HESI RN OB MATERNITY V1 EXAM 2026 –
QUESTIONS AND ANSWERS WITH NGN CASE
SCENARIOS & RATIONALES
Master your specialty exam with this comprehensive study
pack featuring high-yield HESI RN OB/Maternity V1 Exam
(2026) multiple-choice questions complete with answers and
rigorous clinical rationales. Explicitly engineered with
updated Next Generation NCLEX (NGN) clinical case
scenarios, this guide targets critical core competencies
including intrapartum emergencies, advanced fetal heart
monitoring, and neonatal thermoregulation. Ideal for nursing
students seeking a 900+ score, this download ensures
absolute readiness by bridging theoretical concepts with
high-stakes clinical prioritization.
1. A nurse is caring for a client at 34 weeks gestation who
presents with sudden-onset, severe abdominal pain, uterine
tenderness, and dark vaginal bleeding. The client's blood
pressure is 90/50 mmHg, and the fetal heart rate monitor
shows late decelerations. Which condition should the nurse
suspect?
A. Placenta previa
B. Abruptio placentae
,C. Uterine rupture
D. Ectopic pregnancy
Answer: B. Abruptio placentae
Rationale: Abruptio placentae is the premature separation of
a normally implanted placenta from the uterine wall. Classic
manifestations include sudden-onset, severe abdominal
pain, uterine rigidity/tenderness, dark vaginal bleeding, and
signs of maternal shock or fetal distress (e.g., late
decelerations). In contrast, placenta previa presents with
painless, bright red bleeding. Uterine rupture typically occurs
during labor, often accompanied by a sudden loss of uterine
tone or fetal station. Ectopic pregnancy occurs in the first
trimester.
2. A nurse is assessing a postpartum client 4 hours after a
vaginal delivery. The client's fundus is firm, midline, and at
the level of the umbilicus. The nurse notes heavy, bright red
vaginal bleeding with large clots. Which action should the
nurse take first?
A. Massage the fundus vigorously.
B. Administer oxygen via non-rebreather mask.
C. Notify the primary healthcare provider.
D. Assist the client to the bathroom to void.
Answer: C. Notify the primary healthcare provider.
Rationale: Because the uterine fundus is already firm and
midline at the expected level, the heavy bleeding is likely
caused by cervical or vaginal lacerations rather than uterine
atony. Massaging a firm uterus is unnecessary and can
cause discomfort. Immediate notification of the healthcare
provider is required to inspect and repair any lacerations.
,Assisting the client to void is appropriate if the fundus is
displaced to the right or boggy, indicating a full bladder.
3. A nurse is monitoring a client in active labor who is
receiving an intravenous oxytocin infusion. The nurse notes
that the client is experiencing uterine tachysystole, with 6
contractions occurring within a 10-minute window. Which is
the priority nursing intervention?
A. Discontinue the oxytocin infusion immediately.
B. Increase the rate of the maintenance intravenous fluids.
C. Administer oxygen at 8 to 10 L/min via a face mask.
D. Reposition the client to a lateral position.
Answer: A. Discontinue the oxytocin infusion immediately.
Rationale: Uterine tachysystole (more than 5 contractions in
10 minutes) can lead to reduced placental perfusion and fetal
hypoxia. The primary and immediate action is to stop the
oxytocin infusion to reduce uterine activity. Other supportive
measures, such as changing maternal position, increasing IV
fluids, and administering oxygen, are performed after or
alongside stopping the infusion.
4. A nurse is reviewing the laboratory results of a pregnant
client at 32 weeks gestation who has preeclampsia. Which
finding should the nurse report to the healthcare provider as
an indication of HELLP syndrome?
A. Platelet count of 75,000/mm³
B. Hemoglobin of 12 g/dL
C. Blood urea nucleus (BUN) of 15 mg/dL
D. White blood cell count of 11,000/mm³
Answer: A. Platelet count of 75,000/mm³
Rationale: HELLP syndrome stands for Hemolysis, Elevated
, Liver enzymes, and Low Platelets. A platelet count below
100,000/mm³ is a diagnostic criterion for low platelets in
HELLP syndrome. The other laboratory values listed are
within normal references or do not specifically indicate
HELLP syndrome.
5. A nurse is teaching a pregnant client who is Rh-negative
about the administration of RhO(D) immune globulin. Which
statement by the client indicates an understanding of the
teaching?
A. "I will receive this injection at 28 weeks gestation and again
within 72 hours after delivery if my baby is Rh-positive."
B. "I only need this injection if my baby's blood type is also Rh-
negative."
C. "This medication will protect my baby from developing ABO
incompatibility problems."
D. "I will need to receive this injection during every month of my
third trimester."
Answer: A. "I will receive this injection at 28 weeks gestation and
again within 72 hours after delivery if my baby is Rh-positive."
Rationale: RhO(D) immune globulin is routinely administered
to Rh-negative individuals at 28 weeks of gestation and
within 72 hours after birth if the infant is Rh-positive to
prevent isoimmunization. It does not treat ABO
incompatibility, and it is not given monthly.
6. A nurse is caring for a client in the labor and delivery unit.
The fetal heart rate monitor shows a baseline of 140/min, with
sudden, abrupt drops in the rate that resemble the shape of a
"V" and occur independently of contractions. Which action
should the nurse take first?
