Maternity HESI 1 – Exam Review / High-Yield
Notes / Practice Questions (HESI | 2026) |
Versions 1–6 with Verified Answers
1. A 38-week primigravida who works as a secretary and sits at a computer for 8
hours each day tells the nurse that her feet have begun to swell. Which
instruction would be most effective in preventing pooling of blood in the lower
extremities?
Move about every hour
Pooling of blood in the lower extremities results from the enlarged uterus
exerting pressure on the pelvic veins. Moving about every hour will
straighten out the pelvic veins and increase venous return.
2. A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks
gestation in preterm labor. She is given 3 doses of terbutaline sulfate (Brethine)
0.25 mg subcutaneously to stop her labor contractions. The nurse plans to
monitor for which primary side effect of terbutaline sulfate?
Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates
betaadrenergic receptors in the uterine muscle to stop contractions. The beta-
adrenergic agonist properties of the drug may cause tachycardia, increased
cardiac output, restlessness, headache, and a feeling of "nervousness".
3. When do the anterior and posterior fontanels close?
anterior fontanel closes at 12 to 18 months and the posterior by the end
of the second month.
4. When assessing a client who is at 12-weeks gestation, the nurse recommends
that she and her husband consider attending childbirth preparation classes. When
is the best time for the couple to attend these classes?
30 weeks gestation
, at 30 weeks gestation is closest (of the options) to the time parents would be ready
for such classes. Learning is facilitated by an interested pupil! The couple is most
interested in childbirth toward the end of the pregnancy when they are
psychologically ready for the termination of the pregnancy, and the birth of their
child is an immediate concern.
5. The nurse should encourage the laboring client to begin pushing when...
the cervix is completely dilated.
Pushing begins with the second stage of labor, i.e., when the cervix is
completely dilated at 10 cm (C). If pushing begins before the cervix is
completely dilated the cervix can become edematous and may never completely
dilate, necessitating an operative delivery. Many primigravida’s begin active
labor 100% effaced and then proceed to dilate.
6. The nurse instructs a laboring client to use accelerated-blow breathing. The
client begins to complain of tingling fingers and dizziness. What action
should the nurse take?
Have the client breathe into her cupped hands
Tingling fingers and dizziness are signs of hyperventilation (blowing off too much
carbon dioxide). Hyperventilation is treated by retaining carbon dioxide. This can
be facilitated by breathing into a paper bag or cupped hands.
7. Twenty-four hours after admission to the newborn nursery, a full-term male
infant develops localized edema on the right side of his head. The nurse knows
that, in the newborn, an accumulation of blood between the periosteum and skull
which does not cross the suture line is a newborn variation known as...
a cephalohematoma, caused by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn, usually arises
within the first 24 hours after delivery. Trauma from delivery causes capillary
bleeding between the periosteum and the skull.
8. When does the head return to its normal shape?
7-10 days
,9. What did Nurse theorist Reva Rubin describe?
The initial postpartum period as the "taking-in phase," which is characterized by maternal
reliance on others to satisfy the needs for comfort, rest, nourishment, and closeness to families
and the newborn.
10. A couple, concerned because the woman has not been able to conceive, is referred to a
healthcare provider for a fertility workup and a hysterosalpingography is scheduled. Which post
procedure complaint indicates that the fallopian tubes are patent?
Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from a sub
diaphragmatic collection of peritoneal dye/gas.
11. Which nursing intervention is most helpful in relieving postpartum uterine contractions
or "afterpains?"
Lying prone with a pillow on the abdomen
Lying prone keeps the fundus contracted and is especially useful with multiparas, who
commonly experience afterpains due to lack of uterine tone.
12. Which maternal behavior is the nurse most likely to see when a new mother receives her infant
for the first time?
Her arms and hands receive the infant and she then traces the infant's profile with her fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate behaviors described
in during the first visit with the newborn, which may be at delivery or later.
13. A client at 32-weeks gestation is hospitalized with severe pregnancy-induced hypertension
(PIH), and magnesium sulfate is prescribed to control the symptoms. Which assessment
finding indicates the therapeutic drug level has been achieved?
A decreased in respiratory rate from 24 to 16
Magnesium sulfate, a CNS depressant, helps prevent seizures. A decreased respiratory
rate indicates that the drug is effective. (Respiratory rate below 12 indicates toxic effects.)
