HESI RN Maternity
Exam | 2025/2026
Verified Questions &
Rationales
Question 1
A 26-year-old G1P0 at 12 weeks gestation reports nausea and vomiting. The nurse
should recommend which dietary modification to manage symptoms? A. Eat small,
frequent meals low in fat B. Consume large meals three times daily C. Avoid fluids
with meals D. Limit carbohydrate intake
A. Eat small, frequent meals low in fat
Rationale: Small, frequent low-fat meals reduce gastric distension and acid
production, alleviating nausea per ACOG 2025 guidelines. Safety includes
monitoring weight to prevent dehydration; ginger or vitamin B6 as adjuncts if
severe.
Question 2
A nurse is assessing a 32-year-old G2P1 at 36 weeks gestation with a blood
pressure of 148/92 mm Hg. This finding is consistent with: A. Normal pregnancy
hypertension B. Severe preeclampsia C. Gestational hypertension D. Chronic
hypertension
C. Gestational hypertension
Rationale: BP ≥140/90 mm Hg after 20 weeks without proteinuria is gestational
hypertension, requiring weekly monitoring per ACOG 2025. Safety prioritizes fetal
surveillance to prevent progression to preeclampsia.
,Question 3
During labor, a 28-year-old G3P2 is at 6 cm dilation with contractions every 3
minutes. The nurse identifies this as: A. Latent phase B. Active phase C.
Transition phase D. Second stage
B. Active phase
Rationale: Active labor (4-7 cm, contractions q3-5 min) accelerates dilation;
continuous FHR monitoring ensures safety per AWHONN 2025, detecting non -
reassuring patterns early.
Question 4
A postpartum woman at 2 days after cesarean delivery reports leg pain. The nurse
suspects deep vein thrombosis. Priority action is: A. Apply heat to the leg B.
Measure calf circumference and notify provider C. Encourage ambulation D.
Administer acetaminophen
B. Measure calf circumference and notify provider
Rationale: DVT post-cesarean risk (immobility, hypercoagulability); bilateral
measurement detects asymmetry, prompting Doppler US per ACOG 2025 for
prompt anticoagulation.
Question 5
A 22-year-old at 12 weeks gestation requests genetic screening. The nurse
recommends: A. Amniocentesis B. Non-invasive prenatal testing (NIPT) C.
Chorionic villus sampling D. Quad screen
B. Non-invasive prenatal testing (NIPT)
Rationale: NIPT (cfDNA) screens aneuploidy at 10+ weeks with high
sensitivity/low risk per ACOG 2025, ideal for early reassurance; invasive tests if
positive.
Question 6
, A 30-year-old G1P0 in active labor at 5 cm dilation requests an epidural. The nurse
should: A. Delay until 7 cm B. Assess for hypotension risk post-placement C.
Encourage non-pharmacologic methods D. Administer before request
B. Assess for hypotension risk post-placement
Rationale: Epidural causes sympathetic block, dropping BP; left lateral
position/fluids prevent fetal distress per AWHONN 2025 safety protocols.
Question 7
A 4-day postpartum woman breastfeeding reports nipple soreness. The nurse
recommends: A. Apply lanolin cream before feeding B. Ensure proper latch and
air-dry after feeding C. Use nipple shields continuously D. Pump exclusively
B. Ensure proper latch and air-dry after feeding
Rationale: Poor latch causes cracking; correct positioning prevents mastitis per
AAP 2025. Safety includes infection watch.
Question 8
A 16-year-old at 20 weeks gestation with anemia (Hb 9.5 g/dL). Per ACOG 2025,
supplement: A. Iron 30 mg daily B. Iron 60 mg daily C. Vitamin C only D. No
supplement
B. Iron 60 mg daily
Rationale: Therapeutic for Hb <11 g/dL; ferrous sulfate with vitamin C enhances
absorption, monitoring GI tolerance.
Question 9
A nurse is monitoring a woman in labor with meconium-stained amniotic fluid.
Priority is: A. Continuous external monitoring B. Prepare for suctioning at
delivery C. Amnioinfusion D. Oxytocin augmentation
B. Prepare for suctioning at delivery
Rationale: Meconium aspiration risk; intrapartum suction if depressed per NRP
2025.
