HESI PEDS & MATERNITY EXAM 2026/2027 | 100% Correct
Answers with Complete Solutions | NCLEX-RN Aligned |
Maternal-Child Nursing | Pass Guaranteed - A+ Graded
Domain 1: Antepartum Nursing (20 Questions)
Q1: A 28-year-old primigravida at 32 weeks gestation presents to the prenatal clinic with
complaints of headache, visual disturbances, and epigastric pain. Her blood pressure is
158/102 mmHg, and she has 3+ proteinuria. Which nursing intervention is the priority?
A. Administer magnesium sulfate per protocol
B. Place patient on strict bedrest in left lateral position
C. Assess deep tendon reflexes and respiratory rate
D. Prepare for immediate cesarean delivery
Correct Answer: C [CORRECT]
Rationale: The patient is exhibiting classic signs of severe preeclampsia (hypertension
≥160/110 mmHg, proteinuria ≥2+, headache, visual disturbances, epigastric pain).
Before administering magnesium sulfate (Option A), the nurse must establish baseline
neurological and respiratory status, as magnesium sulfate can cause toxicity
manifesting as loss of deep tendon reflexes, respiratory depression, and cardiac arrest.
While bedrest (Option B) is appropriate, it is not the priority over safety assessment.
Immediate cesarean (Option D) is not indicated without fetal compromise or failed
medical management. The priority nursing action is to assess for contraindications to
magnesium sulfate therapy.
,Q2: A 34-year-old G2P1 at 24 weeks gestation is diagnosed with gestational diabetes
mellitus (GDM) after her 3-hour glucose tolerance test. Which dietary instruction is most
appropriate for the nurse to provide?
A. Eliminate all carbohydrates to prevent hyperglycemia
B. Consume three large meals daily to maintain steady glucose
C. Distribute carbohydrates evenly across three meals and three snacks
D. Avoid all fruits and dairy products due to natural sugars
Correct Answer: C [CORRECT]
Rationale: Medical nutrition therapy for GDM focuses on carbohydrate counting and
distribution to maintain euglycemia. Carbohydrates should not be eliminated (Option A)
as they are essential for fetal brain development. Large meals (Option B) cause
postprandial glucose spikes. Fruits and dairy (Option D) provide essential nutrients and
can be included in controlled portions. The correct approach distributes 175g of
carbohydrates across meals and snacks, with 45-60g at breakfast, 45-60g at
lunch/dinner, and 15-30g at snacks, paired with protein and fiber to blunt glucose
excursions.
Q3: A pregnant patient at 18 weeks gestation asks the nurse about foods to avoid
during pregnancy. Which response by the nurse is most accurate?
A. "You should avoid all soft cheeses regardless of whether they are pasteurized"
B. "Deli meats are safe if heated to steaming hot temperature before eating"
C. "Sushi with raw fish is acceptable twice weekly for omega-3 fatty acids"
,D. "Unpasteurized milk is acceptable if sourced from local organic farms"
Correct Answer: B [CORRECT]
Rationale: Listeria monocytogenes prevention is critical in pregnancy. Deli meats and
hot dogs should be heated to internal temperature of 165°F (steaming hot) to kill
potential Listeria (Option B). Pasteurized soft cheeses are safe (Option A). Raw fish
(Option C) carries risk of parasites and mercury exposure. Unpasteurized dairy (Option
D) poses risk of Listeria, E. coli, and Salmonella regardless of source. The nurse must
emphasize that heating deli meats to steaming hot eliminates the Listeria risk while
allowing the patient to consume these protein sources safely.
Q4: During a prenatal visit, a 26-year-old patient at 28 weeks gestation reports
decreased fetal movement over the past 24 hours. Fetal heart rate is 140 bpm with
moderate variability. Which is the nurse's priority action?
A. Reassure the patient that decreased movement is normal at this gestational age
B. Perform a non-stress test (NST) to assess fetal well-being
C. Schedule a biophysical profile for the following week
D. Instruct the patient to drink caffeine to stimulate fetal movement
Correct Answer: B [CORRECT]
Rationale: Maternal perception of decreased fetal movement (DFM) is a significant
predictor of fetal compromise and requires immediate evaluation. The NST (Option B)
assesses fetal heart rate accelerations in response to fetal movement, providing
immediate data on fetal oxygenation status. Reassurance (Option A) is dangerous as
DFM may indicate hypoxia, placental insufficiency, or impending stillbirth. Delaying
, assessment (Option C) is inappropriate for acute concerns. Caffeine (Option D) is
contraindicated in pregnancy and does not substitute for medical evaluation. A reactive
NST (≥2 accelerations in 20 minutes) reassures; non-reactive requires further testing.
Q5: A patient with placenta previa is admitted to the antepartum unit at 30 weeks
gestation with painless vaginal bleeding. Which nursing intervention is contraindicated?
A. External fetal monitoring
B. Digital vaginal examination
C. Intravenous access establishment
D. Type and screen for blood products
Correct Answer: B [CORRECT]
Rationale: Digital vaginal examination is absolutely contraindicated in placenta previa
(Option B) as it may disrupt the placental attachment site, causing catastrophic
hemorrhage. The diagnosis of placenta previa is confirmed by ultrasound, and vaginal
exams are avoided until delivery by cesarean is planned. External monitoring (Option A)
is safe and necessary for fetal assessment. IV access (Option C) and type/screen
(Option D) are essential preparations for potential hemorrhage and transfusion. The
nurse must clearly document that vaginal examination is contraindicated per provider
order.
Q6: A 30-year-old G1P0 at 35 weeks gestation is diagnosed with abruptio placentae
after presenting with painful vaginal bleeding and uterine tenderness. The fetal heart
rate shows late decelerations. What is the priority nursing intervention?
