HESI-Maternity & Pediatrics Questions
and Answers | Latest Version |
2025/2026 | Correct & Verified
A newborn is born at 38 weeks gestation and has a heart rate of 90 bpm. What is the priority
nursing intervention?
✔✔Provide stimulation and administer oxygen as needed, assess for respiratory distress
A postpartum client reports sudden heavy bleeding 2 hours after delivery. What should the nurse
do first?
✔✔Assess uterine tone, massage the fundus, and monitor vital signs
A 3-year-old child presents with high fever and a stiff neck. What is the most important nursing
assessment?
✔✔Assess for signs of meningitis and prepare for immediate medical evaluation
A client at 36 weeks gestation reports decreased fetal movement over the past 12 hours. What is
the priority action?
✔✔Perform a non-stress test and instruct the client on fetal kick counts
1
,A newborn has jaundice with bilirubin of 16 mg/dL at 48 hours of life. What is the best nursing
intervention?
✔✔Initiate phototherapy and encourage frequent breastfeeding to promote bilirubin excretion
A postpartum client is breastfeeding and reports nipple cracking and pain. What should the nurse
do first?
✔✔Assess the latch technique and provide guidance on proper positioning
A child with asthma presents with wheezing and shortness of breath. What is the priority nursing
intervention?
✔✔Administer a prescribed bronchodilator and monitor oxygen saturation
A client in labor at 40 weeks gestation reports contractions every 3 minutes. What should the
nurse assess first?
✔✔Check cervical dilation and effacement to evaluate labor progression
A newborn presents with hypoglycemia, jitteriness, and lethargy. What is the immediate nursing
action?
✔✔Check blood glucose and initiate feeding or IV glucose as ordered
2
,A postpartum client reports severe headache, blurred vision, and swelling of the hands. What is
the priority nursing assessment?
✔✔Check blood pressure and assess for preeclampsia
A 6-month-old infant presents with persistent vomiting and dehydration. What is the priority
nursing intervention?
✔✔Assess hydration status, administer IV fluids, and monitor electrolytes
A client at 32 weeks gestation presents with vaginal bleeding and abdominal pain. What should
the nurse suspect?
✔✔Assess for placental abruption and monitor fetal status
A newborn has a weak cry, poor muscle tone, and cyanosis at birth. What is the initial nursing
action?
✔✔Provide resuscitation according to neonatal resuscitation guidelines
A 4-year-old child is scheduled for a vaccination and expresses fear. What is the best nursing
intervention?
3
, ✔✔Explain the procedure in simple terms and provide comfort measures
A postpartum client reports foul-smelling lochia and fever on day 4. What is the most likely
cause?
✔✔Assess for postpartum infection and notify the healthcare provider
A child with dehydration from diarrhea has a dry mouth, sunken eyes, and decreased urine
output. What is the priority intervention?
✔✔Initiate oral or IV rehydration therapy and monitor fluid balance
A client at 28 weeks gestation presents with severe pruritus and dark urine. What condition
should be suspected?
✔✔Assess for intrahepatic cholestasis of pregnancy and notify provider
A newborn is born via cesarean section and has a respiratory rate of 60/min with grunting. What
is the priority nursing action?
✔✔Provide supplemental oxygen and monitor for respiratory distress
4
and Answers | Latest Version |
2025/2026 | Correct & Verified
A newborn is born at 38 weeks gestation and has a heart rate of 90 bpm. What is the priority
nursing intervention?
✔✔Provide stimulation and administer oxygen as needed, assess for respiratory distress
A postpartum client reports sudden heavy bleeding 2 hours after delivery. What should the nurse
do first?
✔✔Assess uterine tone, massage the fundus, and monitor vital signs
A 3-year-old child presents with high fever and a stiff neck. What is the most important nursing
assessment?
✔✔Assess for signs of meningitis and prepare for immediate medical evaluation
A client at 36 weeks gestation reports decreased fetal movement over the past 12 hours. What is
the priority action?
✔✔Perform a non-stress test and instruct the client on fetal kick counts
1
,A newborn has jaundice with bilirubin of 16 mg/dL at 48 hours of life. What is the best nursing
intervention?
✔✔Initiate phototherapy and encourage frequent breastfeeding to promote bilirubin excretion
A postpartum client is breastfeeding and reports nipple cracking and pain. What should the nurse
do first?
✔✔Assess the latch technique and provide guidance on proper positioning
A child with asthma presents with wheezing and shortness of breath. What is the priority nursing
intervention?
✔✔Administer a prescribed bronchodilator and monitor oxygen saturation
A client in labor at 40 weeks gestation reports contractions every 3 minutes. What should the
nurse assess first?
✔✔Check cervical dilation and effacement to evaluate labor progression
A newborn presents with hypoglycemia, jitteriness, and lethargy. What is the immediate nursing
action?
✔✔Check blood glucose and initiate feeding or IV glucose as ordered
2
,A postpartum client reports severe headache, blurred vision, and swelling of the hands. What is
the priority nursing assessment?
✔✔Check blood pressure and assess for preeclampsia
A 6-month-old infant presents with persistent vomiting and dehydration. What is the priority
nursing intervention?
✔✔Assess hydration status, administer IV fluids, and monitor electrolytes
A client at 32 weeks gestation presents with vaginal bleeding and abdominal pain. What should
the nurse suspect?
✔✔Assess for placental abruption and monitor fetal status
A newborn has a weak cry, poor muscle tone, and cyanosis at birth. What is the initial nursing
action?
✔✔Provide resuscitation according to neonatal resuscitation guidelines
A 4-year-old child is scheduled for a vaccination and expresses fear. What is the best nursing
intervention?
3
, ✔✔Explain the procedure in simple terms and provide comfort measures
A postpartum client reports foul-smelling lochia and fever on day 4. What is the most likely
cause?
✔✔Assess for postpartum infection and notify the healthcare provider
A child with dehydration from diarrhea has a dry mouth, sunken eyes, and decreased urine
output. What is the priority intervention?
✔✔Initiate oral or IV rehydration therapy and monitor fluid balance
A client at 28 weeks gestation presents with severe pruritus and dark urine. What condition
should be suspected?
✔✔Assess for intrahepatic cholestasis of pregnancy and notify provider
A newborn is born via cesarean section and has a respiratory rate of 60/min with grunting. What
is the priority nursing action?
✔✔Provide supplemental oxygen and monitor for respiratory distress
4
