HESI-MATERNITY & PEDIATRICS EXAM 2025 COMPLETE
QUESTIONS WITH ANSWERS 100% RATED CORRECT(ACCURATELY
PASSED)GRADED A+
Question 1
Which of the following is a life-threatening complication of hydatidiform mole (molar
pregnancy)?
A) Increased risk of premature birth.
B) Malignant change and proliferation of residual trophoblastic tissue (choriocarcinoma).
C) Severe fetal anomalies.
D) Postpartum hemorrhage after normal delivery.
E) Low levels of beta hCG.
Correct Answer: B) Malignant change and proliferation of residual trophoblastic tissue
(choriocarcinoma).
Rationale: One of the most serious life-threatening complications of a hydatidiform mole is
the potential for malignant transformation, specifically the development of
choriocarcinoma or gestational trophoblastic neoplasm. Respiratory distress from
embolized vesicles is also a life-threatening complication.
Question 2
A pregnant client presents with vaginal bleeding, a uterus larger than expected for her gestational
age, and excessive nausea and vomiting. These signs and symptoms are indicative of:
A) Placenta previa.
B) Ectopic pregnancy.
C) Abruptio placentae.
D) Molar pregnancy.
E) Preeclampsia.
Correct Answer: D) Molar pregnancy.
Rationale: The classic signs and symptoms of a molar pregnancy include vaginal bleeding
(often dark brown, prune juice-like), a uterus that is larger than expected for the duration
of pregnancy, and excessive nausea and vomiting. Early development of preeclampsia can
also occur.
Question 3
What is the definitive diagnostic method for a molar pregnancy?
A) Fetal heart tone auscultation.
B) Manual pelvic examination.
C) Ultrasound (US) and high levels of beta hCG.
D) Maternal blood pressure monitoring.
E) Urinalysis for protein.
Correct Answer: C) Ultrasound (US) and high levels of beta hCG.
Rationale: The diagnosis of a molar pregnancy is typically made through ultrasound, which
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reveals the characteristic "grape-like" clusters or "snowstorm" pattern, combined with
abnormally high levels of human chorionic gonadotropin (beta hCG).
Question 4
How is a molar pregnancy primarily treated?
A) Expectant management with close monitoring.
B) Immediate induction of labor.
C) Vacuum aspiration to extract the mole, followed by Pitocin to contract the uterus.
D) Surgical removal of the entire uterus (hysterectomy).
E) Administration of chemotherapy.
Correct Answer: C) Vacuum aspiration to extract the mole, followed by Pitocin to contract
the uterus.
Rationale: The primary treatment for a molar pregnancy is the evacuation of the uterine
contents, typically through vacuum aspiration. After the tissue is removed, oxytocin
(Pitocin) is often administered to contract the uterus and minimize bleeding.
Question 5
What is the recommended follow-up protocol for a woman after a molar pregnancy?
A) Daily ultrasound for one month.
B) Evaluation of serum hCG every 1-2 weeks until 3 normal pre-pregnancy levels are attained,
then every 1-2 months for up to a year.
C) Immediate pregnancy allowed after tissue removal.
D) Routine postpartum check-up at 6 weeks.
E) No specific follow-up is needed if all tissue is removed.
Correct Answer: B) Evaluation of serum hCG every 1-2 weeks until 3 normal pre-pregnancy
levels are attained, then every 1-2 months for up to a year.
Rationale: Close follow-up with serial serum hCG levels is crucial after a molar pregnancy
to detect any persistent trophoblastic disease (e.g., gestational trophoblastic neoplasm or
choriocarcinoma). This monitoring typically involves weekly or bi-weekly levels until three
consecutive normal levels are achieved, then monthly or bi-monthly for up to a year.
Question 6
What is a crucial teaching point for a woman after a molar pregnancy?
A) She should resume sexual intercourse immediately to prevent complications.
B) She should avoid getting pregnant until the follow-up protocol is completed.
C) She should expect to breastfeed her next child without issues.
D) She needs to undergo routine genetic counseling.
E) She should anticipate a higher risk of recurrent molar pregnancies.
Correct Answer: B) She should avoid getting pregnant until the follow-up protocol is
completed.
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Rationale: It is imperative for a woman who has had a molar pregnancy to avoid getting
pregnant again until the entire follow-up protocol (including negative serial hCG levels for
the specified duration) is completed. A new pregnancy would produce hCG, making it
impossible to monitor for persistent trophoblastic disease.
Question 7
The implantation of the placenta in the lower uterus, near or covering the fetal presenting part, is
known as:
A) Abruptio placentae.
B) Placenta accreta.
C) Placenta previa.
D) Vasa previa.
E) Hydatidiform mole.
Correct Answer: C) Placenta Previa.
Rationale: Placenta previa is defined by the implantation of the placenta in the lower
uterine segment, such that it lies over or near the internal cervical os (the opening of the
cervix).
Question 8
Which type of placenta previa describes the placenta being implanted in the lower uterus, but its
lower border is more than 3 cm from the internal os?
A) Total previa.
B) Partial previa.
C) Marginal previa.