A. Administer tocolytics to prevent preterm labor
Answers with Complete Solutions | NCLEX-RN Aligned |
Maternal-Child Nursing | Pass Guaranteed - A+ Graded
Domain 1: Antepartum Nursing (20 Questions)
Q1: A 28-year-old primigravida at 32 weeks gestation presents to the prenatal clinic with
complaints of headache, visual disturbances, and epigastric pain. Her blood pressure is
158/102 mmHg, and she has 3+ proteinuria. Which nursing intervention is the priority?
A. Administer magnesium sulfate per protocol
B. Place patient on strict bedrest in left lateral position
C. Assess deep tendon reflexes and respiratory rate
D. Prepare for immediate cesarean delivery
Correct Answer: C [CORRECT]
Rationale: The patient is exhibiting classic signs of severe preeclampsia (hypertension
≥160/110 mmHg, proteinuria ≥2+, headache, visual disturbances, epigastric pain).
Before administering magnesium sulfate (Option A), the nurse must establish baseline
neurological and respiratory status, as magnesium sulfate can cause toxicity
manifesting as loss of deep tendon reflexes, respiratory depression, and cardiac arrest.
While bedrest (Option B) is appropriate, it is not the priority over safety assessment.
Immediate cesarean (Option D) is not indicated without fetal compromise or failed
medical management. The priority nursing action is to assess for contraindications to
magnesium sulfate therapy.
,Q2: A 34-year-old G2P1 at 24 weeks gestation is diagnosed with gestational diabetes
mellitus (GDM) after her 3-hour glucose tolerance test. Which dietary instruction is most
appropriate for the nurse to provide?
A. Eliminate all carbohydrates to prevent hyperglycemia
B. Consume three large meals daily to maintain steady glucose
C. Distribute carbohydrates evenly across three meals and three snacks
D. Avoid all fruits and dairy products due to natural sugars
Correct Answer: C [CORRECT]
Rationale: Medical nutrition therapy for GDM focuses on carbohydrate counting and
distribution to maintain euglycemia. Carbohydrates should not be eliminated (Option A)
as they are essential for fetal brain development. Large meals (Option B) cause
postprandial glucose spikes. Fruits and dairy (Option D) provide essential nutrients and
can be included in controlled portions. The correct approach distributes 175g of
carbohydrates across meals and snacks, with 45-60g at breakfast, 45-60g at
lunch/dinner, and 15-30g at snacks, paired with protein and fiber to blunt glucose
excursions.
Q3: A pregnant patient at 18 weeks gestation asks the nurse about foods to avoid
during pregnancy. Which response by the nurse is most accurate?
A. "You should avoid all soft cheeses regardless of whether they are pasteurized"
B. "Deli meats are safe if heated to steaming hot temperature before eating"
C. "Sushi with raw fish is acceptable twice weekly for omega-3 fatty acids"
,D. "Unpasteurized milk is acceptable if sourced from local organic farms"
Correct Answer: B [CORRECT]
Rationale: Listeria monocytogenes prevention is critical in pregnancy. Deli meats and
hot dogs should be heated to internal temperature of 165°F (steaming hot) to kill
potential Listeria (Option B). Pasteurized soft cheeses are safe (Option A). Raw fish
(Option C) carries risk of parasites and mercury exposure. Unpasteurized dairy (Option
D) poses risk of Listeria, E. coli, and Salmonella regardless of source. The nurse must
emphasize that heating deli meats to steaming hot eliminates the Listeria risk while
allowing the patient to consume these protein sources safely.
Q4: During a prenatal visit, a 26-year-old patient at 28 weeks gestation reports
decreased fetal movement over the past 24 hours. Fetal heart rate is 140 bpm with
moderate variability. Which is the nurse's priority action?
A. Reassure the patient that decreased movement is normal at this gestational age
B. Perform a non-stress test (NST) to assess fetal well-being
C. Schedule a biophysical profile for the following week
D. Instruct the patient to drink caffeine to stimulate fetal movement
Correct Answer: B [CORRECT]
Rationale: Maternal perception of decreased fetal movement (DFM) is a significant
predictor of fetal compromise and requires immediate evaluation. The NST (Option B)
assesses fetal heart rate accelerations in response to fetal movement, providing
immediate data on fetal oxygenation status. Reassurance (Option A) is dangerous as
DFM may indicate hypoxia, placental insufficiency, or impending stillbirth. Delaying
, assessment (Option C) is inappropriate for acute concerns. Caffeine (Option D) is
contraindicated in pregnancy and does not substitute for medical evaluation. A reactive
NST (≥2 accelerations in 20 minutes) reassures; non-reactive requires further testing.
Q5: A patient with placenta previa is admitted to the antepartum unit at 30 weeks
gestation with painless vaginal bleeding. Which nursing intervention is contraindicated?
A. External fetal monitoring
B. Digital vaginal examination
C. Intravenous access establishment
D. Type and screen for blood products
Correct Answer: B [CORRECT]
Rationale: Digital vaginal examination is absolutely contraindicated in placenta previa
(Option B) as it may disrupt the placental attachment site, causing catastrophic
hemorrhage. The diagnosis of placenta previa is confirmed by ultrasound, and vaginal
exams are avoided until delivery by cesarean is planned. External monitoring (Option A)
is safe and necessary for fetal assessment. IV access (Option C) and type/screen
(Option D) are essential preparations for potential hemorrhage and transfusion. The
nurse must clearly document that vaginal examination is contraindicated per provider
order.
Q6: A 30-year-old G1P0 at 35 weeks gestation is diagnosed with abruptio placentae
after presenting with painful vaginal bleeding and uterine tenderness. The fetal heart
rate shows late decelerations. What is the priority nursing intervention?
A. Administer tocolytics to prevent preterm labor
