HESI RN Maternity Exam 2025/2026 –
Actual Exam 80 Questions with
Verified Correct Answers and Detailed
Explanations
Question 1
Client teaching is an important part of the maternity nurse's role. Which factor has the greatest
influence on successful teaching of the gravid client? A. The client's educational background B.
The order in which the information is presented C. The extent to which the pregnancy was
planned D. The client's readiness to learn
Rationale: When teaching any client, readiness to learn is the most important criterion. For
example, a client with severe morning sickness in the first trimester may not be ready to
learn about labor and delivery but is likely ready to learn ways to relieve morning sickness.
Options A, B, and C are less influential than readiness.
Question 2
A 38-week primagravida who works as a secretary and sits at a computer 8 hours a day tells the
nurse that her feet have begun to swell. Which instruction would be most effective in preventing
pooling of blood in the lower extremities? A. Wear elastic support hose during the day B. Walk
for an hour a day C. Move about every hour D. Elevate feet when sitting at her desk
Rationale: Moving about every hour promotes circulation and prevents venous stasis in the
lower extremities, which is a common issue in late pregnancy due to uterine pressure on
pelvic veins. Elastic hose (A) may help but is not the most direct; walking (B) is good but
less frequent; elevating (D) helps but does not address prolonged sitting.
Question 3
An expectant father tells the nurse he fears that his wife is "losing her mind." He states that she is
constantly rubbing her abdomen and talking to the baby and that she actually reprimands the
baby when it moves too much. What recommendation should the nurse make to the expectant
father? A. Suggest that his wife seek professional counseling to deal with her symptoms B.
,Explain that his wife is exhibiting ambivalence about the pregnancy C. Ask him to report similar
abnormal behaviors at the next prenatal visit D. Let him know that these behaviors are part of
normal maternal/fetal bonding which occurs once the mother feels fetal movement
Rationale: These behaviors are positive signs of maternal-fetal bonding and do not reflect
ambivalence or abnormality. Quickening (fetal movement) at 17-20 weeks initiates this
phase. No intervention is needed; reassurance is key.
Question 4
During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus.
When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants
who have: A. Higher birth weights B. Lower birth weights C. More respiratory distress D.
Larger head circumferences
Rationale: Smoking causes vasoconstriction, reducing placental blood flow and leading to
intrauterine growth restriction (IUGR) and lower birth weights. Respiratory distress (C) is
a risk but secondary; head size (D) is not typically affected.
Question 5
A primigravida arrives at the observation unit of the maternity unit because she thinks she is in
labor. The nurse applies the external fetal heart monitor and determines that the fetal heart rate is
140 beats/minute and the contractions are occurring irregularly every 10 to 15 minutes. Which
assessment finding confirms to the nurse that the client is not in labor at this time? A.
Contractions lasting 30 to 40 seconds B. Verbalizes urge to bear down C. Contractions
decrease with walking D. Cervix is 2 cm dilated
Rationale: False labor contractions (Braxton Hicks) often decrease or stop with activity like
walking, whereas true labor contractions intensify. Urge to bear down (B) and dilation (D)
indicate true labor; short duration (A) is nonspecific.
Question 6
At 14-weeks gestation, a client arrives at the Emergency Center complaining of a dull pain in the
right lower quadrant of her abdomen. The nurse obtains a blood sample and initiates an IV.
Thirty minutes after admission, the client reports feeling a sharp abdominal pain and a shoulder
pain. Which diagnosis should the nurse suspect? A. Appendicitis B. Ectopic pregnancy C.
Urinary tract infection D. Gastroenteritis
, Rationale: Shoulder pain indicates referred pain from diaphragmatic irritation due to
intra-abdominal bleeding, classic for ruptured ectopic pregnancy. Appendicitis (A) lacks
shoulder pain; UTI (C) and gastroenteritis (D) do not typically cause acute sharp pain with
bleeding.
Question 7
A client with no prenatal care arrives at the labor unit screaming, "The baby is coming!" The
nurse performs a vaginal examination that reveals the cervix is 3 cm dilated and 75% effaced.
What additional information is most important for the nurse to obtain? A. Gravidity and parity
B. Date of last normal menstrual period C. Fetal presentation and station D. Time of rupture of
membranes
Rationale: Gravidity and parity help assess labor progression risk (e.g., multipara may
progress faster). LMP (B) is useful but secondary; presentation/station (C) and ROM (D)
are important but not most critical initially.
Question 8
A multigravida client at 41 weeks gestation presents in the labor and delivery unit after a non-
stress test indicated that the fetus is experiencing some difficulties in utero. Which diagnostic test
should the nurse prepare the client for additional information about fetal status? A. Biophysical
profile B. Ultrasound for fetal abnormalities C. Maternal serum alpha-fetoprotein screening D.
Percutaneous umbilical blood sampling
Rationale: Biophysical profile (BPP) assesses fetal well-being (breathing, movement, tone,
amniotic fluid, NST) in post-term pregnancies. Ultrasound (B) screens anomalies; AFP (C)
is for neural tube defects; PUBS (D) is invasive for blood sampling.
Question 9
An infant born breech is at risk for what complication? A. Brachial palsy B. Hip dysplasia C.
Respiratory distress D. Hypoglycemia
Rationale: Breech delivery stretches brachial plexus nerves, risking brachial palsy (Erb's
or Klumpke's). Hip dysplasia (B) is associated but not primary; RDS (C) and hypoglycemia
(D) are general preterm risks.
