Test Bank: HESI Maternity (OB) & Pediatrics
Exam 2025 – High-Yield Questions, 100%
Verified Answers & Expert Rationales
Maternal Antepartum, Intrapartum, Postpartum (20
Questions)
Question: A primigravida at 28 weeks gestation reports intermittent uterine contractions.
What is the nurse’s priority action?
Answer: Assess for preterm labor signs, including contraction frequency and cervical
changes.
Rationale: Intermittent contractions at 28 weeks may indicate preterm labor, requiring
immediate assessment of contraction patterns and cervical status to prevent preterm birth.
Question: A pregnant client at 36 weeks gestation has a blood pressure of 150/96 mmHg.
What condition should the nurse suspect?
Answer: Preeclampsia.
Rationale: Elevated blood pressure after 20 weeks gestation is a hallmark of
preeclampsia, requiring further assessment for proteinuria and other symptoms.
Question: During labor, a client’s fetal heart rate (FHR) shows late decelerations. What is
the nurse’s first action?
Answer: Reposition the client to the left lateral position.
Rationale: Late decelerations indicate uteroplacental insufficiency; repositioning
improves placental perfusion, addressing potential fetal hypoxia.
Question: A postpartum client reports heavy vaginal bleeding and a boggy uterus. What is
the nurse’s priority intervention?
Answer: Massage the fundus to promote uterine contraction.
Rationale: A boggy uterus and heavy bleeding suggest uterine atony, a common cause of
postpartum hemorrhage; fundal massage stimulates contractions to control bleeding.
Question: A client at 32 weeks gestation reports decreased fetal movement. What should the
nurse do first?
Answer: Perform a nonstress test (NST).
Rationale: Decreased fetal movement may indicate fetal distress; an NST assesses fetal
well-being by monitoring FHR and movement.
Question: During the second stage of labor, a client reports severe perineal pain. What
should the nurse assess?
, Answer: Perineal bulging and crowning.
Rationale: Severe perineal pain during the second stage often indicates fetal descent and
crowning, signaling imminent delivery.
Question: A postpartum client is diagnosed with endometritis. Which symptom is most
indicative of this condition?
Answer: Foul-smelling lochia.
Rationale: Endometritis, an infection of the uterine lining, commonly presents with foul-
smelling lochia, fever, and uterine tenderness.
Question: A client at 20 weeks gestation has a positive Group B Streptococcus (GBS)
culture. What is the plan of care?
Answer: Administer intrapartum antibiotics during labor.
Rationale: GBS-positive clients receive antibiotics (e.g., penicillin) during labor to
prevent neonatal sepsis, per CDC guidelines.
Question: A laboring client’s membranes rupture, revealing meconium-stained amniotic
fluid. What is the nurse’s priority?
Answer: Monitor fetal heart rate closely.
Rationale: Meconium-stained fluid increases the risk of meconium aspiration syndrome;
continuous FHR monitoring detects fetal distress.
Question: A postpartum client reports calf pain and swelling. What should the nurse suspect?
Answer: Deep vein thrombosis (DVT).
Rationale: Calf pain and swelling postpartum suggest DVT, a risk due to
hypercoagulability and immobility; immediate assessment is critical.
Question: A client at 38 weeks gestation reports regular contractions every 5 minutes. What
should the nurse assess first?
Answer: Cervical dilation and effacement.
Rationale: Regular contractions indicate active labor; assessing cervical changes
confirms labor progression.
Question: What is the purpose of administering oxytocin postpartum?
Answer: To promote uterine involution and control bleeding.
Rationale: Oxytocin stimulates uterine contractions, reducing the risk of postpartum
hemorrhage by aiding uterine involution.
Question: A client in labor has a prolonged second stage. What intervention may be
indicated?
Answer: Assist with vacuum or forceps delivery.
Rationale: Prolonged second stage may require assisted delivery to prevent maternal
exhaustion or fetal distress, per obstetric guidelines.
Question: A pregnant client at 16 weeks gestation asks about safe exercise. What should the
nurse recommend?
