HESI OB Exam 2026| 160 Actual Exam
Questions and Correct Answers Already
Graded A+
1. At 14-weeks gestation, a client arrives at the Emergency Center complaining of a dull pain in
the right lower quadrant of her abdomen. The nurse obtains a blood sample and initiates an IV.
Thirty minutes after admission, the client reports feeling a sharp abdominal pain and a shoulder
pain. Assessment findings include diaphoresis, a heart rate of 120 beats/minute, and a blood
pressure of 86/48. Which action should the nurse implement next?
a. Check the hematocrit results.
b. Administer pain medication.
c. Increase the rate of IV fluids.
d. Monitor client for contractions.
Correct Answer: c
Explanation: Sharp abdominal pain with referred shoulder pain (Kehr’s sign), hypotension, and
tachycardia in a pregnant client at 14 weeks strongly suggests a ruptured ectopic pregnancy with
intra-abdominal bleeding. The priority is to increase IV fluid rate to stabilize blood pressure and
treat hypovolemic shock while preparing for emergency surgery.
2. A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when she could
use a home pregnancy test to diagnose pregnancy. Which response is best?
a. a home pregnancy test can be used right after your first missed period
b. these tests are most accurate after you have missed your second period
c. home pregnancy tests often give false positives and should not be trusted
d. the test can provide accurate information when used right after ovulation
Correct Answer: a
Explanation: Home pregnancy tests detect hCG, which becomes detectable in urine shortly after
implantation. The most reliable time to test is right after the first missed period when hCG levels
are sufficient for accurate detection.
,3. A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse
knows that the most likely presenting symptom for a pediatric client with AIDS is:
a. shortness of breath
b. joint pain
c. a persistent cold
d. organmegaly
Correct Answer: c
Explanation: In infants with perinatally acquired HIV, recurrent or persistent respiratory
infections (such as a persistent cold) are among the most common early clinical manifestations of
AIDS due to impaired immune function.
4. 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?
a. notify the healthcare provider or anesthesiologist
b. continue to assess the blood pressure q5min
c. place the woman in a lateral position
d. turn off continuous epidural
Correct Answer: c
Explanation: Hypotension is a common side effect of epidural anesthesia due to sympathetic
blockade and vasodilation. The immediate nursing action is to place the client in the left lateral
position to relieve aortocaval compression, improve venous return, and increase blood pressure.
5. In developing a teaching plan for expectant parents, the nurse plans to include information
about when the parents can expect the infant's fontanels to close. The nurse bases the explanation
on knowledge that for the normal newborn, the
a. anterior fontanel closes at 2 to 4 months and the posterior by the end of the first week
b. anterior fontanel closes at 5 to 7 months and the posterior by the end of the week
c. anterior fontanel closes at 8 to 11 months and the posterior by the end of the second week
d. anterior fontanel closes at 12 to 18 months and the posterior by the end of the second month
Correct Answer: d
,Explanation: The posterior fontanel typically closes by 2 months of age, while the anterior
fontanel closes between 12 and 18 months. This timeline is important for parents to understand
normal cranial development.
6. A client in active labor is admitted with preeclampsia. Which assessment finding is most
significant in planning this client's care?
a. patellar reflex 4+
b. blood pressure 158/80
c. four hour urine output 240 ml
d. respiration 12/minute
Correct Answer: a
Explanation: A 4+ patellar reflex (hyperreflexia) is a critical sign of severe preeclampsia and
indicates central nervous system irritability, placing the client at high risk for seizures
(eclampsia). This finding requires immediate magnesium sulfate therapy and close monitoring.
7. A 4 week old premature infant has been receiving epoetin alfa for the last three weeks. Which
assessment finding indicates to the nurse that the drug is effective?
a. slowly increasing urine output over the last week
b. respiratory rate changes from the 40s to the 60s
c. changes in apical heart rate from the 180 to the 140s
d. change in indirect bilirubin from 12 mg/dl to 8 mg/dl
Correct Answer: c
Explanation: Epoetin alfa (erythropoietin) stimulates red blood cell production in premature
infants with anemia of prematurity. A decrease in tachycardia (from 180s to 140s) indicates
improved oxygen-carrying capacity and is a key sign of effectiveness.
