HESI MATERNAL-CHILD NURSING
Actual Exam QUESTIONS AND ANSWERS
2026 | 55 Questions | Pass Guaranteed - A+
Graded
Section 1: Antepartum Care
Questions 1-8
Question 1 A 32-year-old G2P1 at 34 weeks gestation presents with severe headache, visual
disturbances, and epigastric pain. Her blood pressure is 168/112 mmHg, and urine protein is 3+.
Based on current ACOG guidelines, what is the priority nursing intervention?
A. Administer oral methyldopa immediately
B. Prepare for immediate vaginal delivery
C. Initiate magnesium sulfate therapy for seizure prophylaxis [CORRECT]
D. Insert indwelling urinary catheter
Correct Answer: C
Rationale: This patient exhibits signs of severe preeclampsia (BP ≥160/110 mmHg with
proteinuria, headache, visual changes, and epigastric pain). According to 2024 ACOG guidelines,
magnesium sulfate is the first-line medication for seizure prophylaxis in severe preeclampsia and
eclampsia. The loading dose is 4g IV over 20 minutes, followed by 2g/hour infusion. While
antihypertensives (A) may be used, seizure prevention takes priority. Immediate delivery (B)
may be indicated but magnesium administration precedes delivery planning. Catheter insertion
(D) is not the priority intervention.
Question 2 A pregnant client at 26 weeks gestation has a 1-hour glucose challenge test result of
142 mg/dL. What is the appropriate next step according to current guidelines?
A. Diagnose gestational diabetes mellitus (GDM)
B. Schedule a 75g 2-hour oral glucose tolerance test (OGTT) [CORRECT]
C. Begin insulin therapy immediately
D. Repeat the 1-hour test in 4 weeks
,Correct Answer: B
Rationale: A 1-hour glucose challenge test value ≥140 mg/dL requires follow-up diagnostic
testing. Current guidelines recommend a 75g 2-hour OGTT for definitive diagnosis of GDM. A
single abnormal screening test does not confirm GDM (A). Insulin therapy (C) is initiated only
after diagnosis and if diet/exercise fails. Waiting 4 weeks (D) delays appropriate diagnosis and
management.
Question 3 A 29-year-old G1P0 at 18 weeks gestation asks about recommended weight gain
during pregnancy. Her pre-pregnancy BMI was 28 kg/m² (overweight). What is the evidence-
based recommendation?
A. 25-35 pounds total
B. 15-25 pounds total [CORRECT]
C. 28-40 pounds total
D. 10-15 pounds total
Correct Answer: B
Rationale: According to Institute of Medicine (IOM) guidelines, overweight women (BMI 25-
29.9) should gain 15-25 pounds (7-11.5 kg) during pregnancy. Underweight women (BMI <18.5)
should gain 28-40 lbs (A). Normal weight women (BMI 18.5-24.9) should gain 25-35 lbs (A).
Obese women (BMI ≥30) should gain 11-20 lbs. Excessive weight gain increases risks of GDM,
preeclampsia, and macrosomia.
Question 4 A pregnant client at 24 weeks gestation reports occasional dizziness when lying flat
on her back. What physiological explanation should the nurse provide?
A. Hypoglycemia from inadequate nutrition
B. Supine hypotensive syndrome from uterine compression of the inferior vena cava
[CORRECT]
C. Anemia requiring iron supplementation
D. Early signs of preeclampsia
Correct Answer: B
Rationale: Supine hypotensive syndrome (aortocaval compression) occurs when the gravid
uterus compresses the inferior vena cava and aorta in the supine position, reducing venous return
and cardiac output. This typically occurs after 20 weeks gestation. The nurse should recommend
left lateral positioning. While hypoglycemia (A), anemia (C), and preeclampsia (D) can cause
dizziness, the positional nature of symptoms indicates supine hypotensive syndrome.
, Question 5 A client at 12 weeks gestation asks about prenatal screening for chromosomal
abnormalities. Which test is available earliest in pregnancy?
