HESI MATERNAL UPDATED 250+ PRACTICE
QUESTIONS WITH ELABORATED ANSWERS/ GRADED
A+.
1. A nurse is assessing a pregnant client at 28 weeks gestation.
Which finding requires immediate intervention?
• A) Fundal height of 28 cm
• B) Blood pressure of 138/88 mmHg
• C) Proteinuria present on urinalysis
• D) Hemoglobin of 11.2 g/dL
Answer: C) Proteinuria present on urinalysis
Rationale: Proteinuria at 28 weeks gestation is a sign of
preeclampsia and requires immediate intervention including
blood pressure monitoring, magnesium sulfate administration if
severe, and possible delivery planning. Normal fundal height
equals weeks of gestation (±2 cm), BP under 140/90 is
1
,acceptable, and hemoglobin of 11.2 g/dL is within normal range
for pregnancy .
2. A client at 10 weeks gestation has a rubella titer drawn. The
result shows non-immune status (1:8). When should the client
receive the rubella vaccine?
• A) Immediately now
• B) After 12 weeks gestation
• C) In the postpartum period
• D) Never – contraindicated
Answer: C) In the postpartum period
Rationale: The rubella vaccine is a live virus and is
contraindicated during pregnancy due to the theoretical risk of
fetal infection. It should be administered in the postpartum
period before discharge to protect future pregnancies .
2
,3. A client at 12 weeks gestation asks the nurse about the
purpose of an ultrasound at this stage. The nurse's best response
is:
• A) "To determine the baby's sex."
• B) "To confirm the due date and check for fetal
abnormalities."
• C) "To measure the baby's weight."
• D) "To check the mother's blood flow."
Answer: B) "To confirm the due date and check for fetal
abnormalities."
Rationale: A first-trimester ultrasound is used to confirm
gestational age, estimate the due date, assess fetal viability,
and screen for early anatomical abnormalities. Sex
determination is not reliable until about 18-20 weeks, weight is
estimated later, and blood flow is assessed with Doppler studies
in high-risk pregnancies .
3
, 4. A client at 16 weeks gestation has a maternal serum alpha-
fetoprotein (MSAFP) level that is elevated. What condition is
associated with this finding?
• A) Down syndrome
• B) Neural tube defect (e.g., spina bifida)
• C) Gestational diabetes
• D) Placenta previa
Answer: B) Neural tube defect (e.g., spina bifida)
Rationale: Elevated MSAFP suggests open neural tube defects
such as spina bifida or anencephaly. Low MSAFP is associated
with aneuploidy (e.g., Down syndrome) .
5. A client at 10 weeks gestation reports nausea and vomiting
throughout the day. Which instruction should the nurse provide?
• A) "Drink fluids with meals to stay hydrated."
• B) "Eat small, frequent meals and avoid an empty stomach."
• C) "Take an antiemetic only when vomiting occurs."
4
QUESTIONS WITH ELABORATED ANSWERS/ GRADED
A+.
1. A nurse is assessing a pregnant client at 28 weeks gestation.
Which finding requires immediate intervention?
• A) Fundal height of 28 cm
• B) Blood pressure of 138/88 mmHg
• C) Proteinuria present on urinalysis
• D) Hemoglobin of 11.2 g/dL
Answer: C) Proteinuria present on urinalysis
Rationale: Proteinuria at 28 weeks gestation is a sign of
preeclampsia and requires immediate intervention including
blood pressure monitoring, magnesium sulfate administration if
severe, and possible delivery planning. Normal fundal height
equals weeks of gestation (±2 cm), BP under 140/90 is
1
,acceptable, and hemoglobin of 11.2 g/dL is within normal range
for pregnancy .
2. A client at 10 weeks gestation has a rubella titer drawn. The
result shows non-immune status (1:8). When should the client
receive the rubella vaccine?
• A) Immediately now
• B) After 12 weeks gestation
• C) In the postpartum period
• D) Never – contraindicated
Answer: C) In the postpartum period
Rationale: The rubella vaccine is a live virus and is
contraindicated during pregnancy due to the theoretical risk of
fetal infection. It should be administered in the postpartum
period before discharge to protect future pregnancies .
2
,3. A client at 12 weeks gestation asks the nurse about the
purpose of an ultrasound at this stage. The nurse's best response
is:
• A) "To determine the baby's sex."
• B) "To confirm the due date and check for fetal
abnormalities."
• C) "To measure the baby's weight."
• D) "To check the mother's blood flow."
Answer: B) "To confirm the due date and check for fetal
abnormalities."
Rationale: A first-trimester ultrasound is used to confirm
gestational age, estimate the due date, assess fetal viability,
and screen for early anatomical abnormalities. Sex
determination is not reliable until about 18-20 weeks, weight is
estimated later, and blood flow is assessed with Doppler studies
in high-risk pregnancies .
3
, 4. A client at 16 weeks gestation has a maternal serum alpha-
fetoprotein (MSAFP) level that is elevated. What condition is
associated with this finding?
• A) Down syndrome
• B) Neural tube defect (e.g., spina bifida)
• C) Gestational diabetes
• D) Placenta previa
Answer: B) Neural tube defect (e.g., spina bifida)
Rationale: Elevated MSAFP suggests open neural tube defects
such as spina bifida or anencephaly. Low MSAFP is associated
with aneuploidy (e.g., Down syndrome) .
5. A client at 10 weeks gestation reports nausea and vomiting
throughout the day. Which instruction should the nurse provide?
• A) "Drink fluids with meals to stay hydrated."
• B) "Eat small, frequent meals and avoid an empty stomach."
• C) "Take an antiemetic only when vomiting occurs."
4
