HESI MATERNITY OB EXAM PREP
QUESTIONS AND CORRECT ANSWERS
1. A nurse is monitoring a client receiving Magnesium Sulfate for preeclampsia. Which
assessment finding should the nurse prioritize as a sign of magnesium toxicity?
A. Respiratory rate of 10 breaths per minute
B. Blood pressure of 140/90 mmHg
C. Presence of 2+ deep tendon reflexes
D. Urine output of 40 mL per hour
Answer: A
Conceptual Explanation: Magnesium sulfate is a CNS depressant. A respiratory rate below
12 breaths per minute, loss of deep tendon reflexes, and decreased urine output are classic
signs of toxicity.
2. A client’s obstetric history is as follows: currently pregnant, one miscarriage at 10 weeks,
one birth at 38 weeks (living), and one birth at 35 weeks (living). Using the GTPAL system,
how should the nurse document this?
A. G4 T2 P1 A0 L2
B. G3 T2 P0 A1 L2
C. G4 T1 P1 A1 L2
,D. G3 T1 P1 A1 L2
Answer: C
Conceptual Explanation: G (Gravida) = 4 (current + 3 past); T (Term) = 1 (38 weeks); P
(Preterm) = 1 (35 weeks); A (Abortion) = 1 (10 weeks); L (Living) = 2.
3. The nurse notes late decelerations on the fetal heart rate monitor. What is the immediate
priority nursing intervention?
A. Perform a vaginal exam to check for cord prolapse
B. Administer oxygen via non-rebreather mask at 8-10 L/min
C. Notify the healthcare provider immediately
D. Reposition the client to a side-lying position
Answer: D
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
first action is to improve blood flow by repositioning the client, followed by fluids, oxygen,
and stopping oxytocin.
4. Which medication is contraindicated for a postpartum client with a history of asthma who
is experiencing a hemorrhage?
A. Oxytocin (Pitocin)
B. Carboprost (Hemabate)
C. Methylergonovine (Methergine)
, D. Misoprostol (Cytotec)
Answer: B
Conceptual Explanation: Carboprost (Hemabate) can cause bronchospasm and is
contraindicated in patients with asthma. Methergine is contraindicated in hypertension.
5. A newborn has a heart rate of 110 bpm, a slow/irregular respiratory effort, some flexion of
extremities, a grimace during suctioning, and a pink body with blue extremities. What is the
Apgar score?
A. 5
B. 6
C. 7
D. 8
Answer: B
Conceptual Explanation: HR >100 (2), Resp slow/irreg (1), Muscle flexion (1), Reflex
grimace (1), Color acrocyanosis (1). Total = 6.
6. Which clinical finding distinguishes abruptio placentae from placenta previa?
A. Painless vaginal bleeding
B. Absence of fetal heart tones
C. Sudden onset of rigid, board-like abdomen
D. Bright red vaginal bleeding
QUESTIONS AND CORRECT ANSWERS
1. A nurse is monitoring a client receiving Magnesium Sulfate for preeclampsia. Which
assessment finding should the nurse prioritize as a sign of magnesium toxicity?
A. Respiratory rate of 10 breaths per minute
B. Blood pressure of 140/90 mmHg
C. Presence of 2+ deep tendon reflexes
D. Urine output of 40 mL per hour
Answer: A
Conceptual Explanation: Magnesium sulfate is a CNS depressant. A respiratory rate below
12 breaths per minute, loss of deep tendon reflexes, and decreased urine output are classic
signs of toxicity.
2. A client’s obstetric history is as follows: currently pregnant, one miscarriage at 10 weeks,
one birth at 38 weeks (living), and one birth at 35 weeks (living). Using the GTPAL system,
how should the nurse document this?
A. G4 T2 P1 A0 L2
B. G3 T2 P0 A1 L2
C. G4 T1 P1 A1 L2
,D. G3 T1 P1 A1 L2
Answer: C
Conceptual Explanation: G (Gravida) = 4 (current + 3 past); T (Term) = 1 (38 weeks); P
(Preterm) = 1 (35 weeks); A (Abortion) = 1 (10 weeks); L (Living) = 2.
3. The nurse notes late decelerations on the fetal heart rate monitor. What is the immediate
priority nursing intervention?
A. Perform a vaginal exam to check for cord prolapse
B. Administer oxygen via non-rebreather mask at 8-10 L/min
C. Notify the healthcare provider immediately
D. Reposition the client to a side-lying position
Answer: D
Conceptual Explanation: Late decelerations indicate uteroplacental insufficiency. The
first action is to improve blood flow by repositioning the client, followed by fluids, oxygen,
and stopping oxytocin.
4. Which medication is contraindicated for a postpartum client with a history of asthma who
is experiencing a hemorrhage?
A. Oxytocin (Pitocin)
B. Carboprost (Hemabate)
C. Methylergonovine (Methergine)
, D. Misoprostol (Cytotec)
Answer: B
Conceptual Explanation: Carboprost (Hemabate) can cause bronchospasm and is
contraindicated in patients with asthma. Methergine is contraindicated in hypertension.
5. A newborn has a heart rate of 110 bpm, a slow/irregular respiratory effort, some flexion of
extremities, a grimace during suctioning, and a pink body with blue extremities. What is the
Apgar score?
A. 5
B. 6
C. 7
D. 8
Answer: B
Conceptual Explanation: HR >100 (2), Resp slow/irreg (1), Muscle flexion (1), Reflex
grimace (1), Color acrocyanosis (1). Total = 6.
6. Which clinical finding distinguishes abruptio placentae from placenta previa?
A. Painless vaginal bleeding
B. Absence of fetal heart tones
C. Sudden onset of rigid, board-like abdomen
D. Bright red vaginal bleeding
