HESI RN Maternity Exam
2025 – Verified Questions
with Correct Answers and
Rationales
1. A primigravida at 38 weeks gestation reports decreased fetal movement. What is the
nurse’s first action?
A. Instruct the client to rest and drink fluids.
B. Perform a nonstress test (NST).
C. Notify the healthcare provider immediately.
D. Teach the client to count fetal kicks daily.
B. Perform a nonstress test (NST).
Rationale: Decreased fetal movement may indicate fetal distress, and a nonstress test is
the first action to assess fetal well-being. Resting or teaching kick counts is secondary,
and notifying the provider follows objective assessment.
2. A client in labor is receiving oxytocin (Pitocin). Which finding requires immediate
intervention?
A. Fetal heart rate of 140 bpm.
B. Contractions every 2 minutes, lasting 90 seconds.
C. Maternal blood pressure of 120/80 mmHg.
D. Cervical dilation of 6 cm.
B. Contractions every 2 minutes, lasting 90 seconds.
Rationale: Contractions lasting 90 seconds and occurring every 2 minutes indicate
uterine hyperstimulation, which can compromise fetal oxygenation. The nurse should
stop the oxytocin and intervene. Other findings are within normal limits.
3. A postpartum client reports heavy vaginal bleeding. What is the nurse’s priority action?
A. Massage the fundus.
B. Administer oxytocin as prescribed.
C. Document the bleeding.
D. Encourage increased fluid intake.
A. Massage the fundus.
Rationale: Heavy vaginal bleeding may indicate uterine atony, a common cause of
postpartum hemorrhage. Fundal massage stimulates uterine contraction to control
bleeding. Administering oxytocin or documenting follows assessment, and fluids are not
the priority.
,4. A newborn is diagnosed with respiratory distress syndrome (RDS). Which intervention
should the nurse anticipate?
A. Administering surfactant therapy.
B. Providing high-flow oxygen via nasal cannula.
C. Initiating bottle feeding to improve strength.
D. Placing the newborn in a prone position.
A. Administering surfactant therapy.
Rationale: RDS is caused by surfactant deficiency in preterm infants, and surfactant
therapy is the primary treatment to improve lung function. High-flow oxygen may be
used but is not specific to RDS. Feeding and prone positioning are inappropriate for acute
RDS.
5. A client at 32 weeks gestation is diagnosed with preeclampsia. Which finding is most
concerning?
A. Blood pressure of 140/90 mmHg.
B. Proteinuria of 1+.
C. Epigastric pain.
D. Mild pedal edema.
C. Epigastric pain.
Rationale: Epigastric pain in preeclampsia may indicate severe disease or impending
eclampsia, requiring immediate intervention. Other findings are common in preeclampsia
but less urgent.
6. A nurse is teaching a client about breastfeeding. Which statement indicates
understanding?
A. “I should breastfeed every 4-6 hours.”
B. “My baby should latch onto the nipple only.”
C. “I should hear swallowing during feeding.”
D. “Breastfeeding requires no dietary changes.”
C. “I should hear swallowing during feeding.”
Rationale: Hearing swallowing indicates effective milk transfer, a sign of successful
breastfeeding. Feeding should occur every 2-3 hours, the baby should latch onto the
areola, and dietary adjustments may be needed for optimal milk production.
7. A client in labor has a fetal heart rate (FHR) of 100 bpm with absent variability. What is
the nurse’s first action?
A. Administer oxygen via face mask.
B. Reposition the client to the left side.
C. Increase the IV fluid rate.
D. Prepare for an immediate cesarean section.
B. Reposition the client to the left side.
Rationale: An FHR of 100 bpm with absent variability suggests fetal distress, possibly
due to cord compression or uteroplacental insufficiency. Repositioning to the left side
improves placental perfusion and is the first action. Oxygen, fluids, or surgery may
follow based on response.
8. A postpartum client is diagnosed with endometritis. Which symptom should the nurse
expect?
A. Clear lochia with no odor.
B. Fever and foul-smelling lochia.
, C. Mild cramping after breastfeeding.
D. Absence of uterine tenderness.
B. Fever and foul-smelling lochia.
Rationale: Endometritis, a uterine infection, is characterized by fever and foul-smelling
lochia. Clear lochia, mild cramping, and lack of tenderness are not associated with
infection.
