HESI MATERNITY PEDS 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 for a routine prenatal
visit. Her blood pressure is 142/92 mmHg, and she reports a headache that has
persisted for 2 days. Urine dipstick shows 2+ protein. Which assessment finding
requires immediate nursing intervention?
A. The patient's fundal height measures 30 cm
B. The patient reports decreased fetal movement over the past 12 hours [CORRECT]
C. The patient's weight gain is 2 lbs since last visit
D. The patient has 1+ pitting edema in her ankles
Correct Answer: B
Rationale: This patient presents with signs of preeclampsia (hypertension ≥140/90
mmHg, proteinuria, and persistent headache). Decreased fetal movement is a critical
warning sign of potential placental insufficiency and fetal compromise, requiring
immediate further assessment with a non-stress test (NST) and possible delivery
planning. Fetal movement counting (kick counts) is a reliable indicator of fetal
well-being; a reduction often precedes fetal demise.
Why other options are incorrect:
● A: Fundal height of 30 cm at 32 weeks is within normal range (±2 cm of
gestational age).
● C: Weight gain of 2 lbs in 2-4 weeks is acceptable in the third trimester.
, ● D: 1+ pitting edema is common in normal pregnancy due to physiologic fluid
retention; while 3-4+ edema is concerning in preeclampsia, 1+ edema alone does
not require immediate intervention.
Q2: A pregnant patient at 8 weeks gestation asks the nurse about foods to avoid during
pregnancy. Which response by the nurse demonstrates correct understanding of
teratogenic risks?
A. "You should avoid soft cheeses made from unpasteurized milk due to risk of Listeria
infection, which can cause miscarriage or stillbirth." [CORRECT]
B. "Sushi is safe to eat as long as it doesn't contain raw shellfish."
C. "You can continue drinking 1-2 glasses of wine per week without risk to the fetus."
D. "Caffeine should be completely eliminated during the first trimester."
Correct Answer: A
Rationale: Listeria monocytogenes infection during pregnancy can cross the placental
barrier, causing chorioamnionitis, fetal infection, preterm labor, miscarriage, or stillbirth.
Pregnant women are advised to avoid unpasteurized dairy products, deli meats, and
refrigerated smoked seafood. The FDA recommends heating deli meats until steaming
hot to kill potential Listeria.
Why other options are incorrect:
● B: All raw or undercooked seafood, including sushi with raw fish, should be
avoided due to risk of parasites, bacteria, and mercury exposure.
● C: No amount of alcohol is considered safe during pregnancy; fetal alcohol
spectrum disorders (FASD) can occur with any level of exposure.
● D: Moderate caffeine intake (200 mg/day or approximately 12 oz of coffee) is
considered safe during pregnancy; complete elimination is not required.
Q3: A 34-year-old pregnant patient with pre-gestational diabetes (Type 1) is at 24 weeks
gestation. Her fasting blood glucose is 98 mg/dL, and her 2-hour postprandial glucose
is 165 mg/dL. Which nursing intervention is the priority?
,A. Recommend increasing her morning insulin dose by 4 units
B. Assess the patient's diet and exercise compliance, then collaborate with the
healthcare provider for insulin adjustment [CORRECT]
C. Instruct the patient that these values are normal for the second trimester
D. Schedule the patient for immediate delivery at 37 weeks
Correct Answer: B
Rationale: Target glucose levels for pregnant patients with diabetes are: fasting ≤95
mg/dL, 1-hour postprandial ≤140 mg/dL, and 2-hour postprandial ≤120 mg/dL. This
patient's values are elevated, increasing risks of macrosomia, congenital anomalies, and
maternal complications. The nurse must first assess dietary intake, meal timing, and
activity level before insulin adjustments, as non-compliance or miscalculation of
carbohydrate intake may be correctable without medication changes. Collaboration with
the provider is essential for insulin dosing decisions.
Why other options are incorrect:
● A: Nurses cannot independently adjust insulin doses; this requires provider
orders based on comprehensive assessment.
● C: These values exceed recommended targets; uncontrolled glucose increases
risk of fetal macrosomia, shoulder dystocia, and neonatal hypoglycemia.
