DEPARTMENT OF NURSING SCIENCES | FACULTY OF HEALTH SCIENCES
HESI MATERNITY (OBSTETRIC NURSING) PROCTORED EXAM –
{2025\2026}
FINAL PROFESSIONAL EXAMINATION || HIGHER TIER EXAM GRADED
A+
PASS GUARANTEED
The nurse is preparing a laboring client for an amniotomy. Immediately after the procedure is
completed, it is most important for the nurse to obtain which information?
A.Maternal blood pressure
B.Maternal temperature
C.Fetal heart rate (FHR)
D.White blood cell count (WBC)
C. Fetal heart rate (FHR)
Rationale:
The FHR should be assessed before and after the procedure to detect changes that may indicate
the presence of cord compression or prolapse. An amniotomy (artificial rupture of membranes
[AROM]) is used to stimulate labor when the condition of the cervix is favorable. The fluid
should be assessed for color, odor, and consistency. Option A should be assessed every 15 to 20
minutes during labor but is not specific for AROM. Option B is monitored hourly after the
membranes are ruptured to detect the development of amnionitis. Option D should be
determined for all clients in labor.
,A nurse receives a shift change report for a newborn who is 12 hours post-vaginal delivery. In
developing a plan of care, the nurse should give the highest priority to which finding?
A.Cyanosis of the hands and feet
B.Skin color that is slightly jaundiced
C.Tiny white papules on the nose or chin
D.Red patches on the cheeks and trunk
B. Skin color that is slightly jaundiced
Rationale: Jaundice, a yellow skin coloration, is caused by elevated levels of bilirubin, which
should be further evaluated in a newborn <24 hours old. Acrocyanosis (blue color of the hands
and feet) is a common finding in newborns; it occurs because the capillary system is immature.
Milia are small white papules present on the nose and chin that are caused by sebaceous gland
blockage and disappear in a few weeks. Small red patches on the cheeks and trunk are called
erythema toxicum neonatorum, a common finding in newborns.
A breastfeeding postpartum client is diagnosed with mastitis, and antibiotic therapy is
prescribed. Which instruction should the nurse provide to this client?
A.Breastfeed the infant, ensuring that both breasts are completely emptied.
B.Feed expressed breast milk to avoid the pain of the infant latching onto the infected breast.
,C.Breastfeed on the unaffected breast only until the mastitis subsides.
D.Dilute expressed breast milk with sterile water to reduce the antibiotic effect on the infant.
A.Breastfeed the infant, ensuring that both breasts are completely emptied.
Rationale:Mastitis, caused by plugged milk ducts, is related to breast engorgement, and
breastfeeding during mastitis facilitates the complete emptying of engorged breasts, eliminating
the pressure on the inflamed breast tissue. Option B is less painful but does not facilitate
complete emptying of the breast tissue. Option C will not relieve the engorgement on the
affected side. Option D will not decrease antibiotic effects on the infant.
A 38-week primigravida who works as a secretary and sits at a computer 8 hours each day tells
the nurse that her feet have begun to swell. Which instruction will aid in the prevention of
pooling of blood in the lower extremities?
A.Wear support stockings.
B.Reduce salt in the diet.
C.Move about every hour.
D.Avoid constrictive clothing.
C.Move about every hour.
Rationale:
, Pooling of blood in the lower extremities results from the enlarged uterus exerting pressure on
the pelvic veins. Moving about every hour will relieve pressure on the pelvic veins and increase
venous return. Option A would increase venous return from varicose veins in the lower
extremities but would be of little help with swelling. Option B might be helpful with generalized
edema but is not specific for edematous lower extremities. Option D does not address venous
return, and there is no indication in the question that constrictive clothing is a problem.
Twenty-four hours after admission to the newborn nursery, a full-term male infant develops
localized swelling on the right side of his head. In a newborn, what is the most likely cause of
this accumulation of blood between the periosteum and skull that does not cross the suture
line?
A.Cephalhematoma, which is caused by forceps trauma
B.Subarachnoid hematoma, which requires immediate drainage
C.Molding, which is caused by pressure during labor
D.Subdural hematoma, which can result in lifelong damage
A.Cephalhematoma, which is caused by forceps trauma
Rationale: Cephalhematoma, 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 skull. Option C is a cranial distortion lasting 5 to 7 days, caused by pressure on
the cranium during vaginal delivery, and is a common variation of the newborn. Options B and D
both involve intracranial bleeding and could not be detected by physical assessment alone.