9. A newborn is receiving phototherapy for hyperbilirubinemia. Which action is most
important?
A. Limit fluid intake to prevent overhydration.
B. Cover the newborn’s eyes during treatment.
C. Keep the newborn fully clothed.
D. Position the newborn prone at all times.
B. Cover the newborn’s eyes during treatment.
Rationale: Phototherapy lights can damage the newborn’s eyes, so eye protection is
critical. Fluid intake supports hydration, clothing is minimal to maximize skin exposure,
and positioning varies for comfort.
10. A client at 28 weeks gestation reports vaginal bleeding and cramping. What is the nurse’s
priority action?
A. Administer tocolytics as prescribed.
B. Assess fetal heart tones and maternal vital signs.
C. Prepare the client for immediate delivery.
D. Encourage bed rest and hydration.
B. Assess fetal heart tones and maternal vital signs.
Rationale: Vaginal bleeding and cramping may indicate preterm labor or placental
issues, so assessing fetal and maternal status is the priority to guide interventions.
Tocolytics, delivery, or bed rest follow assessment.
11. A client is preparing for a cesarean section. Which preoperative teaching is most
important?
A. Encourage ambulation immediately after surgery.
B. Explain the use of spinal anesthesia.
C. Instruct the client to remain NPO after surgery.
D. Teach deep breathing exercises post-delivery.
B. Explain the use of spinal anesthesia.
Rationale: Explaining spinal anesthesia prepares the client for the procedure, reduces
anxiety, and ensures informed consent. Ambulation, NPO status, and exercises are
postoperative concerns.
12. A newborn has an Apgar score of 6 at 5 minutes. What is the nurse’s priority action?
A. Begin resuscitation efforts immediately.
B. Monitor the newborn closely and provide oxygen.
C. Initiate routine newborn care.
D. Place the newborn in an incubator.
B. Monitor the newborn closely and provide oxygen.
Rationale: An Apgar score of 6 indicates moderate distress, requiring close monitoring
and supportive measures like oxygen. Resuscitation is for scores ≤3, routine care is
inappropriate, and an incubator may not be necessary.
2025 – Verified Questions
with Correct Answers and
Rationales
1. A primigravida at 38 weeks gestation reports decreased fetal movement. What is the
nurse’s first action?
A. Instruct the client to rest and drink fluids.
B. Perform a nonstress test (NST).
C. Notify the healthcare provider immediately.
D. Teach the client to count fetal kicks daily.
B. Perform a nonstress test (NST).
Rationale: Decreased fetal movement may indicate fetal distress, and a nonstress test is
the first action to assess fetal well-being. Resting or teaching kick counts is secondary,
and notifying the provider follows objective assessment.
2. A client in labor is receiving oxytocin (Pitocin). Which finding requires immediate
intervention?
A. Fetal heart rate of 140 bpm.
B. Contractions every 2 minutes, lasting 90 seconds.
C. Maternal blood pressure of 120/80 mmHg.
D. Cervical dilation of 6 cm.
B. Contractions every 2 minutes, lasting 90 seconds.
Rationale: Contractions lasting 90 seconds and occurring every 2 minutes indicate
uterine hyperstimulation, which can compromise fetal oxygenation. The nurse should
stop the oxytocin and intervene. Other findings are within normal limits.
3. A postpartum client reports heavy vaginal bleeding. What is the nurse’s priority action?
A. Massage the fundus.
B. Administer oxytocin as prescribed.
C. Document the bleeding.
D. Encourage increased fluid intake.
A. Massage the fundus.
Rationale: Heavy vaginal bleeding may indicate uterine atony, a common cause of
postpartum hemorrhage. Fundal massage stimulates uterine contraction to control
bleeding. Administering oxytocin or documenting follows assessment, and fluids are not
the priority.
,4. A newborn is diagnosed with respiratory distress syndrome (RDS). Which intervention
should the nurse anticipate?
A. Administering surfactant therapy.
B. Providing high-flow oxygen via nasal cannula.
C. Initiating bottle feeding to improve strength.
D. Placing the newborn in a prone position.
A. Administering surfactant therapy.
Rationale: RDS is caused by surfactant deficiency in preterm infants, and surfactant
therapy is the primary treatment to improve lung function. High-flow oxygen may be
used but is not specific to RDS. Feeding and prone positioning are inappropriate for acute
RDS.