● D: While delivery may be indicated at 37-39 weeks for poorly controlled diabetes,
immediate scheduling without further assessment and management is
premature.
Q4: A patient at 28 weeks gestation with placenta previa (confirmed by ultrasound)
presents to the emergency department with painless, bright red vaginal bleeding. Which
nursing intervention is the priority?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Insert an indwelling urinary catheter to monitor output
C. Maintain the patient on strict bed rest in a side-lying position and prepare for possible
cesarean delivery [CORRECT]
, D. Administer oxytocin to strengthen uterine contractions
Correct Answer: C
Rationale: Placenta previa involves placental implantation over or near the internal
cervical os. Painless, bright red bleeding is the hallmark sign. Digital or speculum
vaginal examination is absolutely contraindicated as it may cause catastrophic
hemorrhage. Management includes bed rest (left lateral position to maximize placental
perfusion), continuous fetal monitoring, IV access, type and screen/crossmatch blood
products, and preparation for emergency cesarean delivery if bleeding is heavy or fetal
compromise occurs. Vaginal delivery is contraindicated with complete or partial previa.
Why other options are incorrect:
● A: Vaginal examination is contraindicated in known or suspected placenta previa
due to risk of severe hemorrhage and fetal exsanguination.
● B: While urinary catheterization may be needed before surgery, it is not the
priority over hemodynamic stabilization and positioning.
● D: Oxytocin is contraindicated as uterine contractions could worsen placental
separation and bleeding; tocolytics may be used to prolong pregnancy if preterm
and bleeding is controlled.
Q5: A pregnant patient at 35 weeks gestation with suspected abruptio placentae
presents with painful vaginal bleeding, a rigid/tender uterus, and late decelerations on
the fetal monitor. The patient's blood pressure is 88/50 mmHg, heart rate 118 bpm.
Which nursing action is the priority?
A. Administer terbutaline subcutaneously to stop uterine contractions
B. Prepare the patient for immediate cesarean delivery and initiate large-bore IV fluid
resuscitation [CORRECT]
C. Perform Leopold maneuvers to determine fetal position
D. Apply a fetal scalp electrode for continuous monitoring
Correct Answer: B
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 for a routine prenatal
visit. Her blood pressure is 142/92 mmHg, and she reports a headache that has
persisted for 2 days. Urine dipstick shows 2+ protein. Which assessment finding
requires immediate nursing intervention?
A. The patient's fundal height measures 30 cm
B. The patient reports decreased fetal movement over the past 12 hours [CORRECT]
C. The patient's weight gain is 2 lbs since last visit
D. The patient has 1+ pitting edema in her ankles
Correct Answer: B
Rationale: This patient presents with signs of preeclampsia (hypertension ≥140/90
mmHg, proteinuria, and persistent headache). Decreased fetal movement is a critical
warning sign of potential placental insufficiency and fetal compromise, requiring
immediate further assessment with a non-stress test (NST) and possible delivery
planning. Fetal movement counting (kick counts) is a reliable indicator of fetal
well-being; a reduction often precedes fetal demise.
Why other options are incorrect:
● A: Fundal height of 30 cm at 32 weeks is within normal range (±2 cm of
gestational age).
● C: Weight gain of 2 lbs in 2-4 weeks is acceptable in the third trimester.
, ● D: 1+ pitting edema is common in normal pregnancy due to physiologic fluid
retention; while 3-4+ edema is concerning in preeclampsia, 1+ edema alone does
not require immediate intervention.
Q2: A pregnant patient at 8 weeks gestation asks the nurse about foods to avoid during
pregnancy. Which response by the nurse demonstrates correct understanding of
teratogenic risks?
A. "You should avoid soft cheeses made from unpasteurized milk due to risk of Listeria
infection, which can cause miscarriage or stillbirth." [CORRECT]
B. "Sushi is safe to eat as long as it doesn't contain raw shellfish."
C. "You can continue drinking 1-2 glasses of wine per week without risk to the fetus."
D. "Caffeine should be completely eliminated during the first trimester."
Correct Answer: A
Rationale: Listeria monocytogenes infection during pregnancy can cross the placental
barrier, causing chorioamnionitis, fetal infection, preterm labor, miscarriage, or stillbirth.
