HESI OB/GYN –QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
• Antepartum Care and Fetal Development• Intrapartum Nursing Management• Postpartum Complications and
Recovery• Neonatal Assessment and Care• Reproductive Health and Contraception• High-Risk Obstetric
Conditions• Pharmacological Interventions in Maternity• Ethical and Legal Standards in Obstetric Nursing
INTRODUCTION
The HESI OB/GYN Assessment is a comprehensive evaluation designed to measure the clinical proficiency
and theoretical knowledge of nursing students in the field of maternal-newborn health. This exam focuses on
the essential skills required to provide safe, effective care to the childbearing family throughout the prenatal,
intrapartum, and postpartum periods. Utilizing a combination of foundational theory and complex scenario-
based questions, the assessment emphasizes critical thinking and clinical decision-making. Candidates are
expected to apply evidence-based practices and regulatory standards to real-world clinical situations, ensuring
the highest quality of care for both the mother and the neonate in various healthcare settings.
SECTION ONE: QUESTIONS 1–100
1. A patient at 32 weeks gestation reports sudden, painless vaginal bleeding. Which condition should the
nurse suspect first?
A. Abruptio placentae
🟢 B. Placenta previa
C. Threatened abortion
D. Rupture of membranes
🔴 RATIONALE: Placenta previa is characteristically associated with painless, bright red vaginal bleeding in
the third trimester as the cervix begins to dilate or efface.
, 2. Which medication is the primary treatment for a client experiencing postpartum hemorrhage due to uterine
atony?
A. Magnesium sulfate
B. Terbutaline
🟢 C. Oxytocin
D. Betamethasone
🔴 RATIONALE: Oxytocin is a uterotonic agent that stimulates uterine contractions to compress
intramyometrial blood vessels and stop bleeding caused by atony.
3. A nurse is assessing a newborn and notes a blue tint to the hands and feet, while the trunk is pink. How
should the nurse document this finding?
A. Central cyanosis
🟢 B. Acrocyanosis
C. Harlequin sign
D. Vernix caseosa
🔴 RATIONALE: Acrocyanosis is a normal finding in the first 24 to 48 hours of life caused by vasomotor
instability and peripheral circulatory stagnation.
4. Which of the following is a priority nursing intervention for a client receiving Magnesium Sulfate for
preeclampsia?
🟢 A. Monitoring deep tendon reflexes
B. Encouraging frequent ambulation
C. Checking blood glucose levels
D. Administering oral fluids
🔴 RATIONALE: Loss of deep tendon reflexes is an early sign of magnesium toxicity, which can lead to
respiratory depression and cardiac arrest.
, 5. A pregnant client is diagnosed with Group B Streptococcus (GBS) at 36 weeks. What is the standard
protocol for this patient?
A. Immediate cesarean delivery
B. Oral antibiotics for 10 days
C. No treatment until after delivery
🟢 D. Intrapartum antibiotic prophylaxis
🔴 RATIONALE: GBS-positive women require intravenous antibiotics during labor to prevent vertical
transmission and neonatal sepsis.
6. During the transition phase of labor, a client complains of tingling in her fingers and dizziness. What action
should the nurse take?
🟢 A. Have the client breathe into cupped hands
B. Increase the oxygen flow rate
C. Notify the physician of a potential stroke
D. Turn the client onto her back
🔴 RATIONALE: These are signs of respiratory alkalosis due to hyperventilation; breathing into cupped hands
helps the client re-breathe CO2.
7. Which finding in a urinalysis of a client at 34 weeks gestation would suggest the development of
preeclampsia?
A. Glucose 1+
B. Trace ketones
🟢 C. Protein 2+
D. White blood cells 5 per high-power field
🔴 RATIONALE: Proteinuria is a classic diagnostic criterion for preeclampsia, indicating glomerular
involvement due to systemic vasospasm.
, 8. A nurse is teaching a postpartum client about breastfeeding. Which hormone is responsible for the "let-
down" reflex?
A. Prolactin
B. Estrogen
🟢 C. Oxytocin
D. Progesterone
🔴 RATIONALE: Oxytocin is released in response to nipple stimulation and causes the myoepithelial cells
surrounding the alveoli to contract, ejecting milk.
9. A client at 28 weeks gestation has a negative Rubella titer. What is the appropriate nursing action?
A. Administer the Rubella vaccine immediately
🟢 B. Instruct the client to receive the vaccine postpartum
C. Administer Rubella immune globulin now
D. Advise the client that she is immune to Rubella
🔴 RATIONALE: The Rubella vaccine is a live virus and is contraindicated during pregnancy due to the risk of
fetal infection; it must be given after delivery.
10. Which fetal heart rate pattern is associated with uteroplacental insufficiency?
A. Early decelerations
🟢 B. Late decelerations
C. Accelerations
D. Variable decelerations
🔴 RATIONALE: Late decelerations are caused by decreased blood flow and oxygen to the placenta, requiring
immediate nursing intervention.
