1
FORTIS PN MATERNITY HESI ACTUAL EXAM 2026/2027 COMPLETE ACCURATE
QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED
SOLUTIONS) CURRENTLY UPDATED VERSION
1
A pregnant client at 28 weeks’ gestation reports decreased fetal movement for 12 hours.
The nurse’s best first action is:
A. Perform a nonstress test (NST).
B. Have the client drink a glass of juice and lie on her left side.
C. Schedule an immediate ultrasound.
D. Instruct the client to count fetal movements for the next 24 hours.
Answer: B
Rationale: The quickest, least invasive first step is to stimulate fetal activity (e.g., have the
client drink a sugar-containing beverage and rest in left lateral position) and then perform
fetal movement counts or kick counts. If movement remains decreased, then more advanced
testing (NST, biophysical profile, ultrasound) is indicated.
2
A client in active labor with a history of a prior classical cesarean is in labor. The best
nursing action is:
A. Allow trial of labor with continuous monitoring.
B. Prepare for immediate cesarean birth.
C. Offer pain medication and ambulate.
D. Encourage pushing when fully dilated.
Answer: B
Rationale: A classical (vertical) uterine scar greatly increases risk of uterine rupture during
labor. Trial of labor is contraindicated; immediate cesarean birth is indicated. Continuous
monitoring and surgical prep are priorities.
3
Which maternal sign is most indicative of preeclampsia with severe features?
A. Proteinuria of 1+ on dipstick.
B. Blood pressure 160/102 mmHg on two readings 4 hours apart.
, 2
C. Mild lower extremity edema.
D. Fetal tachycardia.
Answer: B
Rationale: Severe-range blood pressures (≥160 systolic or ≥110 diastolic) on repeated
measurement indicate preeclampsia with severe features. Proteinuria mild or edema alone
are not specific for severe disease. Fetal tachycardia is not diagnostic of maternal
preeclampsia.
4
A nurse is teaching a pregnant client about Rh incompatibility. Which statement by the
client indicates understanding?
A. “If I am Rh-negative, I will always pass it to my baby.”
B. “I should receive Rho(D) immune globulin at 28 weeks if I’m Rh-negative.”
C. “I will only need Rho(D) after delivery if my baby is Rh-negative.”
D. “My blood type won’t affect prenatal testing.”
Answer: B
Rationale: Standard practice for Rh-negative women is to give Rho(D) immune globulin at
~28 weeks and postpartum if the newborn is Rh-positive, and after potential sensitizing
events. A is incorrect and C is incomplete (postpartum only is insufficient). D is false.
5
A newborn is delivered and the nurse notes a heart murmur but otherwise normal vitals.
The priority action is:
A. Discharge home and schedule a follow-up.
B. Obtain an echocardiogram now.
C. Monitor and document, notify the provider.
D. Begin prostaglandin infusion.
Answer: C
Rationale: Many murmurs in newborns are transient; initial appropriate action is to
monitor, document findings, and notify the provider for further assessment. Immediate
echocardiogram may be ordered depending on provider assessment; prostaglandins are
used in specific ductal-dependent lesions — not routine.
6
, 3
A client at 39 weeks in active labor requests an epidural. The nurse recognizes which is a
contraindication?
A. Platelet count of 80,000/mm³.
B. Client refusal of other pain methods.
C. Maternal fever of 37.9°C.
D. Multiparity.
Answer: A
Rationale: Thrombocytopenia (low platelets) increases risk of epidural hematoma and is a
contraindication or requires careful risk/benefit discussion; usually platelets <100,000 are
a concern. The other choices are not absolute contraindications.
7
A woman with PROM (premature rupture of membranes) at 34 weeks is being managed
expectantly. Which intervention is indicated?
A. Immediate induction of labor.
B. Administration of corticosteroids to enhance fetal lung maturity.
C. Routine administration of magnesium sulfate for seizure prophylaxis.
D. Immediate cesarean section.
Answer: B
Rationale: For PROM at 34 weeks, corticosteroids are recommended to accelerate fetal
lung maturity. Management otherwise depends on maternal/fetal status and infection risk;
immediate delivery is not always indicated. Magnesium sulfate is for severe preeclampsia or
for fetal neuroprotection <32 weeks.
