MATERNITY HESI EXAM PREP NEWEST 2026 | HESI MATERIAL
NEWBORN | ALL MODULES COVERED + COMPLETE STUDY GUIDE
+ Q&A + RATIONALES | A+ GRADED | GUARANTEED PASS |
BRANDNEW!!!!!!!!!
A client at 38 weeks gestation presents with a reactive non-stress test. Which action
should the nurse take next?
• A. Prepare the client for an induction of labor
• B. Document the results and continue to monitor
• C. Notify the healthcare provider immediately
• D. Initiate a contraction stress test
Rationale: A reactive NST is defined as two or more accelerations of fetal heart rate of at
least 15 beats per minute lasting at least 15 seconds within a 20-minute period. This is a
reassuring sign of fetal well-being and indicates adequate oxygenation and an intact
autonomic nervous system. No immediate intervention is required; the nurse should
simply document the findings and continue routine monitoring. Induction is not indicated
for a reactive NST. There is no need to notify the provider for a normal result. A CST is
performed when the NST is non-reactive.
A postpartum client who is Rh-negative and has given birth to an Rh-positive infant is to
receive RhoGAM. The nurse understands that this medication is given for which primary
purpose?
• A. To destroy fetal red blood cells in the maternal circulation
• B. To prevent the mother from developing antibodies against Rh-positive blood
• C. To treat the infant’s hemolytic disease of the newborn
• D. To stimulate the mother’s production of Rh antibodies
Rationale: RhoGAM (Rho(D) immune globulin) works by providing passive immunity. It
coats any fetal Rh-positive red blood cells that may have entered the mother's circulation
during delivery, preventing the mother's immune system from recognizing them as foreign.
This prevents the mother from mounting an active immune response and developing anti-
Rh antibodies. It does not destroy fetal cells directly; rather, it masks them. It is not given to
,treat the infant; it is given to protect future pregnancies. It suppresses antibody production,
not stimulates it.
A nurse is caring for a client in active labor who has a history of group B streptococcus
(GBS) colonization. The client’s membranes rupture spontaneously. Which action should
the nurse take first?
• A. Assess the fetal heart rate
• B. Administer the prescribed intravenous antibiotic
• C. Check the client’s temperature
• D. Document the color and odor of the amniotic fluid
Rationale: The priority is to assess fetal well-being immediately after membrane rupture.
Rupture of membranes can lead to umbilical cord prolapse or compression, and the
subsequent change in pressure can cause fetal heart rate decelerations. While
administering antibiotics (for GBS prophylaxis), checking temperature (to monitor for
infection), and documenting fluid characteristics are all important, the immediate
assessment of fetal heart rate takes precedence to ensure fetal safety. The other actions
can be performed quickly after the fetal heart rate is assessed.
A client at 41 weeks gestation is undergoing a biophysical profile (BPP). Which component
of the BPP is considered the most sensitive indicator of acute fetal hypoxia?
• A. Fetal breathing movements
• B. Amniotic fluid volume
• C. Fetal movement
• D. Fetal tone
Rationale: While all components are important, fetal breathing movements are the most
sensitive to acute hypoxia and acidosis. A fetus will cease breathing movements early in
the process of hypoxia to conserve oxygen for vital organs. Amniotic fluid volume reflects
long-term placental function, while fetal tone and movement are also sensitive but
generally not as early an indicator as breathing.
,A postpartum client is diagnosed with a deep vein thrombosis (DVT) in her left calf. Which
assessment finding warrants immediate intervention by the nurse?
• A. Pulse rate of 88 beats per minute
• B. Report of sudden onset of chest pain and dyspnea
• C. Left calf circumference 3 cm greater than the right
• D. Pain in the left calf upon dorsiflexion of the foot
Rationale: Sudden chest pain and dyspnea are classic signs of a pulmonary embolism
(PE), which is a life-threatening complication of a DVT. This requires immediate
intervention, such as administering oxygen and notifying the provider. While an elevated
pulse, increased calf circumference, and calf pain (Homan’s sign) are findings associated
with DVT, they do not indicate a critical, immediate threat to life as does a potential PE.
A nurse is providing education to a pregnant client with gestational diabetes. Which
statement indicates that the client understands the teaching?
• A. "I will need to take insulin every day to control my blood sugar."
• B. "I should eat three large meals a day to keep my blood sugar stable."
• C. "I will need to test my blood glucose levels four times a day."
• D. "Since I have gestational diabetes, I will definitely have type 2 diabetes later."
