1
HESI RN Maternity Actual Exam
2025 – 100% Verified Questions
with OB/GYN Clinical Rationales
Student Name: _________________________
Date: _______________
Time Limit: 90 minutes
Total Questions: 75
Instructions
• This exam contains 75 questions, including multiple-choice and select-all-that-apply
(SATA) formats, covering antepartum, labor, delivery, postpartum, and newborn care.
• Read each question carefully and select the best answer(s) as indicated.
• For SATA questions, select all correct options.
• Time limit: 90 minutes.
• No external resources are permitted during the exam.
• A minimum score of 75% is required to pass, aligning with HESI RN standards.
Antepartum Care
1. A primigravida at 12 weeks gestation reports nausea and vomiting. What is the nurse’s
priority teaching?
A. Increase fluid intake to 4 L/day
B. Eat small, frequent meals
C. Avoid all carbohydrates
D. Take antiemetics before meals
Rationale: Small, frequent meals reduce nausea by preventing gastric distension;
excessive fluids or avoiding carbohydrates may worsen symptoms, per ACOG guidelines.
2. (SATA) Which findings indicate a risk for gestational diabetes mellitus (GDM) in a
pregnant client? (Select all that apply)
A. BMI > 30
B. Previous macrosomic infant
C. Age < 25 years
D. Family history of diabetes
E. Normal fasting glucose
, 2
Rationale: Obesity (BMI > 30), history of macrosomia, and family history are GDM risk
factors; age < 25 and normal glucose are not, per ADA guidelines.
3. A client at 28 weeks gestation has a positive 1-hour glucose tolerance test. What is the
next step?
A. Initiate insulin therapy
B. Perform a 3-hour glucose tolerance test
C. Restrict all carbohydrates
D. Monitor fetal heart rate daily
Rationale: A positive 1-hour test requires a confirmatory 3-hour test to diagnose GDM,
per ACOG.
4. A client at 16 weeks gestation reports spotting. What is the nurse’s priority action?
A. Administer tocolytics
B. Assess for vaginal bleeding and fetal heart tones
C. Prepare for immediate delivery
D. Restrict activity to bedrest
Rationale: Spotting may indicate complications; assessing bleeding and fetal heart tones
guides further management, per AWHONN protocols.
5. A client with preeclampsia at 32 weeks gestation has a blood pressure of 160/100 mmHg.
What is the priority intervention?
A. Administer oral antihypertensives
B. Administer IV magnesium sulfate
C. Induce labor immediately
D. Monitor urine output only
Rationale: Magnesium sulfate prevents seizures in preeclampsia, a priority over other
interventions, per ACOG.
6. (SATA) Which symptoms indicate severe preeclampsia? (Select all that apply)
A. Headache unrelieved by analgesics
B. Proteinuria > 5 g/24 hr
C. Mild edema
D. Epigastric pain
E. Normal platelet count
Rationale: Severe preeclampsia includes headache, proteinuria > 5 g/24 hr, and
epigastric pain; mild edema and normal platelets are not specific, per ACOG.
7. A client at 20 weeks gestation has a fundal height of 16 cm. What is the nurse’s priority
action?
A. Prepare for preterm delivery
B. Notify the provider for possible fetal growth restriction
C. Document as normal
D. Increase maternal fluid intake
Rationale: Fundal height lagging gestation suggests fetal growth restriction, requiring
provider evaluation, per AWHONN.
8. A client with hyperemesis gravidarum is dehydrated. What is the initial fluid
replacement?
A. Dextrose 5% in water
B. Lactated Ringer’s solution
HESI RN Maternity Actual Exam
2025 – 100% Verified Questions
with OB/GYN Clinical Rationales
Student Name: _________________________
Date: _______________
Time Limit: 90 minutes
Total Questions: 75
Instructions
• This exam contains 75 questions, including multiple-choice and select-all-that-apply
(SATA) formats, covering antepartum, labor, delivery, postpartum, and newborn care.
• Read each question carefully and select the best answer(s) as indicated.
• For SATA questions, select all correct options.
• Time limit: 90 minutes.
• No external resources are permitted during the exam.
• A minimum score of 75% is required to pass, aligning with HESI RN standards.
Antepartum Care
1. A primigravida at 12 weeks gestation reports nausea and vomiting. What is the nurse’s
priority teaching?
A. Increase fluid intake to 4 L/day
B. Eat small, frequent meals
C. Avoid all carbohydrates
D. Take antiemetics before meals
Rationale: Small, frequent meals reduce nausea by preventing gastric distension;
excessive fluids or avoiding carbohydrates may worsen symptoms, per ACOG guidelines.
2. (SATA) Which findings indicate a risk for gestational diabetes mellitus (GDM) in a
pregnant client? (Select all that apply)
A. BMI > 30
B. Previous macrosomic infant
C. Age < 25 years
D. Family history of diabetes
E. Normal fasting glucose
, 2
Rationale: Obesity (BMI > 30), history of macrosomia, and family history are GDM risk
factors; age < 25 and normal glucose are not, per ADA guidelines.
3. A client at 28 weeks gestation has a positive 1-hour glucose tolerance test. What is the
next step?
A. Initiate insulin therapy
B. Perform a 3-hour glucose tolerance test
C. Restrict all carbohydrates
D. Monitor fetal heart rate daily
Rationale: A positive 1-hour test requires a confirmatory 3-hour test to diagnose GDM,
per ACOG.
4. A client at 16 weeks gestation reports spotting. What is the nurse’s priority action?
A. Administer tocolytics
B. Assess for vaginal bleeding and fetal heart tones
C. Prepare for immediate delivery
D. Restrict activity to bedrest
Rationale: Spotting may indicate complications; assessing bleeding and fetal heart tones
guides further management, per AWHONN protocols.
5. A client with preeclampsia at 32 weeks gestation has a blood pressure of 160/100 mmHg.
What is the priority intervention?
A. Administer oral antihypertensives
B. Administer IV magnesium sulfate
C. Induce labor immediately
D. Monitor urine output only
Rationale: Magnesium sulfate prevents seizures in preeclampsia, a priority over other
interventions, per ACOG.
6. (SATA) Which symptoms indicate severe preeclampsia? (Select all that apply)
A. Headache unrelieved by analgesics
B. Proteinuria > 5 g/24 hr
C. Mild edema
D. Epigastric pain
E. Normal platelet count
Rationale: Severe preeclampsia includes headache, proteinuria > 5 g/24 hr, and
epigastric pain; mild edema and normal platelets are not specific, per ACOG.
7. A client at 20 weeks gestation has a fundal height of 16 cm. What is the nurse’s priority
action?
A. Prepare for preterm delivery
B. Notify the provider for possible fetal growth restriction
C. Document as normal
D. Increase maternal fluid intake
Rationale: Fundal height lagging gestation suggests fetal growth restriction, requiring
provider evaluation, per AWHONN.
8. A client with hyperemesis gravidarum is dehydrated. What is the initial fluid
replacement?
A. Dextrose 5% in water
B. Lactated Ringer’s solution
