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HESI Peds & Maternity Exam 2026/2027 Actual
Exam | 100% Correct Answers | Verified Latest
Update | Pass Guaranteed - A+ Graded
Section 1: Maternity Nursing (50 Questions)
Q1: A pregnant patient at 28 weeks gestation calls the clinic with concerns about fetal movement.
Which of the following instructions is MOST appropriate regarding fetal movement counting?
A. "You should feel at least 10 movements within 2 hours each day." [CORRECT]
B. "Fetal movements decrease significantly in the third trimester, so don't worry."
C. "Only count movements after meals when blood sugar is elevated."
D. "If you don't feel movement for 24 hours, come to the hospital immediately."
Correct Answer: A
Rationale: The standard kick count recommendation is at least 10 fetal movements within a 2-
hour period. Option B is incorrect—movements should not decrease significantly. Option C is
not required. Option D delays evaluation.
Q2: A patient in active labor has a fetal heart rate of 180 bpm. Which of the following is the
FIRST nursing action?
A. Continue monitoring
B. Turn the patient to her left side [CORRECT]
C. Prepare for immediate delivery
D. Administer oxygen at 2 L/min
Correct Answer: B
Rationale: Fetal tachycardia (>160 bpm) may indicate fetal hypoxia. First action is maternal
repositioning (left side) to improve uteroplacental perfusion. Oxygen (D) may be needed but
positioning is first. Immediate delivery (C) is not indicated.
Q3: The APGAR score at 1 minute for a newborn with heart rate 110, irregular respiratory effort,
grimace reflex, some flexion of extremities, and cyanotic body with pink extremities is:
A. 3
B. 5
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C. 7 [CORRECT]
D. 9
Correct Answer: C
Rationale: Heart rate 110 = 2 points; irregular respirations = 1 point; grimace = 2 points; some
flexion = 1 point; acrocyanosis = 1 point. Total = 7. Acrocyanosis is normal at 1 minute.
Q4: A postpartum patient on day 2 has a temperature of 100.4°F (38°C). Which of the following
is the MOST likely cause?
A. Postpartum infection requiring antibiotics
B. Normal postpartum diuresis and dehydration
C. Breast engorgement or normal postpartum inflammatory response [CORRECT]
D. Immediate surgical intervention needed
Correct Answer: C
Rationale: Low-grade fever (≤100.4°F) in first 24 hours may be normal due to dehydration,
breast engorgement, or inflammatory response. Temperature >100.4°F after first 24 hours
suggests infection. This requires monitoring, not immediate antibiotics (A) or surgery (D).
Q5: A pregnant patient at 32 weeks gestation has a blood pressure of 150/95 mmHg and
proteinuria 2+. Which of the following is the priority nursing intervention?
A. Schedule routine prenatal visit in 2 weeks
B. Assess for headache, visual changes, and epigastric pain [CORRECT]
C. Encourage increased sodium intake
D. Recommend bed rest for remainder of pregnancy
Correct Answer: B
Rationale: This patient has preeclampsia (BP ≥140/90 with proteinuria after 20 weeks). Priority
is assessing for severe features: headache, visual changes, epigastric pain. These indicate
possible progression to severe preeclampsia/eclampsia requiring immediate intervention.
Q6: A newborn has a positive Coombs test and elevated bilirubin. The nurse should anticipate:
A. Phototherapy [CORRECT]
B. Immediate exchange transfusion
C. No intervention needed
,3
D. Discharge with home care
Correct Answer: A
Rationale: Positive Coombs indicates hemolytic disease (Rh or ABO incompatibility) causing
jaundice. Phototherapy is first-line treatment. Exchange transfusion (B) is for severe cases
unresponsive to phototherapy. Intervention is definitely needed (C).
Q7: A patient in labor is 8 cm dilated, contractions every 2 minutes, and states she feels the urge
to push. Which response by the nurse is MOST appropriate?
A. "Go ahead and push with each contraction."
B. "Pant and blow through contractions until you're fully dilated." [CORRECT]
C. "I'll check you again in 2 hours."
D. "We need to prepare for immediate delivery."
Correct Answer: B
Rationale: At 8 cm (transition phase), pushing before full dilation (10 cm) can cause cervical
edema and impede progress. Panting/blowing helps resist urge to push. Checking in 2 hours (C)
is too long. Immediate delivery (D) is not indicated.
Q8: A breastfeeding mother reports cracked, sore nipples. Which instruction is MOST
appropriate?
