HESI RN Maternity – Comprehensive Practice
Exam
SECTION 1: Antepartum (Questions 1-25)
Q1. A client at 12 weeks gestation reports nausea and vomiting. Which
intervention should the nurse recommend FIRST?
• A) Eat small, frequent meals
• B) Drink fluids with meals
• C) Lie flat after eating
• D) Take prenatal vitamins on an empty stomach
Answer: A – Small, frequent meals help prevent the hypoglycemia that can
trigger nausea. High-protein snacks (cheese, nuts) are especially helpful
before bed and upon awakening. Drinking fluids with meals can cause early
satiety and aggravate nausea.
Q2. A nurse is calculating the estimated date of birth (EDB) using
Naegele's rule. The client's last menstrual period (LMP) was May 15.
What is the estimated date of birth?
• A) February 8
• B) February 15
• C) February 22
• D) February 28
Answer: C – Naegele's rule: add 7 days to LMP, subtract 3 months, add 1
year. May 15 → May 22 → February 22 (of the following year). February 22 is
the correct EDB.
Q3. A client at 36 weeks gestation reports that her baby is "dropping."
The nurse should document this as:
, • A) Quickening
• B) Ballottement
• C) Lightening
• D) Engagement
Answer: C – Lightening refers to the descent of the fetal head into the
pelvis, typically occurring 2-4 weeks before labor in primigravidas. The
mother may report the baby "dropping" and may experience increased
urinary frequency and easier breathing.
Q4. A client at 32 weeks gestation is diagnosed with gestational
diabetes. Which finding is MOST concerning?
• A) Fasting blood glucose of 95 mg/dL
• B) Polyhydramnios on ultrasound
• C) Fetal macrosomia
• D) Urinary frequency
Answer: B – Polyhydramnios (excessive amniotic fluid) is a complication of
gestational diabetes associated with fetal anomalies and preterm labor.
Fasting blood glucose of 95 mg/dL is within target range (60-95 mg/dL).
Macrosomia is a common complication but polyhydramnios indicates
more immediate risk.
Q5. A client at 28 weeks gestation with preeclampsia has a blood
pressure of 150/96 mmHg and 2+ proteinuria. The nurse should prepare
for which intervention?
• A) Bed rest
• B) Magnesium sulfate administration
• C) Immediate delivery
• D) Oral antihypertensives
,Answer: B – Magnesium sulfate is the drug of choice for seizure prophylaxis
in preeclampsia with severe features. The client's BP (150/96) and
proteinuria indicate worsening preeclampsia requiring close monitoring
and possible magnesium sulfate therapy.
Q6. A client at 20 weeks gestation reports "I am feeling the baby move."
The nurse should document this as:
• A) Lightening
• B) Ballottement
• C) Quickening
• D) Engagement
Answer: C – Quickening is the mother's perception of fetal movement,
typically occurring between 16-20 weeks gestation (earlier in multiparas).
This is an important milestone in fetal development.
Q7. A client at 24 weeks gestation is diagnosed with a urinary tract
infection. Which antibiotic should the nurse expect to be prescribed?
• A) Doxycycline
• B) Ciprofloxacin
• C) Nitrofurantoin
• D) Tetracycline
Answer: C – Nitrofurantoin is a safe antibiotic for UTIs during pregnancy.
Doxycycline and tetracycline are contraindicated (discoloration of fetal
teeth). Ciprofloxacin is generally avoided during pregnancy due to concern
for fetal cartilage damage.
, Q8. A client at 28 weeks gestation with gestational diabetes has a blood
glucose of 120 mg/dL 2 hours after a meal. What is the appropriate
nursing action?
• A) Notify the healthcare provider
• B) Administer sliding-scale insulin
• C) Document the finding
• D) Encourage the client to walk
Answer: C – This blood glucose is within the target range for gestational
diabetes (<120 mg/dL 2 hours postprandial). Documentation is appropriate;
no intervention is needed.
Q9. A client at 30 weeks gestation reports severe headache, blurred
vision, and epigastric pain. The nurse should suspect:
• A) Normal pregnancy symptoms
• B) Preeclampsia
• C) Gestational diabetes
• D) Placental abruption
Answer: B – Headache, visual disturbances, and epigastric pain (hepatic
capsule distension) are classic signs of severe preeclampsia. These
symptoms require immediate evaluation and treatment to prevent seizures.
Q10. The nurse is assessing a client at 32 weeks gestation. Which
finding is MOST suggestive of preterm labor?
