HESI RN Maternity (Obstetric)
Nursing Exam | Prenatal to
Postpartum Mastery | 2025/2026
Edition
Section 1: Introduction
This in-depth review includes verified obstetrics questions with correct answers,
spanning prenatal care, intrapartum monitoring, labor stages, complications,
postpartum assessments, and newborn care. It provides A+ graded preparation for
maternity-related clinical situations, following current HESI and NCLEX 2025/2026
frameworks. Perfect for mastering maternal health across the reproductive cycle.
Section 2: Exam Questions and Full Answers
1. What should the nurse do first when a pregnant woman at 32 weeks gestation presents
with decreased fetal movement?
A. Perform a non-stress test
B. Administer oxygen
C. Check maternal blood pressure
D. Encourage ambulation
Full Answer: Answer A. Perform a non-stress test. This assesses fetal heart rate and
movement, providing immediate data on fetal well-being. The nurse should also
obtain maternal vital signs, notify the provider, and prepare for further evaluation if
indicated.
2. What is the nurse’s priority action when a woman in active labor is dilated to 6 cm
with a fetal heart rate of 90 bpm?
A. Reposition to left lateral and administer oxygen
B. Increase IV fluids
C. Prepare for immediate delivery
D. Administer analgesics
Full Answer: Answer A. Reposition to left lateral and administer oxygen. This
improves fetal oxygenation due to bradycardia, suggesting cord compression or
placental insufficiency. The nurse should notify the provider and prepare for
emergency delivery if needed.
3. What should the nurse do first when a postpartum woman develops a temperature of
38.3°C on day 2 after a vaginal delivery?
A. Assess perineal area and lochia for infection
B. Administer antipyretics
C. Encourage fluid intake
D. Check blood sugar levels
Full Answer: Answer A. Assess perineal area and lochia for infection. A temperature
of 38.3°C suggests possible endometritis, requiring vital signs, a culture if ordered,
provider notification, and possible antibiotics.
, 4. What should the nurse do when a primigravida at 39 weeks gestation is in the second
stage of labor with no progress for 2 hours?
A. Notify the provider for evaluation
B. Encourage more frequent pushing
C. Administer oxytocin
D. Apply fundal pressure
Full Answer: Answer A. Notify the provider for evaluation. Lack of progress may
indicate cephalopelvic disproportion or fetal distress, requiring monitoring of fetal
heart rate and preparation for possible intervention.
5. What is the nurse’s priority action when a newborn delivered at 37 weeks has a
respiratory rate of 70 breaths per minute and grunting?
A. Assess for respiratory distress syndrome
B. Administer antibiotics
C. Perform a full physical exam
D. Encourage breastfeeding
Full Answer: Answer A. Assess for respiratory distress syndrome. A respiratory rate
of 70 with grunting is abnormal, requiring oxygen, saturation monitoring, neonatal
team notification, and possible NICU transfer.
6. What should the nurse do first when a woman at 28 weeks gestation reports vaginal
bleeding and abdominal pain?
A. Position in left lateral tilt and administer oxygen
B. Perform a vaginal exam
C. Administer IV fluids
D. Apply a cold pack to the abdomen
Full Answer: Answer A. Position in left lateral tilt and administer oxygen. This
improves placental perfusion, as bleeding and pain may indicate placenta previa or
abruption, requiring provider notification and ultrasound preparation.
7. What should the nurse do first when a woman 12 hours postpartum has a boggy uterus
and heavy lochia?
A. Massage the uterus and assess bladder status
B. Administer oxytocin as prescribed
C. Apply an ice pack to the perineum
D. Encourage ambulation
Full Answer: Answer A. Massage the uterus and assess bladder status. A boggy
uterus with heavy lochia suggests postpartum hemorrhage, requiring fundal massage
and bladder emptying to promote uterine contraction, with provider notification if
bleeding persists.
8. What is the nurse’s priority when a woman at 36 weeks gestation has preeclampsia
with a blood pressure of 160/100 mmHg?
A. Administer magnesium sulfate as prescribed
B. Monitor fetal heart rate
C. Check deep tendon reflexes
D. Encourage bed rest
Full Answer: Answer A. Administer magnesium sulfate as prescribed. This prevents
seizures in preeclampsia, a priority given the elevated blood pressure. The nurse
should also monitor fetal heart rate and reflexes, and ensure bed rest, notifying the
provider.
9. What should the nurse do when a woman in the first stage of labor has a contraction
pattern of every 2 minutes lasting 90 seconds?
