2026/2027 HESI EXIT EXAM Version 2 NGN /Maternity and Peds
QUESTIONS AND ANSWERS
EXAM
1. During a high-priority assessment, the practitioner must select the best answer. A pregnant
client reports painless bright-red vaginal bleeding in late pregnancy; which condition should be
considered?
A. normal implantation bleeding
B. placental abruption as the only possibility
✓ C. placenta previa
D. hyperemesis gravidarum
Rationale: Painless bright-red bleeding later in pregnancy is a classic warning sign of placenta previa and
requires evaluation.
2. During a high-priority assessment, careful prioritization is required. A child with suspected
epiglottitis has drooling, stridor, and a tripod posture; what is the priority?
A. force the child to lie flat
B. delay airway preparation
C. inspect the throat aggressively with a tongue blade
✓ D. maintain a calm environment and prepare for controlled airway management
Rationale: Epiglottitis can rapidly obstruct the airway; agitation and unnecessary throat examination can worsen
risk.
3. During a high-priority assessment, a postpartum client reports severe headache and visual
changes with elevated blood pressure; what complication is most concerning?
A. simple seasonal allergy
B. physiologic neonatal jaundice
✓ C. postpartum preeclampsia with risk for seizures
, D. normal postpartum fatigue
Rationale: Severe headache, visual symptoms, and hypertension after birth can indicate preeclampsia and
require urgent evaluation.
4. During a high-priority assessment, the practitioner must select the best answer. A pregnant
client at term reports regular painful contractions that increase in frequency and intensity;
which finding most strongly indicates true labor?
✓ A. progressive cervical dilation and effacement
B. no cervical change over time
C. occasional painless uterine tightening
D. contractions that disappear with rest
Rationale: True labor produces progressive cervical change along with increasingly regular contractions.
5. During a high-priority assessment, careful prioritization is required. A postpartum client has a
boggy uterus and heavy vaginal bleeding; which nursing action is the priority?
A. delay assessment for several hours
B. encourage the client to ambulate immediately
✓ C. massage the uterine fundus while assessing for ongoing hemorrhage
D. offer a routine snack first
Rationale: A boggy uterus can indicate uterine atony, a major cause of postpartum hemorrhage, requiring
prompt fundal assessment and intervention.
6. During a high-priority assessment, a newborn's parent asks why vitamin K is administered
after birth; what is the best explanation?
A. it prevents all neonatal infections
✓ B. it helps prevent vitamin-K-deficiency bleeding in the newborn
C. it treats jaundice directly
D. it replaces routine immunization
Rationale: Newborns have limited vitamin K stores, so prophylaxis helps prevent vitamin-K-deficiency bleeding.
,7. During a high-priority assessment, the practitioner must select the best answer. A child is
prescribed an oral antibiotic; which teaching point best supports safe administration?
✓ A. complete the prescribed course and follow instructions for timing and dosing
B. share leftover medication with siblings
C. stop the drug whenever symptoms improve
D. double the next dose after every missed dose
Rationale: Following the prescribed regimen supports treatment effectiveness and reduces medication errors
and inappropriate sharing.
8. During a high-priority assessment, careful prioritization is required. A newborn develops
respiratory distress shortly after birth; which finding requires immediate attention?
✓ A. grunting with nasal flaring and retractions
B. strong coordinated feeding
C. quiet alertness
D. brief sneezing
Rationale: Grunting, nasal flaring, and retractions indicate increased work of breathing and possible neonatal
respiratory compromise.
9. During a high-priority assessment, a newborn is receiving phototherapy for unconjugated
hyperbilirubinemia; which nursing action is appropriate?
A. cover the entire body with blankets continuously
B. stop feeding to reduce bilirubin
✓ C. protect the eyes and maximize appropriate skin exposure while monitoring hydration and temperature
D. keep the eyes uncovered
Rationale: Phototherapy requires eye protection and appropriate skin exposure, with monitoring for hydration
and temperature changes.
10. During a high-priority assessment, the practitioner must select the best answer. A child with
dehydration has tachycardia, dry mucous membranes, and decreased urine output; which
intervention is most important?
, A. delay treatment until weight loss doubles
B. restrict all fluids
C. encourage vigorous exercise
✓ D. restore fluid volume using the prescribed oral or intravenous rehydration plan
Rationale: The findings indicate fluid deficit, so timely rehydration is the priority.
11. A clinician is reviewing a new case when careful prioritization is required. A child with
suspected epiglottitis has drooling, stridor, and a tripod posture; what is the priority?
A. inspect the throat aggressively with a tongue blade
✓ B. maintain a calm environment and prepare for controlled airway management
C. delay airway preparation
D. force the child to lie flat
Rationale: Epiglottitis can rapidly obstruct the airway; agitation and unnecessary throat examination can worsen
risk.
12. A clinician is reviewing a new case when a postpartum client has a boggy uterus and heavy
vaginal bleeding; which nursing action is the priority?
A. delay assessment for several hours
B. offer a routine snack first
C. encourage the client to ambulate immediately
✓ D. massage the uterine fundus while assessing for ongoing hemorrhage
Rationale: A boggy uterus can indicate uterine atony, a major cause of postpartum hemorrhage, requiring
prompt fundal assessment and intervention.
13. A clinician is reviewing a new case when the practitioner must select the best answer. A
child with dehydration has tachycardia, dry mucous membranes, and decreased urine output;
which intervention is most important?
