Peds & Maternity HESI Exam 2026 –
Complete Practice Questions & Verified
Answers (Latest Updated Study Guide)
Peds & Maternity HESI Exam 2026 – Complete Practice Questions & Verified
Answers
• This study guide contains 200 comprehensive, exam-style multiple choice
questions with verified answers and detailed EXPERT RATIONALE to help you
master Pediatrics and Maternity nursing concepts for the HESI exit exam.
• Use this material by reading each question carefully, selecting your answer before
checking the highlighted correct option, then studying the EXPERT RATIONALE to
reinforce your clinical reasoning and understanding.
QUESTION 1: A nurse is caring for a newborn at 1 minute after birth. The
newborn has a heart rate of 96 bpm, weak cry, some flexion of extremities,
grimaces to stimulation, and has a pink body with blue extremities. What is
the Apgar score?
A. 4
B. 5
C. 6
D. 7
E. 3
Correct Answer: B. 5
EXPERT RATIONALE: Heart rate below 100 = 1 point; weak cry (slow/irregular) = 1 point;
some flexion = 1 point; grimace = 1 point; pink body/blue extremities (acrocyanosis) = 1
point. Total = 5.
QUESTION 2: A client at 36 weeks gestation presents with painless, bright red
vaginal bleeding. Which condition should the nurse suspect first?
, A. Abruptio placentae
B. Preterm labor
C. Uterine rupture
D. Vasa previa
E. Placenta previa
Correct Answer: E. Placenta previa
EXPERT RATIONALE: Placenta previa classically presents with painless, bright red
vaginal bleeding in the third trimester due to the placenta covering the cervical os.
Abruptio placentae presents with painful, dark bleeding.
QUESTION 3: A nurse is assessing a 2-year-old child. Which developmental
milestone is expected at this age?
A. Rides a tricycle
B. Ties shoelaces
C. Speaks in 2-word phrases
D. Counts to 10
E. Skips on one foot
Correct Answer: C. Speaks in 2-word phrases
EXPERT RATIONALE: By age 2, children are expected to use 2-word phrases (e.g., "more
milk"). Riding a tricycle occurs at age 3, and more complex skills develop later in
childhood.
QUESTION 4: A pregnant client at 28 weeks is diagnosed with gestational
diabetes. Which dietary instruction is most important?
A. Eliminate all carbohydrates
B. Increase protein to 100g daily
, C. Consume consistent carbohydrates distributed throughout the day
D. Avoid all fats
E. Eat only two large meals per day
Correct Answer: C. Consume consistent carbohydrates distributed
throughout the day
EXPERT RATIONALE: Consistent carbohydrate distribution prevents blood glucose
spikes. Small frequent meals with controlled carbohydrate content are the cornerstone
of gestational diabetes dietary management.
QUESTION 5: A child is admitted with epiglottitis. Which action should the
nurse take first?
A. Obtain a throat culture
B. Place the child supine
C. Prepare for nasotracheal intubation
D. Administer antipyretics orally
E. Have the child open mouth for inspection
Correct Answer: C. Prepare for nasotracheal intubation
EXPERT RATIONALE: Epiglottitis is a life-threatening emergency. The priority is airway
management. Nothing should be inserted into the mouth as it can cause total airway
obstruction. Intubation equipment must be immediately available.
QUESTION 6: A nurse is caring for a postpartum client who delivered 1 hour
ago. The fundus is boggy and displaced to the right. What is the priority
intervention?
A. Administer oxytocin immediately
B. Massage the fundus firmly
, C. Assist the client to empty her bladder
D. Notify the physician
E. Increase IV fluid rate
Correct Answer: C. Assist the client to empty her bladder
EXPERT RATIONALE: A fundus displaced to the right indicates a full bladder pushing the
uterus. The priority is bladder emptying, which allows the uterus to contract properly
and descend to the midline.
QUESTION 7: A 4-year-old is brought to the ER with a barking cough,
inspiratory stridor, and low-grade fever. Which condition does the nurse
suspect?
A. Epiglottitis
B. Asthma
C. Bronchiolitis
D. Croup (laryngotracheobronchitis)
E. Foreign body aspiration
Correct Answer: D. Croup (laryngotracheobronchitis)
EXPERT RATIONALE: Croup presents with the classic "seal-like" barking cough,
inspiratory stridor, and low-grade fever. It is caused by parainfluenza virus and is most
common in children ages 6 months to 3 years, but can occur up to age 5.
QUESTION 8: A nurse is reviewing a fetal heart rate (FHR) tracing. Which
finding requires immediate intervention?
