HESI MATERNITY/OB PRACTICE EXAM
1. A laboring client is 6 cm dilated and states she feels
increasing pressure and needs to push. What is the nurse’s
best action?
A. Encourage pushing
B. Administer pain medication
C. Perform a sterile vaginal exam
D. Prepare for delivery
Rationale: Pressure may indicate rapid progress; a sterile
exam confirms dilation before pushing is allowed.
2. A postpartum client has saturated a peripad in 30 minutes.
What should the nurse do first?
A. Call the provider
B. Massage the fundus
C. Increase IV fluids
D. Apply oxygen
Rationale: Uterine atony is the most common cause of
postpartum hemorrhage; fundal massage addresses it
immediately.
,3. Which fetal heart rate pattern requires immediate
intervention?
A. Early decelerations
B. Accelerations
C. Moderate variability
D. Recurrent late decelerations
Rationale: Late decelerations reflect uteroplacental
insufficiency and require prompt corrective actions.
4. A client at 10 weeks reports spotting and mild cramping.
What is the priority?
A. Reassure it is normal
B. Assess for ectopic pregnancy
C. Recommend bed rest
D. Obtain fundal height
Rationale: First-trimester bleeding with pain may indicate
ectopic pregnancy, a life-threatening condition.
5. A newborn with cold stress may show which finding?
A. Hyperglycemia
B. Hypoglycemia
C. Bradycardia
D. Respiratory alkalosis
,Rationale: Cold stress increases metabolic demands leading to
rapid glucose depletion.
6. A nurse suspects true labor. Which finding supports this?
A. Contractions stop with walking
B. Irregular contractions
C. Cervical change
D. Pain relieved with hydration
Rationale: True labor is confirmed by progressive cervical
dilation and effacement.
7. Which newborn reflex occurs when the cheek is stroked?
A. Moro
B. Rooting
C. Babinski
D. Tonic neck
Rationale: Rooting helps locate the nipple for feeding.
8. The nurse notes foul-smelling lochia on day 4 postpartum.
What does this indicate?
A. Normal finding
B. Infection
, C. Hemorrhage
D. Retained placenta
Rationale: Lochia should not be foul-smelling; odor strongly
suggests infection.
9. A pregnant client with severe preeclampsia is on
magnesium sulfate. Which finding requires immediate action?
A. 2+ deep tendon reflexes
B. Respirations 10/min
C. Urine output 40 mL/hr
D. Warm, flushed skin
Rationale: Magnesium toxicity causes respiratory depression;
<12 breaths/min is critical.
10. Which assessment indicates a possible placental
abruption?
A. Painless vaginal bleeding
B. Rigid, board-like abdomen
C. Cessation of contractions
D. Foul-smelling discharge
Rationale: Aboard-like abdomen and pain occur with
concealed bleeding in abruption.
1. A laboring client is 6 cm dilated and states she feels
increasing pressure and needs to push. What is the nurse’s
best action?
A. Encourage pushing
B. Administer pain medication
C. Perform a sterile vaginal exam
D. Prepare for delivery
Rationale: Pressure may indicate rapid progress; a sterile
exam confirms dilation before pushing is allowed.
2. A postpartum client has saturated a peripad in 30 minutes.
What should the nurse do first?
A. Call the provider
B. Massage the fundus
C. Increase IV fluids
D. Apply oxygen
Rationale: Uterine atony is the most common cause of
postpartum hemorrhage; fundal massage addresses it
immediately.
,3. Which fetal heart rate pattern requires immediate
intervention?
A. Early decelerations
B. Accelerations
C. Moderate variability
D. Recurrent late decelerations
Rationale: Late decelerations reflect uteroplacental
insufficiency and require prompt corrective actions.
4. A client at 10 weeks reports spotting and mild cramping.
What is the priority?
A. Reassure it is normal
B. Assess for ectopic pregnancy
C. Recommend bed rest
D. Obtain fundal height
Rationale: First-trimester bleeding with pain may indicate
ectopic pregnancy, a life-threatening condition.
5. A newborn with cold stress may show which finding?
A. Hyperglycemia
B. Hypoglycemia
C. Bradycardia
D. Respiratory alkalosis
,Rationale: Cold stress increases metabolic demands leading to
rapid glucose depletion.
6. A nurse suspects true labor. Which finding supports this?
A. Contractions stop with walking
B. Irregular contractions
C. Cervical change
D. Pain relieved with hydration
Rationale: True labor is confirmed by progressive cervical
dilation and effacement.
7. Which newborn reflex occurs when the cheek is stroked?
A. Moro
B. Rooting
C. Babinski
D. Tonic neck
Rationale: Rooting helps locate the nipple for feeding.
8. The nurse notes foul-smelling lochia on day 4 postpartum.
What does this indicate?
A. Normal finding
B. Infection
, C. Hemorrhage
D. Retained placenta
Rationale: Lochia should not be foul-smelling; odor strongly
suggests infection.
9. A pregnant client with severe preeclampsia is on
magnesium sulfate. Which finding requires immediate action?
A. 2+ deep tendon reflexes
B. Respirations 10/min
C. Urine output 40 mL/hr
D. Warm, flushed skin
Rationale: Magnesium toxicity causes respiratory depression;
<12 breaths/min is critical.
10. Which assessment indicates a possible placental
abruption?
A. Painless vaginal bleeding
B. Rigid, board-like abdomen
C. Cessation of contractions
D. Foul-smelling discharge
Rationale: Aboard-like abdomen and pain occur with
concealed bleeding in abruption.