Exam | 2025/2026
Verified Questions &
Rationales
Question 1
A 26-year-old G1P0 at 12 weeks gestation reports nausea and vomiting. The nurse
should recommend which dietary modification to manage symptoms? A. Eat small,
frequent meals low in fat B. Consume large meals three times daily C. Avoid fluids
with meals D. Limit carbohydrate intake
A. Eat small, frequent meals low in fat
Rationale: Small, frequent low-fat meals reduce gastric distension and acid
production, alleviating nausea per ACOG 2025 guidelines. Safety includes
monitoring weight to prevent dehydration; ginger or vitamin B6 as adjuncts if
severe.
Question 2
A nurse is assessing a 32-year-old G2P1 at 36 weeks gestation with a blood
pressure of 148/92 mm Hg. This finding is consistent with: A. Normal pregnancy
hypertension B. Severe preeclampsia C. Gestational hypertension D. Chronic
hypertension
C. Gestational hypertension
Rationale: BP ≥140/90 mm Hg after 20 weeks without proteinuria is gestational
hypertension, requiring weekly monitoring per ACOG 2025. Safety prioritizes fetal
surveillance to prevent progression to preeclampsia.
,Question 3
During labor, a 28-year-old G3P2 is at 6 cm dilation with contractions every 3
minutes. The nurse identifies this as: A. Latent phase B. Active phase C.
Transition phase D. Second stage
B. Active phase
Rationale: Active labor (4-7 cm, contractions q3-5 min) accelerates dilation;
continuous FHR monitoring ensures safety per AWHONN 2025, detecting non -
reassuring patterns early.
Question 4
A postpartum woman at 2 days after cesarean delivery reports leg pain. The nurse
suspects deep vein thrombosis. Priority action is: A. Apply heat to the leg B.
Measure calf circumference and notify provider C. Encourage ambulation D.
Administer acetaminophen
B. Measure calf circumference and notify provider
Rationale: DVT post-cesarean risk (immobility, hypercoagulability); bilateral
measurement detects asymmetry, prompting Doppler US per ACOG 2025 for
prompt anticoagulation.
Question 5
A 22-year-old at 12 weeks gestation requests genetic screening. The nurse
recommends: A. Amniocentesis B. Non-invasive prenatal testing (NIPT) C.
Chorionic villus sampling D. Quad screen
B. Non-invasive prenatal testing (NIPT)
Rationale: NIPT (cfDNA) screens aneuploidy at 10+ weeks with high
sensitivity/low risk per ACOG 2025, ideal for early reassurance; invasive tests if
positive.
Question 6
, A 30-year-old G1P0 in active labor at 5 cm dilation requests an epidural. The nurse
should: A. Delay until 7 cm B. Assess for hypotension risk post-placement C.
Encourage non-pharmacologic methods D. Administer before request
B. Assess for hypotension risk post-placement
Rationale: Epidural causes sympathetic block, dropping BP; left lateral
position/fluids prevent fetal distress per AWHONN 2025 safety protocols.
Question 7
A 4-day postpartum woman breastfeeding reports nipple soreness. The nurse
recommends: A. Apply lanolin cream before feeding B. Ensure proper latch and
air-dry after feeding C. Use nipple shields continuously D. Pump exclusively
B. Ensure proper latch and air-dry after feeding
Rationale: Poor latch causes cracking; correct positioning prevents mastitis per
AAP 2025. Safety includes infection watch.
Question 8
A 16-year-old at 20 weeks gestation with anemia (Hb 9.5 g/dL). Per ACOG 2025,
supplement: A. Iron 30 mg daily B. Iron 60 mg daily C. Vitamin C only D. No
supplement
B. Iron 60 mg daily
Rationale: Therapeutic for Hb <11 g/dL; ferrous sulfate with vitamin C enhances
absorption, monitoring GI tolerance.
Question 9
A nurse is monitoring a woman in labor with meconium-stained amniotic fluid.
Priority is: A. Continuous external monitoring B. Prepare for suctioning at
delivery C. Amnioinfusion D. Oxytocin augmentation
B. Prepare for suctioning at delivery
Rationale: Meconium aspiration risk; intrapartum suction if depressed per NRP
2025.
