HESI OB Maternity Test Bank | 400 Questions
with Correct Answers & Rationales | Latest
Update | 100% Pass Guarantee
1. A client at 38 weeks gestation presents with a blood pressure of 150/95
mmHg and proteinuria (2+). She denies headache or visual changes. Which
diagnosis is most likely?
A) Gestational hypertension
B) Preeclampsia without severe features
C) Chronic hypertension
D) Eclampsia
Answer B: Preeclampsia without severe features
Rationale: New hypertension after 20 weeks with proteinuria defines
preeclampsia. No severe features (BP <160/110, normal platelets/LFTs).
2. A nurse is assessing a fetal heart rate tracing and notes late decelerations.
Which action should the nurse take first?
A) Administer oxygen via face mask
B) Change the mother's position to left lateral
C) Increase the IV fluid rate
D) Discontinue oxytocin if infusing
Answer B: Change the mother's position to left lateral
,Rationale: Late decelerations indicate uteroplacental insufficiency; repositioning
to left lateral improves uterine blood flow and is the first action.
3. A postpartum client who delivered 2 hours ago has a boggy fundus
displaced to the right and heavy lochia with clots. What is the priority
nursing action?
A) Administer methylergonovine
B) Assist the client to void
C) Perform fundal massage
D) Increase the oxytocin infusion rate
Answer B: Assist the client to void
Rationale: A displaced boggy fundus often indicates a distended bladder;
emptying the bladder allows the uterus to contract effectively.
4. A newborn is 5 minutes old. The nurse assigns an APGAR score of 8. What
was the most likely reason for the deduction?
A) Heart rate 100 bpm
B) Acrocyanosis (blue hands and feet)
C) Weak cry
D) Limp body tone
Answer B: Acrocyanosis (blue hands and feet)
Rationale: Acrocyanosis is normal in the first minutes; APGAR 8 often deducts 1
point for color (blue extremities) and 1 for other minor findings.
,5. A client at 32 weeks gestation reports painless, bright red vaginal bleeding.
Which condition is most likely?
A) Abruptio placentae
B) Placenta previa
C) Vasa previa
D) Labor
Answer B: Placenta previa
Rationale: Painless bright red bleeding in the third trimester is classic for placenta
previa. Abruptio placentae causes painful dark bleeding.
6. A nurse is monitoring a client receiving IV magnesium sulfate for
preeclampsia. Which finding indicates magnesium toxicity?
A) Urine output 40 mL/hr
B) Respiratory rate 10 breaths/min
C) Deep tendon reflexes 2+
D) Serum magnesium level 4.5 mg/dL
Answer B: Respiratory rate 10 breaths/min
Rationale: Respiratory depression (<12/min) is a sign of magnesium toxicity;
calcium gluconate is the antidote.
, 7. A client in active labor has a fetal heart rate tracing with variable
decelerations. What is the most common cause?
A) Uteroplacental insufficiency
B) Cord compression
C) Head compression
D) Maternal fever
Answer B: Cord compression
Rationale: Variable decelerations are caused by umbilical cord compression, often
with a "V" or "W" shape unrelated to contractions.
8. A postpartum client with a history of deep vein thrombosis develops
sudden shortness of breath and chest pain. Which action should the nurse
take first?
A) Apply oxygen at 2 L/min
B) Elevate the head of the bed and apply oxygen at 10 L/min via non-rebreather
C) Administer enoxaparin
D) Notify the provider
Answer B: Elevate the head of the bed and apply oxygen at 10 L/min via non-
rebreather
Rationale: Suspected pulmonary embolism requires immediate oxygenation and
positioning to support breathing.
with Correct Answers & Rationales | Latest
Update | 100% Pass Guarantee
1. A client at 38 weeks gestation presents with a blood pressure of 150/95
mmHg and proteinuria (2+). She denies headache or visual changes. Which
diagnosis is most likely?
A) Gestational hypertension
B) Preeclampsia without severe features
C) Chronic hypertension
D) Eclampsia
Answer B: Preeclampsia without severe features
Rationale: New hypertension after 20 weeks with proteinuria defines
preeclampsia. No severe features (BP <160/110, normal platelets/LFTs).
2. A nurse is assessing a fetal heart rate tracing and notes late decelerations.
Which action should the nurse take first?
A) Administer oxygen via face mask
B) Change the mother's position to left lateral
C) Increase the IV fluid rate
D) Discontinue oxytocin if infusing
Answer B: Change the mother's position to left lateral
,Rationale: Late decelerations indicate uteroplacental insufficiency; repositioning
to left lateral improves uterine blood flow and is the first action.
3. A postpartum client who delivered 2 hours ago has a boggy fundus
displaced to the right and heavy lochia with clots. What is the priority
nursing action?
A) Administer methylergonovine
B) Assist the client to void
C) Perform fundal massage
D) Increase the oxytocin infusion rate
Answer B: Assist the client to void
Rationale: A displaced boggy fundus often indicates a distended bladder;
emptying the bladder allows the uterus to contract effectively.
4. A newborn is 5 minutes old. The nurse assigns an APGAR score of 8. What
was the most likely reason for the deduction?
A) Heart rate 100 bpm
B) Acrocyanosis (blue hands and feet)
C) Weak cry
D) Limp body tone
Answer B: Acrocyanosis (blue hands and feet)
Rationale: Acrocyanosis is normal in the first minutes; APGAR 8 often deducts 1
point for color (blue extremities) and 1 for other minor findings.
,5. A client at 32 weeks gestation reports painless, bright red vaginal bleeding.
Which condition is most likely?
A) Abruptio placentae
B) Placenta previa
C) Vasa previa
D) Labor
Answer B: Placenta previa
Rationale: Painless bright red bleeding in the third trimester is classic for placenta
previa. Abruptio placentae causes painful dark bleeding.
6. A nurse is monitoring a client receiving IV magnesium sulfate for
preeclampsia. Which finding indicates magnesium toxicity?
A) Urine output 40 mL/hr
B) Respiratory rate 10 breaths/min
C) Deep tendon reflexes 2+
D) Serum magnesium level 4.5 mg/dL
Answer B: Respiratory rate 10 breaths/min
Rationale: Respiratory depression (<12/min) is a sign of magnesium toxicity;
calcium gluconate is the antidote.
, 7. A client in active labor has a fetal heart rate tracing with variable
decelerations. What is the most common cause?
A) Uteroplacental insufficiency
B) Cord compression
C) Head compression
D) Maternal fever
Answer B: Cord compression
Rationale: Variable decelerations are caused by umbilical cord compression, often
with a "V" or "W" shape unrelated to contractions.
8. A postpartum client with a history of deep vein thrombosis develops
sudden shortness of breath and chest pain. Which action should the nurse
take first?
A) Apply oxygen at 2 L/min
B) Elevate the head of the bed and apply oxygen at 10 L/min via non-rebreather
C) Administer enoxaparin
D) Notify the provider
Answer B: Elevate the head of the bed and apply oxygen at 10 L/min via non-
rebreather
Rationale: Suspected pulmonary embolism requires immediate oxygenation and
positioning to support breathing.