D) Low-lying previa.
E) Complete previa.
Correct Answer: C) Marginal placenta previa.
Rationale: Marginal placenta previa is when the placenta is located in the lower uterine
segment, with its lower border within 3 cm of the internal os but not covering it. Total
previa completely covers the os. Partial previa covers part of the os.
Question 9
What is the classic sign of placenta previa?
A) Painless uterine bleeding in the last half of pregnancy.
B) Severe abdominal pain with a rigid uterus.
C) Uterine irritability and contractions.
D) Dark red vaginal bleeding with tenderness.
E) Hypertension and proteinuria.
Correct Answer: A) Painless uterine bleeding in the last half of pregnancy.
Rationale: The hallmark clinical sign of placenta previa is painless, bright red vaginal
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bleeding that typically occurs in the last half of pregnancy (after 20 weeks). This bleeding is
often sudden and without associated abdominal pain or contractions.
Question 10
In a patient presenting with painless vaginal bleeding in the latter half of pregnancy, which
actions should be avoided?
A) Vital sign monitoring.
B) Fetal heart rate assessment.
C) Manual vaginal examination and administration of oxytocin.
D) External fetal monitoring.
E) Preparing for potential blood transfusion.
Correct Answer: C) Manual examination and administration of oxytocin.
Rationale: If placenta previa is suspected (painless vaginal bleeding), a manual vaginal
examination is absolutely contraindicated because it could rupture the placenta and cause
massive hemorrhage. Administration of oxytocin is also contraindicated as it would
stimulate uterine contractions, which could further detach the placenta and worsen
bleeding.
Question 11
Conservative management of placenta previa, when the mother's cardiovascular status is stable
and the fetus is immature with a reassuring status, typically includes:
A) Immediate cesarean section.
B) Induction of labor.
C) Bedrest, possible tocolytic, and RhoGAM (if indicated).
D) Manual removal of the placenta.
E) Administration of antihypertensive medications.
Correct Answer: C) Bedrest, possible tocolytic, RhoGAM.
Rationale: If the bleeding is minimal, the mother is stable, and the fetus is preterm and not
in distress, conservative management aims to prolong the pregnancy. This typically
involves bedrest (often in the hospital), avoiding activities that might trigger bleeding, and
possibly tocolytic medications to suppress contractions. RhoGAM would be given if the
mother is Rh-negative.
Question 12
Separation of a normally implanted placenta before the fetus is born is termed:
A) Placenta previa.
B) Placenta accreta.
C) Vasa previa.
D) Abruptio placentae.
E) Hydatidiform mole.
QUESTIONS WITH ANSWERS 100% RATED CORRECT(ACCURATELY
PASSED)GRADED A+
Question 1
Which of the following is a life-threatening complication of hydatidiform mole (molar
pregnancy)?
A) Increased risk of premature birth.
B) Malignant change and proliferation of residual trophoblastic tissue (choriocarcinoma).
C) Severe fetal anomalies.
D) Postpartum hemorrhage after normal delivery.
E) Low levels of beta hCG.
Correct Answer: B) Malignant change and proliferation of residual trophoblastic tissue
(choriocarcinoma).
Rationale: One of the most serious life-threatening complications of a hydatidiform mole is
the potential for malignant transformation, specifically the development of
choriocarcinoma or gestational trophoblastic neoplasm. Respiratory distress from
embolized vesicles is also a life-threatening complication.
Question 2
A pregnant client presents with vaginal bleeding, a uterus larger than expected for her gestational
age, and excessive nausea and vomiting. These signs and symptoms are indicative of:
A) Placenta previa.
B) Ectopic pregnancy.
C) Abruptio placentae.
D) Molar pregnancy.
E) Preeclampsia.
Correct Answer: D) Molar pregnancy.
Rationale: The classic signs and symptoms of a molar pregnancy include vaginal bleeding
(often dark brown, prune juice-like), a uterus that is larger than expected for the duration
of pregnancy, and excessive nausea and vomiting. Early development of preeclampsia can
also occur.
Question 3
What is the definitive diagnostic method for a molar pregnancy?
A) Fetal heart tone auscultation.
B) Manual pelvic examination.
C) Ultrasound (US) and high levels of beta hCG.
D) Maternal blood pressure monitoring.
E) Urinalysis for protein.
Correct Answer: C) Ultrasound (US) and high levels of beta hCG.
Rationale: The diagnosis of a molar pregnancy is typically made through ultrasound, which
,[Type here]
reveals the characteristic "grape-like" clusters or "snowstorm" pattern, combined with
abnormally high levels of human chorionic gonadotropin (beta hCG).
Question 4
How is a molar pregnancy primarily treated?
A) Expectant management with close monitoring.
B) Immediate induction of labor.
C) Vacuum aspiration to extract the mole, followed by Pitocin to contract the uterus.
D) Surgical removal of the entire uterus (hysterectomy).
E) Administration of chemotherapy.
Correct Answer: C) Vacuum aspiration to extract the mole, followed by Pitocin to contract
the uterus.
