HESI OB Maternity Version 1 Exam | Actual
V1 Assessment Questions with Answers
(2026/2027)
Domain: Antepartum Nursing Care (25% - Questions 1-14)
Q1: A nurse is caring for a client at 36 weeks gestation who presents with a blood
pressure of 168/102 mm Hg, 3+ proteinuria, and reports a severe headache and
epigastric pain. Which of the following actions should the nurse take first?
A. Administer hydralazine as prescribed
B. Place the client in a left lateral position
C. Assess deep tendon reflexes
D. Prepare for immediate cesarean birth
Correct Answer: B
Rationale: B. [CORRECT] The client is exhibiting signs of severe preeclampsia with
imminent risk of eclampsia. The priority action is to place the client in a left lateral
position to improve venous return, increase cardiac output, and enhance uteroplacental
perfusion while reducing blood pressure. This non-invasive intervention supports
maternal-fetal well-being while preparing for further interventions. A is incorrect;
antihypertensive medication may be indicated but positioning is the immediate priority.
C is incorrect; assessing DTRs is important for evaluating CNS irritability but does not
,address the immediate hemodynamic instability. D is incorrect; cesarean birth may
ultimately be indicated but is not the first action.
Q2: A client at 32 weeks gestation presents with painless, bright red vaginal bleeding.
The uterus is soft and non-tender. Fetal heart rate is 150 bpm with moderate variability.
Which of the following is the priority nursing action?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Prepare the client for immediate induction of labor
C. Place the client on continuous fetal monitoring and initiate IV access
D. Administer betamethasone 12 mg IM
Correct Answer: C
Rationale: C. [CORRECT] The presentation (painless, bright red bleeding, soft non-tender
uterus) is classic for placenta previa. The priority is to establish continuous fetal
monitoring to assess fetal well-being and initiate IV access for potential fluid or blood
product administration. A is incorrect; digital vaginal examination is contraindicated in
suspected placenta previa as it may disrupt the placenta and cause catastrophic
hemorrhage. B is incorrect; induction of labor is contraindicated in placenta previa;
cesarean delivery is typically indicated. D is incorrect; betamethasone is indicated for
preterm labor to accelerate fetal lung maturity, not for placenta previa.
Q3: A nurse is providing education to a client with gestational diabetes at 28 weeks
gestation. Which of the following statements by the client indicates a need for further
teaching?
A. "I will check my blood glucose levels four times daily."
,B. "I need to increase my calorie intake because I am eating for two."
C. "I should report any episodes of hypoglycemia to my provider."
D. "I will monitor my baby's movements daily."
Correct Answer: B
Rationale: B. [CORRECT] Clients with gestational diabetes do not need to "eat for two."
Caloric requirements increase by approximately 300-400 calories per day in the second
and third trimesters, but excessive caloric intake can worsen hyperglycemia. This
statement indicates a need for further teaching. A is correct; blood glucose monitoring
four times daily (fasting and postprandial) is standard. C is correct; hypoglycemia
should be reported to adjust management. D is correct; fetal kick counts are important
for monitoring fetal well-being.
Q4: A client at 34 weeks gestation is diagnosed with severe preeclampsia and is
receiving magnesium sulfate. During the assessment, the nurse notes that the client's
respiratory rate is 10 breaths/minute, deep tendon reflexes are absent, and urine output
is 15 mL/hour. Which of the following actions should the nurse take first?
A. Stop the magnesium sulfate infusion immediately
B. Administer calcium gluconate IV
C. Notify the provider
D. Increase the IV fluid rate
Correct Answer: A
, Rationale: A. [CORRECT] These findings (respiratory rate <12, absent DTRs, urine output
<25 mL/hr) are classic signs of magnesium sulfate toxicity. The priority is to stop the
infusion immediately to prevent further magnesium accumulation and respiratory
arrest. B is incorrect; calcium gluconate is the antidote for magnesium toxicity and
should be administered after discontinuing the infusion. C is incorrect; notification is
important but stopping the infusion takes priority. D is incorrect; increasing fluids is not
indicated and could worsen fluid overload in a preeclamptic client.
Q5: A nurse is caring for a client at 28 weeks gestation who presents with sudden onset
of severe abdominal pain, rigid uterus, and moderate vaginal bleeding. The fetal heart
rate tracing shows late decelerations. Which of the following is the priority nursing
diagnosis?
A. Risk for deficient fluid volume
B. Fear related to threat to fetal well-being
C. Acute pain
D. Risk for impaired fetal gas exchange
Correct Answer: D
Rationale: D. [CORRECT] The presentation (sudden severe abdominal pain, rigid uterus,
bleeding, late decelerations) is consistent with abruptio placentae. Late decelerations
indicate uteroplacental insufficiency and fetal hypoxia. The priority nursing diagnosis
addresses the immediate threat to fetal oxygenation. A is incorrect; while fluid volume
deficit is a concern, fetal compromise takes priority. B is incorrect; psychosocial needs
are important but not the priority in an emergency. C is incorrect; pain management is
secondary to addressing the underlying pathophysiology threatening fetal survival.
