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HESI OB MATERNITY EXAM WITH 70+
CORRECT QUESTIONS AND ANSWERS
PASSING RATE HIGH FOR 2025
A 16 year old gravida 1, para 0 client has just been admitted to the hospital with a diagnosis of eclampsia. She is not presently convulsing. Which intervention should the nurse plan to include in this client's nursing care plan? A. Assess temperature every hour. B. Monitor blood pressure, pulse, and respirations every 4 hours. C. Keep an airway at the bedside. D. Allow family visitation - ANSWERKeep an airway at the bedside A 17 year old client gave birth 12 hours ago she states that she doesn't know how to care for her baby. To promote parent infant attachment behaviors which intervention should the nurse implement. A. Ask if she has help to care for the baby at home. B. Provide a video on newborn safety and care. C. Explored the basis of fears with the client. D. Encourage rooming in while in the hospital. - ANSWEREncourage rooming in while in the hospital A 3-hour old male infants hands and feet as cyanotic, and has an axillary temperature of 96.5 degrees Fahrenheit 35.8 degrees centigrade a respiratory rate of 40 breaths per minute and a heart rate of 165 beats per minute what nursing action should nurse implement. A Administer oxygen by mouth at 2L/min B Gradually warm the infant under a radiant heat source. C Notify the pediatrician of the infant's vital signs D Perform a heel-stick to maintain blood glucose level - ANSWERGradually warm the infant under a radiant heat source
A 30- year-old primigravida delivers a 9-pound infant vaginally after a 30- hour labor. What is the priority nursing action for this client? A. Gently massage the fundus every 4 hours. B. Observe for signs of uterine hemorrhage. C. Encourage direct contact with the infant. D. Assess the blood pressure for hypertension. - ANSWERObserve for signs of uterine hemorrhage. A 38-week primigravida is admitted to labor and delivert after a non-reactive stress test (NST). The nurse begins a contraction stress test (CST) with an oxytocin infusion. Which finding is most important for the nurse to report to the health care provider. A. A pattern of fetal late decelerations. B. Fetal heart rate accelerations with fetal movement. C. Absence of uterine contractions within 20 minutes. D. Spontaneous rupture of membranes. - ANSWERA pattern of fetal late decelerations A client at 30 weeks gestation reports that she has not felt the baby move in the last 24 hours. Concerned she arrives in a panic at the obstetric clinic where she is immediately sent to the hospital. which assessment warrants immediate intervention by the nurse. A Fetal Heart rate 60 beats per minute B Ruptured amniotic membrane C onset of uterine contractions D leaking amniotic fluid. - ANSWERFetal Heart rate 60 beats per minute A client at 31 weeks gestation with a fundal height measurement of 25 c is scheduled for a series of ultrasounds to be performed every two weeks. Which explanation should the nurse provide. A. Assessment for congenital anomalies. B. Recalculation of gestational age. C. Evaluation of fetal growth. D. Determination of fetal presentation. - ANSWEREvaluation of fetal growth
A client in the first trimester of pregnancy calls the prenatal clinic to report she's nauseated, and her stools are black and thick since she started taking iron supplements last week. How should the nurse respond? select all that applies. A. Come to the clinic today. B. Drink a full glass of tea with each iron tablet. C. Increase the consumption of milk while taking iron. D. Changes in color and consistency of stool are normal. E. Take iron supplement at bedtime. - ANSWERChanges in color and consistency of stool are normal A client tells the nurse she thinks she's pregnant. Which signs or symptoms provide the best indication that the client is pregnant. A. Morning sickness. B. Breast tenderness. C. Amenorrhea D. Hegar's Sign - ANSWERAmenorrhea A client who delivered a healthy newborn an hour ago asked the nurse when can she go home. Which information is most important for the nurse to provide the client. A After the baby no longer demonstrates acrocyanosis. B After the vitamin K injection is given to the baby. C When ambulating to avoid does not cause dizziness. D When there is no significant vaginal bleeding. - ANSWERWhen there is no significant vaginal bleeding A client who had her first baby three months ago and is breastfeeding her infant tells the nurse that she is currently using the same diaphragm that she used before becoming pregnant. Which information should the nurse provide this client? A. After ceasing breastfeeding, the diaphragm should be resized. B. Avoid intercourse during ovulation until the size of the diaphragm has been evaluated. C. If no more than 20 pounds was gained during pregnancy, the diaphragm is safe to use.