Pregnant women are advised to avoid unpasteurized dairy products, deli meats, and
refrigerated smoked seafood. The FDA recommends heating deli meats until steaming
hot to kill potential Listeria.
Why other options are incorrect:
● B: All raw or undercooked seafood, including sushi with raw fish, should be
avoided due to risk of parasites, bacteria, and mercury exposure.
● C: No amount of alcohol is considered safe during pregnancy; fetal alcohol
spectrum disorders (FASD) can occur with any level of exposure.
● D: Moderate caffeine intake (200 mg/day or approximately 12 oz of coffee) is
considered safe during pregnancy; complete elimination is not required.
Q3: A 34-year-old pregnant patient with pre-gestational diabetes (Type 1) is at 24 weeks
gestation. Her fasting blood glucose is 98 mg/dL, and her 2-hour postprandial glucose
is 165 mg/dL. Which nursing intervention is the priority?
,A. Recommend increasing her morning insulin dose by 4 units
B. Assess the patient's diet and exercise compliance, then collaborate with the
healthcare provider for insulin adjustment [CORRECT]
C. Instruct the patient that these values are normal for the second trimester
D. Schedule the patient for immediate delivery at 37 weeks
Correct Answer: B
Rationale: Target glucose levels for pregnant patients with diabetes are: fasting ≤95
mg/dL, 1-hour postprandial ≤140 mg/dL, and 2-hour postprandial ≤120 mg/dL. This
patient's values are elevated, increasing risks of macrosomia, congenital anomalies, and
maternal complications. The nurse must first assess dietary intake, meal timing, and
activity level before insulin adjustments, as non-compliance or miscalculation of
carbohydrate intake may be correctable without medication changes. Collaboration with
the provider is essential for insulin dosing decisions.
Why other options are incorrect:
● A: Nurses cannot independently adjust insulin doses; this requires provider
orders based on comprehensive assessment.
● C: These values exceed recommended targets; uncontrolled glucose increases
risk of fetal macrosomia, shoulder dystocia, and neonatal hypoglycemia.
● D: While delivery may be indicated at 37-39 weeks for poorly controlled diabetes,
immediate scheduling without further assessment and management is
premature.
Q4: A patient at 28 weeks gestation with placenta previa (confirmed by ultrasound)
presents to the emergency department with painless, bright red vaginal bleeding. Which
nursing intervention is the priority?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Insert an indwelling urinary catheter to monitor output
C. Maintain the patient on strict bed rest in a side-lying position and prepare for possible
cesarean delivery [CORRECT]
, D. Administer oxytocin to strengthen uterine contractions
Correct Answer: C
Rationale: Placenta previa involves placental implantation over or near the internal
cervical os. Painless, bright red bleeding is the hallmark sign. Digital or speculum
vaginal examination is absolutely contraindicated as it may cause catastrophic
hemorrhage. Management includes bed rest (left lateral position to maximize placental
perfusion), continuous fetal monitoring, IV access, type and screen/crossmatch blood
products, and preparation for emergency cesarean delivery if bleeding is heavy or fetal
compromise occurs. Vaginal delivery is contraindicated with complete or partial previa.
Why other options are incorrect:
● A: Vaginal examination is contraindicated in known or suspected placenta previa
due to risk of severe hemorrhage and fetal exsanguination.
● B: While urinary catheterization may be needed before surgery, it is not the
priority over hemodynamic stabilization and positioning.
● D: Oxytocin is contraindicated as uterine contractions could worsen placental
separation and bleeding; tocolytics may be used to prolong pregnancy if preterm
and bleeding is controlled.
Q5: A pregnant patient at 35 weeks gestation with suspected abruptio placentae
presents with painful vaginal bleeding, a rigid/tender uterus, and late decelerations on
the fetal monitor. The patient's blood pressure is 88/50 mmHg, heart rate 118 bpm.
Which nursing action is the priority?
A. Administer terbutaline subcutaneously to stop uterine contractions
B. Prepare the patient for immediate cesarean delivery and initiate large-bore IV fluid
resuscitation [CORRECT]
C. Perform Leopold maneuvers to determine fetal position
D. Apply a fetal scalp electrode for continuous monitoring
Correct Answer: B