V1 Assessment Questions with Answers
(2026/2027)
Domain: Antepartum Nursing Care (25% - Questions 1-14)
Q1: A nurse is caring for a client at 36 weeks gestation who presents with a blood
pressure of 168/102 mm Hg, 3+ proteinuria, and reports a severe headache and
epigastric pain. Which of the following actions should the nurse take first?
A. Administer hydralazine as prescribed
B. Place the client in a left lateral position
C. Assess deep tendon reflexes
D. Prepare for immediate cesarean birth
Correct Answer: B
Rationale: B. [CORRECT] The client is exhibiting signs of severe preeclampsia with
imminent risk of eclampsia. The priority action is to place the client in a left lateral
position to improve venous return, increase cardiac output, and enhance uteroplacental
perfusion while reducing blood pressure. This non-invasive intervention supports
maternal-fetal well-being while preparing for further interventions. A is incorrect;
antihypertensive medication may be indicated but positioning is the immediate priority.
C is incorrect; assessing DTRs is important for evaluating CNS irritability but does not
,address the immediate hemodynamic instability. D is incorrect; cesarean birth may
ultimately be indicated but is not the first action.
Q2: A client at 32 weeks gestation presents with painless, bright red vaginal bleeding.
The uterus is soft and non-tender. Fetal heart rate is 150 bpm with moderate variability.
Which of the following is the priority nursing action?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Prepare the client for immediate induction of labor
C. Place the client on continuous fetal monitoring and initiate IV access
D. Administer betamethasone 12 mg IM
Correct Answer: C
Rationale: C. [CORRECT] The presentation (painless, bright red bleeding, soft non-tender
uterus) is classic for placenta previa. The priority is to establish continuous fetal
monitoring to assess fetal well-being and initiate IV access for potential fluid or blood
product administration. A is incorrect; digital vaginal examination is contraindicated in
suspected placenta previa as it may disrupt the placenta and cause catastrophic
hemorrhage. B is incorrect; induction of labor is contraindicated in placenta previa;
cesarean delivery is typically indicated. D is incorrect; betamethasone is indicated for
preterm labor to accelerate fetal lung maturity, not for placenta previa.
Q3: A nurse is providing education to a client with gestational diabetes at 28 weeks
gestation. Which of the following statements by the client indicates a need for further
teaching?
A. "I will check my blood glucose levels four times daily."
,B. "I need to increase my calorie intake because I am eating for two."
C. "I should report any episodes of hypoglycemia to my provider."
D. "I will monitor my baby's movements daily."
Correct Answer: B
Rationale: B. [CORRECT] Clients with gestational diabetes do not need to "eat for two."
Caloric requirements increase by approximately 300-400 calories per day in the second
and third trimesters, but excessive caloric intake can worsen hyperglycemia. This
statement indicates a need for further teaching. A is correct; blood glucose monitoring
four times daily (fasting and postprandial) is standard. C is correct; hypoglycemia
should be reported to adjust management. D is correct; fetal kick counts are important
for monitoring fetal well-being.
Q4: A client at 34 weeks gestation is diagnosed with severe preeclampsia and is
receiving magnesium sulfate. During the assessment, the nurse notes that the client's
respiratory rate is 10 breaths/minute, deep tendon reflexes are absent, and urine output
is 15 mL/hour. Which of the following actions should the nurse take first?
A. Stop the magnesium sulfate infusion immediately
B. Administer calcium gluconate IV
C. Notify the provider
D. Increase the IV fluid rate
Correct Answer: A
, Rationale: A. [CORRECT] These findings (respiratory rate <12, absent DTRs, urine output
<25 mL/hr) are classic signs of magnesium sulfate toxicity. The priority is to stop the
infusion immediately to prevent further magnesium accumulation and respiratory
arrest. B is incorrect; calcium gluconate is the antidote for magnesium toxicity and
should be administered after discontinuing the infusion. C is incorrect; notification is
important but stopping the infusion takes priority. D is incorrect; increasing fluids is not
indicated and could worsen fluid overload in a preeclamptic client.
Q5: A nurse is caring for a client at 28 weeks gestation who presents with sudden onset
of severe abdominal pain, rigid uterus, and moderate vaginal bleeding. The fetal heart
rate tracing shows late decelerations. Which of the following is the priority nursing
diagnosis?
A. Risk for deficient fluid volume
B. Fear related to threat to fetal well-being
C. Acute pain
D. Risk for impaired fetal gas exchange
Correct Answer: D
Rationale: D. [CORRECT] The presentation (sudden severe abdominal pain, rigid uterus,
bleeding, late decelerations) is consistent with abruptio placentae. Late decelerations
indicate uteroplacental insufficiency and fetal hypoxia. The priority nursing diagnosis
addresses the immediate threat to fetal oxygenation. A is incorrect; while fluid volume
deficit is a concern, fetal compromise takes priority. B is incorrect; psychosocial needs
are important but not the priority in an emergency. C is incorrect; pain management is
secondary to addressing the underlying pathophysiology threatening fetal survival.
