HESI RN Maternity Actual Exam
2025/2026 – 100% Verified Questions
with OB/GYN Clinical Rationales
This HESI RN Maternity exam for 2025 includes 50 verified questions covering antepartum,
intrapartum, postpartum, and newborn care, with OB/GYN clinical rationales based on ACOG,
AWHONN, and AAP guidelines. Questions are scenario-based, with four options, correct
answer in RED, and rationales emphasizing clinical priorities and safety.
Question 1: A 26-year-old gravida 1 at 12 weeks gestation presents for her first prenatal
visit. What is the priority component of the initial assessment?
A. Fundal height measurement
B. Complete history including medical, surgical, and psychosocial
C. Non-stress test
D. Group B Streptococcus screening
Correct Answer: B. Complete history including medical, surgical, and psychosocial
Rationale: Comprehensive history identifies risks like domestic violence or genetic factors
(ACOG). Fundal height later; NST third trimester; GBS at 36 weeks. Clinical priority: Risk
assessment.
Question 2: A 34-year-old gravida 2, para 1 at 38 weeks gestation reports contractions
every 5 minutes. Cervical exam shows 4 cm dilation and 80% effacement. What is the
priority action?
A. Discharge home
B. Admit for labor
C. Administer tocolytics
D. Perform fetal monitoring
Correct Answer: B. Admit for labor
Rationale: 4 cm dilation indicates active labor; admission for monitoring (ACOG). Tocolytics
contraindicated. Clinical priority: Labor progression.
Question 3: A postpartum client on day 1 after vaginal delivery has a boggy uterus. What is
the priority intervention?
,A. Administer oxytocin
B. Perform fundal massage
C. Assess lochia
D. Empty bladder
Correct Answer: B. Perform fundal massage
Rationale: Massage stimulates contractions to control bleeding from atony (AWHONN).
Oxytocin adjunct; bladder (D) if distended. Clinical priority: Hemorrhage prevention.
Question 4: A newborn at 1 minute has an Apgar score of 3. What is the priority
intervention?
A. Suction mouth and nose
B. Positive pressure ventilation
C. Chest compressions
D. Intubation
Correct Answer: B. Positive pressure ventilation
Rationale: Apgar <4 with HR <100 requires PPV (NRP). Clinical priority: Resuscitation.
Question 5: A 32-year-old gravida 1 at 28 weeks has preterm labor. What is the priority
intervention?
A. Tocolytics
B. Betamethasone
C. Magnesium sulfate
D. Bed rest
Correct Answer: B. Betamethasone
Rationale: Steroids enhance fetal lung maturity at 24-34 weeks (ACOG). Clinical priority: Fetal
lung development.
Question 6: A 2-day postpartum woman has heavy lochia rubra soaking a pad hourly.
What is the priority action?
A. Fundal massage
B. Assess bladder
C. Administer tranexamic acid
D. Check hemoglobin
Correct Answer: B. Assess bladder
Rationale: Full bladder causes atony; empty first (AWHONN). Clinical priority: Uterine tone.
Question 7: A newborn has a capillary blood glucose of 35 mg/dL at 2 hours. What is the
priority intervention?
, A. Breastfeed or formula feed
B. D10W bolus
C. Monitor only
D. Refer to NICU
Correct Answer: A. Breastfeed or formula feed
Rationale: Glucose <40 mg/dL needs feeding; bolus if symptomatic (AAP). Clinical priority:
Hypoglycemia prevention.
Question 8: A 30-year-old gravida 1 at 8 weeks has vaginal spotting. What is the priority
test?
A. Ultrasound
B. Quantitative hCG
C. Progesterone level
D. Pap smear
Correct Answer: B. Quantitative hCG
Rationale: Serial hCG assesses viability (>50% rise) (ACOG). Clinical priority: Rule out
ectopic.
Question 9: A 6-year-old has a fever, sore throat, and strawberry tongue. What is the
diagnosis?
A. Strep throat
B. Scarlet fever
C. Measles
D. Hand-foot-mouth
Correct Answer: B. Scarlet fever
Rationale: Group A strep with exotoxin; penicillin (AAP). Clinical priority: Prevent rheumatic
fever.
Question 10: A 2-week-old has poor feeding and jaundice. What is the priority lab?
A. Bilirubin
B. CBC
C. TSH
D. Electrolytes
Correct Answer: A. Bilirubin
Rationale: Jaundice at 2 weeks pathologic; >15 mg/dL needs phototherapy (AAP). Clinical
priority: Bilirubin toxicity prevention.
