HESI Obstetrics-
Maternity Case
Study (NGN-Style
& Case Scenario)
2025-2026
, HESI
Obstetrics/Maternity
Case Study
(NGN-Style & Case Scenario)
Below is a :
set of structured questions aligned with the
NCLEX Next-Generation (NGN) style,
complete with scenarios, vital signs,
questions, answer choices, correct answers, and expert
rationales
,### Scenario 1
Scenario: Fifteen minutes after the initial assessment, the nurse finds the client
disoriented and lying on her back in a pool of vaginal blood, with the sheets beneath
her saturated with blood.
Vital Signs:
- Blood Pressure: 90/50 mmHg
- Heart Rate: 120 bpm
Question: Which action is most important for the nurse to implement immediately?
Answer Choices:
a. Take vital signs.
b. Massage the fundus.
c. Check the bladder.
d. Increase the IV rate.
ANSWER:b. Massage the fundus.
Expert Rationale:
A boggy fundus is a common cause of postpartum hemorrhage. Immediate fundal
massage is crucial to stimulate uterine contraction and mitigate the risk of significant
blood loss. The nurse should also call for assistance given the severity of the situation.
, ### Scenario 2
Scenario: A nurse performs the first assessment upon the client's arrival to the
postpartum unit.
Question: Where would the nurse expect to palpate the fundus?
Answer Choices:
a. 3 cm above the umbilicus.
b. 1 cm above the umbilicus.
c. To the right of the umbilicus.
d. Midway between the umbilicus and the pubic bone.
b. ANSWER:1 cm above the umbilicus.
Expert Rationale:
Within the first 12 hours postpartum, the fundus should be in the range of 1- 2 cm
above the umbilicus. This indicates that the uterus is contracting properly and is
returning to its normal size.
### Scenario 3
Scenario: A postpartum client is hemorrhaging and the nurse suspects a common
cause.
Question: What is the most likely reason a postpartum patient would be
hemorrhaging?
Maternity Case
Study (NGN-Style
& Case Scenario)
2025-2026
, HESI
Obstetrics/Maternity
Case Study
(NGN-Style & Case Scenario)
Below is a :
set of structured questions aligned with the
NCLEX Next-Generation (NGN) style,
complete with scenarios, vital signs,
questions, answer choices, correct answers, and expert
rationales
,### Scenario 1
Scenario: Fifteen minutes after the initial assessment, the nurse finds the client
disoriented and lying on her back in a pool of vaginal blood, with the sheets beneath
her saturated with blood.
Vital Signs:
- Blood Pressure: 90/50 mmHg
- Heart Rate: 120 bpm
Question: Which action is most important for the nurse to implement immediately?
Answer Choices:
a. Take vital signs.
b. Massage the fundus.
c. Check the bladder.
d. Increase the IV rate.
ANSWER:b. Massage the fundus.
Expert Rationale:
A boggy fundus is a common cause of postpartum hemorrhage. Immediate fundal
massage is crucial to stimulate uterine contraction and mitigate the risk of significant
blood loss. The nurse should also call for assistance given the severity of the situation.
, ### Scenario 2
Scenario: A nurse performs the first assessment upon the client's arrival to the
postpartum unit.
Question: Where would the nurse expect to palpate the fundus?
Answer Choices:
a. 3 cm above the umbilicus.
b. 1 cm above the umbilicus.
c. To the right of the umbilicus.
d. Midway between the umbilicus and the pubic bone.
b. ANSWER:1 cm above the umbilicus.
Expert Rationale:
Within the first 12 hours postpartum, the fundus should be in the range of 1- 2 cm
above the umbilicus. This indicates that the uterus is contracting properly and is
returning to its normal size.
### Scenario 3
Scenario: A postpartum client is hemorrhaging and the nurse suspects a common
cause.
Question: What is the most likely reason a postpartum patient would be
hemorrhaging?
