HESI OB/Maternity Exam | Verified Exam
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A 30-year-old multiparous woman who has a 3-year-old son and a newborn daughter
tells the nurse, "My son is so jealous of my daughter, I don't know how I'll ever manage
both children when I get home." How should the nurse respond?
a. "Tell the older child that he is a big boy now and should love his new sister."
b. "Ask friends and relatives not to bring gifts to the older sibling because you do not
want to spoil him."
c. "Let the older child stay with his grandparents for the first six weeks to allow him to
adjust to the newborn."
d. "Regression in behaviors in the older child is a typical reaction so he needs attention
at this time."
✔️ Correct Answer: d. "Regression in behaviors in the older child is a typical reaction so
he needs attention at this time."
Rationale:
Sibling rivalry and regression (e.g., thumb-sucking, bedwetting) are common, expected
responses in older siblings when a new baby arrives. The nurse should normalize this
reaction and encourage the mother to provide extra attention and reassurance to the
older child. Option A invalidates the child's feelings. Option B may increase jealousy.
Option C separates the child from the family and may worsen feelings of rejection.
,A vaginally delivered infant of an HIV-positive mother is admitted to the newborn
nursery. What intervention should the nurse perform first?
a. Bathe the infant with an antimicrobial soap
b. Measure the head and chest circumference
c. Obtain the infant's footprints
d. Administer vitamin K
✔️ Correct Answer: a. Bathe the infant with an antimicrobial soap
Rationale:
Immediate bathing of the newborn removes maternal blood and body fluids, reducing
the risk of HIV transmission. While vitamin K administration and measurements are
important, the priority is to minimize exposure to potentially infectious fluids.
Antimicrobial soap is recommended for this purpose.
A client in active labor is admitted with preeclampsia. Which assessment finding is most
significant in planning this client's care?
a. Patellar reflex 4+
b. Blood pressure 158/80
c. Four-hour urine output 240 ml
d. Respiration 12/minute
✔️ Correct Answer: a. Patellar reflex 4+
Rationale:
Hyperreflexia (4+ patellar reflex) indicates central nervous system irritability and is a sign
of impending seizure (eclampsia). This requires immediate intervention. While elevated
blood pressure and decreased urine output are concerning, hyperreflexia is the most
significant indicator of imminent seizure activity.
A pregnant client with mitral stenosis Class III is prescribed complete bedrest. The client
asks the nurse, "Why must I stay in bed all the time?" Which response is best for the
nurse to provide?
,a. "Complete bedrest decreases oxygen needs and demands on the heart muscle tissue."
b. "We want your baby to be healthy, and this is the only way we can make sure that will
happen."
c. "I know you're upset. Would you like to talk about some things you could do while in
bed?"
d. "Labor is difficult and you need to use this time to rest before you have to assume all
childcaring duties."
✔️ Correct Answer: a. "Complete bedrest decreases oxygen needs and demands on the
heart muscle tissue."
Rationale:
Bedrest reduces cardiac workload and oxygen consumption in clients with cardiac
conditions. This is a clear, factual explanation. Option B is patronizing and does not
address the client's question. Option C acknowledges feelings but does not answer the
clinical question. Option D is dismissive and inaccurate.
The nurse is preparing a client with a term pregnancy who is in active labor for an
amniotomy. What equipment should the nurse have available at the client's bedside?
(Select all that apply)
a. Litmus paper
b. Fetal scalp electrode
c. A sterile glove
d. An amnihook
e. Sterile vaginal speculum
f. Lubricant
✔️ Correct Answer: c, d, e, f
Rationale:
Amniotomy requires: sterile glove (C), amnihook (D) or other sterile instrument to
rupture membranes, sterile vaginal speculum (E) for visualization, and lubricant (F) for
speculum insertion. Litmus paper (A) is used to test fluid pH but is not needed
immediately at the bedside for the procedure. A fetal scalp electrode (B) is used for
internal fetal monitoring, not for the amniotomy itself.
, The nurse is preparing to give an enema to a laboring client. Which client requires the
most caution when carrying out this procedure?
a. A gravida 6, para 5 who is 38 years of age and in early labor
b. A 37-week primigravida who presents at 100% effacement, 3 cm dilatation, and a -1
station
c. A gravida 2, para 1 who is at 1 cm cervical dilatation and a 0 station admitted for
induction of labor due to post dates
d. A 40-week primigravida who is at 6 cm cervical dilatation and the presenting part is
not engaged
✔️ Correct Answer: d. A 40-week primigravida who is at 6 cm cervical dilatation and the
presenting part is not engaged
Rationale:
When the presenting part is not engaged, there is a risk of cord prolapse with enema
administration due to the increased space and fluid movement. Option D requires the
most caution. Options A, B, and C have engaged presenting parts or are in earlier labor
stages.
A primigravida client who is 5 cm dilated, 90% effaced, and at 0 station is requesting an
epidural for pain relief. Which assessment finding is most important for the nurse to
report to the healthcare provider?
a. Cervical dilation of 5 cm with 90% effacement
b. White blood cell count of 12,000/mm3
c. Hemoglobin of 12 mg/dl and hematocrit of 38%
d. A platelet count of 67,000/mm3
✔️ Correct Answer: d. A platelet count of 67,000/mm3
Rationale:
Epidural anesthesia requires adequate platelet levels. A platelet count of 67,000/mm3 is
significantly below the normal range (150,000-400,000) and increases the risk of
epidural hematoma. This must be reported immediately. The other findings are within
normal limits for a laboring client.
| Questions with Verified Answers
Rationales | Brand new!! | updated version
2026/2027 Frequently Most Tested Questions and 100%
Accurate From Past papers | Graded A+ , Reviewed and
Updated | 100% Guarantee Pass | Latest Exam and Newest
Version!!!