HESI MATERNITY (OBSTETRIC NURSING) PROCTORED EXAM –
{2025\2026}
FINAL PROFESSIONAL EXAMINATION || HIGHER TIER EXAM GRADED
A+
PASS GUARANTEED
The nurse is preparing a laboring client for an amniotomy. Immediately after the procedure is
completed, it is most important for the nurse to obtain which information?
A.Maternal blood pressure
B.Maternal temperature
C.Fetal heart rate (FHR)
D.White blood cell count (WBC)
C. Fetal heart rate (FHR)
Rationale:
The FHR should be assessed before and after the procedure to detect changes that may indicate
the presence of cord compression or prolapse. An amniotomy (artificial rupture of membranes
[AROM]) is used to stimulate labor when the condition of the cervix is favorable. The fluid
should be assessed for color, odor, and consistency. Option A should be assessed every 15 to 20
minutes during labor but is not specific for AROM. Option B is monitored hourly after the
membranes are ruptured to detect the development of amnionitis. Option D should be
determined for all clients in labor.
,A nurse receives a shift change report for a newborn who is 12 hours post-vaginal delivery. In
developing a plan of care, the nurse should give the highest priority to which finding?
A.Cyanosis of the hands and feet
B.Skin color that is slightly jaundiced
C.Tiny white papules on the nose or chin
D.Red patches on the cheeks and trunk
B. Skin color that is slightly jaundiced
Rationale: Jaundice, a yellow skin coloration, is caused by elevated levels of bilirubin, which
should be further evaluated in a newborn <24 hours old. Acrocyanosis (blue color of the hands
and feet) is a common finding in newborns; it occurs because the capillary system is immature.
Milia are small white papules present on the nose and chin that are caused by sebaceous gland
blockage and disappear in a few weeks. Small red patches on the cheeks and trunk are called
erythema toxicum neonatorum, a common finding in newborns.
A breastfeeding postpartum client is diagnosed with mastitis, and antibiotic therapy is
prescribed. Which instruction should the nurse provide to this client?
A.Breastfeed the infant, ensuring that both breasts are completely emptied.
B.Feed expressed breast milk to avoid the pain of the infant latching onto the infected breast.
,C.Breastfeed on the unaffected breast only until the mastitis subsides.
D.Dilute expressed breast milk with sterile water to reduce the antibiotic effect on the infant.
A.Breastfeed the infant, ensuring that both breasts are completely emptied.
Rationale:Mastitis, caused by plugged milk ducts, is related to breast engorgement, and
breastfeeding during mastitis facilitates the complete emptying of engorged breasts, eliminating
the pressure on the inflamed breast tissue. Option B is less painful but does not facilitate
complete emptying of the breast tissue. Option C will not relieve the engorgement on the
affected side. Option D will not decrease antibiotic effects on the infant.
A 38-week primigravida who works as a secretary and sits at a computer 8 hours each day tells
the nurse that her feet have begun to swell. Which instruction will aid in the prevention of
pooling of blood in the lower extremities?
A.Wear support stockings.
B.Reduce salt in the diet.
C.Move about every hour.
D.Avoid constrictive clothing.
C.Move about every hour.
Rationale:
, Pooling of blood in the lower extremities results from the enlarged uterus exerting pressure on
the pelvic veins. Moving about every hour will relieve pressure on the pelvic veins and increase
venous return. Option A would increase venous return from varicose veins in the lower
extremities but would be of little help with swelling. Option B might be helpful with generalized
edema but is not specific for edematous lower extremities. Option D does not address venous
return, and there is no indication in the question that constrictive clothing is a problem.
Twenty-four hours after admission to the newborn nursery, a full-term male infant develops
localized swelling on the right side of his head. In a newborn, what is the most likely cause of
this accumulation of blood between the periosteum and skull that does not cross the suture
line?
A.Cephalhematoma, which is caused by forceps trauma
B.Subarachnoid hematoma, which requires immediate drainage
C.Molding, which is caused by pressure during labor
D.Subdural hematoma, which can result in lifelong damage
A.Cephalhematoma, which is caused by forceps trauma
Rationale: Cephalhematoma, 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 skull. Option C is a cranial distortion lasting 5 to 7 days, caused by pressure on
the cranium during vaginal delivery, and is a common variation of the newborn. Options B and D
both involve intracranial bleeding and could not be detected by physical assessment alone.
