterized by intense contractions,
irritability, and a feeling of loss of control. Pushing is not appropriate until full
dilation. 4 cm is active labor .
9. Immediately after an amniotomy, the nurse notes a loop of umbilical cord
protruding from the vagina. What is the priority action?
A) Cover the cord with dry, sterile gauze.
B) Place the client in a knee-chest position and apply pressure to the presenting
part.
C) Apply sterile saline-soaked gauze to the cord, insert a gloved hand into the
vagina to relieve pressure on the cord, and call for assistance.
D) Administer oxygen at 2 L/min via nasal cannula.
Answer: C
Rationale: This is a prolapsed cord. Immediate relief of pressure on the cord is
critical. The nurse should lift the presenting part off the cord with a gloved hand,
cover the cord with moistened gauze, and prepare for emergency delivery .
10. A client who is group B streptococcus (GBS) positive is admitted in active
labor with ruptured membranes. What medication should the nurse anticipate
administering?
ANSWERS WITH RATIONALE LATEST 2026 ALREADY
GRADED A+
1. A nurse is caring for a client at 12 weeks gestation who reports nausea and
vomiting. Which recommendation is most appropriate?
A) Increase intake of spicy foods to stimulate digestion.
B) Lie flat for 30 minutes after eating.
C) Eat dry crackers before getting out of bed in the morning.
D) Decrease fluid intake to prevent stomach distension.
Answer: C
Rationale: Dry crackers or toast before rising helps stabilize blood sugar and settle
the stomach. Spicy foods can worsen nausea, lying flat promotes reflux, and fluid
intake should be maintained to prevent dehydration .
2. A primigravida at 38 weeks gestation with gestational diabetes is admitted for a
non-stress test (NST). The nurse notes a baseline fetal heart rate of 140 bpm with
moderate variability and two accelerations of 15 bpm above baseline lasting 15
seconds in 20 minutes. How should the nurse interpret this finding?
A) Non-reactive, needs a contraction stress test.
B) Equivocal, needs a biophysical profile.
C) Reactive, indicating fetal well-being.
D) Abnormal, indicating fetal hypoxia.
Answer: C
Rationale: A reactive NST in a term fetus is defined as two accelerations in 20
minutes, a reassuring sign of fetal well-being. A non-reactive result would require
further testing .
3. A nurse is providing education to a client at 10 weeks gestation about
recommended weight gain. The client has a pre-pregnancy BMI of 30. What
weight gain range is most appropriate?
A) 28-40 lbs
B) 25-35 lbs
C) 11-20 lbs
D) 15-25 lbs
Answer: C
,Rationale: For obese women (BMI ≥30), the recommended total weight gain is 11-
20 lbs (5-9 kg). This supports fetal growth while minimizing risks like gestational
hypertension and macrosomia .
4. A nurse is assessing a client at 36 weeks gestation who reports a sudden gush of
fluid from the vagina. The fluid is clear and the fetal heart rate is 155 bpm. What is
the priority nursing action?
A) Assess for cervical dilation.
B) Check the pH of the fluid with nitrazine paper.
C) Administer an oral analgesic for pain.
D) Prepare for immediate cesarean section.
Answer: B
Rationale: Confirming rupture of membranes is the priority. Nitrazine paper turns
blue if amniotic fluid is present (pH 7.1-7.3). Vaginal exams should be limited to
prevent infection if membranes are ruptured .
5. A client with Rh-negative blood at 28 weeks gestation has just received Rho(D)
immune globulin (RhoGAM). The client asks why this is necessary. What is the
best response by the nurse?
A) It prevents the development of Rh antibodies in case of fetal-maternal blood
mixing.
B) It treats anemia in the fetus.
C) It prevents preterm labor.
D) It reduces the risk of gestational diabetes.
Answer: A
Rationale: RhoGAM prevents Rh isoimmunization by binding to Rh-positive fetal
RBCs, preventing maternal antibody formation. It does not treat fetal anemia,
prevent preterm labor, or affect gestational diabetes .
6. A nurse is assessing a client with preeclampsia who is receiving IV magnesium
sulfate. Which finding indicates magnesium toxicity?
A) Respiratory rate of 16 breaths/minute.
B) Urine output of 40 mL/hr.
C) Absent deep tendon reflexes.
D) Serum magnesium level of 5 mEq/L.
Answer: C
Rationale: Absent deep tendon reflexes (areflexia) is a sign of magnesium toxicity.
Other signs include respiratory depression (<12/min) and oliguria (<30 mL/hr). A
level of 5 mEq/L is within therapeutic range (4-7 mEq/L) .
, 7. A client in active labor has received epidural analgesia. The nurse notes the
client's blood pressure is 90/50 mmHg and the fetal heart rate shows late
decelerations. What is the priority nursing action?
A) Administer a fluid bolus and reposition the client.
B) Increase the epidural infusion rate.
C) Prepare for immediate cesarean section.
D) Document the findings as normal.
Answer: A
Rationale: Hypotension from epidural analgesia can compromise uteroplacental
perfusion, causing late decelerations. A fluid bolus and repositioning (lateral) are
the first-line interventions to improve blood pressure and fetal oxygenation .
8. A client in the transition phase of labor (8-10 cm dilation) is assessed. Which
finding is expected?
A) A strong urge to push and bloody show.
B) Irritability, feelings of loss of control, and intense contractions every 2-3
minutes.
C) Contractions lasting 30 seconds with intervals of 5-7 minutes.
D) Cervical dilation of 4 cm.
Answer: B
Rationale: Transition is 8-10 cm dilation, characterized by intense contractions,
irritability, and a feeling of loss of control. Pushing is not appropriate until full
dilation. 4 cm is active labor .
9. Immediately after an amniotomy, the nurse notes a loop of umbilical cord
protruding from the vagina. What is the priority action?
A) Cover the cord with dry, sterile gauze.
B) Place the client in a knee-chest position and apply pressure to the presenting
part.
C) Apply sterile saline-soaked gauze to the cord, insert a gloved hand into the
vagina to relieve pressure on the cord, and call for assistance.
D) Administer oxygen at 2 L/min via nasal cannula.
Answer: C
Rationale: This is a prolapsed cord. Immediate relief of pressure on the cord is
critical. The nurse should lift the presenting part off the cord with a gloved hand,
cover the cord with moistened gauze, and prepare for emergency delivery .
10. A client who is group B streptococcus (GBS) positive is admitted in active
labor with ruptured membranes. What medication should the nurse anticipate
administering?