8
A laboring client suddenly has prolonged early decelerations on the fetal monitor occurring
with each contraction. This pattern most likely indicates:
A. Umbilical cord compression.
B. Uteroplacental insufficiency.
C. Fetal head compression (normal early decels).
D. Fetal hypoxia.
Answer: C
Rationale: Early decelerations that mirror contractions are typically due to fetal head
compression and are usually benign and physiologic. Variable decelerations suggest cord
compression; late decelerations indicate uteroplacental insufficiency.
, 4
9
During a postpartum assessment, the nurse notes the uterus is boggy and above the
umbilicus. The initial nursing action should be:
A. Massage the fundus firmly.
B. Notify the physician.
C. Give the oxytocin injection.
D. Check the bladder for distention.
Answer: A
Rationale: A boggy uterus suggests uterine atony; first-line nursing action is to massage the
fundus to stimulate contraction. Simultaneously check for bladder distention and prepare
medications/orders as needed, but fundal massage is immediate.
10
A pregnant client with diabetes is planning pregnancy. Which statement shows correct
understanding of preconception care?
A. “I should stop my insulin before I get pregnant.”
B. “Tight glucose control before conception reduces congenital malformations.”
C. “Oral hypoglycemic agents are preferred in pregnancy.”
D. “A1C targets are not important preconception.”
Answer: B
Rationale: Good glycemic control prior to conception reduces risk of fetal malformations.
Insulin is generally continued or optimized; many oral hypoglycemics are not
recommended in pregnancy. A1C targets are important preconception.
11
A primigravida at 12 weeks has severe nausea and vomiting, weight loss, and ketonuria. The
probable diagnosis is:
A. Hyperemesis gravidarum.
B. Morning sickness.
C. Gestational diabetes.
D. Preeclampsia.
Answer: A
Rationale: Severe, persistent vomiting with weight loss and ketonuria suggests
hyperemesis gravidarum, which requires aggressive management. Morning sickness is
milder; others are unrelated.
FORTIS PN MATERNITY HESI ACTUAL EXAM 2026/2027 COMPLETE ACCURATE
QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED
SOLUTIONS) CURRENTLY UPDATED VERSION
1
A pregnant client at 28 weeks’ gestation reports decreased fetal movement for 12 hours.
The nurse’s best first action is:
A. Perform a nonstress test (NST).
B. Have the client drink a glass of juice and lie on her left side.
C. Schedule an immediate ultrasound.
D. Instruct the client to count fetal movements for the next 24 hours.
Answer: B
Rationale: The quickest, least invasive first step is to stimulate fetal activity (e.g., have the
client drink a sugar-containing beverage and rest in left lateral position) and then perform
fetal movement counts or kick counts. If movement remains decreased, then more advanced
testing (NST, biophysical profile, ultrasound) is indicated.
2
A client in active labor with a history of a prior classical cesarean is in labor. The best
nursing action is:
A. Allow trial of labor with continuous monitoring.
B. Prepare for immediate cesarean birth.
C. Offer pain medication and ambulate.
D. Encourage pushing when fully dilated.
Answer: B
Rationale: A classical (vertical) uterine scar greatly increases risk of uterine rupture during
labor. Trial of labor is contraindicated; immediate cesarean birth is indicated. Continuous
monitoring and surgical prep are priorities.
3
Which maternal sign is most indicative of preeclampsia with severe features?
A. Proteinuria of 1+ on dipstick.
B. Blood pressure 160/102 mmHg on two readings 4 hours apart.
, 2
C. Mild lower extremity edema.
D. Fetal tachycardia.
Answer: B
Rationale: Severe-range blood pressures (≥160 systolic or ≥110 diastolic) on repeated
measurement indicate preeclampsia with severe features. Proteinuria mild or edema alone
are not specific for severe disease. Fetal tachycardia is not diagnostic of maternal
preeclampsia.
4
A nurse is teaching a pregnant client about Rh incompatibility. Which statement by the
client indicates understanding?