D. Use an alternate form of contraceptive until a new diaphragm is obtained. - ANSWERUse an alternate form of contraceptive until a new diaphragm is obtained. A client who is 24 weeks gestatoin arrives to the clinic reporting swollen hands. On examination the nurse notes the clients as had a rapid weight gain over six weeks. which action should a nurse implements next? A. Review previous blood pressures in the chart. B. Obtain the clients blood pressure. C. Observe and time the client's contractions. Examined the client for pedal edema. D. Examine the client for pedal edema - ANSWERObtain the clients blood pressure A client who is 32 weeks gestation arrives at the clinic reporting nausea and vomiting for the past 24 hours. The nurse reviews the records and observes there has been a rapid weight gain over 6 weeks. Which action should the nurse implement next? A. Ask for a 24 hour diet recall. B. Obtain a blood pressure. C. Inspect for pedal edema. D. Listen to fetal heart rate. - ANSWERObtain a blood pressure A client with 26 weeks gestation was informed this morning that she has an elevated alpha fetal protein (AFP) level. After the health care provider leaves the room, the client asks what she should do next. What information should the nurse provide. A. Reassured the client that the AFP results are likely to be a false reading. B. Explain that his sonogram should be scheduled for definitive results. C. Inform her that a repeat alpha fetoprotein AFP should be evaluated. D. Discuss options for intrauterine surgical correction of congenital defects. - ANSWERExplain that his sonogram should be scheduled for definitive results. A gravida 3 para 3 who is Rh negative delivers a full infant at home with assistance of a nurse midwife. Two days later, the client calls the clinic to ask if it is necessary to see the health care provider since the infant is healthy, and she is not having any complications. The woman's history indicates that both previously born infants were Rh-negative. A.The newborn's blood type should be tested to determine the need for RhoGAM
B. "That is called caput succedaneum. It will absorb and cause no problems." C. "That is called a cephalhematoma. It will cause no problems." D. "That is called a cephalhematoma. It can cause jaundice as it is absorbed." - ANSWERThat is called caput succedaneum. It will absorb and cause no problems A new mother who is a lacto-ovo vegetarian plans to breast feed her infant. Which information should the nurse provide prior to discharge? A Continue prenatal vitamins with B12 While breastfeeding B Avoid using Lanolin-based nipple cream or ointment. C Offer iron fortified supplemental formula daily. D Weigh the baby weekly to evaluate the newborns growth. - ANSWERContinue prenatal vitamins with B12 While breastfeeding A new mother who is breastfeeding her 4-week-old infant and has type 1 diabetes, reports that her insulin needs have decreased since the birth of her child. Which action should the nurse implement? A. Inform her that a decreased need for insulin occurs while breastfeeding. B. Counsel her to increase her caloric intake. C. Advise the client to breastfeed more frequently. D. Schedule an appointment for the client with the diab - ANSWERInform her that a decreased need for insulin occurs while breastfeeding. A newborn with a respiratory rate of 40 breathes per minute at one minute after birth is demonstrating cyanosis of the hands and feet. What action should a nurse take. A. Assess bowel sounds B. Continue to monitor C. Assist with intubation D. Rub infants back - ANSWERContinue to monitor A newborn's assessment reveals spina bifida occulta. Which maternal factor should the nurse identify as having the greatest impact on the development of this newborn complication? A. Folic acid deficiency