A 30-year-old multiparous woman who has a 3-year-old son and a newborn daughter
tells the nurse, "My son is so jealous of my daughter, I don't know how I'll ever manage
both children when I get home." How should the nurse respond?
a. "Tell the older child that he is a big boy now and should love his new sister."
b. "Ask friends and relatives not to bring gifts to the older sibling because you do not
want to spoil him."
c. "Let the older child stay with his grandparents for the first six weeks to allow him to
adjust to the newborn."
d. "Regression in behaviors in the older child is a typical reaction so he needs attention
at this time."
✔️ Correct Answer: d. "Regression in behaviors in the older child is a typical reaction so
he needs attention at this time."
Rationale:
Sibling rivalry and regression (e.g., thumb-sucking, bedwetting) are common, expected
responses in older siblings when a new baby arrives. The nurse should normalize this
reaction and encourage the mother to provide extra attention and reassurance to the
older child. Option A invalidates the child's feelings. Option B may increase jealousy.
Option C separates the child from the family and may worsen feelings of rejection.
,A vaginally delivered infant of an HIV-positive mother is admitted to the newborn
nursery. What intervention should the nurse perform first?
a. Bathe the infant with an antimicrobial soap
b. Measure the head and chest circumference
c. Obtain the infant's footprints
d. Administer vitamin K
✔️ Correct Answer: a. Bathe the infant with an antimicrobial soap
Rationale:
Immediate bathing of the newborn removes maternal blood and body fluids, reducing
the risk of HIV transmission. While vitamin K administration and measurements are
important, the priority is to minimize exposure to potentially infectious fluids.
Antimicrobial soap is recommended for this purpose.
A client in active labor is admitted with preeclampsia. Which assessment finding is most
significant in planning this client's care?
a. Patellar reflex 4+
b. Blood pressure 158/80
c. Four-hour urine output 240 ml
d. Respiration 12/minute
✔️ Correct Answer: a. Patellar reflex 4+
Rationale:
Hyperreflexia (4+ patellar reflex) indicates central nervous system irritability and is a sign
of impending seizure (eclampsia). This requires immediate intervention. While elevated
blood pressure and decreased urine output are concerning, hyperreflexia is the most
significant indicator of imminent seizure activity.
A pregnant client with mitral stenosis Class III is prescribed complete bedrest. The client
asks the nurse, "Why must I stay in bed all the time?" Which response is best for the
nurse to provide?
,a. "Complete bedrest decreases oxygen needs and demands on the heart muscle tissue."
b. "We want your baby to be healthy, and this is the only way we can make sure that will
happen."
c. "I know you're upset. Would you like to talk about some things you could do while in
bed?"
d. "Labor is difficult and you need to use this time to rest before you have to assume all
childcaring duties."
✔️ Correct Answer: a. "Complete bedrest decreases oxygen needs and demands on the
heart muscle tissue."
Rationale:
Bedrest reduces cardiac workload and oxygen consumption in clients with cardiac
conditions. This is a clear, factual explanation. Option B is patronizing and does not
address the client's question. Option C acknowledges feelings but does not answer the
clinical question. Option D is dismissive and inaccurate.
The nurse is preparing a client with a term pregnancy who is in active labor for an
amniotomy. What equipment should the nurse have available at the client's bedside?
(Select all that apply)
a. Litmus paper
b. Fetal scalp electrode
c. A sterile glove
d. An amnihook
e. Sterile vaginal speculum
f. Lubricant
✔️ Correct Answer: c, d, e, f
Rationale:
Amniotomy requires: sterile glove (C), amnihook (D) or other sterile instrument to
rupture membranes, sterile vaginal speculum (E) for visualization, and lubricant (F) for
speculum insertion. Litmus paper (A) is used to test fluid pH but is not needed
immediately at the bedside for the procedure. A fetal scalp electrode (B) is used for
internal fetal monitoring, not for the amniotomy itself.
, The nurse is preparing to give an enema to a laboring client. Which client requires the
most caution when carrying out this procedure?
a. A gravida 6, para 5 who is 38 years of age and in early labor
b. A 37-week primigravida who presents at 100% effacement, 3 cm dilatation, and a -1
station
c. A gravida 2, para 1 who is at 1 cm cervical dilatation and a 0 station admitted for
induction of labor due to post dates
d. A 40-week primigravida who is at 6 cm cervical dilatation and the presenting part is
not engaged
✔️ Correct Answer: d. A 40-week primigravida who is at 6 cm cervical dilatation and the
presenting part is not engaged
Rationale:
When the presenting part is not engaged, there is a risk of cord prolapse with enema
administration due to the increased space and fluid movement. Option D requires the
most caution. Options A, B, and C have engaged presenting parts or are in earlier labor
stages.
A primigravida client who is 5 cm dilated, 90% effaced, and at 0 station is requesting an
epidural for pain relief. Which assessment finding is most important for the nurse to
report to the healthcare provider?
a. Cervical dilation of 5 cm with 90% effacement
b. White blood cell count of 12,000/mm3
c. Hemoglobin of 12 mg/dl and hematocrit of 38%
d. A platelet count of 67,000/mm3
✔️ Correct Answer: d. A platelet count of 67,000/mm3
Rationale:
Epidural anesthesia requires adequate platelet levels. A platelet count of 67,000/mm3 is
significantly below the normal range (150,000-400,000) and increases the risk of
epidural hematoma. This must be reported immediately. The other findings are within
normal limits for a laboring client.