8. A pregnant client tells the nurse that the first day of her last menstrual period was August 2,
2006. Based on Nagele's rule, what is the estimated date of delivery?
a. April 25, 2007
b. May 9, 2007
c. May 29, 2007
d. June 2, 2007
Correct Answer: b
, Explanation: Nagele’s rule: Add 7 days to the first day of the LMP (August 2 + 7 = August 9),
subtract 3 months (May 9), and add 1 year (2007). The estimated due date is May 9, 2007.
9. The nurse is performing a AGA on a full-term newborn during the first hour of transition using
the Dubowitz scale. Based on this assessment, the nurse determines that the neonate has a
maturity rating of 40 weeks. Which findings should the nurse identify to determine if the neonate
is SGA? (Select all that apply.)
a. admission weight of 4 lbs 15 oz
b. head to heel length of 17 in
c. frontal occipital circumference of 12.5 in
d. skin smooth with visible veins and abundant vernix
e. anterior plantar crease and smooth heel surfaces
f. full flexion of all extremities in resting supine position
Correct Answers: a, b, c
Explanation: Small for gestational age (SGA) is determined by measurements below the 10th
percentile for gestational age. Low birth weight (4 lb 15 oz), short length (17 in), and small head
circumference (12.5 in) indicate SGA. Options d, e, and f are normal findings for a term infant.
10. The nurse assess a client admitted to the labor and delivery unit and obtains the following
data: BP 110/68, FHR 110 bpm, cervix 1 cm dilated and uneffaced. Based on these assessment
findings, what intervention should the nurse implement?
a. insert a fetal monitor
b. assess for cervical changes q1H
c. monitor bleeding from IV sites
d. perform Leopold's maneuvers
Correct Answer: c
Explanation: The findings suggest possible placental abruption or bleeding (especially if there is
concealed hemorrhage). Monitoring for signs of bleeding (including from IV sites) is essential to
detect coagulopathy or disseminated intravascular coagulation (DIC).
11. Immediately after birth a newborn infant is suctioned, dried, and placed under a radiant
warmer. The infant has spontaneous respirations and the nurse assess an apical heart rate of 80
bpm and respirations 20. What action should the nurse perform next?
a. initiate positive pressure ventilation
Questions and Correct Answers Already
Graded A+
1. At 14-weeks gestation, a client arrives at the Emergency Center complaining of a dull pain in
the right lower quadrant of her abdomen. The nurse obtains a blood sample and initiates an IV.
Thirty minutes after admission, the client reports feeling a sharp abdominal pain and a shoulder
pain. Assessment findings include diaphoresis, a heart rate of 120 beats/minute, and a blood
pressure of 86/48. Which action should the nurse implement next?
a. Check the hematocrit results.
b. Administer pain medication.
c. Increase the rate of IV fluids.
d. Monitor client for contractions.
Correct Answer: c
Explanation: Sharp abdominal pain with referred shoulder pain (Kehr’s sign), hypotension, and
tachycardia in a pregnant client at 14 weeks strongly suggests a ruptured ectopic pregnancy with
intra-abdominal bleeding. The priority is to increase IV fluid rate to stabilize blood pressure and
treat hypovolemic shock while preparing for emergency surgery.
2. A woman who thinks she could be pregnant calls her neighbor, a nurse, to ask when she could
use a home pregnancy test to diagnose pregnancy. Which response is best?
a. a home pregnancy test can be used right after your first missed period
b. these tests are most accurate after you have missed your second period
c. home pregnancy tests often give false positives and should not be trusted
d. the test can provide accurate information when used right after ovulation
Correct Answer: a
Explanation: Home pregnancy tests detect hCG, which becomes detectable in urine shortly after
implantation. The most reliable time to test is right after the first missed period when hCG levels
are sufficient for accurate detection.
,3. A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse
knows that the most likely presenting symptom for a pediatric client with AIDS is:
a. shortness of breath
b. joint pain
c. a persistent cold
d. organmegaly
Correct Answer: c
Explanation: In infants with perinatally acquired HIV, recurrent or persistent respiratory
infections (such as a persistent cold) are among the most common early clinical manifestations of
AIDS due to impaired immune function.