B. Preeclampsia C. Tobacco use D. Short interval pregnancy - ANSWERFolic acid deficiency A newborn's head circumference is 12 inches (30.5cm), and his chest measurement is 13 inches (33cm). The nurse notes that this infant has no molding, and was at breech presentation delivery by c section. What action should the nurse take based on these data? A. No action needs to be taken, it is normal for an infant born by caesarean section to have a small head circumference. B. Notify the pediatrician immediately. These signs support the possibility of hydrocephalus. C. Call these findings to the attention of the pediatrician. The head/chest ratio is abnormal. D. Record the findings on the chart. They are within normal limits. - ANSWERCall these findings to the attention of the pediatrician. The head/chest ratio is abnormal. A newborn's head circumference is 12inches and his chest measurement is 13 inches. The nurse notes that this infant has no molding, and was a breech presentation delivered by Cesarean section. What action should the nurse take based on these data? A. No action need be taken. It is normal for an infant born by Cesarean section to have a small head circumference. B. Notify the pediatrician immediately. These findings support the possibility of hydrocephalus. C. Call these findings to the attention of the pediatrician. The head/chest ratio is abnormal. D. Record the findings on the chart. They are within normal limits. - ANSWERCall these findings to the attention of the pediatrician. The head/chest ratio is abnormal A pregnant client mentions in a history that she changes cats litter box daily. Which test should the nurse anticipate the health care provider to prescribe. A Biophysical profile. B Fern test. C Amniocentesis. D Torch screening. - ANSWERTorch screening
A primipara client at 42 weeks gestation is admitted for induction. within one hour after initiating an oxytocin infusion, her cervix is 100% effaced and 6 cm dilated, contractions are occurring every 1 minute with a 75 second duration. when nurse stops the oxytocin and starts oxygen. After 30 minutes of uterine rest, the contractions are occurring every 5 minutes with 20 second duration. Which intervention should the nurse implement? A. Notify nursery about the client's response. B. Check for clonus in both feet. C. Stop oxygen per cannula. D. Restart oxytocin infusion rate per protocol. - ANSWERRestart oxytocin infusion rate per protocol A primiparous woman presents in labor with the following labs. hemoglobin 10.9 g/dl (109 g/dl) Hematocrit 29% (0.29) hepatitis surface antigen positive, Group B Streptococcus positive and rubella non-immune. which intervention should the nurse implement? A. Transfuse 2 units packs red blood cells. B. Give measles mumps rubella vaccine 0.5 ML. C. Administer ampicillin 2 grams intravenously. D. Inject hepatitis B immune globulin 0.5 milliliters. - ANSWERAdminister ampicillin 2 grams intravenously A woman in her third trimester of pregnancy has been in active labor for the past 8 hours and has dilated 3cm. The nurse's assessment findings and electronic fetal monitoring(EFM) are consistent with hypotonic dystocia, and the healthcare provider prescribed and oxytocin drip. Which data is most important for the nurse to monitor? A. Preparation for emergency cesarean birth. B. Client's hourly blood pressure. C. Checking the perineum for bulging. D. Intensity, interval, and length of contractions. - ANSWERIntensity, interval, and length of contractions. A woman who is 38 weeks gestation is receiving magnesium sulfate for severe preeclampsia. Which assessment finding warrants immediate intervention by the nurse? A. Dizziness when standing. B. Sinus tachycardia.