Actual Exam 80 Questions with
Verified Correct Answers and Detailed
Explanations
Question 1
Client teaching is an important part of the maternity nurse's role. Which factor has the greatest
influence on successful teaching of the gravid client? A. The client's educational background B.
The order in which the information is presented C. The extent to which the pregnancy was
planned D. The client's readiness to learn
Rationale: When teaching any client, readiness to learn is the most important criterion. For
example, a client with severe morning sickness in the first trimester may not be ready to
learn about labor and delivery but is likely ready to learn ways to relieve morning sickness.
Options A, B, and C are less influential than readiness.
Question 2
A 38-week primagravida who works as a secretary and sits at a computer 8 hours a day tells the
nurse that her feet have begun to swell. Which instruction would be most effective in preventing
pooling of blood in the lower extremities? A. Wear elastic support hose during the day B. Walk
for an hour a day C. Move about every hour D. Elevate feet when sitting at her desk
Rationale: Moving about every hour promotes circulation and prevents venous stasis in the
lower extremities, which is a common issue in late pregnancy due to uterine pressure on
pelvic veins. Elastic hose (A) may help but is not the most direct; walking (B) is good but
less frequent; elevating (D) helps but does not address prolonged sitting.
Question 3
An expectant father tells the nurse he fears that his wife is "losing her mind." He states that she is
constantly rubbing her abdomen and talking to the baby and that she actually reprimands the
baby when it moves too much. What recommendation should the nurse make to the expectant
father? A. Suggest that his wife seek professional counseling to deal with her symptoms B.
,Explain that his wife is exhibiting ambivalence about the pregnancy C. Ask him to report similar
abnormal behaviors at the next prenatal visit D. Let him know that these behaviors are part of
normal maternal/fetal bonding which occurs once the mother feels fetal movement
Rationale: These behaviors are positive signs of maternal-fetal bonding and do not reflect
ambivalence or abnormality. Quickening (fetal movement) at 17-20 weeks initiates this
phase. No intervention is needed; reassurance is key.
Question 4
During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus.
When compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants
who have: A. Higher birth weights B. Lower birth weights C. More respiratory distress D.
Larger head circumferences
Rationale: Smoking causes vasoconstriction, reducing placental blood flow and leading to
intrauterine growth restriction (IUGR) and lower birth weights. Respiratory distress (C) is
a risk but secondary; head size (D) is not typically affected.
Question 5
A primigravida arrives at the observation unit of the maternity unit because she thinks she is in
labor. The nurse applies the external fetal heart monitor and determines that the fetal heart rate is
140 beats/minute and the contractions are occurring irregularly every 10 to 15 minutes. Which
assessment finding confirms to the nurse that the client is not in labor at this time? A.
Contractions lasting 30 to 40 seconds B. Verbalizes urge to bear down C. Contractions
decrease with walking D. Cervix is 2 cm dilated
Rationale: False labor contractions (Braxton Hicks) often decrease or stop with activity like
walking, whereas true labor contractions intensify. Urge to bear down (B) and dilation (D)
indicate true labor; short duration (A) is nonspecific.
Question 6
At 14-weeks gestation, a client arrives at the Emergency Center complaining of a dull pain in the
right lower quadrant of her abdomen. The nurse obtains a blood sample and initiates an IV.
Thirty minutes after admission, the client reports feeling a sharp abdominal pain and a shoulder
pain. Which diagnosis should the nurse suspect? A. Appendicitis B. Ectopic pregnancy C.
Urinary tract infection D. Gastroenteritis
, Rationale: Shoulder pain indicates referred pain from diaphragmatic irritation due to
intra-abdominal bleeding, classic for ruptured ectopic pregnancy. Appendicitis (A) lacks
shoulder pain; UTI (C) and gastroenteritis (D) do not typically cause acute sharp pain with
bleeding.
Question 7
A client with no prenatal care arrives at the labor unit screaming, "The baby is coming!" The
nurse performs a vaginal examination that reveals the cervix is 3 cm dilated and 75% effaced.
What additional information is most important for the nurse to obtain? A. Gravidity and parity
B. Date of last normal menstrual period C. Fetal presentation and station D. Time of rupture of
membranes
Rationale: Gravidity and parity help assess labor progression risk (e.g., multipara may
progress faster). LMP (B) is useful but secondary; presentation/station (C) and ROM (D)
are important but not most critical initially.
Question 8
A multigravida client at 41 weeks gestation presents in the labor and delivery unit after a non-
stress test indicated that the fetus is experiencing some difficulties in utero. Which diagnostic test
should the nurse prepare the client for additional information about fetal status? A. Biophysical
profile B. Ultrasound for fetal abnormalities C. Maternal serum alpha-fetoprotein screening D.
Percutaneous umbilical blood sampling
Rationale: Biophysical profile (BPP) assesses fetal well-being (breathing, movement, tone,
amniotic fluid, NST) in post-term pregnancies. Ultrasound (B) screens anomalies; AFP (C)
is for neural tube defects; PUBS (D) is invasive for blood sampling.
Question 9
An infant born breech is at risk for what complication? A. Brachial palsy B. Hip dysplasia C.
Respiratory distress D. Hypoglycemia
Rationale: Breech delivery stretches brachial plexus nerves, risking brachial palsy (Erb's
or Klumpke's). Hip dysplasia (B) is associated but not primary; RDS (C) and hypoglycemia
(D) are general preterm risks.
