1
2025 HESI Maternity OB Exam
Version 1 – 55 Updated Questions with
100% Verified Answers | Official
Graded A+ Copy
Question 1
A primigravida at 38 weeks gestation reports decreased fetal movement. What is the nurse’s
priority action?
A. Instruct the client to drink water and rest
B. Perform a nonstress test (NST)
C. Schedule an ultrasound for the next day
D. Reassure the client that this is normal
Correct Answer: B
Rationale: Decreased fetal movement at 38 weeks may indicate fetal distress. A nonstress test
(NST) is the priority to assess fetal well-being by monitoring heart rate and movement. Resting
or scheduling later delays care, and reassurance is inappropriate without assessment.
Question 2
A client in labor at 39 weeks gestation has a cervical dilation of 8 cm. She reports intense back
pain. What is the likely cause?
A. Posterior fetal position
B. Cervical effacement
C. Uterine rupture
D. Placental abruption
Correct Answer: A
Rationale: Intense back pain during labor is often caused by a posterior fetal position, where the
fetal occiput presses against the maternal sacrum. Cervical effacement does not cause back pain,
and uterine rupture or abruption would present with additional severe symptoms.
Question 3
, 2
A postpartum client develops a temperature of 100.4°F on day 2. What is the most likely cause?
A. Endometritis
B. Mastitis
C. Dehydration
D. Normal postpartum response
Correct Answer: A
Rationale: A fever of 100.4°F or higher on postpartum day 2 suggests endometritis, an infection
of the uterine lining. Mastitis typically occurs later, dehydration does not cause fever, and normal
postpartum fever is transient and lower.
Question 4
A client at 32 weeks gestation presents with bright red vaginal bleeding and no pain. What is the
nurse’s priority action?
A. Prepare for immediate cesarean delivery
B. Perform a vaginal exam
C. Place the client on a fetal monitor
D. Administer magnesium sulfate
Correct Answer: C
Rationale: Painless bright red bleeding at 32 weeks suggests placenta previa. The priority is to
assess fetal and maternal status with a fetal monitor. Vaginal exams are contraindicated, cesarean
delivery may not be immediate, and magnesium sulfate is irrelevant.
Question 5
A client in labor receives an epidural at 4 cm dilation. Which complication should the nurse
monitor for?
A. Hypertension
B. Hypotension
C. Tachycardia
D. Hyperthermia
Correct Answer: B
Rationale: Epidural anesthesia can cause maternal hypotension due to sympathetic blockade,
reducing blood flow to the placenta. Hypertension, tachycardia, and hyperthermia are not
common epidural complications.
Question 6
, 3
A newborn at 1 hour of life has a heart rate of 90 bpm and irregular respirations. What is the
nurse’s priority action?
A. Administer oxygen via blow-by
B. Initiate positive pressure ventilation
C. Stimulate the newborn
D. Wrap the newborn in a blanket
Correct Answer: B
Rationale: A heart rate below 100 bpm with irregular respirations in a newborn indicates the
need for positive pressure ventilation per neonatal resuscitation guidelines. Stimulation is
insufficient, and oxygen or wrapping is not the priority.
Question 7
A client at 36 weeks gestation has a positive Group B Streptococcus (GBS) culture. What is the
nurse’s priority action during labor?
A. Administer antibiotics
B. Monitor fetal heart rate
C. Perform a vaginal exam
D. Encourage ambulation
Correct Answer: A
Rationale: GBS-positive clients require intrapartum antibiotics (e.g., penicillin) to prevent
neonatal sepsis. While fetal monitoring is important, antibiotics are the priority to reduce
infection risk.
Question 8
A client in the second stage of labor is pushing ineffectively. What is the nurse’s best
intervention?
A. Encourage longer pushes
B. Administer oxytocin
C. Change the client’s position
D. Prepare for vacuum delivery
Correct Answer: C
Rationale: Changing positions (e.g., squatting or side-lying) can improve pushing effectiveness
by aligning the pelvis. Longer pushes may exhaust the client, oxytocin is for induction, and
vacuum delivery is premature without further assessment.