C. Absent patellar reflexes. D. Lower back pain. - ANSWERAbsent patellar reflexes A woman who is trying to get pregnant tells the nurse that she was very disappointed several months ago when she was informed that her positive pregnancy test was a false positive. Which method of testing provides the greatest degree of accuracy? A. Visualization of implantation by vaginal ultrasound. B. Presence of amenorrhea for 2 months. C. Maternal blood serum tests positive for alpha-fetoprotein. D. Complaints of feeling tired all of the time. - ANSWERVisualization of implantation by vaginal ultrasound An ambulatory client at 39-weeks gestation presents to the emergency center with an obvious injury to her arm that occurred as the result of a fall. Which concurrent symptom is a priority for the nurse to assess. A. Ecchymotic knees. B. Dribbling urine. C. 1+ pedal edema. D. Pain in the forearm. - ANSWEREcchymotic knees An unlicensed assistive personnel (UAP) reports to the charge nurse that a client who delivers a 7- pound infant 12 hours ago is reporting a severe headache. The client blood pressure is 110/70 mmHg, respiratory rate is 18 breaths/minute, heart rate is 74 bpm, and temperature is 98.6F. The client's fundus is firm and one fingerbreadth above the umbilicus. Which action should the charge nurse implement first? A. Notify the healthcare provider of the assessment findings. B. Obtain a STAT hemoglobin and hematocrit. C. Assign a practical nurse (PN) to reassess the client's vital signs. D. Determine if the client received anesthesia during delivery. - ANSWERDetermine if the client received anesthesia during delivery
Following a minor motor vehicle collision, a client at 36-weeks gestation is brought to the emergency center. She is lying supine on a backboard, is awake, and denies any complaints. Her blood pressure is 80/50 mmHg and heart rate is 130 bpm. Which action should the nurse implement first? A. Palpate the abdomen for contractions. B. Tilt the backboard sideways to displace the uterus laterally. C. Obtain a blood sample for complete blood count. D. Infuse 1,000 mL normal saline using a large bare IV. - ANSWERTilt the backboard sideways to displace the uterus laterally Following a traumatic delivery an infant receives an initial Apgar score of 3. which intervention is most important for the nurse to implement. A Page the pediatrician STAT B Continue resuscitative efforts C Repeat the Apgar assessment in 5 minutes D Inform the parents of the infant's condition. - ANSWERContinue resuscitative efforts Four client at full term present to the labor and delivery unit at the same time. which client should a nurse access first. A Multipara with contractions occurring every three minutes. B Multiple scheduled for non stress test and biophysical profile. C Primipara with vaginal show and leaking membranes. D Primipara with burning on urination and urinary frequency. - ANSWERMultipara with contractions occurring every three minutes If primigravida at 36 weeks gestation who is RH negative experienced abdominal trauma in a motor vehicle collision. Which assessment finding is most important for the nurse to report to the health care provider? A Fetal heart rate at 162 beats /minute B Mild contractions every 10 minutes. C Trace of protein in the urine D Positive fetal hemoglobin testing - ANSWERMild contractions every 10 minutes
On the first postpartum day the nurse examines the breast of a new mother. Which condition is the nurse most likely to find. A Firm larger and very tender to touch. B Slightly firm with immediate let-down response. C Soft with no change from before delivery. D Filling and secreting colostrum. - ANSWERFilling and secreting colostrum The healthcare provider prescribes 10 units per liters of oxytocin via IV drip to augment a client's labor because she's experiencing a prolonged active phase. Which finding would cause the nurse to immediately discontinue the oxytocin. A. Contraction duration of 100 seconds. B. For contractions in 10 minutes. C. Uterus is soft. D. Early deceleration of fetal heart rate. - ANSWEREarly deceleration of fetal heart rate The healthcare provider prescribes zidovudine 100mg po 5x daily for a pregnant woman who is HIV positive. The drug is available in a 240mL bottle labeled, "50mg/5mL." How many mL should the nurse administer? A. 8. B. 8 C. 10. D. 10 - ANSWER The more of a breastfeeding 24-hour old infant is very concerned about the techniques involved in breastfeeding. She calls the nurse with each feeding to seek reassurance that she is doing it right she tells the nurse, "Now my daughter is not getting enough to eat" which response would be best for the nurse to make. A. Feed your baby hourly until you feel confident that your child is receiving enough milk. B. Don't worry soon your milk will come in and you will feel how full your breasts are. C. Since you are so concerned you should probably supplement breastfeeding with formula. D. If your baby's urine is straw colored, she's getting enough milk. - ANSWERIf your baby's urine is straw colored, she's getting enough milk
