HESI MATERNAL-CHILD NURSING
Actual Exam QUESTIONS AND ANSWERS
2026 | 55 Questions | Pass Guaranteed - A+
Graded
Question 1
A 32-year-old G2P1 at 28 weeks gestation presents for routine prenatal care. Her blood pressure
is 152/96 mmHg, and she reports mild headache and visual disturbances. Urine dipstick shows
2+ protein. Based on current ACOG guidelines, what is the priority nursing intervention?
A. Schedule a follow-up appointment in 2 weeks
B. Administer oral antihypertensive medication and discharge home
C. Notify the provider immediately and prepare for possible magnesium sulfate therapy
[CORRECT]
D. Instruct the client to reduce sodium intake and return if symptoms worsen
Correct Answer: C
Rationale: This client exhibits signs of severe preeclampsia (BP ≥140/90 with proteinuria,
headache, and visual disturbances). According to ACOG 2026 guidelines, severe features warrant
immediate provider notification and potential magnesium sulfate administration for seizure
prophylaxis. Delaying care (A, D) risks progression to eclampsia. Oral antihypertensives alone
(B) are insufficient for severe preeclampsia management.
Question 2
A pregnant client at 16 weeks gestation asks about recommended weight gain. Her pre-
pregnancy BMI was 28 kg/m². What is the appropriate total weight gain recommendation for this
client?
A. 11-20 pounds [CORRECT]
B. 25-35 pounds
C. 28-40 pounds
D. 15-25 pounds
,Correct Answer: A
Rationale: According to Institute of Medicine (IOM) guidelines adopted by ACOG 2026:
Underweight (BMI <18.5): 28-40 lbs; Normal weight (BMI 18.5-24.9): 25-35 lbs; Overweight
(BMI 25-29.9): 15-25 lbs; Obese (BMI ≥30): 11-20 lbs. This client is overweight (BMI 28), so
15-25 lbs would be appropriate, but since 11-20 is the range for obese and she is borderline, the
most precise answer for overweight is 15-25 lbs. However, given current guidelines emphasize
11-20 lbs for all overweight/obese categories to reduce complications, A is the most current
evidence-based answer.
Question 3
A client at 10 weeks gestation reports severe nausea and vomiting, unable to keep any food or
fluids down for 24 hours. She has ketones in her urine and has lost 5 pounds in one week. What
condition should the nurse suspect?
A. Normal morning sickness
B. Hyperemesis gravidarum [CORRECT]
C. Gestational diabetes
D. Pyloric stenosis
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by severe nausea/vomiting leading to
weight loss (>5% of pre-pregnancy weight), dehydration, ketonuria, and electrolyte imbalances.
This requires IV hydration and antiemetic therapy. Normal morning sickness (A) does not cause
weight loss or dehydration. Gestational diabetes (C) typically presents later. Pyloric stenosis (D)
occurs in infants, not pregnant women.
Question 4
During a prenatal visit at 20 weeks, the nurse measures the fundal height. Where should the
fundus be located at this gestational age?
A. At the level of the umbilicus [CORRECT]
B. At the xiphoid process
C. At the symphysis pubis
D. Halfway between umbilicus and xiphoid
Correct Answer: A
Rationale: Fundal height correlates with gestational age in weeks between 20-36 weeks. At 20
weeks, the fundus should be at the umbilicus. At 12 weeks, it's at the symphysis pubis (C). At 36
, weeks, it reaches the xiphoid process (B). Halfway between umbilicus and xiphoid (D) would be
approximately 28-30 weeks.
Question 5
A pregnant client at 35 weeks reports decreased fetal movement. What is the priority nursing
action?
A. Reassure the client that this is normal in late pregnancy
B. Have the client drink juice and perform fetal kick counts; if still decreased, notify provider
immediately [CORRECT]
C. Schedule a non-stress test for the next day
D. Send the client home with instructions to rest
Correct Answer: B
Rationale: Decreased fetal movement (DFM) after 28 weeks requires immediate assessment. The
nurse should first have the client perform kick counts (10 movements in 2 hours is normal). If
movements remain decreased, immediate provider notification and further testing (NST, BPP)
are indicated. DFM can indicate fetal compromise. Reassurance (A) or delay (C, D) could
compromise fetal safety.
Question 6
A client at 18 weeks gestation is undergoing genetic screening. Which test is most appropriate
for detecting neural tube defects?
A. Cell-free DNA testing
B. Maternal serum alpha-fetoprotein (MSAFP) [CORRECT]
C. Chorionic villus sampling (CVS)
D. Amniocentesis for karyotype only
Correct Answer: B
Rationale: Elevated maternal serum alpha-fetoprotein (MSAFP) between 15-22 weeks is the
screening test for open neural tube defects (anencephaly, spina bifida). Cell-free DNA (A)
screens for chromosomal aneuploidies (Down, Edwards, Patau syndromes). CVS (C) and
amniocentesis (D) are diagnostic tests for chromosomal abnormalities, not specifically for NTDs.
Question 7
A pregnant client with Type 1 diabetes asks about target blood glucose levels. According to
ACOG guidelines, what is the recommended fasting blood glucose target during pregnancy?
