1
Page | 1 HESI MATERNITY PRACTICE
QUESTIONS 2025 | NEXT GEN FORMAT |
VERIFIED AND EXPLAINED
1. A pregnant client at 30 weeks’ gestation reports headaches, blurred vision,
and upper abdominal pain. Which condition should the nurse suspect?
A. Gestational diabetes
B. Preterm labor
C. Preeclampsia ✅
D. Urinary tract infection
Rationale:
These are classic signs of preeclampsia, a hypertensive disorder of pregnancy.
Headaches, visual disturbances (e.g., blurred vision), and right upper quadrant
pain (epigastric pain) indicate liver involvement and increased risk of
complications such as eclampsia or HELLP syndrome. This condition is
, 2
characterized by new-onset hypertension and proteinuria after 20 weeks'
gestation. It requires urgent evaluation to prevent maternal and fetal harm.
Gestational diabetes usually presents with no pain, while preterm labor often
Page | 2
includes uterine contractions, and a UTI typically presents with dysuria or
frequency, not visual symptoms.
2. Which fetal heart rate (FHR) pattern is most concerning and requires
immediate intervention?
A. Early decelerations
B. Variable decelerations
C. Late decelerations ✅
D. Accelerations
Rationale:
Late decelerations are associated with uteroplacental insufficiency and indicate
fetal hypoxia. They begin after the contraction starts and return to baseline after
the contraction ends, which is concerning. Immediate nursing interventions
include repositioning the mother, oxygen administration, and notifying the
healthcare provider. Early decelerations are benign and linked to head
compression. Variable decelerations are due to cord compression and may be
, 3
managed conservatively unless persistent. Accelerations are a reassuring sign of
fetal well-being.
Page | 3
3. A G2P1 client in labor is fully dilated and feels the urge to push. What is the
nurse’s next best action?
A. Apply fundal pressure
B. Instruct the client to pant
C. Encourage pushing with contractions ✅
D. Check for cervical dilation again
Rationale:
When a client is fully dilated (10 cm) and has an urge to push, the nurse should
encourage pushing with contractions to aid in the second stage of labor. This
supports fetal descent and birth. Fundal pressure is not recommended due to
risks, and panting is typically advised during early labor to reduce pushing urge
before full dilation. Re-checking dilation is unnecessary if full dilation has
already been confirmed.
, 4
4. What is the priority nursing intervention when caring for a newborn
immediately after birth?
A. Administer vitamin K
Page | 4
B. Perform the first bath
C. Ensure a clear airway ✅
D. Apply identification bands
Rationale:
The priority immediately after birth is to ensure a clear airway to support
effective breathing. Suctioning the mouth and nose may be necessary, especially
if there is meconium-stained fluid or secretions. Once the airway is clear and the
baby is stable, secondary interventions like vitamin K administration,
identification bands, and the first bath can be performed. Airway, breathing, and
circulation (ABC) principles guide immediate newborn care.
5. A nurse is reviewing lab values of a client in the third trimester. Which
finding is most concerning?
A. Hemoglobin 10.5 g/dL
B. White blood cells 13,000/mm³
C. Platelets 90,000/mm³ ✅
Page | 1 HESI MATERNITY PRACTICE
QUESTIONS 2025 | NEXT GEN FORMAT |
VERIFIED AND EXPLAINED
1. A pregnant client at 30 weeks’ gestation reports headaches, blurred vision,
and upper abdominal pain. Which condition should the nurse suspect?
A. Gestational diabetes
B. Preterm labor
C. Preeclampsia ✅
D. Urinary tract infection
Rationale:
These are classic signs of preeclampsia, a hypertensive disorder of pregnancy.
Headaches, visual disturbances (e.g., blurred vision), and right upper quadrant
pain (epigastric pain) indicate liver involvement and increased risk of
complications such as eclampsia or HELLP syndrome. This condition is
, 2
characterized by new-onset hypertension and proteinuria after 20 weeks'
gestation. It requires urgent evaluation to prevent maternal and fetal harm.
Gestational diabetes usually presents with no pain, while preterm labor often
Page | 2
includes uterine contractions, and a UTI typically presents with dysuria or
frequency, not visual symptoms.
2. Which fetal heart rate (FHR) pattern is most concerning and requires
immediate intervention?
A. Early decelerations
B. Variable decelerations
C. Late decelerations ✅
D. Accelerations
Rationale:
Late decelerations are associated with uteroplacental insufficiency and indicate
fetal hypoxia. They begin after the contraction starts and return to baseline after
the contraction ends, which is concerning. Immediate nursing interventions
include repositioning the mother, oxygen administration, and notifying the
healthcare provider. Early decelerations are benign and linked to head
compression. Variable decelerations are due to cord compression and may be
, 3
managed conservatively unless persistent. Accelerations are a reassuring sign of
fetal well-being.
Page | 3
3. A G2P1 client in labor is fully dilated and feels the urge to push. What is the
nurse’s next best action?
A. Apply fundal pressure
B. Instruct the client to pant
C. Encourage pushing with contractions ✅
D. Check for cervical dilation again
Rationale:
When a client is fully dilated (10 cm) and has an urge to push, the nurse should
encourage pushing with contractions to aid in the second stage of labor. This
supports fetal descent and birth. Fundal pressure is not recommended due to
risks, and panting is typically advised during early labor to reduce pushing urge
before full dilation. Re-checking dilation is unnecessary if full dilation has
already been confirmed.
, 4
4. What is the priority nursing intervention when caring for a newborn
immediately after birth?
A. Administer vitamin K
Page | 4
B. Perform the first bath
C. Ensure a clear airway ✅
D. Apply identification bands
Rationale:
The priority immediately after birth is to ensure a clear airway to support
effective breathing. Suctioning the mouth and nose may be necessary, especially
if there is meconium-stained fluid or secretions. Once the airway is clear and the
baby is stable, secondary interventions like vitamin K administration,
identification bands, and the first bath can be performed. Airway, breathing, and
circulation (ABC) principles guide immediate newborn care.
5. A nurse is reviewing lab values of a client in the third trimester. Which
finding is most concerning?
A. Hemoglobin 10.5 g/dL
B. White blood cells 13,000/mm³
C. Platelets 90,000/mm³ ✅
