1
HESI Maternity OB Exam 2026: 250 Accurate
Questions with Detailed Answers & Rationales
- Most Tested Questions for Guaranteed Pass
1. The nurse is providing care for a newborn who was delivered vaginally
assisted by forceps. The nurse observes red marks on the head with swelling
that does not cross the suture line. Which condition should the nurse
document in the medical record?
A. Caput succedaneum
B. Hydrocephalus
C. Cephalhematoma
D. Microcephaly
Answer: C
Rationale: Cephalhematoma is a collection of blood between the periosteum
and the skull bone that does not cross suture lines. It is commonly associated
with forceps-assisted delivery. Caput succedaneum crosses suture lines and is
edema rather than blood.
2. A client at 34 weeks gestation comes to the birthing center complaining of
vaginal bleeding that began one hour ago. The nurse's assessment reveals
approximately 30 mL of bright red vaginal bleeding. Fetal heart rate is 130-140
beats per minute, no contractions, and no complaints of pain. What is the
most likely cause of this client's bleeding?
A. Abruptio placentae
B. Placenta previa
C. Normal bloody show indicating induction of labor
D. A ruptured blood vessel in the vaginal vault
, 2
Answer: B
Rationale: Placenta previa presents with painless, bright red vaginal bleeding
in the third trimester. The uterus is typically soft and non-tender. Abruptio
placentae presents with painful bleeding and a rigid, tender uterus.
3. A client at 30 weeks gestation reports that she has not felt the baby move
in the last 24 hours. Concerned, she arrives in a panic at the obstetric clinic
where she is immediately sent to the hospital. Which assessment warrants
immediate intervention by the nurse?
A. Fetal heart rate 60 beats per minute
B. Ruptured amniotic membrane
C. Onset of uterine contractions
D. Leaking amniotic fluid
Answer: A
Rationale: A fetal heart rate of 60 beats per minute indicates severe fetal
bradycardia and requires immediate intervention. Normal fetal heart rate is
110-160 beats per minute.
4. A client at 37 weeks gestation presents to labor and delivery with
contractions every two minutes. The nurse observes several shallow small
vesicles on her pubis, labia, and perineum. The nurse should recognize the
client is exhibiting symptoms of which condition?
A. Genital warts
B. Syphilis
C. Herpes simplex virus
, 3
D. German measles
Answer: C
Rationale: Herpes simplex virus presents with shallow, painful vesicles on the
genital area. Genital warts present as flesh-colored, cauliflower-like lesions.
Syphilis presents with a painless chancre.
5. The nurse is planning care for a client at 30 weeks gestation who is
experiencing preterm labor. Which maternity prescription is most important
in preventing this fetus from developing respiratory distress syndrome?
A. Ampicillin 1 gram IV push every 8 hours
B. Betamethasone 12 mg deep IM
C. Terbutaline 0.25 mg subcutaneously every 15 minutes times 3
D. Butorphanol tartrate 1 mg IV push every 2 hours PRN
Answer: B
Rationale: Betamethasone is a corticosteroid that accelerates fetal lung
maturity by stimulating surfactant production. It is the priority medication for
preventing respiratory distress syndrome in preterm infants.
6. A 16-year-old gravida 1 para 0 client has just been admitted to the hospital
with a diagnosis of eclampsia. She is not presently convulsing. Which
intervention should the nurse plan to include in this client's nursing care plan?
A. Allow liberal family visitation
, 4
B. Keep an airway at the bedside
C. Assess temperature every hour
D. Monitor blood pressure, pulse, and respiration every 4 hours
Answer: B
Rationale: An airway must be readily available at the bedside for a client with
eclampsia because she is at risk for seizures, which can compromise the
airway. A quiet, darkened environment with minimal stimulation is preferred.
7. At 12 hours after the birth of a healthy infant, the mother complains of
feeling constant vaginal pressure. The nurse determines the fundus is firm and
at midline with moderate rubra lochia. Which action should the nurse take?
A. Check the suprapubic area for distention
B. Inform the client to take a warm sitz bath
C. Inspect the client's perineal and rectal areas
D. Apply a fresh pad and check in 1 hour
Answer: C
Rationale: Constant vaginal pressure with a firm, midline fundus suggests a
perineal hematoma or vaginal laceration. The nurse should inspect the
perineal and rectal areas for swelling, discoloration, or hematoma formation.
8. A primigravida at 36 weeks gestation who is Rh-negative experienced
abdominal trauma in a motor vehicle collision. Which assessment finding is
most important for the nurse to report to the health care provider?
