HESI PN Maternal-Newborn Exam
2025/2026 Verified Questions & Answers
Questions 1-15: Postpartum
Question 1: Postpartum
A 28-year-old primipara is 6 hours postpartum after a vaginal delivery with a midline
episiotomy. She reports perineal pain rated 7/10 and is reluctant to ambulate. The nurse's priority
assessment is:
A. Fundal height and lochia
B. Signs of hematoma formation at the episiotomy site
C. Breast tenderness
D. Bowel sounds
B. Signs of hematoma formation at the episiotomy site
Rationale: Postpartum hemorrhage from vessel rupture can cause hematoma, a surgical site
complication prioritized in the first 24 hours per AWHONN guidelines. Early detection via
inspection (ecchymosis, swelling) ensures safety by prompting ice, binder, or surgical
evacuation, preventing infection or extension.
Question 2: Postpartum
A client 2 days postpartum after cesarean delivery has a temperature of 100.4°F (38°C). Uterus is
firm at the umbilicus with moderate lochia rubra. The nurse suspects:
A. Endometritis
B. Postoperative atelectasis from shallow breathing
C. Urinary tract infection
D. Mastitis
B. Postoperative atelectasis from shallow breathing
Rationale: Low-grade fever in early postpartum cesarean recovery often stems from atelectasis
due to anesthesia and pain-limited respiration. ACOG emphasizes incentive spirometry and
,ambulation for prevention, ensuring pulmonary safety without unnecessary antibiotics that risk
resistance.
Question 3: Postpartum
During a home visit on day 3 postpartum, the client reports "blues" with tearfulness and
irritability. Vital signs are stable, and bonding is evident. The nurse's best response is:
A. Refer to psychiatry
B. Reassure that this is common and resolves in 10-14 days; provide coping strategies
C. Prescribe antidepressants
D. Assess for suicidal ideation only
B. Reassure that this is common and resolves in 10-14 days; provide coping strategies
Rationale: Baby blues affect 70-80% of new mothers due to hormonal shifts; APA guidelines
support normalization and non-pharmacologic support (e.g., rest, social support) for
self-resolution, promoting family-centered care and preventing escalation to PPD.
Question 4: Postpartum
A 32-year-old multipara 12 hours postpartum has a boggy uterus at the umbilicus with heavy
lochia. Fundal massage is performed. The next action is:
A. Administer methylergonovine
B. Express clots and encourage voiding to empty the bladder
C. Prepare for D&C
D. Increase IV fluids
B. Express clots and encourage voiding to empty the bladder
Rationale: Bladder distention displaces the uterus, causing atony and hemorrhage (primary
cause in 20% of PPH). AWHONN protocols prioritize non-pharmacologic measures like
massage and catheterization for uterine contraction, enhancing safety before uterotonics.
Question 5: Postpartum
A client 1 week postpartum after VBAC reports severe headache and blurred vision when sitting
up. BP is 160/100 mmHg. The nurse recognizes this as:
A. Migraine exacerbation
B. Postpartum preeclampsia
, C. Dehydration
D. Normal fatigue
B. Postpartum preeclampsia
Rationale: Preeclampsia can onset up to 6 weeks postpartum; ACOG mandates magnesium
sulfate and antihypertensives for seizure prevention, with urgent evaluation ensuring maternal
safety in this delayed hypertensive window.
Question 6: Postpartum
During discharge teaching, a client asks about resuming intercourse 4 days postpartum. The
nurse explains:
A. Safe immediately if no pain
B. Wait 4-6 weeks or until lochia ceases and follow-up confirms healing
C. Use condoms only
D. Avoid until 3 months
B. Wait 4-6 weeks or until lochia ceases and follow-up confirms healing
Rationale: Cervix closure and endometrial regeneration take 4-6 weeks; ACOG guidelines
prevent infection (endometritis risk) and promote contraception counseling, supporting
reproductive health and STI prevention.
Question 7: Postpartum
A 25-year-old G2P2 client has a hemoglobin of 8.5 g/dL on day 2 postpartum. She is
asymptomatic. The intervention is:
A. Transfuse PRBCs
B. Oral iron supplementation and dietary teaching
C. IV iron sucrose
D. Observation only
B. Oral iron supplementation and dietary teaching
Rationale: Physiologic nadir from hemodilution; ACOG recommends 65 mg elemental iron
daily with heme sources for repletion, avoiding transfusion risks in stable clients to support
energy and bonding.