Rationale: Gestational diabetes is typically managed with diet, exercise, and blood
glucose monitoring. The standard recommendation is to test fasting and postprandial
(usually 1-2 hours after each meal) blood glucose levels, totaling four times a day. Insulin
may be required if diet and exercise are not sufficient, but it is not the first-line treatment
for all clients. Eating three large meals can cause glucose spikes; small, frequent meals are
preferred. While there is an increased risk of developing type 2 diabetes later in life, it is not
a certainty.
A client is receiving magnesium sulfate for severe preeclampsia. The nurse assesses a
respiratory rate of 10 breaths per minute, deep tendon reflexes of 1+, and urine output of 20
mL over the last hour. Which action should the nurse take first?
• A. Administer calcium gluconate
, • B. Decrease the magnesium sulfate infusion rate
• C. Stop the magnesium sulfate infusion
• D. Place the client in a left lateral position
Rationale: The findings of a respiratory rate of <12/min, hyporeflexia (1+), and oliguria (<30
mL/hr) indicate magnesium toxicity. The antidote for magnesium toxicity is calcium
gluconate. However, the first and most critical nursing action is to stop the magnesium
sulfate infusion immediately to prevent further toxicity. While administering calcium
gluconate (A) is the next step, stopping the infusion takes priority. Decreasing the rate (B)
may not be sufficient to reverse an acute toxic state. Positioning (D) is not the primary
intervention for toxicity.
A newborn is exhibiting signs of respiratory distress syndrome (RDS). Which finding would
the nurse expect to observe?
• A. Expiratory grunting and nasal flaring
• B. Decreased respiratory rate of 30 breaths per minute
• C. Pinkish skin color and strong cry
• D. Symmetrical chest movement
Rationale: Respiratory distress syndrome in a newborn is characterized by signs of
respiratory distress, including expiratory grunting (the newborn's attempt to maintain
positive end-expiratory pressure), nasal flaring, intercostal retractions, and tachypnea (not
a decreased rate). A respiratory rate of 30 breaths per minute is on the low end of normal
for a newborn (normal is 30-60). A pinkish skin color and strong cry are signs of well-being,
not distress. Symmetrical chest movement is expected and does not indicate RDS.
A client who is 12 hours postpartum has a fundus that is firm, midline, and at the level of
the umbilicus. The client is experiencing moderate lochia rubra with small clots. Which
action should the nurse take?
• A. Document the findings
• B. Massage the fundus vigorously
• C. Notify the healthcare provider
NEWBORN | ALL MODULES COVERED + COMPLETE STUDY GUIDE
+ Q&A + RATIONALES | A+ GRADED | GUARANTEED PASS |
BRANDNEW!!!!!!!!!
A client at 38 weeks gestation presents with a reactive non-stress test. Which action
should the nurse take next?
• A. Prepare the client for an induction of labor
• B. Document the results and continue to monitor
• C. Notify the healthcare provider immediately
• D. Initiate a contraction stress test
Rationale: A reactive NST is defined as two or more accelerations of fetal heart rate of at
least 15 beats per minute lasting at least 15 seconds within a 20-minute period. This is a
reassuring sign of fetal well-being and indicates adequate oxygenation and an intact
autonomic nervous system. No immediate intervention is required; the nurse should
simply document the findings and continue routine monitoring. Induction is not indicated
for a reactive NST. There is no need to notify the provider for a normal result. A CST is
performed when the NST is non-reactive.
A postpartum client who is Rh-negative and has given birth to an Rh-positive infant is to
receive RhoGAM. The nurse understands that this medication is given for which primary
purpose?
• A. To destroy fetal red blood cells in the maternal circulation
• B. To prevent the mother from developing antibodies against Rh-positive blood
• C. To treat the infant’s hemolytic disease of the newborn
• D. To stimulate the mother’s production of Rh antibodies
Rationale: RhoGAM (Rho(D) immune globulin) works by providing passive immunity. It
coats any fetal Rh-positive red blood cells that may have entered the mother's circulation
during delivery, preventing the mother's immune system from recognizing them as foreign.
This prevents the mother from mounting an active immune response and developing anti-
Rh antibodies. It does not destroy fetal cells directly; rather, it masks them. It is not given to
,treat the infant; it is given to protect future pregnancies. It suppresses antibody production,
not stimulates it.
A nurse is caring for a client in active labor who has a history of group B streptococcus
(GBS) colonization. The client’s membranes rupture spontaneously. Which action should
the nurse take first?
• A. Assess the fetal heart rate
• B. Administer the prescribed intravenous antibiotic
• C. Check the client’s temperature
• D. Document the color and odor of the amniotic fluid
Rationale: The priority is to assess fetal well-being immediately after membrane rupture.