QUESTIONS AND ANSWERS WITH NGN CASE
SCENARIOS & RATIONALES
Master your specialty exam with this comprehensive study
pack featuring high-yield HESI RN OB/Maternity V1 Exam
(2026) multiple-choice questions complete with answers and
rigorous clinical rationales. Explicitly engineered with
updated Next Generation NCLEX (NGN) clinical case
scenarios, this guide targets critical core competencies
including intrapartum emergencies, advanced fetal heart
monitoring, and neonatal thermoregulation. Ideal for nursing
students seeking a 900+ score, this download ensures
absolute readiness by bridging theoretical concepts with
high-stakes clinical prioritization.
1. A nurse is caring for a client at 34 weeks gestation who
presents with sudden-onset, severe abdominal pain, uterine
tenderness, and dark vaginal bleeding. The client's blood
pressure is 90/50 mmHg, and the fetal heart rate monitor
shows late decelerations. Which condition should the nurse
suspect?
A. Placenta previa
B. Abruptio placentae
,C. Uterine rupture
D. Ectopic pregnancy
Answer: B. Abruptio placentae
Rationale: Abruptio placentae is the premature separation of
a normally implanted placenta from the uterine wall. Classic
manifestations include sudden-onset, severe abdominal
pain, uterine rigidity/tenderness, dark vaginal bleeding, and
signs of maternal shock or fetal distress (e.g., late
decelerations). In contrast, placenta previa presents with
painless, bright red bleeding. Uterine rupture typically occurs
during labor, often accompanied by a sudden loss of uterine
tone or fetal station. Ectopic pregnancy occurs in the first
trimester.
2. A nurse is assessing a postpartum client 4 hours after a
vaginal delivery. The client's fundus is firm, midline, and at
the level of the umbilicus. The nurse notes heavy, bright red
vaginal bleeding with large clots. Which action should the
nurse take first?
A. Massage the fundus vigorously.
B. Administer oxygen via non-rebreather mask.
C. Notify the primary healthcare provider.
D. Assist the client to the bathroom to void.
Answer: C. Notify the primary healthcare provider.
Rationale: Because the uterine fundus is already firm and
midline at the expected level, the heavy bleeding is likely
caused by cervical or vaginal lacerations rather than uterine
atony. Massaging a firm uterus is unnecessary and can
cause discomfort. Immediate notification of the healthcare
provider is required to inspect and repair any lacerations.
,Assisting the client to void is appropriate if the fundus is
displaced to the right or boggy, indicating a full bladder.
3. A nurse is monitoring a client in active labor who is
receiving an intravenous oxytocin infusion. The nurse notes
that the client is experiencing uterine tachysystole, with 6
contractions occurring within a 10-minute window. Which is
the priority nursing intervention?
A. Discontinue the oxytocin infusion immediately.
B. Increase the rate of the maintenance intravenous fluids.
C. Administer oxygen at 8 to 10 L/min via a face mask.
D. Reposition the client to a lateral position.
Answer: A. Discontinue the oxytocin infusion immediately.
Rationale: Uterine tachysystole (more than 5 contractions in
10 minutes) can lead to reduced placental perfusion and fetal
hypoxia. The primary and immediate action is to stop the
oxytocin infusion to reduce uterine activity. Other supportive
measures, such as changing maternal position, increasing IV
fluids, and administering oxygen, are performed after or
alongside stopping the infusion.
4. A nurse is reviewing the laboratory results of a pregnant
client at 32 weeks gestation who has preeclampsia. Which
finding should the nurse report to the healthcare provider as
an indication of HELLP syndrome?
A. Platelet count of 75,000/mm³
B. Hemoglobin of 12 g/dL
C. Blood urea nucleus (BUN) of 15 mg/dL
D. White blood cell count of 11,000/mm³
Answer: A. Platelet count of 75,000/mm³
Rationale: HELLP syndrome stands for Hemolysis, Elevated
, Liver enzymes, and Low Platelets. A platelet count below
100,000/mm³ is a diagnostic criterion for low platelets in
HELLP syndrome. The other laboratory values listed are
within normal references or do not specifically indicate
HELLP syndrome.
5. A nurse is teaching a pregnant client who is Rh-negative
about the administration of RhO(D) immune globulin. Which
statement by the client indicates an understanding of the
teaching?
A. "I will receive this injection at 28 weeks gestation and again
within 72 hours after delivery if my baby is Rh-positive."
B. "I only need this injection if my baby's blood type is also Rh-
negative."
C. "This medication will protect my baby from developing ABO
incompatibility problems."
D. "I will need to receive this injection during every month of my
third trimester."
Answer: A. "I will receive this injection at 28 weeks gestation and
again within 72 hours after delivery if my baby is Rh-positive."
Rationale: RhO(D) immune globulin is routinely administered
to Rh-negative individuals at 28 weeks of gestation and
within 72 hours after birth if the infant is Rh-positive to
prevent isoimmunization. It does not treat ABO
incompatibility, and it is not given monthly.
6. A nurse is caring for a client in the labor and delivery unit.
The fetal heart rate monitor shows a baseline of 140/min, with
sudden, abrupt drops in the rate that resemble the shape of a
"V" and occur independently of contractions. Which action
should the nurse take first?