5. A client at 32 weeks gestation is diagnosed with preeclampsia. Which finding is most
concerning?
A. Blood pressure of 140/90 mmHg.
B. Proteinuria of 1+.
C. Epigastric pain.
D. Mild pedal edema.
C. Epigastric pain.
Rationale: Epigastric pain in preeclampsia may indicate severe disease or impending
eclampsia, requiring immediate intervention. Other findings are common in preeclampsia
but less urgent.
6. A nurse is teaching a client about breastfeeding. Which statement indicates
understanding?
A. “I should breastfeed every 4-6 hours.”
B. “My baby should latch onto the nipple only.”
C. “I should hear swallowing during feeding.”
D. “Breastfeeding requires no dietary changes.”
C. “I should hear swallowing during feeding.”
Rationale: Hearing swallowing indicates effective milk transfer, a sign of successful
breastfeeding. Feeding should occur every 2-3 hours, the baby should latch onto the
areola, and dietary adjustments may be needed for optimal milk production.
7. A client in labor has a fetal heart rate (FHR) of 100 bpm with absent variability. What is
the nurse’s first action?
A. Administer oxygen via face mask.
B. Reposition the client to the left side.
C. Increase the IV fluid rate.
D. Prepare for an immediate cesarean section.
B. Reposition the client to the left side.
Rationale: An FHR of 100 bpm with absent variability suggests fetal distress, possibly
due to cord compression or uteroplacental insufficiency. Repositioning to the left side
improves placental perfusion and is the first action. Oxygen, fluids, or surgery may
follow based on response.
8. A postpartum client is diagnosed with endometritis. Which symptom should the nurse
expect?
A. Clear lochia with no odor.
B. Fever and foul-smelling lochia.
, C. Mild cramping after breastfeeding.
D. Absence of uterine tenderness.
B. Fever and foul-smelling lochia.
Rationale: Endometritis, a uterine infection, is characterized by fever and foul-smelling
lochia. Clear lochia, mild cramping, and lack of tenderness are not associated with
infection.
9. A newborn is receiving phototherapy for hyperbilirubinemia. Which action is most
important?
A. Limit fluid intake to prevent overhydration.
B. Cover the newborn’s eyes during treatment.
C. Keep the newborn fully clothed.
D. Position the newborn prone at all times.
B. Cover the newborn’s eyes during treatment.
Rationale: Phototherapy lights can damage the newborn’s eyes, so eye protection is
critical. Fluid intake supports hydration, clothing is minimal to maximize skin exposure,
and positioning varies for comfort.
10. A client at 28 weeks gestation reports vaginal bleeding and cramping. What is the nurse’s
priority action?
A. Administer tocolytics as prescribed.
B. Assess fetal heart tones and maternal vital signs.
C. Prepare the client for immediate delivery.
D. Encourage bed rest and hydration.
B. Assess fetal heart tones and maternal vital signs.
Rationale: Vaginal bleeding and cramping may indicate preterm labor or placental
issues, so assessing fetal and maternal status is the priority to guide interventions.
Tocolytics, delivery, or bed rest follow assessment.
11. A client is preparing for a cesarean section. Which preoperative teaching is most
important?
A. Encourage ambulation immediately after surgery.
B. Explain the use of spinal anesthesia.
C. Instruct the client to remain NPO after surgery.
D. Teach deep breathing exercises post-delivery.
B. Explain the use of spinal anesthesia.
Rationale: Explaining spinal anesthesia prepares the client for the procedure, reduces
anxiety, and ensures informed consent. Ambulation, NPO status, and exercises are
postoperative concerns.
12. A newborn has an Apgar score of 6 at 5 minutes. What is the nurse’s priority action?
A. Begin resuscitation efforts immediately.
B. Monitor the newborn closely and provide oxygen.
C. Initiate routine newborn care.
D. Place the newborn in an incubator.
B. Monitor the newborn closely and provide oxygen.
Rationale: An Apgar score of 6 indicates moderate distress, requiring close monitoring
and supportive measures like oxygen. Resuscitation is for scores ≤3, routine care is
inappropriate, and an incubator may not be necessary.
