HESI Obstetrics-Maternity Case Study (NGN-Style
& Case Scenario) – Complete Exam Preparation
with Questions, Answers, and Rationales
Description:
This document provides a comprehensive set of HESI-style
obstetrics and maternity case studies, including NGN-style
scenarios. It covers maternal assessment, postpartum
complications, newborn care, pregnancy nutrition, fetal
monitoring, labor progression, medications, and genetic testing.
Each question includes answer choices, the correct answer, and a
detailed rationale, making it highly valuable for exam preparation
and clinical practice review.
### Scenario 1
Scenario: Fifteen minutes after the initial assessment, the nurse
finds the client disoriented and lying on her back in a pool of
vaginal blood, with the sheets beneath her saturated with blood.
Vital Signs:
- Blood Pressure: 90/50 mmHg
- Heart Rate: 120 bpm
Question: Which action is most important for the nurse to
implement immediately?
,Answer Choices:
a. Take vital signs.
b. Massage the fundus.
c. Check the bladder.
d. Increase the IV rate.
-ANSWER:b. Massage the fundus.
Rationale::
A boggy fundus is a common cause of postpartum hemorrhage.
Immediate fundal massage is crucial to stimulate uterine
contraction and mitigate the risk of significant blood loss. The
nurse should also call for assistance given the severity of the
situation.
### Scenario 2
Scenario: A nurse performs the first assessment upon the client's
arrival to the postpartum unit.
Question: Where would the nurse expect to palpate the fundus?
Answer Choices:
a. 3 cm above the umbilicus.
b. 1 cm above the umbilicus.
c. To the right of the umbilicus.
d. Midway between the umbilicus and the pubic bone.
,b. -ANSWER:1 cm above the umbilicus.
Rationale::
Within the first 12 hours postpartum, the fundus should be in the
range of 1- 2 cm above the umbilicus. This indicates that the
uterus is contracting properly and is returning to its normal size.
### Scenario 3
Scenario: A postpartum client is hemorrhaging and the nurse
suspects a common cause.
Question: What is the most likely reason a postpartum patient
would be hemorrhaging?
-ANSWER:Uterine atony (a "boggy" fundus).
Rationale::
Uterine atony is the inability of the uterus to contract effectively,
which is a leading cause of postpartum hemorrhage. This
condition causes the blood vessels at the placental site to remain
open, leading to significant blood loss.
---
, ### Scenario 4
Scenario: After massaging the fundus, the nurse calls for help.
Question: What should be assessed immediately after fundus is
massaged?
-ANSWER:Assess for bladder distention.
Rationale::
A full bladder can impede uterine contraction, which may
exacerbate bleeding. It is essential to assess for bladder distention
to ensure optimal uterine function and reduce the risk of
hemorrhage.
### Scenario 5
Scenario: The nurse conducts a gestational age assessment of a
newborn.
Question: Which findings may indicate postmaturity? (Select all
that apply)
Answer Choices:
a. Testes descended, good rugae.
b. Formed ears with instant recall.
c. Peeling, parchment-like skin.
d. Thin with loose skin and little subcutaneous fat.
& Case Scenario) – Complete Exam Preparation
with Questions, Answers, and Rationales
Description:
This document provides a comprehensive set of HESI-style
obstetrics and maternity case studies, including NGN-style
scenarios. It covers maternal assessment, postpartum
complications, newborn care, pregnancy nutrition, fetal
monitoring, labor progression, medications, and genetic testing.
Each question includes answer choices, the correct answer, and a
detailed rationale, making it highly valuable for exam preparation
and clinical practice review.
### Scenario 1
Scenario: Fifteen minutes after the initial assessment, the nurse
finds the client disoriented and lying on her back in a pool of
vaginal blood, with the sheets beneath her saturated with blood.
Vital Signs:
- Blood Pressure: 90/50 mmHg
- Heart Rate: 120 bpm
Question: Which action is most important for the nurse to
implement immediately?
,Answer Choices:
a. Take vital signs.
b. Massage the fundus.
c. Check the bladder.
d. Increase the IV rate.
-ANSWER:b. Massage the fundus.
Rationale::
A boggy fundus is a common cause of postpartum hemorrhage.
Immediate fundal massage is crucial to stimulate uterine
contraction and mitigate the risk of significant blood loss. The
nurse should also call for assistance given the severity of the
situation.
### Scenario 2
Scenario: A nurse performs the first assessment upon the client's
arrival to the postpartum unit.
Question: Where would the nurse expect to palpate the fundus?
Answer Choices:
a. 3 cm above the umbilicus.
b. 1 cm above the umbilicus.
c. To the right of the umbilicus.
d. Midway between the umbilicus and the pubic bone.
,b. -ANSWER:1 cm above the umbilicus.
Rationale::
Within the first 12 hours postpartum, the fundus should be in the
range of 1- 2 cm above the umbilicus. This indicates that the
uterus is contracting properly and is returning to its normal size.
### Scenario 3
Scenario: A postpartum client is hemorrhaging and the nurse
suspects a common cause.
Question: What is the most likely reason a postpartum patient
would be hemorrhaging?
-ANSWER:Uterine atony (a "boggy" fundus).
Rationale::
Uterine atony is the inability of the uterus to contract effectively,
which is a leading cause of postpartum hemorrhage. This
condition causes the blood vessels at the placental site to remain
open, leading to significant blood loss.
---
, ### Scenario 4
Scenario: After massaging the fundus, the nurse calls for help.
Question: What should be assessed immediately after fundus is
massaged?
-ANSWER:Assess for bladder distention.
Rationale::
A full bladder can impede uterine contraction, which may
exacerbate bleeding. It is essential to assess for bladder distention
to ensure optimal uterine function and reduce the risk of
hemorrhage.
### Scenario 5
Scenario: The nurse conducts a gestational age assessment of a
newborn.
Question: Which findings may indicate postmaturity? (Select all
that apply)
Answer Choices:
a. Testes descended, good rugae.
b. Formed ears with instant recall.
c. Peeling, parchment-like skin.
d. Thin with loose skin and little subcutaneous fat.
