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HESI Maternity & OB Test Bank 2025 | 100 NCLEX-
Style Labor, Postpartum, and Newborn Questions with
Rationales | A+ Guaranteed Pass
1. Labor Progress – Cervical Changes
Question:
A nurse assesses a patient in active labor. Her cervix is 6 cm dilated, 100% effaced, and the fetus is at
0 station. What stage and phase of labor is she in?
A. First stage – latent phase
B. First stage – active phase
C. First stage – transition phase
D. Second stage – pushing phase
✅ Answer: B. First stage – active phase
Rationale:
Cervical dilation from 4–7 cm defines the active phase of the first stage of labor. Effacement and
fetal station are normal for this phase.
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2. Fetal Heart Rate – Late Decelerations
Question:
A patient in labor has fetal heart rate tracings showing late decelerations. What is the nurse’s first
action?
A. Reposition the patient to her left side
B. Increase oxytocin infusion
C. Administer oxygen and continue monitoring
D. Call the provider immediately
✅ Answer: A. Reposition the patient to her left side
Rationale:
Late decelerations indicate uteroplacental insufficiency. The first intervention is to improve
perfusion by repositioning, followed by oxygen and notifying the provider.
3. Fundal Assessment – Postpartum Hemorrhage
Question:
One hour after delivery, the nurse palpates a boggy uterus above the umbilicus. What is the priority
nursing action?
A. Start oxytocin
B. Notify the provider
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C. Massage the uterus firmly
D. Apply an ice pack to the perineum
✅ Answer: C. Massage the uterus firmly
Rationale:
A boggy uterus indicates uterine atony, the most common cause of postpartum hemorrhage. The
first action is fundal massage to stimulate contraction.
4. Magnesium Sulfate – Preeclampsia
Question:
A woman with severe preeclampsia is receiving magnesium sulfate. Which finding should the nurse
report immediately?
A. Patellar reflexes 2+
B. Respiratory rate of 10/min
C. Urine output 35 mL/hr
D. Patient drowsy but arousable
✅ Answer: B. Respiratory rate of 10/min
Rationale:
Magnesium toxicity can cause respiratory depression. A RR <12/min requires holding the infusion
and notifying the provider.
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5. Newborn – Thermoregulation
Question:
Which newborn assessment finding requires immediate intervention?
A. Axillary temperature of 97.8°F (36.5°C)
B. Slight acrocyanosis
C. Blood glucose of 50 mg/dL
D. Cold, mottled skin and weak cry
✅ Answer: D. Cold, mottled skin and weak cry
Rationale:
This indicates poor thermoregulation and possible hypoxia or hypoglycemia. Immediate warming
and glucose monitoring are required.
6. Group B Streptococcus (GBS) – Labor Care
Question:
A GBS-positive pregnant woman is admitted in labor. What is the priority nursing intervention?
A. Administer ampicillin IV every 4 hours
B. Collect a new vaginal swab
C. Delay antibiotics until membranes rupture
D. Prepare for cesarean delivery
✅ Answer: A. Administer ampicillin IV every 4 hours
HESI Maternity & OB Test Bank 2025 | 100 NCLEX-
Style Labor, Postpartum, and Newborn Questions with
Rationales | A+ Guaranteed Pass
1. Labor Progress – Cervical Changes
Question:
A nurse assesses a patient in active labor. Her cervix is 6 cm dilated, 100% effaced, and the fetus is at
0 station. What stage and phase of labor is she in?
A. First stage – latent phase
B. First stage – active phase
C. First stage – transition phase
D. Second stage – pushing phase
✅ Answer: B. First stage – active phase
Rationale:
Cervical dilation from 4–7 cm defines the active phase of the first stage of labor. Effacement and
fetal station are normal for this phase.
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2. Fetal Heart Rate – Late Decelerations
Question:
A patient in labor has fetal heart rate tracings showing late decelerations. What is the nurse’s first
action?
A. Reposition the patient to her left side
B. Increase oxytocin infusion
C. Administer oxygen and continue monitoring
D. Call the provider immediately
✅ Answer: A. Reposition the patient to her left side
Rationale:
Late decelerations indicate uteroplacental insufficiency. The first intervention is to improve
perfusion by repositioning, followed by oxygen and notifying the provider.
3. Fundal Assessment – Postpartum Hemorrhage
Question:
One hour after delivery, the nurse palpates a boggy uterus above the umbilicus. What is the priority
nursing action?
A. Start oxytocin
B. Notify the provider
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C. Massage the uterus firmly
D. Apply an ice pack to the perineum
✅ Answer: C. Massage the uterus firmly
Rationale:
A boggy uterus indicates uterine atony, the most common cause of postpartum hemorrhage. The
first action is fundal massage to stimulate contraction.
4. Magnesium Sulfate – Preeclampsia
Question:
A woman with severe preeclampsia is receiving magnesium sulfate. Which finding should the nurse
report immediately?
A. Patellar reflexes 2+
B. Respiratory rate of 10/min
C. Urine output 35 mL/hr
D. Patient drowsy but arousable
✅ Answer: B. Respiratory rate of 10/min
Rationale:
Magnesium toxicity can cause respiratory depression. A RR <12/min requires holding the infusion
and notifying the provider.
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5. Newborn – Thermoregulation
Question:
Which newborn assessment finding requires immediate intervention?
A. Axillary temperature of 97.8°F (36.5°C)
B. Slight acrocyanosis
C. Blood glucose of 50 mg/dL
D. Cold, mottled skin and weak cry
✅ Answer: D. Cold, mottled skin and weak cry
Rationale:
This indicates poor thermoregulation and possible hypoxia or hypoglycemia. Immediate warming
and glucose monitoring are required.
6. Group B Streptococcus (GBS) – Labor Care
Question:
A GBS-positive pregnant woman is admitted in labor. What is the priority nursing intervention?
A. Administer ampicillin IV every 4 hours
B. Collect a new vaginal swab
C. Delay antibiotics until membranes rupture
D. Prepare for cesarean delivery
✅ Answer: A. Administer ampicillin IV every 4 hours
