HESI RN Maternity Exam 2025/2026 –
Practice Exam 80 Non-Repeating Multiple-
Choice Questions with Verified Correct
Answers and Detailed Rationales
Question 1: Antepartum Care
A primigravida at 12 weeks gestation reports nausea and vomiting. What is the nurse’s best
recommendation?
A. Eat small, frequent meals high in carbohydrates.
B. Avoid all fluids until vomiting subsides.
C. Take antacids before meals.
D. Increase intake of fatty foods for energy.
A. Eat small, frequent meals high in carbohydrates.
Rationale: Morning sickness is common in the first trimester due to hormonal changes
(hCG, estrogen). Small, frequent, high-carbohydrate meals stabilize gastric acid and blood
sugar, reducing nausea. Avoiding fluids (B) risks dehydration, antacids (C) are not
indicated, and fatty foods (D) may worsen nausea.
Question 2: Antepartum Care
A client at 28 weeks gestation has a positive glucose tolerance test. What is the priority nursing
action?
A. Administer insulin immediately.
B. Teach carbohydrate counting and dietary management.
C. Schedule a cesarean delivery.
D. Restrict all sugar intake completely.
B. Teach carbohydrate counting and dietary management.
Rationale: Gestational diabetes mellitus (GDM) is managed initially with diet and exercise
per ADA guidelines. Carbohydrate counting helps maintain euglycemia, preventing fetal
macrosomia and maternal complications. Insulin (A) is second-line, cesarean (C) is
premature, and total sugar restriction (D) is unnecessary.
Question 3: Intrapartum Care
During labor, a client’s fetal heart rate shows late decelerations. What is the nurse’s first action?
A. Increase IV fluid rate.
B. Place the client in left lateral position.
,C. Administer oxygen at 2 L/min.
D. Prepare for immediate delivery.
B. Place the client in left lateral position.
Rationale: Late decelerations indicate uteroplacental insufficiency. Left lateral positioning
improves placental perfusion by relieving IVC compression, addressing the cause. Fluids
(A) and oxygen (C) are secondary, and delivery (D) is considered if interventions fail, per
ACOG guidelines.
Question 4: Postpartum Care
A postpartum client on day 2 reports heavy vaginal bleeding and passing large clots. What is the
priority assessment?
A. Fundal height and consistency.
B. Lochia color and odor.
C. Breast engorgement.
D. Perineal pain.
A. Fundal height and consistency.
Rationale: Heavy bleeding and clots suggest postpartum hemorrhage, often due to uterine
atony. Assessing the fundus for firmness and position (midline, at/near umbilicus) identifies
atony, guiding interventions like massage or oxytocin. Other assessments (B, C, D) are less
urgent.
Question 5: Newborn Care
A newborn’s Apgar score at 1 minute is 6. What does this indicate?
A. Severe distress requiring resuscitation.
B. Mild distress; provide stimulation and oxygen.
C. Normal; no intervention needed.
D. Critical condition; intubate immediately.
B. Mild distress; provide stimulation and oxygen.
Rationale: An Apgar of 4-6 indicates mild to moderate distress. Stimulation (warming,
drying) and supplemental oxygen support transition to extrauterine life. Scores <4 (A, D)
require aggressive resuscitation, and 7-10 (C) is normal, per NRP guidelines.
Question 6: Antepartum Care
A client at 34 weeks gestation reports decreased fetal movement. What is the nurse’s priority
action?
A. Reassure the client it’s normal.
B. Perform a non-stress test (NST).
, C. Teach kick counting techniques.
D. Schedule an ultrasound in 1 week.
B. Perform a non-stress test (NST).
Rationale: Decreased fetal movement may indicate fetal compromise. An NST assesses fetal
heart rate accelerations, reflecting well-being. Reassurance (A) delays evaluation, teaching
(C) is secondary, and delaying ultrasound (D) risks missing urgent issues, per ACOG.
Question 7: Intrapartum Care
A client in active labor has a cervical dilation of 6 cm and contractions every 3 minutes. What
stage of labor is this?
A. Latent phase.
B. Active phase.
C. Transition phase.
D. Second stage.
B. Active phase.
Rationale: Active phase (4-7 cm dilation) involves regular, frequent contractions and
progressive cervical change. Latent (0-3 cm) is slower, transition (8-10 cm) is intense, and
second stage begins at full dilation, per labor physiology.
Question 8: Postpartum Care
A client 4 hours post-cesarean reports calf pain and swelling. What is the priority nursing action?
A. Massage the calf to relieve tension.
B. Apply a warm compress to the area.
C. Assess for Homans’ sign and notify provider.
D. Encourage ambulation immediately.
C. Assess for Homans’ sign and notify provider.
Rationale: Calf pain and swelling post-cesarean suggest deep vein thrombosis (DVT), a
common postpartum complication. Assessing Homans’ sign (pain on dorsiflexion) and
notifying the provider facilitate diagnosis (e.g., ultrasound) and anticoagulation. Massage
(A) and heat (B) risk embolization, and ambulation (D) is unsafe until ruled out.
Question 9: Newborn Care
A newborn is diagnosed with jaundice at 36 hours. What is the most likely cause?