A. Notify the provider of hyperstimulation
Nursing Exam | Prenatal to
Postpartum Mastery | 2025/2026
Edition
Section 1: Introduction
This in-depth review includes verified obstetrics questions with correct answers,
spanning prenatal care, intrapartum monitoring, labor stages, complications,
postpartum assessments, and newborn care. It provides A+ graded preparation for
maternity-related clinical situations, following current HESI and NCLEX 2025/2026
frameworks. Perfect for mastering maternal health across the reproductive cycle.
Section 2: Exam Questions and Full Answers
1. What should the nurse do first when a pregnant woman at 32 weeks gestation presents
with decreased fetal movement?
A. Perform a non-stress test
B. Administer oxygen
C. Check maternal blood pressure
D. Encourage ambulation
Full Answer: Answer A. Perform a non-stress test. This assesses fetal heart rate and
movement, providing immediate data on fetal well-being. The nurse should also
obtain maternal vital signs, notify the provider, and prepare for further evaluation if
indicated.
2. What is the nurse’s priority action when a woman in active labor is dilated to 6 cm
with a fetal heart rate of 90 bpm?
A. Reposition to left lateral and administer oxygen
B. Increase IV fluids
C. Prepare for immediate delivery
D. Administer analgesics
Full Answer: Answer A. Reposition to left lateral and administer oxygen. This
improves fetal oxygenation due to bradycardia, suggesting cord compression or
placental insufficiency. The nurse should notify the provider and prepare for
emergency delivery if needed.
3. What should the nurse do first when a postpartum woman develops a temperature of
38.3°C on day 2 after a vaginal delivery?
A. Assess perineal area and lochia for infection
B. Administer antipyretics
C. Encourage fluid intake
D. Check blood sugar levels
Full Answer: Answer A. Assess perineal area and lochia for infection. A temperature
of 38.3°C suggests possible endometritis, requiring vital signs, a culture if ordered,
provider notification, and possible antibiotics.
, 4. What should the nurse do when a primigravida at 39 weeks gestation is in the second
stage of labor with no progress for 2 hours?
A. Notify the provider for evaluation
B. Encourage more frequent pushing
C. Administer oxytocin
D. Apply fundal pressure
Full Answer: Answer A. Notify the provider for evaluation. Lack of progress may
indicate cephalopelvic disproportion or fetal distress, requiring monitoring of fetal
heart rate and preparation for possible intervention.
5. What is the nurse’s priority action when a newborn delivered at 37 weeks has a
respiratory rate of 70 breaths per minute and grunting?
A. Assess for respiratory distress syndrome
B. Administer antibiotics
C. Perform a full physical exam
D. Encourage breastfeeding
Full Answer: Answer A. Assess for respiratory distress syndrome. A respiratory rate
of 70 with grunting is abnormal, requiring oxygen, saturation monitoring, neonatal
team notification, and possible NICU transfer.
6. What should the nurse do first when a woman at 28 weeks gestation reports vaginal
bleeding and abdominal pain?
A. Position in left lateral tilt and administer oxygen
B. Perform a vaginal exam
C. Administer IV fluids
D. Apply a cold pack to the abdomen
Full Answer: Answer A. Position in left lateral tilt and administer oxygen. This
improves placental perfusion, as bleeding and pain may indicate placenta previa or
abruption, requiring provider notification and ultrasound preparation.
7. What should the nurse do first when a woman 12 hours postpartum has a boggy uterus
and heavy lochia?
A. Massage the uterus and assess bladder status
B. Administer oxytocin as prescribed
C. Apply an ice pack to the perineum
D. Encourage ambulation
Full Answer: Answer A. Massage the uterus and assess bladder status. A boggy
uterus with heavy lochia suggests postpartum hemorrhage, requiring fundal massage
and bladder emptying to promote uterine contraction, with provider notification if
bleeding persists.
8. What is the nurse’s priority when a woman at 36 weeks gestation has preeclampsia
with a blood pressure of 160/100 mmHg?
A. Administer magnesium sulfate as prescribed
B. Monitor fetal heart rate
C. Check deep tendon reflexes
D. Encourage bed rest
Full Answer: Answer A. Administer magnesium sulfate as prescribed. This prevents
seizures in preeclampsia, a priority given the elevated blood pressure. The nurse
should also monitor fetal heart rate and reflexes, and ensure bed rest, notifying the
provider.
9. What should the nurse do when a woman in the first stage of labor has a contraction
pattern of every 2 minutes lasting 90 seconds?
A. Notify the provider of hyperstimulation
