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2025 OB Maternity HESI EXIT Exam –
Versions 1, 2 & 3 | 100% Correct
Questions in Updated NextGen Format |
Full Test Bank | A+ Guaranteed
1. A primigravida at 38 weeks gestation presents with regular contractions every 5 minutes.
The nurse assesses a fetal heart rate (FHR) of 130 bpm with moderate variability. What is
the most appropriate initial action?
A. Notify the healthcare provider immediately.
B. Continue monitoring the FHR and contractions.
C. Prepare for an emergency cesarean section.
D. Administer oxygen via face mask at 10 L/min.
Correct Answer: B
Rationale: An FHR of 130 bpm with moderate variability is within normal limits (110–
160 bpm). Regular monitoring is appropriate as there are no signs of fetal distress. HESI
standards emphasize ongoing assessment in uncomplicated labor scenarios.
2. A client at 34 weeks gestation is diagnosed with preeclampsia. Which assessment finding
requires immediate intervention?
A. Blood pressure of 140/90 mmHg.
B. Proteinuria of 2+ on dipstick.
C. Severe headache and visual disturbances.
D. Mild ankle edema.
Correct Answer: C
Rationale: Severe headache and visual disturbances indicate worsening preeclampsia,
potentially progressing to eclampsia, requiring urgent intervention. HESI prioritizes
recognizing neurological symptoms as critical.
3. A postpartum client reports heavy vaginal bleeding 6 hours after delivery. The nurse
notes a boggy uterus. What is the priority nursing action?
A. Administer oxytocin as prescribed.
B. Perform fundal massage.
C. Assess vital signs.
D. Notify the healthcare provider.
Correct Answer: B
Rationale: A boggy uterus indicates uterine atony, the leading cause of postpartum
hemorrhage. Fundal massage is the priority to promote uterine contraction and reduce
bleeding. HESI emphasizes immediate hands-on interventions for atony.
4. A client at 28 weeks gestation reports decreased fetal movement. What is the nurse’s first
action?
A. Perform a nonstress test (NST).
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B. Encourage the client to drink juice and count movements.
C. Prepare for an ultrasound.
D. Notify the healthcare provider.
Correct Answer: B
Rationale: Encouraging fluid intake and counting fetal movements is the initial step to
assess fetal well-being. HESI standards recommend non-invasive actions first unless
distress is evident.
5. A client in labor receives an epidural. Which assessment is most critical immediately
after administration?
A. Fetal heart rate variability.
B. Maternal blood pressure.
C. Contraction frequency.
D. Level of pain relief.
Correct Answer: B
Rationale: Epidurals can cause maternal hypotension, which may compromise fetal
perfusion. Monitoring blood pressure is critical per HESI guidelines to ensure maternal
and fetal safety.
6. A newborn is assessed for Apgar scores at 1 minute and receives a score of 6. What is the
nurse’s priority action?
A. Initiate resuscitation efforts.
B. Reassess the Apgar score at 5 minutes.
C. Notify the pediatrician immediately.
D. Place the newborn under a radiant warmer.
Correct Answer: A
Rationale: An Apgar score of 6 indicates moderate distress, requiring immediate
interventions like stimulation or oxygen. HESI emphasizes prompt action for low Apgar
scores.
7. A client at 36 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
finding indicates toxicity?
A. Respiratory rate of 16 breaths/min.
B. Deep tendon reflexes absent.
C. Blood pressure of 150/95 mmHg.
D. Urine output of 50 mL/hr.
Correct Answer: B
Rationale: Absent deep tendon reflexes are a sign of magnesium toxicity, requiring
immediate cessation of the infusion. HESI standards highlight reflex assessment as key in
magnesium therapy.
8. A primipara is breastfeeding her newborn. She reports nipple soreness. What is the
nurse’s best recommendation?
A. Apply lanolin cream after feedings.
B. Use a nipple shield during feedings.
C. Stop breastfeeding for 24 hours.
D. Supplement with formula.
Correct Answer: A
Rationale: Lanolin cream soothes sore nipples and promotes healing without interrupting
breastfeeding. HESI promotes evidence-based breastfeeding support.
, 3
9. A client at 39 weeks gestation has a positive Group B Streptococcus (GBS) culture. What
is the priority intervention during labor?