14. Urinary output must be monitored when administering magnesium sulfate and should be at least
30 ml per hour. (The therapeutic level of magnesium sulfate for a PIH client is 4.8 to 9.6
mg/dl.) What is the therapeutic level of magnesium sulfate?
, The therapeutic level of magnesium sulfate for a PIH client is 4.8 to 9.6 mg/dl. What
does it help prevent? helps prevent seizures What indicates toxic levels? 3
Respiratory rate below 12 indicates toxic effects. Urine
output of less than 100 ml/4 hours Absent DTRs
15. Twenty minutes after a continuous epidural anesthetic is administered, a laboring
client's blood pressure drops from 120/80 to 90/60. What action should the nurse
take?
Place woman in a lateral position
The nurse should immediately turn the woman to a lateral position, place a
pillow or wedge under the right hip to deflect the uterus, increase the rate of the
main line IV infusion, and administer oxygen by face mask at 10-12 L/min. If the
blood pressure remains low, especially if it further decreases, the
anesthesiologist/healthcare provider should be notified immediately.
16. A client at 28-weeks gestation calls the antepartum clinic and states that she is
experiencing a small amount of vaginal bleeding which she describes as bright
red. She further states that she is not experiencing any uterine contractions or
abdominal pain. What instruction should the nurse provide?
Come to the clinic today for an ultrasound
Third trimester painless bleeding is characteristic of a placenta previa. Bright red bleeding
may be intermittent, occur in gushes, or be continuous. Rarely is the first incidence life-
threatening, nor cause for hypovolemic shock. Diagnosis is confirmed by transabdominal
ultrasound.
17. An off-duty nurse finds a woman in a supermarket parking lot delivering an infant
while her husband is screaming for someone to help his wife. Which intervention
has the highest priority?
Put the newborn to breast
Putting the newborn to breast will help contract the uterus and prevent
a postpartum hemorrhage--this intervention has the highest priority.
18. A pregnant client with mitral stenosis Class III is prescribed complete bedrest.
The client asks the nurse, "Why must I stay in bed all the time?" Which response
is best for the nurse to provide this client?
Notes / Practice Questions (HESI | 2026) |
Versions 1–6 with Verified Answers
1. A 38-week primigravida who works as a secretary and sits at a computer for 8
hours each day tells the nurse that her feet have begun to swell. Which
instruction would be most effective in preventing pooling of blood in the lower
extremities?
Move about every hour
Pooling of blood in the lower extremities results from the enlarged uterus
exerting pressure on the pelvic veins. Moving about every hour will
straighten out the pelvic veins and increase venous return.
2. A 26-year-old, gravida 2, para 1 client is admitted to the hospital at 28-weeks
gestation in preterm labor. She is given 3 doses of terbutaline sulfate (Brethine)
0.25 mg subcutaneously to stop her labor contractions. The nurse plans to
monitor for which primary side effect of terbutaline sulfate?
Tachycardia and a feeling of nervousness
Terbutaline sulfate (Brethine), a beta-sympathomimetic drug, stimulates
betaadrenergic receptors in the uterine muscle to stop contractions. The beta-
adrenergic agonist properties of the drug may cause tachycardia, increased
cardiac output, restlessness, headache, and a feeling of "nervousness".
3. When do the anterior and posterior fontanels close?
anterior fontanel closes at 12 to 18 months and the posterior by the end
of the second month.
4. When assessing a client who is at 12-weeks gestation, the nurse recommends
that she and her husband consider attending childbirth preparation classes. When
is the best time for the couple to attend these classes?
30 weeks gestation
, at 30 weeks gestation is closest (of the options) to the time parents would be ready
for such classes. Learning is facilitated by an interested pupil! The couple is most
interested in childbirth toward the end of the pregnancy when they are
psychologically ready for the termination of the pregnancy, and the birth of their
child is an immediate concern.
5. The nurse should encourage the laboring client to begin pushing when...
the cervix is completely dilated.
Pushing begins with the second stage of labor, i.e., when the cervix is
completely dilated at 10 cm (C). If pushing begins before the cervix is
completely dilated the cervix can become edematous and may never completely
dilate, necessitating an operative delivery. Many primigravida’s begin active
labor 100% effaced and then proceed to dilate.
6. The nurse instructs a laboring client to use accelerated-blow breathing. The
client begins to complain of tingling fingers and dizziness. What action
should the nurse take?