Rupture of membranes can lead to umbilical cord prolapse or compression, and the
subsequent change in pressure can cause fetal heart rate decelerations. While
administering antibiotics (for GBS prophylaxis), checking temperature (to monitor for
infection), and documenting fluid characteristics are all important, the immediate
assessment of fetal heart rate takes precedence to ensure fetal safety. The other actions
can be performed quickly after the fetal heart rate is assessed.
A client at 41 weeks gestation is undergoing a biophysical profile (BPP). Which component
of the BPP is considered the most sensitive indicator of acute fetal hypoxia?
• A. Fetal breathing movements
• B. Amniotic fluid volume
• C. Fetal movement
• D. Fetal tone
Rationale: While all components are important, fetal breathing movements are the most
sensitive to acute hypoxia and acidosis. A fetus will cease breathing movements early in
the process of hypoxia to conserve oxygen for vital organs. Amniotic fluid volume reflects
long-term placental function, while fetal tone and movement are also sensitive but
generally not as early an indicator as breathing.
,A postpartum client is diagnosed with a deep vein thrombosis (DVT) in her left calf. Which
assessment finding warrants immediate intervention by the nurse?
• A. Pulse rate of 88 beats per minute
• B. Report of sudden onset of chest pain and dyspnea
• C. Left calf circumference 3 cm greater than the right
• D. Pain in the left calf upon dorsiflexion of the foot
Rationale: Sudden chest pain and dyspnea are classic signs of a pulmonary embolism
(PE), which is a life-threatening complication of a DVT. This requires immediate
intervention, such as administering oxygen and notifying the provider. While an elevated
pulse, increased calf circumference, and calf pain (Homan’s sign) are findings associated
with DVT, they do not indicate a critical, immediate threat to life as does a potential PE.
A nurse is providing education to a pregnant client with gestational diabetes. Which
statement indicates that the client understands the teaching?
• A. "I will need to take insulin every day to control my blood sugar."
• B. "I should eat three large meals a day to keep my blood sugar stable."
• C. "I will need to test my blood glucose levels four times a day."
• D. "Since I have gestational diabetes, I will definitely have type 2 diabetes later."
Rationale: Gestational diabetes is typically managed with diet, exercise, and blood
glucose monitoring. The standard recommendation is to test fasting and postprandial
(usually 1-2 hours after each meal) blood glucose levels, totaling four times a day. Insulin
may be required if diet and exercise are not sufficient, but it is not the first-line treatment
for all clients. Eating three large meals can cause glucose spikes; small, frequent meals are
preferred. While there is an increased risk of developing type 2 diabetes later in life, it is not
a certainty.
A client is receiving magnesium sulfate for severe preeclampsia. The nurse assesses a
respiratory rate of 10 breaths per minute, deep tendon reflexes of 1+, and urine output of 20
mL over the last hour. Which action should the nurse take first?
• A. Administer calcium gluconate
, • B. Decrease the magnesium sulfate infusion rate
• C. Stop the magnesium sulfate infusion
• D. Place the client in a left lateral position
Rationale: The findings of a respiratory rate of <12/min, hyporeflexia (1+), and oliguria (<30
mL/hr) indicate magnesium toxicity. The antidote for magnesium toxicity is calcium
gluconate. However, the first and most critical nursing action is to stop the magnesium
sulfate infusion immediately to prevent further toxicity. While administering calcium
gluconate (A) is the next step, stopping the infusion takes priority. Decreasing the rate (B)
may not be sufficient to reverse an acute toxic state. Positioning (D) is not the primary
intervention for toxicity.
A newborn is exhibiting signs of respiratory distress syndrome (RDS). Which finding would
the nurse expect to observe?
• A. Expiratory grunting and nasal flaring
• B. Decreased respiratory rate of 30 breaths per minute
• C. Pinkish skin color and strong cry
• D. Symmetrical chest movement
Rationale: Respiratory distress syndrome in a newborn is characterized by signs of
respiratory distress, including expiratory grunting (the newborn's attempt to maintain
positive end-expiratory pressure), nasal flaring, intercostal retractions, and tachypnea (not
a decreased rate). A respiratory rate of 30 breaths per minute is on the low end of normal
for a newborn (normal is 30-60). A pinkish skin color and strong cry are signs of well-being,
not distress. Symmetrical chest movement is expected and does not indicate RDS.
A client who is 12 hours postpartum has a fundus that is firm, midline, and at the level of
the umbilicus. The client is experiencing moderate lochia rubra with small clots. Which
action should the nurse take?
• A. Document the findings
• B. Massage the fundus vigorously
• C. Notify the healthcare provider