Exam 2025 – High-Yield Questions, 100%
Verified Answers & Expert Rationales
Maternal Antepartum, Intrapartum, Postpartum (20
Questions)
Question: A primigravida at 28 weeks gestation reports intermittent uterine contractions.
What is the nurse’s priority action?
Answer: Assess for preterm labor signs, including contraction frequency and cervical
changes.
Rationale: Intermittent contractions at 28 weeks may indicate preterm labor, requiring
immediate assessment of contraction patterns and cervical status to prevent preterm birth.
Question: A pregnant client at 36 weeks gestation has a blood pressure of 150/96 mmHg.
What condition should the nurse suspect?
Answer: Preeclampsia.
Rationale: Elevated blood pressure after 20 weeks gestation is a hallmark of
preeclampsia, requiring further assessment for proteinuria and other symptoms.
Question: During labor, a client’s fetal heart rate (FHR) shows late decelerations. What is
the nurse’s first action?
Answer: Reposition the client to the left lateral position.
Rationale: Late decelerations indicate uteroplacental insufficiency; repositioning
improves placental perfusion, addressing potential fetal hypoxia.
Question: A postpartum client reports heavy vaginal bleeding and a boggy uterus. What is
the nurse’s priority intervention?
Answer: Massage the fundus to promote uterine contraction.
Rationale: A boggy uterus and heavy bleeding suggest uterine atony, a common cause of
postpartum hemorrhage; fundal massage stimulates contractions to control bleeding.
Question: A client at 32 weeks gestation reports decreased fetal movement. What should the
nurse do first?
Answer: Perform a nonstress test (NST).
Rationale: Decreased fetal movement may indicate fetal distress; an NST assesses fetal
well-being by monitoring FHR and movement.
Question: During the second stage of labor, a client reports severe perineal pain. What
should the nurse assess?
, Answer: Perineal bulging and crowning.
Rationale: Severe perineal pain during the second stage often indicates fetal descent and
crowning, signaling imminent delivery.
Question: A postpartum client is diagnosed with endometritis. Which symptom is most
indicative of this condition?
Answer: Foul-smelling lochia.
Rationale: Endometritis, an infection of the uterine lining, commonly presents with foul-
smelling lochia, fever, and uterine tenderness.
Question: A client at 20 weeks gestation has a positive Group B Streptococcus (GBS)
culture. What is the plan of care?
Answer: Administer intrapartum antibiotics during labor.
Rationale: GBS-positive clients receive antibiotics (e.g., penicillin) during labor to
prevent neonatal sepsis, per CDC guidelines.
Question: A laboring client’s membranes rupture, revealing meconium-stained amniotic
fluid. What is the nurse’s priority?
Answer: Monitor fetal heart rate closely.
Rationale: Meconium-stained fluid increases the risk of meconium aspiration syndrome;
continuous FHR monitoring detects fetal distress.
Question: A postpartum client reports calf pain and swelling. What should the nurse suspect?
Answer: Deep vein thrombosis (DVT).
Rationale: Calf pain and swelling postpartum suggest DVT, a risk due to
hypercoagulability and immobility; immediate assessment is critical.
Question: A client at 38 weeks gestation reports regular contractions every 5 minutes. What
should the nurse assess first?
Answer: Cervical dilation and effacement.
Rationale: Regular contractions indicate active labor; assessing cervical changes
confirms labor progression.
Question: What is the purpose of administering oxytocin postpartum?
Answer: To promote uterine involution and control bleeding.
Rationale: Oxytocin stimulates uterine contractions, reducing the risk of postpartum
hemorrhage by aiding uterine involution.
Question: A client in labor has a prolonged second stage. What intervention may be
indicated?
Answer: Assist with vacuum or forceps delivery.
Rationale: Prolonged second stage may require assisted delivery to prevent maternal
exhaustion or fetal distress, per obstetric guidelines.
Question: A pregnant client at 16 weeks gestation asks about safe exercise. What should the
nurse recommend?