A. Pathologic jaundice from hemolysis.
B. Physiologic jaundice from immature liver.
C. Breast milk jaundice.
D. Sepsis-related jaundice.
Practice Exam 80 Non-Repeating Multiple-
Choice Questions with Verified Correct
Answers and Detailed Rationales
Question 1: Antepartum Care
A primigravida at 12 weeks gestation reports nausea and vomiting. What is the nurse’s best
recommendation?
A. Eat small, frequent meals high in carbohydrates.
B. Avoid all fluids until vomiting subsides.
C. Take antacids before meals.
D. Increase intake of fatty foods for energy.
A. Eat small, frequent meals high in carbohydrates.
Rationale: Morning sickness is common in the first trimester due to hormonal changes
(hCG, estrogen). Small, frequent, high-carbohydrate meals stabilize gastric acid and blood
sugar, reducing nausea. Avoiding fluids (B) risks dehydration, antacids (C) are not
indicated, and fatty foods (D) may worsen nausea.
Question 2: Antepartum Care
A client at 28 weeks gestation has a positive glucose tolerance test. What is the priority nursing
action?
A. Administer insulin immediately.
B. Teach carbohydrate counting and dietary management.
C. Schedule a cesarean delivery.
D. Restrict all sugar intake completely.
B. Teach carbohydrate counting and dietary management.
Rationale: Gestational diabetes mellitus (GDM) is managed initially with diet and exercise
per ADA guidelines. Carbohydrate counting helps maintain euglycemia, preventing fetal
macrosomia and maternal complications. Insulin (A) is second-line, cesarean (C) is
premature, and total sugar restriction (D) is unnecessary.
Question 3: Intrapartum Care
During labor, a client’s fetal heart rate shows late decelerations. What is the nurse’s first action?
A. Increase IV fluid rate.
B. Place the client in left lateral position.
,C. Administer oxygen at 2 L/min.
D. Prepare for immediate delivery.
B. Place the client in left lateral position.
Rationale: Late decelerations indicate uteroplacental insufficiency. Left lateral positioning
improves placental perfusion by relieving IVC compression, addressing the cause. Fluids
(A) and oxygen (C) are secondary, and delivery (D) is considered if interventions fail, per
ACOG guidelines.
Question 4: Postpartum Care
A postpartum client on day 2 reports heavy vaginal bleeding and passing large clots. What is the
priority assessment?
A. Fundal height and consistency.
B. Lochia color and odor.
C. Breast engorgement.
D. Perineal pain.
A. Fundal height and consistency.
Rationale: Heavy bleeding and clots suggest postpartum hemorrhage, often due to uterine
atony. Assessing the fundus for firmness and position (midline, at/near umbilicus) identifies
atony, guiding interventions like massage or oxytocin. Other assessments (B, C, D) are less
urgent.
Question 5: Newborn Care
A newborn’s Apgar score at 1 minute is 6. What does this indicate?
A. Severe distress requiring resuscitation.
B. Mild distress; provide stimulation and oxygen.
C. Normal; no intervention needed.
D. Critical condition; intubate immediately.
B. Mild distress; provide stimulation and oxygen.
Rationale: An Apgar of 4-6 indicates mild to moderate distress. Stimulation (warming,
drying) and supplemental oxygen support transition to extrauterine life. Scores <4 (A, D)
require aggressive resuscitation, and 7-10 (C) is normal, per NRP guidelines.
Question 6: Antepartum Care
A client at 34 weeks gestation reports decreased fetal movement. What is the nurse’s priority
action?
A. Reassure the client it’s normal.
B. Perform a non-stress test (NST).
, C. Teach kick counting techniques.
D. Schedule an ultrasound in 1 week.
B. Perform a non-stress test (NST).
Rationale: Decreased fetal movement may indicate fetal compromise. An NST assesses fetal
heart rate accelerations, reflecting well-being. Reassurance (A) delays evaluation, teaching
(C) is secondary, and delaying ultrasound (D) risks missing urgent issues, per ACOG.
Question 7: Intrapartum Care
A client in active labor has a cervical dilation of 6 cm and contractions every 3 minutes. What
stage of labor is this?
A. Latent phase.
B. Active phase.
C. Transition phase.
D. Second stage.
B. Active phase.
Rationale: Active phase (4-7 cm dilation) involves regular, frequent contractions and
progressive cervical change. Latent (0-3 cm) is slower, transition (8-10 cm) is intense, and
second stage begins at full dilation, per labor physiology.
Question 8: Postpartum Care
A client 4 hours post-cesarean reports calf pain and swelling. What is the priority nursing action?
A. Massage the calf to relieve tension.
B. Apply a warm compress to the area.
C. Assess for Homans’ sign and notify provider.
D. Encourage ambulation immediately.
C. Assess for Homans’ sign and notify provider.
Rationale: Calf pain and swelling post-cesarean suggest deep vein thrombosis (DVT), a
common postpartum complication. Assessing Homans’ sign (pain on dorsiflexion) and
notifying the provider facilitate diagnosis (e.g., ultrasound) and anticoagulation. Massage
(A) and heat (B) risk embolization, and ambulation (D) is unsafe until ruled out.
Question 9: Newborn Care
A newborn is diagnosed with jaundice at 36 hours. What is the most likely cause?
A. Pathologic jaundice from hemolysis.
B. Physiologic jaundice from immature liver.
C. Breast milk jaundice.
D. Sepsis-related jaundice.