4. 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?
a. notify the healthcare provider or anesthesiologist
b. continue to assess the blood pressure q5min
c. place the woman in a lateral position
d. turn off continuous epidural
Correct Answer: c
Explanation: Hypotension is a common side effect of epidural anesthesia due to sympathetic
blockade and vasodilation. The immediate nursing action is to place the client in the left lateral
position to relieve aortocaval compression, improve venous return, and increase blood pressure.
5. In developing a teaching plan for expectant parents, the nurse plans to include information
about when the parents can expect the infant's fontanels to close. The nurse bases the explanation
on knowledge that for the normal newborn, the
a. anterior fontanel closes at 2 to 4 months and the posterior by the end of the first week
b. anterior fontanel closes at 5 to 7 months and the posterior by the end of the week
c. anterior fontanel closes at 8 to 11 months and the posterior by the end of the second week
d. anterior fontanel closes at 12 to 18 months and the posterior by the end of the second month
Correct Answer: d
,Explanation: The posterior fontanel typically closes by 2 months of age, while the anterior
fontanel closes between 12 and 18 months. This timeline is important for parents to understand
normal cranial development.
6. A client in active labor is admitted with preeclampsia. Which assessment finding is most
significant in planning this client's care?
a. patellar reflex 4+
b. blood pressure 158/80
c. four hour urine output 240 ml
d. respiration 12/minute
Correct Answer: a
Explanation: A 4+ patellar reflex (hyperreflexia) is a critical sign of severe preeclampsia and
indicates central nervous system irritability, placing the client at high risk for seizures
(eclampsia). This finding requires immediate magnesium sulfate therapy and close monitoring.
7. A 4 week old premature infant has been receiving epoetin alfa for the last three weeks. Which
assessment finding indicates to the nurse that the drug is effective?
a. slowly increasing urine output over the last week
b. respiratory rate changes from the 40s to the 60s
c. changes in apical heart rate from the 180 to the 140s
d. change in indirect bilirubin from 12 mg/dl to 8 mg/dl
Correct Answer: c
Explanation: Epoetin alfa (erythropoietin) stimulates red blood cell production in premature
infants with anemia of prematurity. A decrease in tachycardia (from 180s to 140s) indicates
improved oxygen-carrying capacity and is a key sign of effectiveness.
8. A pregnant client tells the nurse that the first day of her last menstrual period was August 2,
2006. Based on Nagele's rule, what is the estimated date of delivery?
a. April 25, 2007
b. May 9, 2007
c. May 29, 2007
d. June 2, 2007
Correct Answer: b
, Explanation: Nagele’s rule: Add 7 days to the first day of the LMP (August 2 + 7 = August 9),
subtract 3 months (May 9), and add 1 year (2007). The estimated due date is May 9, 2007.
9. The nurse is performing a AGA on a full-term newborn during the first hour of transition using
the Dubowitz scale. Based on this assessment, the nurse determines that the neonate has a
maturity rating of 40 weeks. Which findings should the nurse identify to determine if the neonate
is SGA? (Select all that apply.)
a. admission weight of 4 lbs 15 oz
b. head to heel length of 17 in
c. frontal occipital circumference of 12.5 in
d. skin smooth with visible veins and abundant vernix
e. anterior plantar crease and smooth heel surfaces
f. full flexion of all extremities in resting supine position
Correct Answers: a, b, c
Explanation: Small for gestational age (SGA) is determined by measurements below the 10th
percentile for gestational age. Low birth weight (4 lb 15 oz), short length (17 in), and small head
circumference (12.5 in) indicate SGA. Options d, e, and f are normal findings for a term infant.
10. The nurse assess a client admitted to the labor and delivery unit and obtains the following
data: BP 110/68, FHR 110 bpm, cervix 1 cm dilated and uneffaced. Based on these assessment
findings, what intervention should the nurse implement?
a. insert a fetal monitor
b. assess for cervical changes q1H
c. monitor bleeding from IV sites
d. perform Leopold's maneuvers
Correct Answer: c
Explanation: The findings suggest possible placental abruption or bleeding (especially if there is
concealed hemorrhage). Monitoring for signs of bleeding (including from IV sites) is essential to
detect coagulopathy or disseminated intravascular coagulation (DIC).
11. Immediately after birth a newborn infant is suctioned, dried, and placed under a radiant
warmer. The infant has spontaneous respirations and the nurse assess an apical heart rate of 80
bpm and respirations 20. What action should the nurse perform next?
a. initiate positive pressure ventilation
