OB/MATERNITY HESI LATEST 2024 COMPLETE EXAM |
250 ACTUAL QUESTIONS WITH 100% CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) GRADED A+
TABLE OF CONTENTS
SECTION 1: ANTEPARTUM CARE & ASSESSMENT ......................... Questions 1-50
SECTION 2: INTRAPARTUM CARE & LABOR MANAGEMENT .................. Questions 51-100
SECTION 3: POSTPARTUM CARE & ASSESSMENT ........................ Questions 101-150
SECTION 4: NEWBORN ASSESSMENT & CARE ........................... Questions 151-200
SECTION 5: OBSTETRIC COMPLICATIONS & EMERGENCIES ............... Questions 201-250
SECTION 1: ANTEPARTUM CARE & ASSESSMENT
QUESTION 1
The nurse identifies crepitus when examining the chest of a newborn who was
delivered vaginally. Which further assessment should the nurse perform?
A) Elicit a positive scarf sign on the affected side
B) Observe for an asymmetrical Moro (startle) reflex
C) Watch for swelling of fingers on the affected side
D) Note paralysis of affected extremity and muscles
☑ CORRECT ANSWER: B) Observe for an asymmetrical Moro (startle) reflex
RATIONALE: The most common neonatal birth trauma due to vaginal delivery is
fracture of the clavicle. Although an infant may be asymptomatic, a fractured
clavicle should be suspected if an infant has limited use of the affected arm,
malposition of the arm, an asymmetric Moro reflex, crepitus over the clavicle,
focal swelling or tenderness, or cries when the arm is moved.
QUESTION 2
A 30-year-old gravida 2, para 1 client is admitted to the hospital at 26-weeks
gestation in preterm labor. She is started on an IV solution of terbutaline
(Brethine). Which assessment is the highest priority for the nurse to monitor
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,during the administration of this drug?
A) Maternal blood pressure and respirations
B) Maternal and fetal heart rates
C) Hourly urinary output
D) Deep tendon reflexes
☑ CORRECT ANSWER: B) Maternal and fetal heart rates
RATIONALE: Terbutaline is a beta-adrenergic agonist used as a tocolytic agent.
It can cause maternal tachycardia and fetal tachycardia as significant side
effects. The highest priority assessment during administration is monitoring
maternal and fetal heart rates to detect tachycardia and potential cardiac
complications.
QUESTION 3
A client at 32 weeks gestation is admitted with pre-eclampsia. Which finding
indicates severe pre-eclampsia requiring immediate intervention?
A) Blood pressure 150/90 mmHg
B) 1+ proteinuria
C) Platelet count 80,000/μL
D) Mild headache
☑ CORRECT ANSWER: C) Platelet count 80,000/μL
RATIONALE: Severe pre-eclampsia is characterized by blood pressure ≥160/110
mmHg, proteinuria ≥5g/24 hours, and signs of end-organ damage including
thrombocytopenia (platelet count <100,000/μL), elevated liver enzymes, and
renal insufficiency. A platelet count of 80,000/μL indicates HELLP syndrome
and requires immediate intervention.
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,QUESTION 4
A client at 28 weeks gestation reports decreased fetal movement. What is the
nurse's priority action?
A) Reassure the client that decreased movement is normal at this gestation
B) Instruct the client to drink orange juice and rest
C) Perform a non-stress test (NST)
D) Schedule an ultrasound for the next day
☑ CORRECT ANSWER: C) Perform a non-stress test (NST)
RATIONALE: Decreased fetal movement may indicate fetal compromise. The
priority
action is to assess fetal well-being with a non-stress test (NST). The nurse
should not reassure the client without further assessment, as decreased fetal
movement requires immediate evaluation.
QUESTION 5
Which finding is most concerning in a client at 38 weeks gestation with
gestational diabetes?
A) Fasting blood glucose 95 mg/dL
B) 1-hour postprandial glucose 130 mg/dL
C) Estimated fetal weight 4,800g
D) 2-hour postprandial glucose 140 mg/dL
☑ CORRECT ANSWER: C) Estimated fetal weight 4,800g
RATIONALE: An estimated fetal weight of 4,800g indicates macrosomia (≥4,500g),
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, which is a concern in gestational diabetes. Macrosomia increases the risk of
shoulder dystocia, birth trauma, and cesarean section. The other values are
within acceptable ranges for a client with gestational diabetes.
QUESTION 6
A client at 10 weeks gestation reports nausea and vomiting. Which dietary
recommendation should the nurse provide?
A) Avoid eating breakfast and eat a large lunch
B) Eat small, frequent meals throughout the day
C) Increase intake of high-fat foods
D) Drink large amounts of water with meals
☑ CORRECT ANSWER: B) Eat small, frequent meals throughout the day
RATIONALE: Small, frequent meals help manage nausea and vomiting in early
pregnancy. The client should avoid an empty stomach, which can worsen nausea.
High-fat foods and large meals should be avoided as they can exacerbate
nausea.
QUESTION 7
A client at 39 weeks gestation is scheduled for induction of labor. Which
cervical finding indicates a favorable cervix for induction?
