1
HESI Maternity & Pediatrics 2025 | 260 Verified Real
Questions with A+ Rationales | RN & PN Combo Exam
Pack
1. A nurse is caring for a client at 36 weeks of gestation who reports sudden onset of painless
vaginal bleeding. Which condition does the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical insufficiency
Answer: A. Placenta previa
Rationale: Placenta previa typically presents as painless, bright red vaginal bleeding in the
third trimester due to the placenta partially or completely covering the cervical os. Abruptio
placentae causes painful, dark bleeding with uterine tenderness, and uterine rupture causes
sudden pain and fetal distress. Cervical insufficiency typically leads to preterm labor
without active bleeding.
, 2
2. A newborn delivered by cesarean section has nasal flaring and mild intercostal retractions.
What is the nurse’s priority action?
A. Suction the airway
B. Place in prone position
C. Apply oxygen via nasal cannula
D. Assess oxygen saturation
Answer: D. Assess oxygen saturation
Rationale: Transient tachypnea of the newborn is common after C-section due to retained
lung fluid, often presenting as mild respiratory distress. Pulse oximetry assessment comes first
to determine the need for oxygen support, as interventions are guided by SpO₂ readings.
3. A nurse is caring for a 3-year-old with epiglottitis. Which nursing action is priority?
A. Obtain a throat culture
B. Prepare for emergency intubation
C. Administer cough suppressant
D. Encourage oral fluids
Answer: B. Prepare for emergency intubation
Rationale: Epiglottitis is a life-threatening airway obstruction caused by H. influenzae type
B, presenting with drooling, dysphagia, and stridor. Airway protection is the priority; throat
exams or swabs can trigger complete obstruction.
, 3
4. A nurse provides education to a postpartum client with mastitis. Which statement indicates
correct understanding?
A. “I should stop breastfeeding until the infection clears.”
B. “I will continue breastfeeding from both breasts.”
C. “I will pump only from the infected breast.”
D. “I should apply cold compresses only.”
Answer: B. I will continue breastfeeding from both breasts.
Rationale: Mastitis is usually caused by milk stasis and bacterial entry, and continuing
breastfeeding promotes milk drainage and healing. Abrupt cessation can worsen
engorgement and infection. Warm compresses before feeds help milk flow.
5. A 2-year-old is admitted with vomiting and diarrhea. Which assessment finding is most
concerning?
A. Dry mucous membranes
B. Capillary refill 5 seconds
C. Sunken fontanel
D. Weight loss of 2 lbs
Answer: B. Capillary refill 5 seconds
Rationale: Prolonged capillary refill (>3 sec) indicates poor perfusion and possible
hypovolemic shock from severe dehydration. Dry mucosa and sunken fontanel indicate
mild/moderate dehydration, but delayed perfusion is an emergency sign.
, 4
6. A pregnant client at 28 weeks presents with blood pressure 162/100, proteinuria, and severe
headache. What is the priority intervention?
A. Place the client in Trendelenburg
B. Prepare for magnesium sulfate administration
C. Start oxytocin infusion
D. Encourage oral fluids
Answer: B. Prepare for magnesium sulfate administration
Rationale: Severe preeclampsia requires seizure prophylaxis with magnesium sulfate and
blood pressure management. Trendelenburg and oxytocin are inappropriate; fluid overload
can worsen pulmonary edema risk.
7. A 5-year-old with nephrotic syndrome is admitted with periorbital edema and proteinuria.
Which is the primary nursing goal?
A. Monitor blood glucose
B. Reduce fluid retention and edema
C. Restrict physical activity
D. Prepare for dialysis
Answer: B. Reduce fluid retention and edema
HESI Maternity & Pediatrics 2025 | 260 Verified Real
Questions with A+ Rationales | RN & PN Combo Exam
Pack
1. A nurse is caring for a client at 36 weeks of gestation who reports sudden onset of painless
vaginal bleeding. Which condition does the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical insufficiency
Answer: A. Placenta previa
Rationale: Placenta previa typically presents as painless, bright red vaginal bleeding in the
third trimester due to the placenta partially or completely covering the cervical os. Abruptio
placentae causes painful, dark bleeding with uterine tenderness, and uterine rupture causes
sudden pain and fetal distress. Cervical insufficiency typically leads to preterm labor
without active bleeding.
, 2
2. A newborn delivered by cesarean section has nasal flaring and mild intercostal retractions.
What is the nurse’s priority action?
A. Suction the airway
B. Place in prone position
C. Apply oxygen via nasal cannula
D. Assess oxygen saturation
Answer: D. Assess oxygen saturation
Rationale: Transient tachypnea of the newborn is common after C-section due to retained
lung fluid, often presenting as mild respiratory distress. Pulse oximetry assessment comes first
to determine the need for oxygen support, as interventions are guided by SpO₂ readings.
3. A nurse is caring for a 3-year-old with epiglottitis. Which nursing action is priority?
A. Obtain a throat culture
B. Prepare for emergency intubation
C. Administer cough suppressant
D. Encourage oral fluids
Answer: B. Prepare for emergency intubation
Rationale: Epiglottitis is a life-threatening airway obstruction caused by H. influenzae type
B, presenting with drooling, dysphagia, and stridor. Airway protection is the priority; throat
exams or swabs can trigger complete obstruction.
, 3
4. A nurse provides education to a postpartum client with mastitis. Which statement indicates
correct understanding?
A. “I should stop breastfeeding until the infection clears.”
B. “I will continue breastfeeding from both breasts.”
C. “I will pump only from the infected breast.”
D. “I should apply cold compresses only.”
Answer: B. I will continue breastfeeding from both breasts.
Rationale: Mastitis is usually caused by milk stasis and bacterial entry, and continuing
breastfeeding promotes milk drainage and healing. Abrupt cessation can worsen
engorgement and infection. Warm compresses before feeds help milk flow.
5. A 2-year-old is admitted with vomiting and diarrhea. Which assessment finding is most
concerning?
A. Dry mucous membranes
B. Capillary refill 5 seconds
C. Sunken fontanel
D. Weight loss of 2 lbs
Answer: B. Capillary refill 5 seconds
Rationale: Prolonged capillary refill (>3 sec) indicates poor perfusion and possible
hypovolemic shock from severe dehydration. Dry mucosa and sunken fontanel indicate
mild/moderate dehydration, but delayed perfusion is an emergency sign.
, 4
6. A pregnant client at 28 weeks presents with blood pressure 162/100, proteinuria, and severe
headache. What is the priority intervention?
A. Place the client in Trendelenburg
B. Prepare for magnesium sulfate administration
C. Start oxytocin infusion
D. Encourage oral fluids
Answer: B. Prepare for magnesium sulfate administration
Rationale: Severe preeclampsia requires seizure prophylaxis with magnesium sulfate and
blood pressure management. Trendelenburg and oxytocin are inappropriate; fluid overload
can worsen pulmonary edema risk.
7. A 5-year-old with nephrotic syndrome is admitted with periorbital edema and proteinuria.
Which is the primary nursing goal?
A. Monitor blood glucose
B. Reduce fluid retention and edema
C. Restrict physical activity
D. Prepare for dialysis
Answer: B. Reduce fluid retention and edema