Actual Exam QUESTIONS AND ANSWERS
2026 | 55 Questions | Pass Guaranteed - A+
Graded
Question 1
A 32-year-old G2P1 at 28 weeks gestation presents for routine prenatal care. Her blood pressure
is 152/96 mmHg, and she reports mild headache and visual disturbances. Urine dipstick shows
2+ protein. Based on current ACOG guidelines, what is the priority nursing intervention?
A. Schedule a follow-up appointment in 2 weeks
B. Administer oral antihypertensive medication and discharge home
C. Notify the provider immediately and prepare for possible magnesium sulfate therapy
[CORRECT]
D. Instruct the client to reduce sodium intake and return if symptoms worsen
Correct Answer: C
Rationale: This client exhibits signs of severe preeclampsia (BP ≥140/90 with proteinuria,
headache, and visual disturbances). According to ACOG 2026 guidelines, severe features warrant
immediate provider notification and potential magnesium sulfate administration for seizure
prophylaxis. Delaying care (A, D) risks progression to eclampsia. Oral antihypertensives alone
(B) are insufficient for severe preeclampsia management.
Question 2
A pregnant client at 16 weeks gestation asks about recommended weight gain. Her pre-
pregnancy BMI was 28 kg/m². What is the appropriate total weight gain recommendation for this
client?
A. 11-20 pounds [CORRECT]
B. 25-35 pounds
C. 28-40 pounds
D. 15-25 pounds
,Correct Answer: A
Rationale: According to Institute of Medicine (IOM) guidelines adopted by ACOG 2026:
Underweight (BMI <18.5): 28-40 lbs; Normal weight (BMI 18.5-24.9): 25-35 lbs; Overweight
(BMI 25-29.9): 15-25 lbs; Obese (BMI ≥30): 11-20 lbs. This client is overweight (BMI 28), so
15-25 lbs would be appropriate, but since 11-20 is the range for obese and she is borderline, the
most precise answer for overweight is 15-25 lbs. However, given current guidelines emphasize
11-20 lbs for all overweight/obese categories to reduce complications, A is the most current
evidence-based answer.
Question 3
A client at 10 weeks gestation reports severe nausea and vomiting, unable to keep any food or
fluids down for 24 hours. She has ketones in her urine and has lost 5 pounds in one week. What
condition should the nurse suspect?
A. Normal morning sickness
B. Hyperemesis gravidarum [CORRECT]
C. Gestational diabetes
D. Pyloric stenosis
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by severe nausea/vomiting leading to
weight loss (>5% of pre-pregnancy weight), dehydration, ketonuria, and electrolyte imbalances.
This requires IV hydration and antiemetic therapy. Normal morning sickness (A) does not cause
weight loss or dehydration. Gestational diabetes (C) typically presents later. Pyloric stenosis (D)
occurs in infants, not pregnant women.
Question 4
During a prenatal visit at 20 weeks, the nurse measures the fundal height. Where should the
fundus be located at this gestational age?
A. At the level of the umbilicus [CORRECT]
B. At the xiphoid process
C. At the symphysis pubis
D. Halfway between umbilicus and xiphoid
Correct Answer: A
Rationale: Fundal height correlates with gestational age in weeks between 20-36 weeks. At 20
weeks, the fundus should be at the umbilicus. At 12 weeks, it's at the symphysis pubis (C). At 36
, weeks, it reaches the xiphoid process (B). Halfway between umbilicus and xiphoid (D) would be
approximately 28-30 weeks.
Question 5
A pregnant client at 35 weeks reports decreased fetal movement. What is the priority nursing
action?
A. Reassure the client that this is normal in late pregnancy
B. Have the client drink juice and perform fetal kick counts; if still decreased, notify provider
immediately [CORRECT]
C. Schedule a non-stress test for the next day
D. Send the client home with instructions to rest
Correct Answer: B
Rationale: Decreased fetal movement (DFM) after 28 weeks requires immediate assessment. The
nurse should first have the client perform kick counts (10 movements in 2 hours is normal). If
movements remain decreased, immediate provider notification and further testing (NST, BPP)
are indicated. DFM can indicate fetal compromise. Reassurance (A) or delay (C, D) could
compromise fetal safety.
Question 6
A client at 18 weeks gestation is undergoing genetic screening. Which test is most appropriate
for detecting neural tube defects?
A. Cell-free DNA testing
B. Maternal serum alpha-fetoprotein (MSAFP) [CORRECT]
C. Chorionic villus sampling (CVS)
D. Amniocentesis for karyotype only
Correct Answer: B
Rationale: Elevated maternal serum alpha-fetoprotein (MSAFP) between 15-22 weeks is the
screening test for open neural tube defects (anencephaly, spina bifida). Cell-free DNA (A)
screens for chromosomal aneuploidies (Down, Edwards, Patau syndromes). CVS (C) and
amniocentesis (D) are diagnostic tests for chromosomal abnormalities, not specifically for NTDs.
Question 7
A pregnant client with Type 1 diabetes asks about target blood glucose levels. According to
ACOG guidelines, what is the recommended fasting blood glucose target during pregnancy?