A. Administer antibiotics as prescribed.
B. Monitor fetal heart rate continuously.
C. Prepare for a cesarean delivery.
D. Assess cervical dilation hourly.
Correct Answer: A
Rationale: GBS-positive clients require intrapartum antibiotics to prevent neonatal
sepsis. HESI prioritizes infection prevention in GBS cases.
10. A postpartum client is diagnosed with endometritis. Which symptom is most likely
present?
A. Foul-smelling lochia.
B. Breast engorgement.
C. Perineal edema.
D. Hemorrhoids.
Correct Answer: A
Rationale: Foul-smelling lochia is a hallmark of endometritis, indicating uterine
infection. HESI emphasizes recognizing infection signs postpartum.
11. A client at 32 weeks gestation presents with preterm labor. Which medication is most
likely prescribed to promote fetal lung maturity?
A. Magnesium sulfate.
B. Betamethasone.
C. Nifedipine.
D. Oxytocin.
Correct Answer: B
Rationale: Betamethasone is a corticosteroid used to enhance fetal lung maturity in
preterm labor. HESI standards prioritize fetal protection in preterm scenarios.
12. A newborn is diagnosed with jaundice. Which intervention is most appropriate?
A. Initiate phototherapy.
B. Increase formula feedings.
C. Administer vitamin K.
D. Monitor blood glucose levels.
Correct Answer: A
Rationale: Phototherapy is the standard treatment for neonatal jaundice to reduce
bilirubin levels. HESI emphasizes evidence-based jaundice management.
13. A client in the second stage of labor is pushing. The fetal head is at +2 station. What is
the nurse’s priority action?
A. Encourage pushing with each contraction.
B. Prepare for immediate delivery.
C. Administer oxygen via nasal cannula.
D. Check the fetal heart rate.
Correct Answer: A
Rationale: At +2 station, the fetus is descending, and encouraging pushing is appropriate.
HESI promotes active support during the second stage.
14. A client at 40 weeks gestation is in active labor. The nurse notes late decelerations on the
FHR monitor. What is the priority intervention?
2025 OB Maternity HESI EXIT Exam –
Versions 1, 2 & 3 | 100% Correct
Questions in Updated NextGen Format |
Full Test Bank | A+ Guaranteed
1. A primigravida at 38 weeks gestation presents with regular contractions every 5 minutes.
The nurse assesses a fetal heart rate (FHR) of 130 bpm with moderate variability. What is
the most appropriate initial action?
A. Notify the healthcare provider immediately.
B. Continue monitoring the FHR and contractions.
C. Prepare for an emergency cesarean section.
D. Administer oxygen via face mask at 10 L/min.
Correct Answer: B
Rationale: An FHR of 130 bpm with moderate variability is within normal limits (110–
160 bpm). Regular monitoring is appropriate as there are no signs of fetal distress. HESI
standards emphasize ongoing assessment in uncomplicated labor scenarios.
2. A client at 34 weeks gestation is diagnosed with preeclampsia. Which assessment finding
requires immediate intervention?
A. Blood pressure of 140/90 mmHg.
B. Proteinuria of 2+ on dipstick.
C. Severe headache and visual disturbances.
D. Mild ankle edema.
Correct Answer: C
Rationale: Severe headache and visual disturbances indicate worsening preeclampsia,
potentially progressing to eclampsia, requiring urgent intervention. HESI prioritizes
recognizing neurological symptoms as critical.
3. A postpartum client reports heavy vaginal bleeding 6 hours after delivery. The nurse
notes a boggy uterus. What is the priority nursing action?
A. Administer oxytocin as prescribed.
B. Perform fundal massage.
C. Assess vital signs.
D. Notify the healthcare provider.
Correct Answer: B
Rationale: A boggy uterus indicates uterine atony, the leading cause of postpartum
hemorrhage. Fundal massage is the priority to promote uterine contraction and reduce
bleeding. HESI emphasizes immediate hands-on interventions for atony.
4. A client at 28 weeks gestation reports decreased fetal movement. What is the nurse’s first
action?