A. restrict all fluids
B. encourage vigorous exercise
C. delay treatment until weight loss doubles
QUESTIONS AND ANSWERS
EXAM
1. During a high-priority assessment, the practitioner must select the best answer. A pregnant
client reports painless bright-red vaginal bleeding in late pregnancy; which condition should be
considered?
A. normal implantation bleeding
B. placental abruption as the only possibility
✓ C. placenta previa
D. hyperemesis gravidarum
Rationale: Painless bright-red bleeding later in pregnancy is a classic warning sign of placenta previa and
requires evaluation.
2. During a high-priority assessment, careful prioritization is required. A child with suspected
epiglottitis has drooling, stridor, and a tripod posture; what is the priority?
A. force the child to lie flat
B. delay airway preparation
C. inspect the throat aggressively with a tongue blade
✓ D. maintain a calm environment and prepare for controlled airway management
Rationale: Epiglottitis can rapidly obstruct the airway; agitation and unnecessary throat examination can worsen
risk.
3. During a high-priority assessment, a postpartum client reports severe headache and visual
changes with elevated blood pressure; what complication is most concerning?
A. simple seasonal allergy
B. physiologic neonatal jaundice
✓ C. postpartum preeclampsia with risk for seizures
, D. normal postpartum fatigue
Rationale: Severe headache, visual symptoms, and hypertension after birth can indicate preeclampsia and
require urgent evaluation.
4. During a high-priority assessment, the practitioner must select the best answer. A pregnant
client at term reports regular painful contractions that increase in frequency and intensity;
which finding most strongly indicates true labor?
✓ A. progressive cervical dilation and effacement
B. no cervical change over time
C. occasional painless uterine tightening
D. contractions that disappear with rest
Rationale: True labor produces progressive cervical change along with increasingly regular contractions.
5. During a high-priority assessment, careful prioritization is required. A postpartum client has a
boggy uterus and heavy vaginal bleeding; which nursing action is the priority?
A. delay assessment for several hours
B. encourage the client to ambulate immediately
✓ C. massage the uterine fundus while assessing for ongoing hemorrhage
D. offer a routine snack first
Rationale: A boggy uterus can indicate uterine atony, a major cause of postpartum hemorrhage, requiring
prompt fundal assessment and intervention.
6. During a high-priority assessment, a newborn's parent asks why vitamin K is administered
after birth; what is the best explanation?
A. it prevents all neonatal infections
✓ B. it helps prevent vitamin-K-deficiency bleeding in the newborn
C. it treats jaundice directly
D. it replaces routine immunization
Rationale: Newborns have limited vitamin K stores, so prophylaxis helps prevent vitamin-K-deficiency bleeding.
,7. During a high-priority assessment, the practitioner must select the best answer. A child is
prescribed an oral antibiotic; which teaching point best supports safe administration?
✓ A. complete the prescribed course and follow instructions for timing and dosing
B. share leftover medication with siblings
C. stop the drug whenever symptoms improve
D. double the next dose after every missed dose
Rationale: Following the prescribed regimen supports treatment effectiveness and reduces medication errors
and inappropriate sharing.
8. During a high-priority assessment, careful prioritization is required. A newborn develops
respiratory distress shortly after birth; which finding requires immediate attention?
✓ A. grunting with nasal flaring and retractions
B. strong coordinated feeding
C. quiet alertness
D. brief sneezing
Rationale: Grunting, nasal flaring, and retractions indicate increased work of breathing and possible neonatal
respiratory compromise.
9. During a high-priority assessment, a newborn is receiving phototherapy for unconjugated
hyperbilirubinemia; which nursing action is appropriate?
A. cover the entire body with blankets continuously
B. stop feeding to reduce bilirubin
✓ C. protect the eyes and maximize appropriate skin exposure while monitoring hydration and temperature
D. keep the eyes uncovered
Rationale: Phototherapy requires eye protection and appropriate skin exposure, with monitoring for hydration
and temperature changes.
10. During a high-priority assessment, the practitioner must select the best answer. A child with
dehydration has tachycardia, dry mucous membranes, and decreased urine output; which
intervention is most important?
, A. delay treatment until weight loss doubles
B. restrict all fluids
C. encourage vigorous exercise
✓ D. restore fluid volume using the prescribed oral or intravenous rehydration plan
Rationale: The findings indicate fluid deficit, so timely rehydration is the priority.
11. A clinician is reviewing a new case when careful prioritization is required. A child with
suspected epiglottitis has drooling, stridor, and a tripod posture; what is the priority?
A. inspect the throat aggressively with a tongue blade
✓ B. maintain a calm environment and prepare for controlled airway management
C. delay airway preparation
D. force the child to lie flat
Rationale: Epiglottitis can rapidly obstruct the airway; agitation and unnecessary throat examination can worsen
risk.
12. A clinician is reviewing a new case when a postpartum client has a boggy uterus and heavy
vaginal bleeding; which nursing action is the priority?
A. delay assessment for several hours
B. offer a routine snack first
C. encourage the client to ambulate immediately
✓ D. massage the uterine fundus while assessing for ongoing hemorrhage
Rationale: A boggy uterus can indicate uterine atony, a major cause of postpartum hemorrhage, requiring
prompt fundal assessment and intervention.
13. A clinician is reviewing a new case when the practitioner must select the best answer. A
child with dehydration has tachycardia, dry mucous membranes, and decreased urine output;
which intervention is most important?
A. restrict all fluids
B. encourage vigorous exercise
C. delay treatment until weight loss doubles
