HESI MATERNAL NEWBORN COMPREHENSIVE EXAM – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE
CORE DOMAINS
Antepartum Assessment and Care Intrapartum Fetal Monitoring and Management
Postpartum Physiological and Psychosocial Changes Newborn Transition and Assessment
Maternal and Neonatal Complications Pharmacological Interventions in Obstetrics Ethical
and Legal Standards in Perinatal Care Labor Induction and Augmentation Strategies
INTRODUCTION
The purpose of this comprehensive examination is to evaluate the clinical proficiency and
theoretical knowledge of nursing students regarding maternal and newborn care. This
assessment covers essential concepts, including high-risk pregnancy management, neonatal
stabilization, and postpartum health promotion. Through a variety of multiple-choice and
complex, scenario-based questions, candidates are tested on their ability to apply critical
thinking and clinical judgment to real-world perinatal scenarios. Emphasis is placed on
evidence-based practice, safety, legal compliance, and ethical decision-making, ensuring that
the candidate is prepared to provide safe, high-quality care to diverse maternal and neonatal
patient populations.
SECTION ONE: QUESTIONS 1–100
1. A client at 34 weeks gestation reports a sudden onset of painless, bright red vaginal
bleeding. Which action is the priority nursing intervention? A. Perform a sterile
vaginal exam to assess cervical dilation. B. Monitor the fetal heart rate and maternal
vital signs. C. Administer a vaginal suppository for suspected infection. D. Encourage
the client to ambulate to promote fetal descent. B. Monitor the fetal heart rate
and maternal vital signs. Explanation: Painless, bright red bleeding in the third
trimester is a classic sign of placenta previa; vaginal exams are contraindicated due to
the risk of hemorrhage.
2. Which physiological change should the nurse expect to see in a client who is 24 hours
postpartum? A. Diaphoresis and diuresis. B. Hypertension and tachycardia. C.
Decreased white blood cell count. D. Increased fibrinogen levels. A. Diaphoresis
and diuresis. Explanation: During the early postpartum period, the body excretes
excess fluid accumulated during pregnancy through increased sweating and urine
output.
3. A nurse is caring for a newborn diagnosed with respiratory distress syndrome (RDS).
Which treatment does the nurse anticipate administering? A. Intravenous antibiotics.
B. Exogenous surfactant. C. Vitamin K injection. D. Intravenous fluids. B.
, Exogenous surfactant. Explanation: RDS is caused by a deficiency of surfactant in
the premature infant's lungs; exogenous surfactant replacement therapy helps
reduce surface tension and improve lung compliance.
4. A primigravida at 40 weeks gestation is in the active phase of labor. The nurse notes
variable decelerations on the fetal monitor. What is the priority action? A. Administer
oxygen via non-rebreather mask. B. Reposition the client to the lateral side. C.
Increase the rate of IV fluids. D. Perform a sterile vaginal exam. B. Reposition the
client to the lateral side. Explanation: Variable decelerations are typically caused
by umbilical cord compression; changing maternal position is the first step to
alleviate pressure on the cord.
5. A nurse is assessing a newborn 1 hour after birth. Which finding requires immediate
notification of the healthcare provider? A. Acrocyanosis of the hands and feet. B.
Presence of lanugo on the shoulders. C. Nasal flaring and grunting. D. Heart rate of
140 beats per minute. C. Nasal flaring and grunting. Explanation: Nasal
flaring, grunting, and retractions are clinical signs of respiratory distress in a newborn
and require immediate intervention.
6. Which instruction is most important for a breastfeeding mother to prevent mastitis?
A. Avoid wearing a bra. B. Wash nipples with soap and water daily. C. Rotate
positions to ensure complete breast emptying. D. Limit feeding time to 10 minutes
per side. C. Rotate positions to ensure complete breast emptying.
Explanation: Complete emptying of the breast prevents stasis of milk, which is a
primary cause of mastitis.
7. A nurse is administering magnesium sulfate to a client with severe preeclampsia.
Which finding would indicate magnesium toxicity? A. Hypertension. B. Hyperreflexia.
C. Decreased respiratory rate. D. Increased urine output. C. Decreased
respiratory rate. Explanation: Magnesium sulfate acts as a central nervous system
depressant; respiratory depression is a primary sign of toxicity.
8. When assessing a client who is 36 weeks pregnant, the nurse notes dependent
edema. What is the most appropriate action? A. Instruct the client to restrict salt
intake severely. B. Assess for other signs of preeclampsia. C. Advise the client to lie
flat on her back. D. Administer a diuretic as ordered. B. Assess for other signs of
preeclampsia. Explanation: While mild edema is common in pregnancy, it can be
a sign of preeclampsia; the nurse must rule out hypertension and proteinuria.
9. A client in active labor with a fetus in the occiput posterior position is experiencing
severe back pain. What nursing intervention is most helpful? A. Administer a
sedative. B. Apply counter-pressure to the sacral area. C. Instruct the client to push
harder. D. Administer IV analgesics. B. Apply counter-pressure to the sacral area.