A. Perform a nonstress test (NST).
, 2
B. Encourage the client to drink juice and count movements.
C. Prepare for an ultrasound.
D. Notify the healthcare provider.
Correct Answer: B
Rationale: Encouraging fluid intake and counting fetal movements is the initial step to
assess fetal well-being. HESI standards recommend non-invasive actions first unless
distress is evident.
5. A client in labor receives an epidural. Which assessment is most critical immediately
after administration?
A. Fetal heart rate variability.
B. Maternal blood pressure.
C. Contraction frequency.
D. Level of pain relief.
Correct Answer: B
Rationale: Epidurals can cause maternal hypotension, which may compromise fetal
perfusion. Monitoring blood pressure is critical per HESI guidelines to ensure maternal
and fetal safety.
6. A newborn is assessed for Apgar scores at 1 minute and receives a score of 6. What is the
nurse’s priority action?
A. Initiate resuscitation efforts.
B. Reassess the Apgar score at 5 minutes.
C. Notify the pediatrician immediately.
D. Place the newborn under a radiant warmer.
Correct Answer: A
Rationale: An Apgar score of 6 indicates moderate distress, requiring immediate
interventions like stimulation or oxygen. HESI emphasizes prompt action for low Apgar
scores.
7. A client at 36 weeks gestation is receiving magnesium sulfate for preeclampsia. Which
finding indicates toxicity?
A. Respiratory rate of 16 breaths/min.
B. Deep tendon reflexes absent.
C. Blood pressure of 150/95 mmHg.
D. Urine output of 50 mL/hr.
Correct Answer: B
Rationale: Absent deep tendon reflexes are a sign of magnesium toxicity, requiring
immediate cessation of the infusion. HESI standards highlight reflex assessment as key in
magnesium therapy.
8. A primipara is breastfeeding her newborn. She reports nipple soreness. What is the
nurse’s best recommendation?
A. Apply lanolin cream after feedings.
B. Use a nipple shield during feedings.
C. Stop breastfeeding for 24 hours.
D. Supplement with formula.
Correct Answer: A
Rationale: Lanolin cream soothes sore nipples and promotes healing without interrupting
breastfeeding. HESI promotes evidence-based breastfeeding support.
, 3
9. A client at 39 weeks gestation has a positive Group B Streptococcus (GBS) culture. What
is the priority intervention during labor?
A. Administer antibiotics as prescribed.
B. Monitor fetal heart rate continuously.
C. Prepare for a cesarean delivery.
D. Assess cervical dilation hourly.
Correct Answer: A
Rationale: GBS-positive clients require intrapartum antibiotics to prevent neonatal
sepsis. HESI prioritizes infection prevention in GBS cases.
10. A postpartum client is diagnosed with endometritis. Which symptom is most likely
present?
A. Foul-smelling lochia.
B. Breast engorgement.
C. Perineal edema.
D. Hemorrhoids.
Correct Answer: A
Rationale: Foul-smelling lochia is a hallmark of endometritis, indicating uterine
infection. HESI emphasizes recognizing infection signs postpartum.
11. A client at 32 weeks gestation presents with preterm labor. Which medication is most
likely prescribed to promote fetal lung maturity?
A. Magnesium sulfate.
B. Betamethasone.
C. Nifedipine.
D. Oxytocin.
Correct Answer: B
Rationale: Betamethasone is a corticosteroid used to enhance fetal lung maturity in
preterm labor. HESI standards prioritize fetal protection in preterm scenarios.
12. A newborn is diagnosed with jaundice. Which intervention is most appropriate?
A. Initiate phototherapy.
B. Increase formula feedings.
C. Administer vitamin K.
D. Monitor blood glucose levels.
Correct Answer: A
Rationale: Phototherapy is the standard treatment for neonatal jaundice to reduce
bilirubin levels. HESI emphasizes evidence-based jaundice management.
13. A client in the second stage of labor is pushing. The fetal head is at +2 station. What is
the nurse’s priority action?
A. Encourage pushing with each contraction.
B. Prepare for immediate delivery.
C. Administer oxygen via nasal cannula.
D. Check the fetal heart rate.
Correct Answer: A
Rationale: At +2 station, the fetus is descending, and encouraging pushing is appropriate.
HESI promotes active support during the second stage.
14. A client at 40 weeks gestation is in active labor. The nurse notes late decelerations on the
FHR monitor. What is the priority intervention?