Rationale: The primary treatment for a molar pregnancy is the evacuation of the uterine
contents, typically through vacuum aspiration. After the tissue is removed, oxytocin
(Pitocin) is often administered to contract the uterus and minimize bleeding.
Question 5
What is the recommended follow-up protocol for a woman after a molar pregnancy?
A) Daily ultrasound for one month.
B) Evaluation of serum hCG every 1-2 weeks until 3 normal pre-pregnancy levels are attained,
then every 1-2 months for up to a year.
C) Immediate pregnancy allowed after tissue removal.
D) Routine postpartum check-up at 6 weeks.
E) No specific follow-up is needed if all tissue is removed.
Correct Answer: B) Evaluation of serum hCG every 1-2 weeks until 3 normal pre-pregnancy
levels are attained, then every 1-2 months for up to a year.
Rationale: Close follow-up with serial serum hCG levels is crucial after a molar pregnancy
to detect any persistent trophoblastic disease (e.g., gestational trophoblastic neoplasm or
choriocarcinoma). This monitoring typically involves weekly or bi-weekly levels until three
consecutive normal levels are achieved, then monthly or bi-monthly for up to a year.
Question 6
What is a crucial teaching point for a woman after a molar pregnancy?
A) She should resume sexual intercourse immediately to prevent complications.
B) She should avoid getting pregnant until the follow-up protocol is completed.
C) She should expect to breastfeed her next child without issues.
D) She needs to undergo routine genetic counseling.
E) She should anticipate a higher risk of recurrent molar pregnancies.
Correct Answer: B) She should avoid getting pregnant until the follow-up protocol is
completed.
,[Type here]
Rationale: It is imperative for a woman who has had a molar pregnancy to avoid getting
pregnant again until the entire follow-up protocol (including negative serial hCG levels for
the specified duration) is completed. A new pregnancy would produce hCG, making it
impossible to monitor for persistent trophoblastic disease.
Question 7
The implantation of the placenta in the lower uterus, near or covering the fetal presenting part, is
known as:
A) Abruptio placentae.
B) Placenta accreta.
C) Placenta previa.
D) Vasa previa.
E) Hydatidiform mole.
Correct Answer: C) Placenta Previa.
Rationale: Placenta previa is defined by the implantation of the placenta in the lower
uterine segment, such that it lies over or near the internal cervical os (the opening of the
cervix).
Question 8
Which type of placenta previa describes the placenta being implanted in the lower uterus, but its
lower border is more than 3 cm from the internal os?
A) Total previa.
B) Partial previa.
C) Marginal previa.
D) Low-lying previa.
E) Complete previa.
Correct Answer: C) Marginal placenta previa.
Rationale: Marginal placenta previa is when the placenta is located in the lower uterine
segment, with its lower border within 3 cm of the internal os but not covering it. Total
previa completely covers the os. Partial previa covers part of the os.
Question 9
What is the classic sign of placenta previa?
A) Painless uterine bleeding in the last half of pregnancy.
B) Severe abdominal pain with a rigid uterus.
C) Uterine irritability and contractions.
D) Dark red vaginal bleeding with tenderness.
E) Hypertension and proteinuria.
Correct Answer: A) Painless uterine bleeding in the last half of pregnancy.
Rationale: The hallmark clinical sign of placenta previa is painless, bright red vaginal
, [Type here]
bleeding that typically occurs in the last half of pregnancy (after 20 weeks). This bleeding is
often sudden and without associated abdominal pain or contractions.
Question 10
In a patient presenting with painless vaginal bleeding in the latter half of pregnancy, which
actions should be avoided?
A) Vital sign monitoring.
B) Fetal heart rate assessment.
C) Manual vaginal examination and administration of oxytocin.
D) External fetal monitoring.
E) Preparing for potential blood transfusion.
Correct Answer: C) Manual examination and administration of oxytocin.
Rationale: If placenta previa is suspected (painless vaginal bleeding), a manual vaginal
examination is absolutely contraindicated because it could rupture the placenta and cause
massive hemorrhage. Administration of oxytocin is also contraindicated as it would
stimulate uterine contractions, which could further detach the placenta and worsen
bleeding.
Question 11
Conservative management of placenta previa, when the mother's cardiovascular status is stable
and the fetus is immature with a reassuring status, typically includes:
A) Immediate cesarean section.
B) Induction of labor.
C) Bedrest, possible tocolytic, and RhoGAM (if indicated).
D) Manual removal of the placenta.
E) Administration of antihypertensive medications.
Correct Answer: C) Bedrest, possible tocolytic, RhoGAM.
Rationale: If the bleeding is minimal, the mother is stable, and the fetus is preterm and not
in distress, conservative management aims to prolong the pregnancy. This typically
involves bedrest (often in the hospital), avoiding activities that might trigger bleeding, and
possibly tocolytic medications to suppress contractions. RhoGAM would be given if the
mother is Rh-negative.
Question 12
Separation of a normally implanted placenta before the fetus is born is termed:
A) Placenta previa.
B) Placenta accreta.
C) Vasa previa.
D) Abruptio placentae.
E) Hydatidiform mole.