A) Bishop score of 4
B) Bishop score of 6
C) Bishop score of 8
D) Bishop score of 2
☑ CORRECT ANSWER: C) Bishop score of 8
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250 ACTUAL QUESTIONS WITH 100% CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) GRADED A+
TABLE OF CONTENTS
SECTION 1: ANTEPARTUM CARE & ASSESSMENT ......................... Questions 1-50
SECTION 2: INTRAPARTUM CARE & LABOR MANAGEMENT .................. Questions 51-100
SECTION 3: POSTPARTUM CARE & ASSESSMENT ........................ Questions 101-150
SECTION 4: NEWBORN ASSESSMENT & CARE ........................... Questions 151-200
SECTION 5: OBSTETRIC COMPLICATIONS & EMERGENCIES ............... Questions 201-250
SECTION 1: ANTEPARTUM CARE & ASSESSMENT
QUESTION 1
The nurse identifies crepitus when examining the chest of a newborn who was
delivered vaginally. Which further assessment should the nurse perform?
A) Elicit a positive scarf sign on the affected side
B) Observe for an asymmetrical Moro (startle) reflex
C) Watch for swelling of fingers on the affected side
D) Note paralysis of affected extremity and muscles
☑ CORRECT ANSWER: B) Observe for an asymmetrical Moro (startle) reflex
RATIONALE: The most common neonatal birth trauma due to vaginal delivery is
fracture of the clavicle. Although an infant may be asymptomatic, a fractured
clavicle should be suspected if an infant has limited use of the affected arm,
malposition of the arm, an asymmetric Moro reflex, crepitus over the clavicle,
focal swelling or tenderness, or cries when the arm is moved.
QUESTION 2
A 30-year-old gravida 2, para 1 client is admitted to the hospital at 26-weeks
gestation in preterm labor. She is started on an IV solution of terbutaline
(Brethine). Which assessment is the highest priority for the nurse to monitor
1|Page
,during the administration of this drug?
A) Maternal blood pressure and respirations
B) Maternal and fetal heart rates
C) Hourly urinary output
D) Deep tendon reflexes
☑ CORRECT ANSWER: B) Maternal and fetal heart rates
RATIONALE: Terbutaline is a beta-adrenergic agonist used as a tocolytic agent.
It can cause maternal tachycardia and fetal tachycardia as significant side
effects. The highest priority assessment during administration is monitoring
maternal and fetal heart rates to detect tachycardia and potential cardiac
complications.
QUESTION 3
A client at 32 weeks gestation is admitted with pre-eclampsia. Which finding
indicates severe pre-eclampsia requiring immediate intervention?
A) Blood pressure 150/90 mmHg
B) 1+ proteinuria
C) Platelet count 80,000/μL
D) Mild headache
☑ CORRECT ANSWER: C) Platelet count 80,000/μL
RATIONALE: Severe pre-eclampsia is characterized by blood pressure ≥160/110
mmHg, proteinuria ≥5g/24 hours, and signs of end-organ damage including
thrombocytopenia (platelet count <100,000/μL), elevated liver enzymes, and
renal insufficiency. A platelet count of 80,000/μL indicates HELLP syndrome
and requires immediate intervention.
2|Page
,QUESTION 4
A client at 28 weeks gestation reports decreased fetal movement. What is the
nurse's priority action?
A) Reassure the client that decreased movement is normal at this gestation
B) Instruct the client to drink orange juice and rest
C) Perform a non-stress test (NST)
D) Schedule an ultrasound for the next day
☑ CORRECT ANSWER: C) Perform a non-stress test (NST)
RATIONALE: Decreased fetal movement may indicate fetal compromise. The
priority
action is to assess fetal well-being with a non-stress test (NST). The nurse
should not reassure the client without further assessment, as decreased fetal
movement requires immediate evaluation.
QUESTION 5
Which finding is most concerning in a client at 38 weeks gestation with
gestational diabetes?
A) Fasting blood glucose 95 mg/dL
B) 1-hour postprandial glucose 130 mg/dL
C) Estimated fetal weight 4,800g
D) 2-hour postprandial glucose 140 mg/dL
☑ CORRECT ANSWER: C) Estimated fetal weight 4,800g
RATIONALE: An estimated fetal weight of 4,800g indicates macrosomia (≥4,500g),
3|Page
, which is a concern in gestational diabetes. Macrosomia increases the risk of
shoulder dystocia, birth trauma, and cesarean section. The other values are
within acceptable ranges for a client with gestational diabetes.
QUESTION 6
A client at 10 weeks gestation reports nausea and vomiting. Which dietary
recommendation should the nurse provide?
A) Avoid eating breakfast and eat a large lunch
B) Eat small, frequent meals throughout the day
C) Increase intake of high-fat foods
D) Drink large amounts of water with meals
☑ CORRECT ANSWER: B) Eat small, frequent meals throughout the day
RATIONALE: Small, frequent meals help manage nausea and vomiting in early
pregnancy. The client should avoid an empty stomach, which can worsen nausea.
High-fat foods and large meals should be avoided as they can exacerbate
nausea.
QUESTION 7
A client at 39 weeks gestation is scheduled for induction of labor. Which
cervical finding indicates a favorable cervix for induction?
A) Bishop score of 4
B) Bishop score of 6
C) Bishop score of 8
D) Bishop score of 2
☑ CORRECT ANSWER: C) Bishop score of 8
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