HESI Exit Exam Maternity and Pediatric Nursing Questions and Answers with Rationale 2026/2027

,HESI Exit Exam Maternity and Pediatric Nursing Questions
and Answers with Rationale 2026/2027


Question 1

A primigravida client at 38 weeks gestation is admitted to the labor and
delivery unit in active labor. The fetal heart rate baseline is 140 beats per
minute with moderate variability and early decelerations coinciding with
uterine contractions. What is the appropriate nursing action?

 A. Prepare for an emergent Cesarean section.
 B. Continue to monitor the fetal heart rate pattern as a normal
finding.
 C. Administer oxygen via non-rebreather mask at 10 L/min.
 D. Stop the oxytocin infusion immediately.

Correct Answer: B. Continue to monitor the fetal heart rate pattern as a
normal finding.

 Rationale: Early decelerations are benign mirror images of uterine
contractions caused by head compression during labor. They
require no interventions other than routine continued observation.

Question 2

A nurse is assessing a newborn infant delivered 1 minute ago. The infant
has a heart rate of 130 beats per minute, cries vigorously upon
stimulation, has flexion of the extremities, grimaces to suctioning, and
possesses a pink body with blue extremities (acrocyanosis). What is the
newborn's Apgar score?

 A. 7
 B. 8
 C. 9
 D. 10

,Correct Answer: C. 9

 Rationale: Scoring breakdown: Heart rate > 100 bpm = 2;
Cry/vigorous = 2; Flexion of extremities = 2; Grimace/reflex
irritability = 2; Body pink, extremities blue (acrocyanosis) = 1.
Total score is 2 + 2 + 2 + 2 + 1 = 9.

Question 3

A postpartum client who delivered a term infant 4 hours ago reports
severe, persistent lower back pain and a feeling of pressure in the
perineum, despite receiving prescribed analgesics. Upon inspection, the
fundus is firm and midline, but a small, tense, exquisitely tender bluish
swelling is visible on the right labia. What complication has likely
developed?

 A. Uterine atony
 B. Vaginal hematoma
 C. Postpartum endometritis
 D. Cervical laceration

Correct Answer: B. Vaginal hematoma

 Rationale: A vaginal hematoma is characterized by severe perineal
or pelvic pain and pressure accompanied by a firm uterus and a
visible, tender, discolored swelling. It results from blood vessel
injury during delivery.

Question 4

An infant is admitted to the pediatric unit with a diagnosis of acute
bronchiolitis caused by respiratory syncytial virus (RSV). Which
isolation precautions should the nurse implement immediately?

 A. Airborne precautions
 B. Droplet precautions in addition to standard precautions
 C. Contact precautions in addition to standard precautions

,  D. Protective environment (reverse isolation)

Correct Answer: C. Contact precautions in addition to standard
precautions

 Rationale: RSV is primarily transmitted through direct contact with
respiratory secretions or contaminated surfaces. Contact
precautions (gown and gloves) are required alongside standard
precautions.

Question 5

A nurse is caring for a 4-year-old child admitted with acute epiglottitis.
Which nursing action is strictly contraindicated for this child?

 A. Administering intravenous antibiotic therapy
 B. Leaving the child in a comfortable upright position
 C. Attempting to examine the throat using a tongue depressor or
obtaining a throat culture
 D. Keeping emergency intubation equipment at the bedside

Correct Answer: C. Attempting to examine the throat using a tongue
depressor or obtaining a throat culture

 Rationale: In a child with epiglottitis, any stimulation of the throat
with a tongue depressor or swab can trigger sudden, fatal complete
laryngospasm and airway obstruction. Examination of the airway
should only be performed by an experienced provider with
intubation equipment ready.

Question 6

A nurse is assessing a 2-month-old infant during a routine well-child
visit. Which developmental milestone or physical finding should the
nurse expect to observe?

 A. The ability to sit unsupported without assistance