D Encourage pushing with each contraction. - ANSWERPerform a vaginal exam The nurse is caring for a newborn who is 18 inches long, weighs 4 pounds, 14 ounces, has a head circumference of 13 inches, and a chest circumference of 10 inches. Based on these physical findings, assessment for which condition has the highest priority? A. Hyperbilirubinemia B. Polycythemia C. Hyperthermia D. Hypoglycemia - ANSWERHypoglycemia The nurse is caring for a postpartum client who is exhibiting symptoms of a spinal headache 24 hours following delivery of a normal newborn. Prior to the anesthesiologist arrival on the unit, which action should the nurse perform? A. Cleanse the spinal injection site. B. Place procedure equipment at bedside. C. Apply an abdominal binder. D. Insert an indwelling Foley catheter. - ANSWERPlace procedure equipment at bedside The nurse is conducting a home health visit of a client who delivered 3 weeks ago and is formula feeding the infant. Which observations should the nurse find most concerning? A. The client notes infant feeds every 2-3 hours and voids 5-6 times per day. B. The client is in pajama's and infant is freshly bathed. C. Used bottles are in the kitchen and infant is in a swing. D. The clients eyes are red from crying and infant is fussing in the crib. - ANSWERThe clients eyes are red from crying and infant is fussing in the crib The nurse is planning care for a client at 30 weeks gestation who is experiencing preterm labor which maternity description is most important in preventing this fetus from developing respiratory distress syndrome. A Ampicillin 1 gram IV push q8h B Betamethasone 12 mg deep IM C Terbutaline 0.25 mg subcutaneously q 15 minutes X 3
D Butorphanol tartrate 1mg IV push q2h PRN. - ANSWERBetamethasone 12 mg deep IM The nurse is planning discharge teaching for 4 mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period? A. A multiparous client who lives with her husband and his family members. B. A primiparous woman who has recently immigrated to the U.S. with her spouse. C. A multiparous female with a large family living in the community. D. A primiparous adolescent living at home with her parents and significant other. - ANSWERA primiparous woman who has recently immigrated to the U.S. with her spouse The nurse is preparing a young couple and their 24-hour-old infant for discharge from the hospital. In conducting discharge teaching, which intervention is most important for the nurse to implement? A. Ensure that they have the pediatric clinic's phone number. B. Provide the results of the infant's hearing test to the parents. C. Request a return demonstration of a diaper change. D. Evaluate infant feeding technique prior to discharge. - ANSWEREvaluate infant feeding technique prior to discharge The nurse is preparing to administer phytonadione to a newborn. Which statement made by the parents indicates understanding why the nurse is administering this medication? A. Improve insufficient dietary intake. B. Stimulate the immune system. C. Prevent hemorrhagic disorders. D. Help an immature liver. - ANSWERPrevent hemorrhagic disorders. The nurse is providing care for a newborn who was delivered vaginally assisted by forceps. The nurse observes red marks on the head with swelling that does not cross the suture line. Which condition should the nurse documents in the medical record? A Caput succedaneum B Hydrocephalus C Cephalhematoma
D Clots may form inside a boggy uterus and needs to be expelled - ANSWERBoth the lower uterine segment and the fundus must be massaged The nurse's assessment of a preterm infant reveals decreased muscle tone, signs of respiratory difficulty, irritability, and mottled, cool skin. Which intervention should the nurse implement first? A. Assess the infant's blood glucose level. B. Nipple feed 1oz 5% glucose in water. C. Place the infant in a side-lying position. D. Position a radiant warmer over the crib. - ANSWERPosition a radiant warmer over the crib Upon admission to the nursery, the nurse places a newborn supine under a radiant warmer, an external heat source. What intervention should the nurse implement to ensure safe thermoregulation? A. Wrap the infant in two blankets and place the radiant warmer on low. B. Dry the newborn's scalp and place a stockinet cap on the head. C. Move temperature probe over the ribs when turning to a lateral position. D. Place temperature probe on the abdomen in line with the radiant heat source. - ANSWERPlace temperature probe on the abdomen in line with the radiant heat source Using the Ballard Gestational Age Assessment Tool, the nurse determines that a 15-minute old infant has a gestational age of 42-weeks. Based on this finding, which intervention is most important for the nurse to implement? A. Provide blow-by oxygen B. Draw arterial blood gases C. Obtain a capillary blood glucose D. Apply a pulse oximeter to the foot - ANSWERObtain a capillary blood glucose What should be the primary focus of nursing care in the transitional phase of Labor for a client who anticipates an unmedicated delivery. A Assessing the strength of uterine contractions B Re-evaluate the need for medication C Remind her to push 3 times with each contraction.
D Assessing her to maintain control. - ANSWERAssessing the strength of uterine contractions
