2026-2027 HESI MATERNITY OB EXAMINATION ||
LATEST VERSION WITH APPROVED QUESTIONS AND
CORRECT ANSWERS WITH WELL REVISED
RATIONALES || 100% PASS || BRANDNEW!!!!!
A nurse assessing a newborn delivered vaginally with forceps notes red marks on the scalp
and localized swelling that does not cross the suture lines. Which condition should the nurse
document?
A. Caput succedaneum
B. Hydrocephalus
C. Cephalhematoma
D. Microcephaly
Correct Answer: C. Cephalhematoma
Rationale:
Cephalhematoma is a collection of blood beneath the periosteum caused by trauma during
delivery, especially forceps or vacuum-assisted births. Because the bleeding occurs beneath
the periosteum, the swelling is confined to one cranial bone and does not cross suture lines.
The condition may appear several hours after birth and usually resolves spontaneously over
weeks to months. Careful observation is required because breakdown of the blood may
contribute to jaundice.
Caput succedaneum differs because it is edema of the scalp that crosses suture lines.
Hydrocephalus involves enlargement of the ventricles with increased head circumference,
while microcephaly refers to an abnormally small head size related to impaired brain
development.
A client at 34 weeks’ gestation arrives with painless bright red vaginal bleeding that began
one hour ago. Fetal heart rate is 130–140 beats/minute, contractions are absent, and the
client denies pain. What is the most likely cause of the bleeding?
A. Abruptio placentae
B. Placenta previa
C. Normal bloody show indicating labor
D. Ruptured vaginal blood vessel
Correct Answer: B. Placenta previa
,Rationale:
Placenta previa occurs when the placenta implants in the lower uterine segment partially or
completely covering the cervical os. The classic presentation is painless, bright red vaginal
bleeding during the second or third trimester. Uterine tone is typically soft, and fetal distress
may initially be absent.
Abruptio placentae usually presents with painful dark bleeding, uterine tenderness, and
contractions. Bloody show occurs near labor onset and is usually mixed with mucus. A
ruptured vaginal vessel would not typically produce recurrent third-trimester bleeding of
this nature.
A client at 30 weeks’ gestation reports absence of fetal movement for 24 hours. Which
assessment finding requires immediate nursing intervention?
A. Fetal heart rate of 60 beats/minute
B. Ruptured amniotic membranes
C. Onset of uterine contractions
D. Leaking amniotic fluid
Correct Answer: A. Fetal heart rate of 60 beats/minute
Rationale:
A fetal heart rate of 60 beats/minute indicates profound fetal bradycardia and severe fetal
compromise. Immediate intervention is required to prevent fetal hypoxia, acidosis, and
death. Normal fetal heart rate ranges from 110–160 beats/minute.
Although ruptured membranes, contractions, and leaking fluid are significant findings, they
are not as immediately life-threatening as severe bradycardia.
A client at 37 weeks’ gestation presents with contractions every two minutes. The nurse
observes clusters of shallow vesicles on the labia and perineum. Which condition should the
nurse suspect?
A. Genital warts
B. Syphilis
C. Herpes simplex virus
D. German measles
Correct Answer: C. Herpes simplex virus
Rationale:
Painful vesicular lesions on the genitalia are characteristic of herpes simplex virus (HSV).
Active genital herpes during labor presents a major risk for neonatal herpes infection, which
,can lead to severe neurologic injury or death. Cesarean delivery is often indicated if active
lesions are present.
Genital warts present as cauliflower-like growths caused by HPV. Syphilis lesions are
chancres or rashes rather than vesicles. German measles is a systemic viral illness and does
not produce genital vesicles.
A client at 30 weeks’ gestation is experiencing preterm labor. Which prescription is most
important for preventing respiratory distress syndrome in the fetus?
A. Ampicillin 1 g IV every 8 hours
B. Betamethasone 12 mg IM
C. Terbutaline 0.25 mg subcutaneously
D. Butorphanol tartrate 1 mg IV PRN
Correct Answer: B. Betamethasone 12 mg IM
Rationale:
Betamethasone is a corticosteroid administered to accelerate fetal lung maturity by
stimulating surfactant production. This significantly decreases the risk of neonatal
respiratory distress syndrome, intraventricular hemorrhage, and neonatal mortality in
preterm infants.
Terbutaline suppresses contractions but does not mature fetal lungs. Ampicillin treats
infection, and butorphanol is an analgesic.