A. Early decelerations
B. Accelerations with fetal movement
C. Baseline FHR of 140 bpm
Complete Practice Questions & Verified
Answers (Latest Updated Study Guide)
Peds & Maternity HESI Exam 2026 – Complete Practice Questions & Verified
Answers
• This study guide contains 200 comprehensive, exam-style multiple choice
questions with verified answers and detailed EXPERT RATIONALE to help you
master Pediatrics and Maternity nursing concepts for the HESI exit exam.
• Use this material by reading each question carefully, selecting your answer before
checking the highlighted correct option, then studying the EXPERT RATIONALE to
reinforce your clinical reasoning and understanding.
QUESTION 1: A nurse is caring for a newborn at 1 minute after birth. The
newborn has a heart rate of 96 bpm, weak cry, some flexion of extremities,
grimaces to stimulation, and has a pink body with blue extremities. What is
the Apgar score?
A. 4
B. 5
C. 6
D. 7
E. 3
Correct Answer: B. 5
EXPERT RATIONALE: Heart rate below 100 = 1 point; weak cry (slow/irregular) = 1 point;
some flexion = 1 point; grimace = 1 point; pink body/blue extremities (acrocyanosis) = 1
point. Total = 5.
QUESTION 2: A client at 36 weeks gestation presents with painless, bright red
vaginal bleeding. Which condition should the nurse suspect first?
, A. Abruptio placentae
B. Preterm labor
C. Uterine rupture
D. Vasa previa
E. Placenta previa
Correct Answer: E. Placenta previa
EXPERT RATIONALE: Placenta previa classically presents with painless, bright red
vaginal bleeding in the third trimester due to the placenta covering the cervical os.
Abruptio placentae presents with painful, dark bleeding.
QUESTION 3: A nurse is assessing a 2-year-old child. Which developmental
milestone is expected at this age?
A. Rides a tricycle
B. Ties shoelaces
C. Speaks in 2-word phrases
D. Counts to 10
E. Skips on one foot
Correct Answer: C. Speaks in 2-word phrases
EXPERT RATIONALE: By age 2, children are expected to use 2-word phrases (e.g., "more
milk"). Riding a tricycle occurs at age 3, and more complex skills develop later in
childhood.
QUESTION 4: A pregnant client at 28 weeks is diagnosed with gestational
diabetes. Which dietary instruction is most important?
A. Eliminate all carbohydrates
B. Increase protein to 100g daily
, C. Consume consistent carbohydrates distributed throughout the day
D. Avoid all fats
E. Eat only two large meals per day
Correct Answer: C. Consume consistent carbohydrates distributed
throughout the day
EXPERT RATIONALE: Consistent carbohydrate distribution prevents blood glucose
spikes. Small frequent meals with controlled carbohydrate content are the cornerstone
of gestational diabetes dietary management.
QUESTION 5: A child is admitted with epiglottitis. Which action should the
nurse take first?
A. Obtain a throat culture
B. Place the child supine
C. Prepare for nasotracheal intubation
D. Administer antipyretics orally
E. Have the child open mouth for inspection
Correct Answer: C. Prepare for nasotracheal intubation
EXPERT RATIONALE: Epiglottitis is a life-threatening emergency. The priority is airway
management. Nothing should be inserted into the mouth as it can cause total airway
obstruction. Intubation equipment must be immediately available.
QUESTION 6: A nurse is caring for a postpartum client who delivered 1 hour
ago. The fundus is boggy and displaced to the right. What is the priority
intervention?
A. Administer oxytocin immediately
B. Massage the fundus firmly
, C. Assist the client to empty her bladder
D. Notify the physician
E. Increase IV fluid rate
Correct Answer: C. Assist the client to empty her bladder
EXPERT RATIONALE: A fundus displaced to the right indicates a full bladder pushing the
uterus. The priority is bladder emptying, which allows the uterus to contract properly
and descend to the midline.
QUESTION 7: A 4-year-old is brought to the ER with a barking cough,
inspiratory stridor, and low-grade fever. Which condition does the nurse
suspect?
A. Epiglottitis
B. Asthma
C. Bronchiolitis
D. Croup (laryngotracheobronchitis)
E. Foreign body aspiration
Correct Answer: D. Croup (laryngotracheobronchitis)
EXPERT RATIONALE: Croup presents with the classic "seal-like" barking cough,
inspiratory stridor, and low-grade fever. It is caused by parainfluenza virus and is most
common in children ages 6 months to 3 years, but can occur up to age 5.
QUESTION 8: A nurse is reviewing a fetal heart rate (FHR) tracing. Which
finding requires immediate intervention?
A. Early decelerations
B. Accelerations with fetal movement
C. Baseline FHR of 140 bpm