, Explanation: Back labor is common with occiput posterior positioning; counter-
pressure provides significant pain relief by offsetting the pressure of the fetal head.
10. A nurse is planning care for a client with gestational diabetes. Which statement by
the client indicates an understanding of the condition? A. I will not need insulin after
the baby is born. B. My baby is at risk for being underweight. C. I should exercise only
during the first trimester. D. My glucose levels will return to normal immediately after
labor. A. I will not need insulin after the baby is born. Explanation:
Gestational diabetes typically resolves postpartum, though the client remains at risk
for developing type 2 diabetes later in life.
11. A newborn is identified as "small for gestational age" (SGA). Which nursing diagnosis
is the priority? A. Risk for delayed development. B. Risk for unstable blood glucose. C.
Risk for ineffective thermoregulation. D. Risk for altered nutrition. B. Risk for
unstable blood glucose. Explanation: SGA infants have limited glycogen stores
and are at high risk for hypoglycemia immediately following birth.
12. A nurse is teaching a client about the use of an oral contraceptive pill. What should
be included in the teaching? A. Take the pill at different times each day. B. Use a
backup method if a pill is missed. C. The pill prevents all sexually transmitted
infections. D. Discontinue the pill if spotting occurs. B. Use a backup method if a
pill is missed. Explanation: Missing a dose decreases the effectiveness of oral
contraceptives, necessitating a backup barrier method to prevent unintended
pregnancy.
13. Which assessment finding in a postpartum client would alert the nurse to potential
hemorrhage? A. Firm fundus at the umbilicus. B. Lochia rubra with large clots. C.
Moderate lochia serosa. D. Uterus displaced to the right. D. Uterus displaced to
the right. Explanation: A displaced fundus, often caused by a full bladder,
prevents the uterus from contracting effectively, increasing the risk of postpartum
hemorrhage.
14. A client at 32 weeks gestation with preterm labor is receiving terbutaline. Which
assessment is priority? A. Maternal pulse rate. B. Fetal heart rate variability. C.
Maternal blood pressure. D. Maternal temperature. A. Maternal pulse rate.
Explanation: Terbutaline is a beta-adrenergic agonist and commonly causes maternal
tachycardia; the nurse must monitor heart rate closely.
15. What is the most accurate method to assess the intensity of uterine contractions? A.
Palpation of the fundus. B. External tocodynamometer. C. Internal pressure catheter.
D. Client's report of pain. C. Internal pressure catheter. Explanation: An
intrauterine pressure catheter (IUPC) provides a direct, quantitative measurement of
uterine contraction intensity in mmHg.
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS |
LATEST EXAM UPDATE
CORE DOMAINS
Antepartum Assessment and Care Intrapartum Fetal Monitoring and Management
Postpartum Physiological and Psychosocial Changes Newborn Transition and Assessment
Maternal and Neonatal Complications Pharmacological Interventions in Obstetrics Ethical
and Legal Standards in Perinatal Care Labor Induction and Augmentation Strategies
INTRODUCTION
The purpose of this comprehensive examination is to evaluate the clinical proficiency and
theoretical knowledge of nursing students regarding maternal and newborn care. This
assessment covers essential concepts, including high-risk pregnancy management, neonatal
stabilization, and postpartum health promotion. Through a variety of multiple-choice and
complex, scenario-based questions, candidates are tested on their ability to apply critical
thinking and clinical judgment to real-world perinatal scenarios. Emphasis is placed on
evidence-based practice, safety, legal compliance, and ethical decision-making, ensuring that
the candidate is prepared to provide safe, high-quality care to diverse maternal and neonatal
patient populations.
SECTION ONE: QUESTIONS 1–100
1. A client at 34 weeks gestation reports a sudden onset of painless, bright red vaginal
bleeding. Which action is the priority nursing intervention? A. Perform a sterile
vaginal exam to assess cervical dilation. B. Monitor the fetal heart rate and maternal
vital signs. C. Administer a vaginal suppository for suspected infection. D. Encourage
the client to ambulate to promote fetal descent. B. Monitor the fetal heart rate
and maternal vital signs. Explanation: Painless, bright red bleeding in the third
trimester is a classic sign of placenta previa; vaginal exams are contraindicated due to
the risk of hemorrhage.
2. Which physiological change should the nurse expect to see in a client who is 24 hours
postpartum? A. Diaphoresis and diuresis. B. Hypertension and tachycardia. C.
Decreased white blood cell count. D. Increased fibrinogen levels. A. Diaphoresis
and diuresis. Explanation: During the early postpartum period, the body excretes
excess fluid accumulated during pregnancy through increased sweating and urine
output.
3. A nurse is caring for a newborn diagnosed with respiratory distress syndrome (RDS).
Which treatment does the nurse anticipate administering? A. Intravenous antibiotics.
B. Exogenous surfactant. C. Vitamin K injection. D. Intravenous fluids. B.
, Exogenous surfactant. Explanation: RDS is caused by a deficiency of surfactant in
the premature infant's lungs; exogenous surfactant replacement therapy helps
reduce surface tension and improve lung compliance.