A. "Stop breastfeeding and switch to formula."
B. "Ensure proper latch and positioning, and apply expressed breast milk to nipples."
[CORRECT]
C. "Use soap and water to clean nipples after each feeding."
D. "Limit feeding time to 5 minutes per side."
Correct Answer: B
Rationale: Proper latch prevents and treats sore nipples. Breast milk has healing properties. Soap
(C) dries nipples. Limiting time (D) reduces milk supply and doesn't address cause. Stopping
breastfeeding (A) is unnecessary.
Q9: A patient at 36 weeks gestation reports painless vaginal bleeding. Which condition should
the nurse suspect?
A. Placental abruption
B. Placenta previa [CORRECT]
, 4
C. Normal bloody show
D. Cervical laceration
Correct Answer: B
Rationale: Painless late-pregnancy bleeding suggests placenta previa (placenta over cervical os).
Abruption (A) causes painful bleeding. Bloody show (C) occurs with labor onset. Cervical
laceration (D) is usually postpartum.
Q10: A newborn's weight drops from 3,500 g to 3,220 g by day 3 of life. Which response by the
nurse is MOST appropriate?
A. "This is abnormal and requires formula supplementation."
B. "This is within normal limits for newborn weight loss." [CORRECT]
C. "We need to start IV fluids immediately."
D. "Your baby is failing to thrive."
Correct Answer: B
Rationale: Newborns typically lose 5-10% of birth weight (up to 7-10% is acceptable) due to
fluid loss and inadequate intake initially. This represents 8% loss—within normal. Reassurance
and continued monitoring are appropriate.
Q11: A pregnant patient with type 1 diabetes is at increased risk for:
A. Macrosomia and neonatal hypoglycemia [CORRECT]
B. Small for gestational age infant only
C. No increased risks if glucose is controlled
D. Preterm labor only
Correct Answer: A
Rationale: Maternal diabetes increases risk of macrosomia (large baby) due to fetal
hyperinsulinemia, and subsequent neonatal hypoglycemia (after placental glucose source
removed). Even with control, risks exist. SGA (B) is not typical.
Q12: A patient in active labor requests epidural anesthesia. Which assessment is MOST
important before administration?
A. Fetal position
B. Maternal blood pressure and hydration status [CORRECT]
C. Time of last meal
HESI Peds & Maternity Exam 2026/2027 Actual
Exam | 100% Correct Answers | Verified Latest
Update | Pass Guaranteed - A+ Graded
Section 1: Maternity Nursing (50 Questions)
Q1: A pregnant patient at 28 weeks gestation calls the clinic with concerns about fetal movement.
Which of the following instructions is MOST appropriate regarding fetal movement counting?
A. "You should feel at least 10 movements within 2 hours each day." [CORRECT]
B. "Fetal movements decrease significantly in the third trimester, so don't worry."
C. "Only count movements after meals when blood sugar is elevated."
D. "If you don't feel movement for 24 hours, come to the hospital immediately."
Correct Answer: A
Rationale: The standard kick count recommendation is at least 10 fetal movements within a 2-
hour period. Option B is incorrect—movements should not decrease significantly. Option C is
not required. Option D delays evaluation.
Q2: A patient in active labor has a fetal heart rate of 180 bpm. Which of the following is the
FIRST nursing action?
A. Continue monitoring
B. Turn the patient to her left side [CORRECT]
C. Prepare for immediate delivery
D. Administer oxygen at 2 L/min
Correct Answer: B
Rationale: Fetal tachycardia (>160 bpm) may indicate fetal hypoxia. First action is maternal
repositioning (left side) to improve uteroplacental perfusion. Oxygen (D) may be needed but
positioning is first. Immediate delivery (C) is not indicated.
Q3: The APGAR score at 1 minute for a newborn with heart rate 110, irregular respiratory effort,
grimace reflex, some flexion of extremities, and cyanotic body with pink extremities is:
A. 3
B. 5
,2
C. 7 [CORRECT]
D. 9
Correct Answer: C
Rationale: Heart rate 110 = 2 points; irregular respirations = 1 point; grimace = 2 points; some
flexion = 1 point; acrocyanosis = 1 point. Total = 7. Acrocyanosis is normal at 1 minute.
Q4: A postpartum patient on day 2 has a temperature of 100.4°F (38°C). Which of the following
is the MOST likely cause?