A. Quad marker screening
B. Cell-free DNA testing [CORRECT]
C. Amniocentesis
D. Chorionic villus sampling (CVS)
Correct Answer: B
Rationale: Cell-free DNA (cfDNA) testing can be performed as early as 10 weeks gestation,
analyzing fetal DNA from maternal blood. It screens for trisomies 21, 18, and 13, and sex
chromosome abnormalities. Quad screening (A) occurs at 15-22 weeks. Amniocentesis (C) is
performed at 15-20 weeks. CVS (D) is performed at 10-13 weeks but is invasive. cfDNA is non-
invasive and has higher sensitivity than traditional screening.
Question 6 A pregnant client at 28 weeks gestation is Rh-negative and has a negative antibody
screen. Her partner is Rh-positive. What is the appropriate management?
A. No intervention needed until delivery
B. Administer Rho(D) immune globulin (RhoGAM) at 28 weeks [CORRECT]
C. Wait and test the baby at birth
D. Administer RhoGAM only if there is vaginal bleeding
Correct Answer: B
Rationale: Standard protocol for Rh-negative, unsensitized pregnant women includes RhoGAM
administration at approximately 28 weeks gestation (antepartum dose) and within 72 hours
postpartum if the infant is Rh-positive. This prevents sensitization and protects future
pregnancies. Waiting until delivery (A, C) misses the opportunity to prevent sensitization during
pregnancy. RhoGAM is indicated at 28 weeks regardless of bleeding history (D).
Question 7 A client at 32 weeks gestation reports decreased fetal movement over the past 24
hours. What is the priority nursing action?
A. Reassure the client that this is normal
B. Instruct the client to drink juice and rest, then call back
C. Perform a non-stress test (NST) immediately [CORRECT]
D. Schedule a routine prenatal visit in 1 week
Correct Answer: C
Rationale: Decreased fetal movement (DFM) is a potentially serious sign requiring immediate
evaluation. A non-stress test assesses fetal well-being by monitoring fetal heart rate patterns in
Actual Exam QUESTIONS AND ANSWERS
2026 | 55 Questions | Pass Guaranteed - A+
Graded
Section 1: Antepartum Care
Questions 1-8
Question 1 A 32-year-old G2P1 at 34 weeks gestation presents with severe headache, visual
disturbances, and epigastric pain. Her blood pressure is 168/112 mmHg, and urine protein is 3+.
Based on current ACOG guidelines, what is the priority nursing intervention?
A. Administer oral methyldopa immediately
B. Prepare for immediate vaginal delivery
C. Initiate magnesium sulfate therapy for seizure prophylaxis [CORRECT]
D. Insert indwelling urinary catheter
Correct Answer: C
Rationale: This patient exhibits signs of severe preeclampsia (BP ≥160/110 mmHg with
proteinuria, headache, visual changes, and epigastric pain). According to 2024 ACOG guidelines,
magnesium sulfate is the first-line medication for seizure prophylaxis in severe preeclampsia and
eclampsia. The loading dose is 4g IV over 20 minutes, followed by 2g/hour infusion. While
antihypertensives (A) may be used, seizure prevention takes priority. Immediate delivery (B)
may be indicated but magnesium administration precedes delivery planning. Catheter insertion
(D) is not the priority intervention.
Question 2 A pregnant client at 26 weeks gestation has a 1-hour glucose challenge test result of
142 mg/dL. What is the appropriate next step according to current guidelines?
A. Diagnose gestational diabetes mellitus (GDM)
B. Schedule a 75g 2-hour oral glucose tolerance test (OGTT) [CORRECT]
C. Begin insulin therapy immediately
D. Repeat the 1-hour test in 4 weeks
,Correct Answer: B
Rationale: A 1-hour glucose challenge test value ≥140 mg/dL requires follow-up diagnostic
testing. Current guidelines recommend a 75g 2-hour OGTT for definitive diagnosis of GDM. A
single abnormal screening test does not confirm GDM (A). Insulin therapy (C) is initiated only
after diagnosis and if diet/exercise fails. Waiting 4 weeks (D) delays appropriate diagnosis and
management.