4. A primigravida at 40 weeks gestation is in the active phase of labor. The nurse notes
variable decelerations on the fetal monitor. What is the priority action? A. Administer
oxygen via non-rebreather mask. B. Reposition the client to the lateral side. C.
Increase the rate of IV fluids. D. Perform a sterile vaginal exam. B. Reposition the
client to the lateral side. Explanation: Variable decelerations are typically caused
by umbilical cord compression; changing maternal position is the first step to
alleviate pressure on the cord.
5. A nurse is assessing a newborn 1 hour after birth. Which finding requires immediate
notification of the healthcare provider? A. Acrocyanosis of the hands and feet. B.
Presence of lanugo on the shoulders. C. Nasal flaring and grunting. D. Heart rate of
140 beats per minute. C. Nasal flaring and grunting. Explanation: Nasal
flaring, grunting, and retractions are clinical signs of respiratory distress in a newborn
and require immediate intervention.
6. Which instruction is most important for a breastfeeding mother to prevent mastitis?
A. Avoid wearing a bra. B. Wash nipples with soap and water daily. C. Rotate
positions to ensure complete breast emptying. D. Limit feeding time to 10 minutes
per side. C. Rotate positions to ensure complete breast emptying.
Explanation: Complete emptying of the breast prevents stasis of milk, which is a
primary cause of mastitis.
7. A nurse is administering magnesium sulfate to a client with severe preeclampsia.
Which finding would indicate magnesium toxicity? A. Hypertension. B. Hyperreflexia.
C. Decreased respiratory rate. D. Increased urine output. C. Decreased
respiratory rate. Explanation: Magnesium sulfate acts as a central nervous system
depressant; respiratory depression is a primary sign of toxicity.
8. When assessing a client who is 36 weeks pregnant, the nurse notes dependent
edema. What is the most appropriate action? A. Instruct the client to restrict salt
intake severely. B. Assess for other signs of preeclampsia. C. Advise the client to lie
flat on her back. D. Administer a diuretic as ordered. B. Assess for other signs of
preeclampsia. Explanation: While mild edema is common in pregnancy, it can be
a sign of preeclampsia; the nurse must rule out hypertension and proteinuria.
9. A client in active labor with a fetus in the occiput posterior position is experiencing
severe back pain. What nursing intervention is most helpful? A. Administer a
sedative. B. Apply counter-pressure to the sacral area. C. Instruct the client to push
harder. D. Administer IV analgesics. B. Apply counter-pressure to the sacral area.
, Explanation: Back labor is common with occiput posterior positioning; counter-
pressure provides significant pain relief by offsetting the pressure of the fetal head.
10. A nurse is planning care for a client with gestational diabetes. Which statement by
the client indicates an understanding of the condition? A. I will not need insulin after
the baby is born. B. My baby is at risk for being underweight. C. I should exercise only
during the first trimester. D. My glucose levels will return to normal immediately after
labor. A. I will not need insulin after the baby is born. Explanation:
Gestational diabetes typically resolves postpartum, though the client remains at risk
for developing type 2 diabetes later in life.
11. A newborn is identified as "small for gestational age" (SGA). Which nursing diagnosis
is the priority? A. Risk for delayed development. B. Risk for unstable blood glucose. C.
Risk for ineffective thermoregulation. D. Risk for altered nutrition. B. Risk for
unstable blood glucose. Explanation: SGA infants have limited glycogen stores
and are at high risk for hypoglycemia immediately following birth.
12. A nurse is teaching a client about the use of an oral contraceptive pill. What should
be included in the teaching? A. Take the pill at different times each day. B. Use a
backup method if a pill is missed. C. The pill prevents all sexually transmitted
infections. D. Discontinue the pill if spotting occurs. B. Use a backup method if a
pill is missed. Explanation: Missing a dose decreases the effectiveness of oral
contraceptives, necessitating a backup barrier method to prevent unintended
pregnancy.
13. Which assessment finding in a postpartum client would alert the nurse to potential
hemorrhage? A. Firm fundus at the umbilicus. B. Lochia rubra with large clots. C.
Moderate lochia serosa. D. Uterus displaced to the right. D. Uterus displaced to
the right. Explanation: A displaced fundus, often caused by a full bladder,
prevents the uterus from contracting effectively, increasing the risk of postpartum
hemorrhage.
14. A client at 32 weeks gestation with preterm labor is receiving terbutaline. Which
assessment is priority? A. Maternal pulse rate. B. Fetal heart rate variability. C.
Maternal blood pressure. D. Maternal temperature. A. Maternal pulse rate.
Explanation: Terbutaline is a beta-adrenergic agonist and commonly causes maternal
tachycardia; the nurse must monitor heart rate closely.
15. What is the most accurate method to assess the intensity of uterine contractions? A.
Palpation of the fundus. B. External tocodynamometer. C. Internal pressure catheter.
D. Client's report of pain. C. Internal pressure catheter. Explanation: An
intrauterine pressure catheter (IUPC) provides a direct, quantitative measurement of
uterine contraction intensity in mmHg.
