HESI MATERNITY OB PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS
1. A client at 34 weeks gestation with severe preeclampsia is receiving Magnesium Sulfate.
The nurse notes a respiratory rate of 10 breaths per minute and absent deep tendon reflexes.
What is the priority nursing action?
A. Increase the IV fluid rate
B. Continue to monitor the client’s vital signs
C. Stop the Magnesium Sulfate infusion
D. Prepare the client for an emergency Cesarean section
Answer: C
Conceptual Explanation: Respiratory depression (less than 12 breaths/min) and loss of
deep tendon reflexes are classic signs of Magnesium toxicity. The immediate priority is to
stop the infusion to prevent further toxicity or cardiac arrest.
2. Which fetal heart rate pattern should the nurse identify as indicative of uteroplacental
insufficiency?
A. Accelerations
B. Early decelerations
C. Variable decelerations
,D. Late decelerations
Answer: D
Conceptual Explanation: Late decelerations are caused by decreased blood flow and
oxygen to the placenta (uteroplacental insufficiency). Early decelerations are caused by
head compression, and variable decelerations by cord compression.
3. A multiparous client at 32 weeks gestation arrives in the ER reporting painless, bright red
vaginal bleeding. What condition should the nurse suspect?
A. Abruptio Placentae
B. Placenta Previa
C. Uterine Rupture
D. Preeclampsia
Answer: B
Conceptual Explanation: The hallmark of placenta previa is painless, bright red vaginal
bleeding in the second or third trimester. Abruptio placentae usually presents with severe
pain and a board-like abdomen.
4. The nurse is assessing a client 2 hours postpartum and finds the fundus is boggy and
displaced to the right. What is the nurse’s first action?
A. Massage the fundus until firm
B. Call the physician immediately
, C. Administer oxytocin as ordered
D. Assist the client to void
Answer: D
Conceptual Explanation: A fundus displaced to the right usually indicates a full bladder,
which prevents uterine contraction. Assisting the client to void is the first step to allow the
uterus to return to the midline and contract.
5. A pregnant woman who is Rh-negative is scheduled for an amniocentesis. For which reason
would Rho(D) immune globulin (RhoGAM) be administered?
A. To stimulate fetal lung maturity before the procedure
B. To prevent the fetus from developing Down Syndrome
C. To treat maternal antibodies already present in the system
D. To prevent Rh isoimmunization if fetal blood enters maternal circulation
Answer: D
Conceptual Explanation: RhoGAM is given to Rh-negative mothers after invasive
procedures like amniocentesis to prevent the mother from producing antibodies against
Rh-positive fetal blood that may have entered her circulation.
QUESTIONS AND CORRECT ANSWERS
1. A client at 34 weeks gestation with severe preeclampsia is receiving Magnesium Sulfate.
The nurse notes a respiratory rate of 10 breaths per minute and absent deep tendon reflexes.
What is the priority nursing action?
A. Increase the IV fluid rate
B. Continue to monitor the client’s vital signs
C. Stop the Magnesium Sulfate infusion
D. Prepare the client for an emergency Cesarean section
Answer: C
Conceptual Explanation: Respiratory depression (less than 12 breaths/min) and loss of
deep tendon reflexes are classic signs of Magnesium toxicity. The immediate priority is to
stop the infusion to prevent further toxicity or cardiac arrest.
2. Which fetal heart rate pattern should the nurse identify as indicative of uteroplacental
insufficiency?
A. Accelerations
B. Early decelerations
C. Variable decelerations
,D. Late decelerations
Answer: D
Conceptual Explanation: Late decelerations are caused by decreased blood flow and
oxygen to the placenta (uteroplacental insufficiency). Early decelerations are caused by
head compression, and variable decelerations by cord compression.
3. A multiparous client at 32 weeks gestation arrives in the ER reporting painless, bright red
vaginal bleeding. What condition should the nurse suspect?
A. Abruptio Placentae
B. Placenta Previa
C. Uterine Rupture
D. Preeclampsia
Answer: B
Conceptual Explanation: The hallmark of placenta previa is painless, bright red vaginal
bleeding in the second or third trimester. Abruptio placentae usually presents with severe
pain and a board-like abdomen.
4. The nurse is assessing a client 2 hours postpartum and finds the fundus is boggy and
displaced to the right. What is the nurse’s first action?
A. Massage the fundus until firm
B. Call the physician immediately
, C. Administer oxytocin as ordered
D. Assist the client to void
Answer: D
Conceptual Explanation: A fundus displaced to the right usually indicates a full bladder,
which prevents uterine contraction. Assisting the client to void is the first step to allow the
uterus to return to the midline and contract.
5. A pregnant woman who is Rh-negative is scheduled for an amniocentesis. For which reason
would Rho(D) immune globulin (RhoGAM) be administered?
A. To stimulate fetal lung maturity before the procedure
B. To prevent the fetus from developing Down Syndrome
C. To treat maternal antibodies already present in the system
D. To prevent Rh isoimmunization if fetal blood enters maternal circulation
Answer: D
Conceptual Explanation: RhoGAM is given to Rh-negative mothers after invasive
procedures like amniocentesis to prevent the mother from producing antibodies against
Rh-positive fetal blood that may have entered her circulation.