11. A client in active labor has a prolapsed umbilical cord. What is the priority nursing action?
Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
• Antepartum Care and Fetal Development• Intrapartum Nursing Management• Postpartum Complications and
Recovery• Neonatal Assessment and Care• Reproductive Health and Contraception• High-Risk Obstetric
Conditions• Pharmacological Interventions in Maternity• Ethical and Legal Standards in Obstetric Nursing
INTRODUCTION
The HESI OB/GYN Assessment is a comprehensive evaluation designed to measure the clinical proficiency
and theoretical knowledge of nursing students in the field of maternal-newborn health. This exam focuses on
the essential skills required to provide safe, effective care to the childbearing family throughout the prenatal,
intrapartum, and postpartum periods. Utilizing a combination of foundational theory and complex scenario-
based questions, the assessment emphasizes critical thinking and clinical decision-making. Candidates are
expected to apply evidence-based practices and regulatory standards to real-world clinical situations, ensuring
the highest quality of care for both the mother and the neonate in various healthcare settings.
SECTION ONE: QUESTIONS 1–100
1. A patient at 32 weeks gestation reports sudden, painless vaginal bleeding. Which condition should the
nurse suspect first?
A. Abruptio placentae
🟢 B. Placenta previa
C. Threatened abortion
D. Rupture of membranes
🔴 RATIONALE: Placenta previa is characteristically associated with painless, bright red vaginal bleeding in
the third trimester as the cervix begins to dilate or efface.
, 2. Which medication is the primary treatment for a client experiencing postpartum hemorrhage due to uterine
atony?
A. Magnesium sulfate
B. Terbutaline
🟢 C. Oxytocin
D. Betamethasone
🔴 RATIONALE: Oxytocin is a uterotonic agent that stimulates uterine contractions to compress
intramyometrial blood vessels and stop bleeding caused by atony.
3. A nurse is assessing a newborn and notes a blue tint to the hands and feet, while the trunk is pink. How
should the nurse document this finding?
A. Central cyanosis
🟢 B. Acrocyanosis
C. Harlequin sign
D. Vernix caseosa
🔴 RATIONALE: Acrocyanosis is a normal finding in the first 24 to 48 hours of life caused by vasomotor
instability and peripheral circulatory stagnation.
4. Which of the following is a priority nursing intervention for a client receiving Magnesium Sulfate for
preeclampsia?
🟢 A. Monitoring deep tendon reflexes
B. Encouraging frequent ambulation
C. Checking blood glucose levels
D. Administering oral fluids
🔴 RATIONALE: Loss of deep tendon reflexes is an early sign of magnesium toxicity, which can lead to
respiratory depression and cardiac arrest.
, 5. A pregnant client is diagnosed with Group B Streptococcus (GBS) at 36 weeks. What is the standard
protocol for this patient?
A. Immediate cesarean delivery
B. Oral antibiotics for 10 days
C. No treatment until after delivery
🟢 D. Intrapartum antibiotic prophylaxis
🔴 RATIONALE: GBS-positive women require intravenous antibiotics during labor to prevent vertical
transmission and neonatal sepsis.
6. During the transition phase of labor, a client complains of tingling in her fingers and dizziness. What action
should the nurse take?
🟢 A. Have the client breathe into cupped hands
B. Increase the oxygen flow rate
C. Notify the physician of a potential stroke
D. Turn the client onto her back
🔴 RATIONALE: These are signs of respiratory alkalosis due to hyperventilation; breathing into cupped hands
helps the client re-breathe CO2.
7. Which finding in a urinalysis of a client at 34 weeks gestation would suggest the development of
preeclampsia?
A. Glucose 1+
B. Trace ketones
🟢 C. Protein 2+
D. White blood cells 5 per high-power field
🔴 RATIONALE: Proteinuria is a classic diagnostic criterion for preeclampsia, indicating glomerular
involvement due to systemic vasospasm.
, 8. A nurse is teaching a postpartum client about breastfeeding. Which hormone is responsible for the "let-
down" reflex?
A. Prolactin
B. Estrogen
🟢 C. Oxytocin
D. Progesterone
🔴 RATIONALE: Oxytocin is released in response to nipple stimulation and causes the myoepithelial cells
surrounding the alveoli to contract, ejecting milk.
9. A client at 28 weeks gestation has a negative Rubella titer. What is the appropriate nursing action?
A. Administer the Rubella vaccine immediately
🟢 B. Instruct the client to receive the vaccine postpartum
C. Administer Rubella immune globulin now
D. Advise the client that she is immune to Rubella
🔴 RATIONALE: The Rubella vaccine is a live virus and is contraindicated during pregnancy due to the risk of
fetal infection; it must be given after delivery.
10. Which fetal heart rate pattern is associated with uteroplacental insufficiency?
A. Early decelerations
🟢 B. Late decelerations
C. Accelerations
D. Variable decelerations
🔴 RATIONALE: Late decelerations are caused by decreased blood flow and oxygen to the placenta, requiring
immediate nursing intervention.
11. A client in active labor has a prolapsed umbilical cord. What is the priority nursing action?