A 16-year-old gravida 1 para 0 client is admitted with eclampsia but is not actively seizing.
Which intervention is most important?
A. Allow unrestricted visitation
B. Keep an airway at the bedside
C. Assess temperature hourly
D. Monitor vital signs every 4 hours
Correct Answer: B. Keep an airway at the bedside
Rationale:
Clients with eclampsia are at high risk for seizures. Maintaining airway equipment at the
bedside is critical to preserve oxygenation during seizure activity. Emergency seizure
precautions include padded side rails, oxygen setup, suction equipment, and airway devices.
Monitoring every four hours is insufficient for an unstable client. Family visitation and hourly
temperatures are secondary concerns.
, Twelve hours after delivery, a client reports persistent vaginal pressure. The fundus is firm
and midline with moderate rubra lochia. What should the nurse do first?
A. Assess for bladder distention
B. Recommend a warm sitz bath
C. Inspect the perineal and rectal areas
D. Reassess in one hour
Correct Answer: C. Inspect the perineal and rectal areas
Rationale:
Persistent pressure despite a firm uterus suggests a perineal hematoma. Inspection is
necessary to identify swelling, discoloration, or concealed bleeding. Hematomas can become
life-threatening if not recognized promptly.
A distended bladder usually causes uterine displacement and bogginess. Delaying
assessment may worsen complications.
A 36-week pregnant Rh-negative client experiences abdominal trauma in a motor vehicle
accident. Which finding is most important to report?
A. Fetal heart rate of 162 beats/minute
B. Mild contractions every 10 minutes
C. Trace proteinuria
D. Positive fetal hemoglobin test
Correct Answer: D. Positive fetal hemoglobin test
Rationale:
A positive fetal hemoglobin test indicates fetomaternal hemorrhage, where fetal blood has
entered the maternal circulation. In an Rh-negative mother, this increases the risk of
isoimmunization and hemolytic disease in future pregnancies. Immediate administration of
Rh immune globulin may be necessary.
Mild contractions and mild tachycardia may occur after trauma but are less critical than
confirmed fetomaternal bleeding.
Using the Ballard Gestational Age Assessment Tool, the nurse determines a newborn is 42
weeks’ gestation. Which intervention is most important?
A. Provide blow-by oxygen
B. Obtain a capillary blood glucose
LATEST VERSION WITH APPROVED QUESTIONS AND
CORRECT ANSWERS WITH WELL REVISED
RATIONALES || 100% PASS || BRANDNEW!!!!!
A nurse assessing a newborn delivered vaginally with forceps notes red marks on the scalp
and localized swelling that does not cross the suture lines. Which condition should the nurse
document?
A. Caput succedaneum
B. Hydrocephalus
C. Cephalhematoma
D. Microcephaly
Correct Answer: C. Cephalhematoma
Rationale:
Cephalhematoma is a collection of blood beneath the periosteum caused by trauma during
delivery, especially forceps or vacuum-assisted births. Because the bleeding occurs beneath
the periosteum, the swelling is confined to one cranial bone and does not cross suture lines.
The condition may appear several hours after birth and usually resolves spontaneously over
weeks to months. Careful observation is required because breakdown of the blood may
contribute to jaundice.
Caput succedaneum differs because it is edema of the scalp that crosses suture lines.
Hydrocephalus involves enlargement of the ventricles with increased head circumference,
while microcephaly refers to an abnormally small head size related to impaired brain
development.
A client at 34 weeks’ gestation arrives with painless bright red vaginal bleeding that began
one hour ago. Fetal heart rate is 130–140 beats/minute, contractions are absent, and the
client denies pain. What is the most likely cause of the bleeding?
A. Abruptio placentae
B. Placenta previa
C. Normal bloody show indicating labor
D. Ruptured vaginal blood vessel
Correct Answer: B. Placenta previa
,Rationale:
Placenta previa occurs when the placenta implants in the lower uterine segment partially or
completely covering the cervical os. The classic presentation is painless, bright red vaginal
bleeding during the second or third trimester. Uterine tone is typically soft, and fetal distress
may initially be absent.
Abruptio placentae usually presents with painful dark bleeding, uterine tenderness, and
contractions. Bloody show occurs near labor onset and is usually mixed with mucus. A
ruptured vaginal vessel would not typically produce recurrent third-trimester bleeding of
this nature.
A client at 30 weeks’ gestation reports absence of fetal movement for 24 hours. Which
assessment finding requires immediate nursing intervention?