Question 3 A 29-year-old G1P0 at 18 weeks gestation asks about recommended weight gain
during pregnancy. Her pre-pregnancy BMI was 28 kg/m² (overweight). What is the evidence-
based recommendation?
A. 25-35 pounds total
B. 15-25 pounds total [CORRECT]
C. 28-40 pounds total
D. 10-15 pounds total
Correct Answer: B
Rationale: According to Institute of Medicine (IOM) guidelines, overweight women (BMI 25-
29.9) should gain 15-25 pounds (7-11.5 kg) during pregnancy. Underweight women (BMI <18.5)
should gain 28-40 lbs (A). Normal weight women (BMI 18.5-24.9) should gain 25-35 lbs (A).
Obese women (BMI ≥30) should gain 11-20 lbs. Excessive weight gain increases risks of GDM,
preeclampsia, and macrosomia.
Question 4 A pregnant client at 24 weeks gestation reports occasional dizziness when lying flat
on her back. What physiological explanation should the nurse provide?
A. Hypoglycemia from inadequate nutrition
B. Supine hypotensive syndrome from uterine compression of the inferior vena cava
[CORRECT]
C. Anemia requiring iron supplementation
D. Early signs of preeclampsia
Correct Answer: B
Rationale: Supine hypotensive syndrome (aortocaval compression) occurs when the gravid
uterus compresses the inferior vena cava and aorta in the supine position, reducing venous return
and cardiac output. This typically occurs after 20 weeks gestation. The nurse should recommend
left lateral positioning. While hypoglycemia (A), anemia (C), and preeclampsia (D) can cause
dizziness, the positional nature of symptoms indicates supine hypotensive syndrome.
, Question 5 A client at 12 weeks gestation asks about prenatal screening for chromosomal
abnormalities. Which test is available earliest in pregnancy?
A. Quad marker screening
B. Cell-free DNA testing [CORRECT]
C. Amniocentesis
D. Chorionic villus sampling (CVS)
Correct Answer: B
Rationale: Cell-free DNA (cfDNA) testing can be performed as early as 10 weeks gestation,
analyzing fetal DNA from maternal blood. It screens for trisomies 21, 18, and 13, and sex
chromosome abnormalities. Quad screening (A) occurs at 15-22 weeks. Amniocentesis (C) is
performed at 15-20 weeks. CVS (D) is performed at 10-13 weeks but is invasive. cfDNA is non-
invasive and has higher sensitivity than traditional screening.
Question 6 A pregnant client at 28 weeks gestation is Rh-negative and has a negative antibody
screen. Her partner is Rh-positive. What is the appropriate management?
A. No intervention needed until delivery
B. Administer Rho(D) immune globulin (RhoGAM) at 28 weeks [CORRECT]
C. Wait and test the baby at birth
D. Administer RhoGAM only if there is vaginal bleeding
Correct Answer: B
Rationale: Standard protocol for Rh-negative, unsensitized pregnant women includes RhoGAM
administration at approximately 28 weeks gestation (antepartum dose) and within 72 hours
postpartum if the infant is Rh-positive. This prevents sensitization and protects future
pregnancies. Waiting until delivery (A, C) misses the opportunity to prevent sensitization during
pregnancy. RhoGAM is indicated at 28 weeks regardless of bleeding history (D).
Question 7 A client at 32 weeks gestation reports decreased fetal movement over the past 24
hours. What is the priority nursing action?
A. Reassure the client that this is normal
B. Instruct the client to drink juice and rest, then call back
C. Perform a non-stress test (NST) immediately [CORRECT]
D. Schedule a routine prenatal visit in 1 week
Correct Answer: C
Rationale: Decreased fetal movement (DFM) is a potentially serious sign requiring immediate
evaluation. A non-stress test assesses fetal well-being by monitoring fetal heart rate patterns in