A. Postpartum infection requiring antibiotics
B. Normal postpartum diuresis and dehydration
C. Breast engorgement or normal postpartum inflammatory response [CORRECT]
D. Immediate surgical intervention needed
Correct Answer: C
Rationale: Low-grade fever (≤100.4°F) in first 24 hours may be normal due to dehydration,
breast engorgement, or inflammatory response. Temperature >100.4°F after first 24 hours
suggests infection. This requires monitoring, not immediate antibiotics (A) or surgery (D).
Q5: A pregnant patient at 32 weeks gestation has a blood pressure of 150/95 mmHg and
proteinuria 2+. Which of the following is the priority nursing intervention?
A. Schedule routine prenatal visit in 2 weeks
B. Assess for headache, visual changes, and epigastric pain [CORRECT]
C. Encourage increased sodium intake
D. Recommend bed rest for remainder of pregnancy
Correct Answer: B
Rationale: This patient has preeclampsia (BP ≥140/90 with proteinuria after 20 weeks). Priority
is assessing for severe features: headache, visual changes, epigastric pain. These indicate
possible progression to severe preeclampsia/eclampsia requiring immediate intervention.
Q6: A newborn has a positive Coombs test and elevated bilirubin. The nurse should anticipate:
A. Phototherapy [CORRECT]
B. Immediate exchange transfusion
C. No intervention needed
,3
D. Discharge with home care
Correct Answer: A
Rationale: Positive Coombs indicates hemolytic disease (Rh or ABO incompatibility) causing
jaundice. Phototherapy is first-line treatment. Exchange transfusion (B) is for severe cases
unresponsive to phototherapy. Intervention is definitely needed (C).
Q7: A patient in labor is 8 cm dilated, contractions every 2 minutes, and states she feels the urge
to push. Which response by the nurse is MOST appropriate?
A. "Go ahead and push with each contraction."
B. "Pant and blow through contractions until you're fully dilated." [CORRECT]
C. "I'll check you again in 2 hours."
D. "We need to prepare for immediate delivery."
Correct Answer: B
Rationale: At 8 cm (transition phase), pushing before full dilation (10 cm) can cause cervical
edema and impede progress. Panting/blowing helps resist urge to push. Checking in 2 hours (C)
is too long. Immediate delivery (D) is not indicated.
Q8: A breastfeeding mother reports cracked, sore nipples. Which instruction is MOST
appropriate?
A. "Stop breastfeeding and switch to formula."
B. "Ensure proper latch and positioning, and apply expressed breast milk to nipples."
[CORRECT]
C. "Use soap and water to clean nipples after each feeding."
D. "Limit feeding time to 5 minutes per side."
Correct Answer: B
Rationale: Proper latch prevents and treats sore nipples. Breast milk has healing properties. Soap
(C) dries nipples. Limiting time (D) reduces milk supply and doesn't address cause. Stopping
breastfeeding (A) is unnecessary.
Q9: A patient at 36 weeks gestation reports painless vaginal bleeding. Which condition should
the nurse suspect?
A. Placental abruption
B. Placenta previa [CORRECT]
, 4
C. Normal bloody show
D. Cervical laceration
Correct Answer: B
Rationale: Painless late-pregnancy bleeding suggests placenta previa (placenta over cervical os).
Abruption (A) causes painful bleeding. Bloody show (C) occurs with labor onset. Cervical
laceration (D) is usually postpartum.
Q10: A newborn's weight drops from 3,500 g to 3,220 g by day 3 of life. Which response by the
nurse is MOST appropriate?
A. "This is abnormal and requires formula supplementation."
B. "This is within normal limits for newborn weight loss." [CORRECT]
C. "We need to start IV fluids immediately."
D. "Your baby is failing to thrive."
Correct Answer: B
Rationale: Newborns typically lose 5-10% of birth weight (up to 7-10% is acceptable) due to
fluid loss and inadequate intake initially. This represents 8% loss—within normal. Reassurance
and continued monitoring are appropriate.
Q11: A pregnant patient with type 1 diabetes is at increased risk for:
A. Macrosomia and neonatal hypoglycemia [CORRECT]
B. Small for gestational age infant only
C. No increased risks if glucose is controlled
D. Preterm labor only
Correct Answer: A
Rationale: Maternal diabetes increases risk of macrosomia (large baby) due to fetal
hyperinsulinemia, and subsequent neonatal hypoglycemia (after placental glucose source
removed). Even with control, risks exist. SGA (B) is not typical.
Q12: A patient in active labor requests epidural anesthesia. Which assessment is MOST
important before administration?
A. Fetal position
B. Maternal blood pressure and hydration status [CORRECT]
C. Time of last meal