A. Fetal heart rate of 60 beats/minute
B. Ruptured amniotic membranes
C. Onset of uterine contractions
D. Leaking amniotic fluid
Correct Answer: A. Fetal heart rate of 60 beats/minute
Rationale:
A fetal heart rate of 60 beats/minute indicates profound fetal bradycardia and severe fetal
compromise. Immediate intervention is required to prevent fetal hypoxia, acidosis, and
death. Normal fetal heart rate ranges from 110–160 beats/minute.
Although ruptured membranes, contractions, and leaking fluid are significant findings, they
are not as immediately life-threatening as severe bradycardia.
A client at 37 weeks’ gestation presents with contractions every two minutes. The nurse
observes clusters of shallow vesicles on the labia and perineum. Which condition should the
nurse suspect?
A. Genital warts
B. Syphilis
C. Herpes simplex virus
D. German measles
Correct Answer: C. Herpes simplex virus
Rationale:
Painful vesicular lesions on the genitalia are characteristic of herpes simplex virus (HSV).
Active genital herpes during labor presents a major risk for neonatal herpes infection, which
,can lead to severe neurologic injury or death. Cesarean delivery is often indicated if active
lesions are present.
Genital warts present as cauliflower-like growths caused by HPV. Syphilis lesions are
chancres or rashes rather than vesicles. German measles is a systemic viral illness and does
not produce genital vesicles.
A client at 30 weeks’ gestation is experiencing preterm labor. Which prescription is most
important for preventing respiratory distress syndrome in the fetus?
A. Ampicillin 1 g IV every 8 hours
B. Betamethasone 12 mg IM
C. Terbutaline 0.25 mg subcutaneously
D. Butorphanol tartrate 1 mg IV PRN
Correct Answer: B. Betamethasone 12 mg IM
Rationale:
Betamethasone is a corticosteroid administered to accelerate fetal lung maturity by
stimulating surfactant production. This significantly decreases the risk of neonatal
respiratory distress syndrome, intraventricular hemorrhage, and neonatal mortality in
preterm infants.
Terbutaline suppresses contractions but does not mature fetal lungs. Ampicillin treats
infection, and butorphanol is an analgesic.
A 16-year-old gravida 1 para 0 client is admitted with eclampsia but is not actively seizing.
Which intervention is most important?
A. Allow unrestricted visitation
B. Keep an airway at the bedside
C. Assess temperature hourly
D. Monitor vital signs every 4 hours
Correct Answer: B. Keep an airway at the bedside
Rationale:
Clients with eclampsia are at high risk for seizures. Maintaining airway equipment at the
bedside is critical to preserve oxygenation during seizure activity. Emergency seizure
precautions include padded side rails, oxygen setup, suction equipment, and airway devices.
Monitoring every four hours is insufficient for an unstable client. Family visitation and hourly
temperatures are secondary concerns.
, Twelve hours after delivery, a client reports persistent vaginal pressure. The fundus is firm
and midline with moderate rubra lochia. What should the nurse do first?
A. Assess for bladder distention
B. Recommend a warm sitz bath
C. Inspect the perineal and rectal areas
D. Reassess in one hour
Correct Answer: C. Inspect the perineal and rectal areas
Rationale:
Persistent pressure despite a firm uterus suggests a perineal hematoma. Inspection is
necessary to identify swelling, discoloration, or concealed bleeding. Hematomas can become
life-threatening if not recognized promptly.
A distended bladder usually causes uterine displacement and bogginess. Delaying
assessment may worsen complications.
A 36-week pregnant Rh-negative client experiences abdominal trauma in a motor vehicle
accident. Which finding is most important to report?
A. Fetal heart rate of 162 beats/minute
B. Mild contractions every 10 minutes
C. Trace proteinuria
D. Positive fetal hemoglobin test
Correct Answer: D. Positive fetal hemoglobin test
Rationale:
A positive fetal hemoglobin test indicates fetomaternal hemorrhage, where fetal blood has
entered the maternal circulation. In an Rh-negative mother, this increases the risk of
isoimmunization and hemolytic disease in future pregnancies. Immediate administration of
Rh immune globulin may be necessary.
Mild contractions and mild tachycardia may occur after trauma but are less critical than
confirmed fetomaternal bleeding.
Using the Ballard Gestational Age Assessment Tool, the nurse determines a newborn is 42
weeks’ gestation. Which intervention is most important?
A. Provide blow-by oxygen
B. Obtain a capillary blood glucose
