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,HESI RN Maternity Exam 2026 | OB Nursing Exam
Prep | NGN Questions (Pdf)
. A nurse is assessing a client at 35 weeks gestation with
severe preeclampsia. Which finding indicates magnesium
sulfate toxicity?
A. Deep tendon reflexes 2+
B. Respiratory rate 14 breaths/min
C. Urine output 35 mL/hr
D. Absent patellar reflexes
Answer: D
Rationale: Magnesium sulfate toxicity causes loss of
patellar (deep tendon) reflexes first, typically at serum
levels of 8-10 mEq/L. Respiratory depression occurs at
higher levels (>10 mEq/L). Normal DTRs are 1-2+.
Normal respiratory rate is 12-20 breaths/min. Normal
urine output is ≥30 mL/hr. Absent reflexes require
immediate discontinuation of magnesium and
administration of calcium gluconate.
2
,2. A newborn has Apgar scores of 4 at 1 minute and 7 at
5 minutes. Which action should the nurse take at 1 minute?
A. Begin chest compressions
B. Administer epinephrine
C. Provide positive pressure ventilation
D. Place under radiant warmer, dry, and stimulate
Answer: D
Rationale: An Apgar score of 4 at 1 minute indicates
moderate distress. The initial steps of newborn
resuscitation are: warm, dry, stimulate, and position the
airway. Positive pressure ventilation is initiated only if the
newborn is apneic, gasping, or heart rate <100 bpm
after these initial steps. Chest compressions are for heart
rate <60 bpm despite adequate ventilation. Epinephrine
is given after at least 30-60 seconds of compressions.
3
, 3. A client at 40 weeks gestation is in active labor. The
nurse notes the fetal heart rate baseline is 175 bpm.
What is the priority nursing action?
A. Document the finding as normal
B. Administer oxygen at 10 L/min via non-rebreather
mask
C. Turn the client to the left lateral position
D. Notify the provider immediately
Answer: C
Rationale: Fetal tachycardia (>160 bpm) requires
assessment for cause. The first intervention is maternal
repositioning to left lateral to improve placental perfusion
and rule out supine hypotension syndrome. After
repositioning, assess maternal temperature, hydration
status, and rule out chorioamnionitis. Oxygen may be
added if repositioning does not improve the FHR.
Provider notification comes after initial interventions unless
the client is unstable.
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,HESI RN Maternity Exam 2026 | OB Nursing Exam
Prep | NGN Questions (Pdf)
. A nurse is assessing a client at 35 weeks gestation with
severe preeclampsia. Which finding indicates magnesium
sulfate toxicity?
A. Deep tendon reflexes 2+
B. Respiratory rate 14 breaths/min
C. Urine output 35 mL/hr
D. Absent patellar reflexes
Answer: D
Rationale: Magnesium sulfate toxicity causes loss of
patellar (deep tendon) reflexes first, typically at serum
levels of 8-10 mEq/L. Respiratory depression occurs at
higher levels (>10 mEq/L). Normal DTRs are 1-2+.
Normal respiratory rate is 12-20 breaths/min. Normal
urine output is ≥30 mL/hr. Absent reflexes require
immediate discontinuation of magnesium and
administration of calcium gluconate.
2
,2. A newborn has Apgar scores of 4 at 1 minute and 7 at
5 minutes. Which action should the nurse take at 1 minute?
A. Begin chest compressions
B. Administer epinephrine
C. Provide positive pressure ventilation
D. Place under radiant warmer, dry, and stimulate
Answer: D
Rationale: An Apgar score of 4 at 1 minute indicates
moderate distress. The initial steps of newborn
resuscitation are: warm, dry, stimulate, and position the
airway. Positive pressure ventilation is initiated only if the
newborn is apneic, gasping, or heart rate <100 bpm
after these initial steps. Chest compressions are for heart
rate <60 bpm despite adequate ventilation. Epinephrine
is given after at least 30-60 seconds of compressions.
3
, 3. A client at 40 weeks gestation is in active labor. The
nurse notes the fetal heart rate baseline is 175 bpm.
What is the priority nursing action?
A. Document the finding as normal
B. Administer oxygen at 10 L/min via non-rebreather
mask
C. Turn the client to the left lateral position
D. Notify the provider immediately
Answer: C
Rationale: Fetal tachycardia (>160 bpm) requires
assessment for cause. The first intervention is maternal
repositioning to left lateral to improve placental perfusion
and rule out supine hypotension syndrome. After
repositioning, assess maternal temperature, hydration
status, and rule out chorioamnionitis. Oxygen may be
added if repositioning does not improve the FHR.
Provider notification comes after initial interventions unless
the client is unstable.
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