Have the client breathe into her cupped hands
Tingling fingers and dizziness are signs of hyperventilation (blowing off too much
carbon dioxide). Hyperventilation is treated by retaining carbon dioxide. This can
be facilitated by breathing into a paper bag or cupped hands.
7. Twenty-four hours after admission to the newborn nursery, a full-term male
infant develops localized edema on the right side of his head. The nurse knows
that, in the newborn, an accumulation of blood between the periosteum and skull
which does not cross the suture line is a newborn variation known as...
a cephalohematoma, caused by forceps trauma and may last up to 8 weeks.
Cephalohematoma, a slight abnormal variation of the newborn, usually arises
within the first 24 hours after delivery. Trauma from delivery causes capillary
bleeding between the periosteum and the skull.
8. When does the head return to its normal shape?
7-10 days
,9. What did Nurse theorist Reva Rubin describe?
The initial postpartum period as the "taking-in phase," which is characterized by maternal
reliance on others to satisfy the needs for comfort, rest, nourishment, and closeness to families
and the newborn.
10. A couple, concerned because the woman has not been able to conceive, is referred to a
healthcare provider for a fertility workup and a hysterosalpingography is scheduled. Which post
procedure complaint indicates that the fallopian tubes are patent?
Shoulder pain
If the tubes are patent (open), pain is referred to the shoulder from a sub
diaphragmatic collection of peritoneal dye/gas.
11. Which nursing intervention is most helpful in relieving postpartum uterine contractions
or "afterpains?"
Lying prone with a pillow on the abdomen
Lying prone keeps the fundus contracted and is especially useful with multiparas, who
commonly experience afterpains due to lack of uterine tone.
12. Which maternal behavior is the nurse most likely to see when a new mother receives her infant
for the first time?
Her arms and hands receive the infant and she then traces the infant's profile with her fingertips.
Attachment/bonding theory indicates that most mothers will demonstrate behaviors described
in during the first visit with the newborn, which may be at delivery or later.
13. A client at 32-weeks gestation is hospitalized with severe pregnancy-induced hypertension
(PIH), and magnesium sulfate is prescribed to control the symptoms. Which assessment
finding indicates the therapeutic drug level has been achieved?
A decreased in respiratory rate from 24 to 16
Magnesium sulfate, a CNS depressant, helps prevent seizures. A decreased respiratory
rate indicates that the drug is effective. (Respiratory rate below 12 indicates toxic effects.)
14. Urinary output must be monitored when administering magnesium sulfate and should be at least
30 ml per hour. (The therapeutic level of magnesium sulfate for a PIH client is 4.8 to 9.6
mg/dl.) What is the therapeutic level of magnesium sulfate?
, The therapeutic level of magnesium sulfate for a PIH client is 4.8 to 9.6 mg/dl. What
does it help prevent? helps prevent seizures What indicates toxic levels? 3
Respiratory rate below 12 indicates toxic effects. Urine
output of less than 100 ml/4 hours Absent DTRs
15. Twenty minutes after a continuous epidural anesthetic is administered, a laboring
client's blood pressure drops from 120/80 to 90/60. What action should the nurse
take?
Place woman in a lateral position
The nurse should immediately turn the woman to a lateral position, place a
pillow or wedge under the right hip to deflect the uterus, increase the rate of the
main line IV infusion, and administer oxygen by face mask at 10-12 L/min. If the
blood pressure remains low, especially if it further decreases, the
anesthesiologist/healthcare provider should be notified immediately.
16. A client at 28-weeks gestation calls the antepartum clinic and states that she is
experiencing a small amount of vaginal bleeding which she describes as bright
red. She further states that she is not experiencing any uterine contractions or
abdominal pain. What instruction should the nurse provide?
Come to the clinic today for an ultrasound
Third trimester painless bleeding is characteristic of a placenta previa. Bright red bleeding
may be intermittent, occur in gushes, or be continuous. Rarely is the first incidence life-
threatening, nor cause for hypovolemic shock. Diagnosis is confirmed by transabdominal
ultrasound.
17. An off-duty nurse finds a woman in a supermarket parking lot delivering an infant
while her husband is screaming for someone to help his wife. Which intervention
has the highest priority?
Put the newborn to breast
Putting the newborn to breast will help contract the uterus and prevent
a postpartum hemorrhage--this intervention has the highest priority.
18. A pregnant client with mitral stenosis Class III is prescribed complete bedrest.
The client asks the nurse, "Why must I stay in bed all the time?" Which response
is best for the nurse to provide this client?