• A) Braxton Hicks contractions
• B) Rupture of membranes
• C) Cervical dilation
• D) Weight gain
Exam
SECTION 1: Antepartum (Questions 1-25)
Q1. A client at 12 weeks gestation reports nausea and vomiting. Which
intervention should the nurse recommend FIRST?
• A) Eat small, frequent meals
• B) Drink fluids with meals
• C) Lie flat after eating
• D) Take prenatal vitamins on an empty stomach
Answer: A – Small, frequent meals help prevent the hypoglycemia that can
trigger nausea. High-protein snacks (cheese, nuts) are especially helpful
before bed and upon awakening. Drinking fluids with meals can cause early
satiety and aggravate nausea.
Q2. A nurse is calculating the estimated date of birth (EDB) using
Naegele's rule. The client's last menstrual period (LMP) was May 15.
What is the estimated date of birth?
• A) February 8
• B) February 15
• C) February 22
• D) February 28
Answer: C – Naegele's rule: add 7 days to LMP, subtract 3 months, add 1
year. May 15 → May 22 → February 22 (of the following year). February 22 is
the correct EDB.
Q3. A client at 36 weeks gestation reports that her baby is "dropping."
The nurse should document this as:
, • A) Quickening
• B) Ballottement
• C) Lightening
• D) Engagement
Answer: C – Lightening refers to the descent of the fetal head into the
pelvis, typically occurring 2-4 weeks before labor in primigravidas. The
mother may report the baby "dropping" and may experience increased
urinary frequency and easier breathing.
Q4. A client at 32 weeks gestation is diagnosed with gestational
diabetes. Which finding is MOST concerning?
• A) Fasting blood glucose of 95 mg/dL
• B) Polyhydramnios on ultrasound
• C) Fetal macrosomia
• D) Urinary frequency
Answer: B – Polyhydramnios (excessive amniotic fluid) is a complication of
gestational diabetes associated with fetal anomalies and preterm labor.
Fasting blood glucose of 95 mg/dL is within target range (60-95 mg/dL).
Macrosomia is a common complication but polyhydramnios indicates
more immediate risk.
Q5. A client at 28 weeks gestation with preeclampsia has a blood
pressure of 150/96 mmHg and 2+ proteinuria. The nurse should prepare
for which intervention?
• A) Bed rest
• B) Magnesium sulfate administration
• C) Immediate delivery
• D) Oral antihypertensives
,Answer: B – Magnesium sulfate is the drug of choice for seizure prophylaxis
in preeclampsia with severe features. The client's BP (150/96) and
proteinuria indicate worsening preeclampsia requiring close monitoring
and possible magnesium sulfate therapy.
Q6. A client at 20 weeks gestation reports "I am feeling the baby move."
The nurse should document this as:
• A) Lightening
• B) Ballottement
• C) Quickening
• D) Engagement
Answer: C – Quickening is the mother's perception of fetal movement,
typically occurring between 16-20 weeks gestation (earlier in multiparas).
This is an important milestone in fetal development.
Q7. A client at 24 weeks gestation is diagnosed with a urinary tract
infection. Which antibiotic should the nurse expect to be prescribed?
• A) Doxycycline
• B) Ciprofloxacin
• C) Nitrofurantoin
• D) Tetracycline
Answer: C – Nitrofurantoin is a safe antibiotic for UTIs during pregnancy.
Doxycycline and tetracycline are contraindicated (discoloration of fetal
teeth). Ciprofloxacin is generally avoided during pregnancy due to concern
for fetal cartilage damage.
, Q8. A client at 28 weeks gestation with gestational diabetes has a blood
glucose of 120 mg/dL 2 hours after a meal. What is the appropriate
nursing action?
• A) Notify the healthcare provider
• B) Administer sliding-scale insulin
• C) Document the finding
• D) Encourage the client to walk
Answer: C – This blood glucose is within the target range for gestational
diabetes (<120 mg/dL 2 hours postprandial). Documentation is appropriate;
no intervention is needed.
Q9. A client at 30 weeks gestation reports severe headache, blurred
vision, and epigastric pain. The nurse should suspect:
• A) Normal pregnancy symptoms
• B) Preeclampsia
• C) Gestational diabetes
• D) Placental abruption
Answer: B – Headache, visual disturbances, and epigastric pain (hepatic
capsule distension) are classic signs of severe preeclampsia. These
symptoms require immediate evaluation and treatment to prevent seizures.
Q10. The nurse is assessing a client at 32 weeks gestation. Which
finding is MOST suggestive of preterm labor?
• A) Braxton Hicks contractions
• B) Rupture of membranes
• C) Cervical dilation
• D) Weight gain