Question 8: Postpartum
2025/2026 Verified Questions & Answers
Questions 1-15: Postpartum
Question 1: Postpartum
A 28-year-old primipara is 6 hours postpartum after a vaginal delivery with a midline
episiotomy. She reports perineal pain rated 7/10 and is reluctant to ambulate. The nurse's priority
assessment is:
A. Fundal height and lochia
B. Signs of hematoma formation at the episiotomy site
C. Breast tenderness
D. Bowel sounds
B. Signs of hematoma formation at the episiotomy site
Rationale: Postpartum hemorrhage from vessel rupture can cause hematoma, a surgical site
complication prioritized in the first 24 hours per AWHONN guidelines. Early detection via
inspection (ecchymosis, swelling) ensures safety by prompting ice, binder, or surgical
evacuation, preventing infection or extension.
Question 2: Postpartum
A client 2 days postpartum after cesarean delivery has a temperature of 100.4°F (38°C). Uterus is
firm at the umbilicus with moderate lochia rubra. The nurse suspects:
A. Endometritis
B. Postoperative atelectasis from shallow breathing
C. Urinary tract infection
D. Mastitis
B. Postoperative atelectasis from shallow breathing
Rationale: Low-grade fever in early postpartum cesarean recovery often stems from atelectasis
due to anesthesia and pain-limited respiration. ACOG emphasizes incentive spirometry and
,ambulation for prevention, ensuring pulmonary safety without unnecessary antibiotics that risk
resistance.
Question 3: Postpartum
During a home visit on day 3 postpartum, the client reports "blues" with tearfulness and
irritability. Vital signs are stable, and bonding is evident. The nurse's best response is:
A. Refer to psychiatry
B. Reassure that this is common and resolves in 10-14 days; provide coping strategies
C. Prescribe antidepressants
D. Assess for suicidal ideation only
B. Reassure that this is common and resolves in 10-14 days; provide coping strategies
Rationale: Baby blues affect 70-80% of new mothers due to hormonal shifts; APA guidelines
support normalization and non-pharmacologic support (e.g., rest, social support) for
self-resolution, promoting family-centered care and preventing escalation to PPD.
Question 4: Postpartum
A 32-year-old multipara 12 hours postpartum has a boggy uterus at the umbilicus with heavy
lochia. Fundal massage is performed. The next action is:
A. Administer methylergonovine
B. Express clots and encourage voiding to empty the bladder
C. Prepare for D&C
D. Increase IV fluids
B. Express clots and encourage voiding to empty the bladder
Rationale: Bladder distention displaces the uterus, causing atony and hemorrhage (primary
cause in 20% of PPH). AWHONN protocols prioritize non-pharmacologic measures like
massage and catheterization for uterine contraction, enhancing safety before uterotonics.
Question 5: Postpartum
A client 1 week postpartum after VBAC reports severe headache and blurred vision when sitting
up. BP is 160/100 mmHg. The nurse recognizes this as:
A. Migraine exacerbation
B. Postpartum preeclampsia
, C. Dehydration
D. Normal fatigue
B. Postpartum preeclampsia
Rationale: Preeclampsia can onset up to 6 weeks postpartum; ACOG mandates magnesium
sulfate and antihypertensives for seizure prevention, with urgent evaluation ensuring maternal
safety in this delayed hypertensive window.
Question 6: Postpartum
During discharge teaching, a client asks about resuming intercourse 4 days postpartum. The
nurse explains:
A. Safe immediately if no pain
B. Wait 4-6 weeks or until lochia ceases and follow-up confirms healing
C. Use condoms only
D. Avoid until 3 months
B. Wait 4-6 weeks or until lochia ceases and follow-up confirms healing
Rationale: Cervix closure and endometrial regeneration take 4-6 weeks; ACOG guidelines
prevent infection (endometritis risk) and promote contraception counseling, supporting
reproductive health and STI prevention.
Question 7: Postpartum
A 25-year-old G2P2 client has a hemoglobin of 8.5 g/dL on day 2 postpartum. She is
asymptomatic. The intervention is:
A. Transfuse PRBCs
B. Oral iron supplementation and dietary teaching
C. IV iron sucrose
D. Observation only
B. Oral iron supplementation and dietary teaching
Rationale: Physiologic nadir from hemodilution; ACOG recommends 65 mg elemental iron
daily with heme sources for repletion, avoiding transfusion risks in stable clients to support
energy and bonding.
Question 8: Postpartum