2025/2026 – 100% Verified Questions
with OB/GYN Clinical Rationales
This HESI RN Maternity exam for 2025 includes 50 verified questions covering antepartum,
intrapartum, postpartum, and newborn care, with OB/GYN clinical rationales based on ACOG,
AWHONN, and AAP guidelines. Questions are scenario-based, with four options, correct
answer in RED, and rationales emphasizing clinical priorities and safety.
Question 1: A 26-year-old gravida 1 at 12 weeks gestation presents for her first prenatal
visit. What is the priority component of the initial assessment?
A. Fundal height measurement
B. Complete history including medical, surgical, and psychosocial
C. Non-stress test
D. Group B Streptococcus screening
Correct Answer: B. Complete history including medical, surgical, and psychosocial
Rationale: Comprehensive history identifies risks like domestic violence or genetic factors
(ACOG). Fundal height later; NST third trimester; GBS at 36 weeks. Clinical priority: Risk
assessment.
Question 2: A 34-year-old gravida 2, para 1 at 38 weeks gestation reports contractions
every 5 minutes. Cervical exam shows 4 cm dilation and 80% effacement. What is the
priority action?
A. Discharge home
B. Admit for labor
C. Administer tocolytics
D. Perform fetal monitoring
Correct Answer: B. Admit for labor
Rationale: 4 cm dilation indicates active labor; admission for monitoring (ACOG). Tocolytics
contraindicated. Clinical priority: Labor progression.
Question 3: A postpartum client on day 1 after vaginal delivery has a boggy uterus. What is
the priority intervention?
,A. Administer oxytocin
B. Perform fundal massage
C. Assess lochia
D. Empty bladder
Correct Answer: B. Perform fundal massage
Rationale: Massage stimulates contractions to control bleeding from atony (AWHONN).
Oxytocin adjunct; bladder (D) if distended. Clinical priority: Hemorrhage prevention.
Question 4: A newborn at 1 minute has an Apgar score of 3. What is the priority
intervention?
A. Suction mouth and nose
B. Positive pressure ventilation
C. Chest compressions
D. Intubation
Correct Answer: B. Positive pressure ventilation
Rationale: Apgar <4 with HR <100 requires PPV (NRP). Clinical priority: Resuscitation.
Question 5: A 32-year-old gravida 1 at 28 weeks has preterm labor. What is the priority
intervention?
A. Tocolytics
B. Betamethasone
C. Magnesium sulfate
D. Bed rest
Correct Answer: B. Betamethasone
Rationale: Steroids enhance fetal lung maturity at 24-34 weeks (ACOG). Clinical priority: Fetal
lung development.
Question 6: A 2-day postpartum woman has heavy lochia rubra soaking a pad hourly.
What is the priority action?
A. Fundal massage
B. Assess bladder
C. Administer tranexamic acid
D. Check hemoglobin
Correct Answer: B. Assess bladder
Rationale: Full bladder causes atony; empty first (AWHONN). Clinical priority: Uterine tone.
Question 7: A newborn has a capillary blood glucose of 35 mg/dL at 2 hours. What is the
priority intervention?
, A. Breastfeed or formula feed
B. D10W bolus
C. Monitor only
D. Refer to NICU
Correct Answer: A. Breastfeed or formula feed
Rationale: Glucose <40 mg/dL needs feeding; bolus if symptomatic (AAP). Clinical priority:
Hypoglycemia prevention.
Question 8: A 30-year-old gravida 1 at 8 weeks has vaginal spotting. What is the priority
test?
A. Ultrasound
B. Quantitative hCG
C. Progesterone level
D. Pap smear
Correct Answer: B. Quantitative hCG
Rationale: Serial hCG assesses viability (>50% rise) (ACOG). Clinical priority: Rule out
ectopic.
Question 9: A 6-year-old has a fever, sore throat, and strawberry tongue. What is the
diagnosis?
A. Strep throat
B. Scarlet fever
C. Measles
D. Hand-foot-mouth
Correct Answer: B. Scarlet fever
Rationale: Group A strep with exotoxin; penicillin (AAP). Clinical priority: Prevent rheumatic
fever.
Question 10: A 2-week-old has poor feeding and jaundice. What is the priority lab?
A. Bilirubin
B. CBC
C. TSH
D. Electrolytes
Correct Answer: A. Bilirubin
Rationale: Jaundice at 2 weeks pathologic; >15 mg/dL needs phototherapy (AAP). Clinical
priority: Bilirubin toxicity prevention.