A. “If I am Rh-negative, I will always pass it to my baby.”
B. “I should receive Rho(D) immune globulin at 28 weeks if I’m Rh-negative.”
C. “I will only need Rho(D) after delivery if my baby is Rh-negative.”
D. “My blood type won’t affect prenatal testing.”
Answer: B
Rationale: Standard practice for Rh-negative women is to give Rho(D) immune globulin at
~28 weeks and postpartum if the newborn is Rh-positive, and after potential sensitizing
events. A is incorrect and C is incomplete (postpartum only is insufficient). D is false.
5
A newborn is delivered and the nurse notes a heart murmur but otherwise normal vitals.
The priority action is:
A. Discharge home and schedule a follow-up.
B. Obtain an echocardiogram now.
C. Monitor and document, notify the provider.
D. Begin prostaglandin infusion.
Answer: C
Rationale: Many murmurs in newborns are transient; initial appropriate action is to
monitor, document findings, and notify the provider for further assessment. Immediate
echocardiogram may be ordered depending on provider assessment; prostaglandins are
used in specific ductal-dependent lesions — not routine.
6
, 3
A client at 39 weeks in active labor requests an epidural. The nurse recognizes which is a
contraindication?
A. Platelet count of 80,000/mm³.
B. Client refusal of other pain methods.
C. Maternal fever of 37.9°C.
D. Multiparity.
Answer: A
Rationale: Thrombocytopenia (low platelets) increases risk of epidural hematoma and is a
contraindication or requires careful risk/benefit discussion; usually platelets <100,000 are
a concern. The other choices are not absolute contraindications.
7
A woman with PROM (premature rupture of membranes) at 34 weeks is being managed
expectantly. Which intervention is indicated?
A. Immediate induction of labor.
B. Administration of corticosteroids to enhance fetal lung maturity.
C. Routine administration of magnesium sulfate for seizure prophylaxis.
D. Immediate cesarean section.
Answer: B
Rationale: For PROM at 34 weeks, corticosteroids are recommended to accelerate fetal
lung maturity. Management otherwise depends on maternal/fetal status and infection risk;
immediate delivery is not always indicated. Magnesium sulfate is for severe preeclampsia or
for fetal neuroprotection <32 weeks.
8
A laboring client suddenly has prolonged early decelerations on the fetal monitor occurring
with each contraction. This pattern most likely indicates:
A. Umbilical cord compression.
B. Uteroplacental insufficiency.
C. Fetal head compression (normal early decels).
D. Fetal hypoxia.
Answer: C
Rationale: Early decelerations that mirror contractions are typically due to fetal head
compression and are usually benign and physiologic. Variable decelerations suggest cord
compression; late decelerations indicate uteroplacental insufficiency.
, 4
9
During a postpartum assessment, the nurse notes the uterus is boggy and above the
umbilicus. The initial nursing action should be:
A. Massage the fundus firmly.
B. Notify the physician.
C. Give the oxytocin injection.
D. Check the bladder for distention.
Answer: A
Rationale: A boggy uterus suggests uterine atony; first-line nursing action is to massage the
fundus to stimulate contraction. Simultaneously check for bladder distention and prepare
medications/orders as needed, but fundal massage is immediate.
10
A pregnant client with diabetes is planning pregnancy. Which statement shows correct
understanding of preconception care?
A. “I should stop my insulin before I get pregnant.”
B. “Tight glucose control before conception reduces congenital malformations.”
C. “Oral hypoglycemic agents are preferred in pregnancy.”
D. “A1C targets are not important preconception.”
Answer: B
Rationale: Good glycemic control prior to conception reduces risk of fetal malformations.
Insulin is generally continued or optimized; many oral hypoglycemics are not
recommended in pregnancy. A1C targets are important preconception.
11
A primigravida at 12 weeks has severe nausea and vomiting, weight loss, and ketonuria. The
probable diagnosis is:
A. Hyperemesis gravidarum.
B. Morning sickness.
C. Gestational diabetes.
D. Preeclampsia.
Answer: A
Rationale: Severe, persistent vomiting with weight loss and ketonuria suggests
hyperemesis gravidarum, which requires aggressive management. Morning sickness is
milder; others are unrelated.