A. Fetal heart rate at 162 beats/minute
HESI Maternity OB Exam 2026: 250 Accurate
Questions with Detailed Answers & Rationales
- Most Tested Questions for Guaranteed Pass
1. The nurse is providing care for a newborn who was delivered vaginally
assisted by forceps. The nurse observes red marks on the head with swelling
that does not cross the suture line. Which condition should the nurse
document in the medical record?
A. Caput succedaneum
B. Hydrocephalus
C. Cephalhematoma
D. Microcephaly
Answer: C
Rationale: Cephalhematoma is a collection of blood between the periosteum
and the skull bone that does not cross suture lines. It is commonly associated
with forceps-assisted delivery. Caput succedaneum crosses suture lines and is
edema rather than blood.
2. A client at 34 weeks gestation comes to the birthing center complaining of
vaginal bleeding that began one hour ago. The nurse's assessment reveals
approximately 30 mL of bright red vaginal bleeding. Fetal heart rate is 130-140
beats per minute, no contractions, and no complaints of pain. What is the
most likely cause of this client's bleeding?
A. Abruptio placentae
B. Placenta previa
C. Normal bloody show indicating induction of labor
D. A ruptured blood vessel in the vaginal vault
, 2
Answer: B
Rationale: Placenta previa presents with painless, bright red vaginal bleeding
in the third trimester. The uterus is typically soft and non-tender. Abruptio
placentae presents with painful bleeding and a rigid, tender uterus.
3. A client at 30 weeks gestation reports that she has not felt the baby move
in the last 24 hours. Concerned, she arrives in a panic at the obstetric clinic
where she is immediately sent to the hospital. Which assessment warrants
immediate intervention by the nurse?
A. Fetal heart rate 60 beats per minute
B. Ruptured amniotic membrane
C. Onset of uterine contractions
D. Leaking amniotic fluid
Answer: A
Rationale: A fetal heart rate of 60 beats per minute indicates severe fetal
bradycardia and requires immediate intervention. Normal fetal heart rate is
110-160 beats per minute.
4. A client at 37 weeks gestation presents to labor and delivery with
contractions every two minutes. The nurse observes several shallow small
vesicles on her pubis, labia, and perineum. The nurse should recognize the
client is exhibiting symptoms of which condition?
A. Genital warts
B. Syphilis
C. Herpes simplex virus
, 3
D. German measles
Answer: C
Rationale: Herpes simplex virus presents with shallow, painful vesicles on the
genital area. Genital warts present as flesh-colored, cauliflower-like lesions.
Syphilis presents with a painless chancre.
5. The nurse is planning care for a client at 30 weeks gestation who is
experiencing preterm labor. Which maternity prescription is most important
in preventing this fetus from developing respiratory distress syndrome?
A. Ampicillin 1 gram IV push every 8 hours
B. Betamethasone 12 mg deep IM
C. Terbutaline 0.25 mg subcutaneously every 15 minutes times 3
D. Butorphanol tartrate 1 mg IV push every 2 hours PRN
Answer: B
Rationale: Betamethasone is a corticosteroid that accelerates fetal lung
maturity by stimulating surfactant production. It is the priority medication for
preventing respiratory distress syndrome in preterm infants.
6. A 16-year-old gravida 1 para 0 client has just been admitted to the hospital
with a diagnosis of eclampsia. She is not presently convulsing. Which
intervention should the nurse plan to include in this client's nursing care plan?
A. Allow liberal family visitation
, 4
B. Keep an airway at the bedside
C. Assess temperature every hour
D. Monitor blood pressure, pulse, and respiration every 4 hours
Answer: B
Rationale: An airway must be readily available at the bedside for a client with
eclampsia because she is at risk for seizures, which can compromise the
airway. A quiet, darkened environment with minimal stimulation is preferred.
7. At 12 hours after the birth of a healthy infant, the mother complains of
feeling constant vaginal pressure. The nurse determines the fundus is firm and
at midline with moderate rubra lochia. Which action should the nurse take?
A. Check the suprapubic area for distention
B. Inform the client to take a warm sitz bath
C. Inspect the client's perineal and rectal areas
D. Apply a fresh pad and check in 1 hour
Answer: C
Rationale: Constant vaginal pressure with a firm, midline fundus suggests a
perineal hematoma or vaginal laceration. The nurse should inspect the
perineal and rectal areas for swelling, discoloration, or hematoma formation.
8. A primigravida at 36 weeks gestation who is Rh-negative experienced
abdominal trauma in a motor vehicle collision. Which assessment finding is
most important for the nurse to report to the health care provider?
A. Fetal heart rate at 162 beats/minute