2025 HESI Maternity OB Exam
Version 1 – 55 Updated Questions with
100% Verified Answers | Official
Graded A+ Copy
Question 1
A primigravida at 38 weeks gestation reports decreased fetal movement. What is the nurse’s
priority action?
A. Instruct the client to drink water and rest
B. Perform a nonstress test (NST)
C. Schedule an ultrasound for the next day
D. Reassure the client that this is normal
Correct Answer: B
Rationale: Decreased fetal movement at 38 weeks may indicate fetal distress. A nonstress test
(NST) is the priority to assess fetal well-being by monitoring heart rate and movement. Resting
or scheduling later delays care, and reassurance is inappropriate without assessment.
Question 2
A client in labor at 39 weeks gestation has a cervical dilation of 8 cm. She reports intense back
pain. What is the likely cause?
A. Posterior fetal position
B. Cervical effacement
C. Uterine rupture
D. Placental abruption
Correct Answer: A
Rationale: Intense back pain during labor is often caused by a posterior fetal position, where the
fetal occiput presses against the maternal sacrum. Cervical effacement does not cause back pain,
and uterine rupture or abruption would present with additional severe symptoms.
Question 3
, 2
A postpartum client develops a temperature of 100.4°F on day 2. What is the most likely cause?
A. Endometritis
B. Mastitis
C. Dehydration
D. Normal postpartum response
Correct Answer: A
Rationale: A fever of 100.4°F or higher on postpartum day 2 suggests endometritis, an infection
of the uterine lining. Mastitis typically occurs later, dehydration does not cause fever, and normal
postpartum fever is transient and lower.
Question 4
A client at 32 weeks gestation presents with bright red vaginal bleeding and no pain. What is the
nurse’s priority action?
A. Prepare for immediate cesarean delivery
B. Perform a vaginal exam
C. Place the client on a fetal monitor
D. Administer magnesium sulfate
Correct Answer: C
Rationale: Painless bright red bleeding at 32 weeks suggests placenta previa. The priority is to
assess fetal and maternal status with a fetal monitor. Vaginal exams are contraindicated, cesarean
delivery may not be immediate, and magnesium sulfate is irrelevant.
Question 5
A client in labor receives an epidural at 4 cm dilation. Which complication should the nurse
monitor for?
A. Hypertension
B. Hypotension
C. Tachycardia
D. Hyperthermia
Correct Answer: B
Rationale: Epidural anesthesia can cause maternal hypotension due to sympathetic blockade,
reducing blood flow to the placenta. Hypertension, tachycardia, and hyperthermia are not
common epidural complications.
Question 6
, 3
A newborn at 1 hour of life has a heart rate of 90 bpm and irregular respirations. What is the
nurse’s priority action?
A. Administer oxygen via blow-by
B. Initiate positive pressure ventilation
C. Stimulate the newborn
D. Wrap the newborn in a blanket
Correct Answer: B
Rationale: A heart rate below 100 bpm with irregular respirations in a newborn indicates the
need for positive pressure ventilation per neonatal resuscitation guidelines. Stimulation is
insufficient, and oxygen or wrapping is not the priority.
Question 7
A client at 36 weeks gestation has a positive Group B Streptococcus (GBS) culture. What is the
nurse’s priority action during labor?
A. Administer antibiotics
B. Monitor fetal heart rate
C. Perform a vaginal exam
D. Encourage ambulation
Correct Answer: A
Rationale: GBS-positive clients require intrapartum antibiotics (e.g., penicillin) to prevent
neonatal sepsis. While fetal monitoring is important, antibiotics are the priority to reduce
infection risk.
Question 8
A client in the second stage of labor is pushing ineffectively. What is the nurse’s best
intervention?
A. Encourage longer pushes
B. Administer oxytocin
C. Change the client’s position
D. Prepare for vacuum delivery
Correct Answer: C
Rationale: Changing positions (e.g., squatting or side-lying) can improve pushing effectiveness
by aligning the pelvis. Longer pushes may exhaust the client, oxytocin is for induction, and
vacuum delivery is premature without further assessment.
