OB MATERNITY HESI EXIT EXAM |
Versions 1, 2 & 3 — Practice Test Bank —
250 MCQs | with correct answers and
rationales
1. A primigravida at 39 weeks gestation reports decreased fetal movement. Which
nursing action is the priority?
A) Reassure the patient that decreased movement is normal near term
B) Instruct the patient to perform a fetal kick count and report fewer than 10
movements in 2 hours (correct answer)
C) Schedule a non-stress test for the following week
D) Advise the patient to drink cold water and lie on her left side
Rationale: Decreased fetal movement requires immediate assessment; the kick
count test (10 movements in 2 hours) is the initial screening tool; if the count is
inadequate, further evaluation (NST, BPP) is urgently needed to rule out fetal
compromise.
2. A client at 28 weeks gestation presents with painless, bright red vaginal
bleeding. What is the most likely cause?
A) Placental abruption
B) Placenta previa (correct answer)
, C) Preterm labor
D) Cervical polyp
Rationale: Painless, bright red vaginal bleeding in the second or third
trimester is the classic presentation of placenta previa (low-lying placenta);
placental abruption typically presents with painful, dark red bleeding.
3. What is the priority nursing intervention for a patient with suspected placenta
previa?
A) Perform a vaginal examination to assess cervical dilation
B) Place the patient on bed rest, establish IV access, and monitor fetal heart
tones — do NOT perform a vaginal examination (correct answer)
C) Prepare the patient for immediate cesarean birth
D) Administer tocolytic therapy immediately
Rationale: Vaginal examination is strictly contraindicated with placenta
previa — it can precipitate severe hemorrhage; IV access, bed rest,
continuous fetal monitoring, and cross-matching blood are immediate
priorities.
4. A multigravida at 34 weeks presents with sudden, severe abdominal pain and
board-like uterine rigidity. Vital signs show BP 88/50, HR 128. What condition
does the nurse suspect?
A) Placenta previa
, B) Placental abruption (correct answer)
C) Uterine rupture
D) Preterm labor
Rationale: Sudden severe abdominal pain, board-like (rigid) uterus, and
maternal shock (hypotension, tachycardia) are hallmarks of severe placental
abruption (abruptio placentae) with concealed hemorrhage.
5. What is the Nagele's Rule for calculating the estimated date of delivery (EDD)?
A) First day of LMP + 9 months + 7 days
B) First day of LMP − 3 months + 7 days + 1 year (correct answer)
C) First day of LMP + 40 weeks
D) Last day of LMP + 280 days
Rationale: Nagele's Rule: take the first day of the last menstrual period,
subtract 3 months, add 7 days, and add 1 year (or add 9 months and 7 days)
— gives the estimated due date at approximately 40 weeks gestation.
6. A patient's LMP was October 10. Using Nagele's Rule, what is the EDD?
A) June 17
B) July 17 (correct answer)
C) August 10
D) June 10
, Rationale: October 10 − 3 months = July 10; July 10 + 7 days = July 17; the
EDD is July 17 of the following year.
7. At which gestational age is quickening (first perception of fetal movement)
typically first felt by a primigravida?
A) 8–10 weeks
B) 14–16 weeks
C) 18–20 weeks (correct answer)
D) 24–26 weeks
Rationale: Primigravidas typically first perceive fetal movement (quickening)
between 18–20 weeks; multigravidas may feel movement earlier (16–18 weeks)
because they recognize the sensation from previous pregnancies.
8. What is the expected fundal height at 20 weeks gestation?
A) At the symphysis pubis
B) At the umbilicus (correct answer)
C) 2 cm above the umbilicus
D) Halfway between the symphysis and umbilicus
Rationale: After 20 weeks gestation, fundal height in centimeters
approximately equals gestational age in weeks (McDonald's rule); at 20 weeks,
the fundus is at the umbilicus (approximately 20 cm from symphysis pubis).
Versions 1, 2 & 3 — Practice Test Bank —
250 MCQs | with correct answers and
rationales
1. A primigravida at 39 weeks gestation reports decreased fetal movement. Which
nursing action is the priority?
A) Reassure the patient that decreased movement is normal near term
B) Instruct the patient to perform a fetal kick count and report fewer than 10
movements in 2 hours (correct answer)
C) Schedule a non-stress test for the following week
D) Advise the patient to drink cold water and lie on her left side
Rationale: Decreased fetal movement requires immediate assessment; the kick
count test (10 movements in 2 hours) is the initial screening tool; if the count is
inadequate, further evaluation (NST, BPP) is urgently needed to rule out fetal
compromise.
2. A client at 28 weeks gestation presents with painless, bright red vaginal
bleeding. What is the most likely cause?
A) Placental abruption
B) Placenta previa (correct answer)
, C) Preterm labor
D) Cervical polyp
Rationale: Painless, bright red vaginal bleeding in the second or third
trimester is the classic presentation of placenta previa (low-lying placenta);
placental abruption typically presents with painful, dark red bleeding.
3. What is the priority nursing intervention for a patient with suspected placenta
previa?
A) Perform a vaginal examination to assess cervical dilation
B) Place the patient on bed rest, establish IV access, and monitor fetal heart
tones — do NOT perform a vaginal examination (correct answer)
C) Prepare the patient for immediate cesarean birth
D) Administer tocolytic therapy immediately
Rationale: Vaginal examination is strictly contraindicated with placenta
previa — it can precipitate severe hemorrhage; IV access, bed rest,
continuous fetal monitoring, and cross-matching blood are immediate
priorities.
4. A multigravida at 34 weeks presents with sudden, severe abdominal pain and
board-like uterine rigidity. Vital signs show BP 88/50, HR 128. What condition
does the nurse suspect?
A) Placenta previa
, B) Placental abruption (correct answer)
C) Uterine rupture
D) Preterm labor
Rationale: Sudden severe abdominal pain, board-like (rigid) uterus, and
maternal shock (hypotension, tachycardia) are hallmarks of severe placental
abruption (abruptio placentae) with concealed hemorrhage.
5. What is the Nagele's Rule for calculating the estimated date of delivery (EDD)?
A) First day of LMP + 9 months + 7 days
B) First day of LMP − 3 months + 7 days + 1 year (correct answer)
C) First day of LMP + 40 weeks
D) Last day of LMP + 280 days
Rationale: Nagele's Rule: take the first day of the last menstrual period,
subtract 3 months, add 7 days, and add 1 year (or add 9 months and 7 days)
— gives the estimated due date at approximately 40 weeks gestation.
6. A patient's LMP was October 10. Using Nagele's Rule, what is the EDD?
A) June 17
B) July 17 (correct answer)
C) August 10
D) June 10
, Rationale: October 10 − 3 months = July 10; July 10 + 7 days = July 17; the
EDD is July 17 of the following year.
7. At which gestational age is quickening (first perception of fetal movement)
typically first felt by a primigravida?
A) 8–10 weeks
B) 14–16 weeks
C) 18–20 weeks (correct answer)
D) 24–26 weeks
Rationale: Primigravidas typically first perceive fetal movement (quickening)
between 18–20 weeks; multigravidas may feel movement earlier (16–18 weeks)
because they recognize the sensation from previous pregnancies.
8. What is the expected fundal height at 20 weeks gestation?
A) At the symphysis pubis
B) At the umbilicus (correct answer)
C) 2 cm above the umbilicus
D) Halfway between the symphysis and umbilicus
Rationale: After 20 weeks gestation, fundal height in centimeters
approximately equals gestational age in weeks (McDonald's rule); at 20 weeks,
the fundus is at the umbilicus (approximately 20 cm from symphysis pubis).
