Complete HESI Maternal Health Exam
Prep and Study Companion 2025
A client in the third trimester of pregnancy is experiencing shortness of breath when lying flat.
Which position should the nurse recommend to promote optimal breathing?
a. Supine with a small pillow under the head
b. Trendelenburg position
c. Sitting with the head and chest elevated
d. Right lateral position
Correct answer: c. Sitting with the head and chest elevated
Rationale:
The enlarging uterus presses on the diaphragm during the third trimester, leading to shortness of
breath when the client lies flat. Sitting upright or elevating the head and chest facilitates lung
expansion and eases breathing. The supine and Trendelenburg positions worsen pressure on the
diaphragm and inferior vena cava. Right lateral positioning does not relieve dyspnea effectively.
A nurse is caring for a postpartum client who is experiencing uterine atony. Which medication
should the nurse anticipate administering to control bleeding?
a. Oxytocin
b. Nifedipine
c. Terbutaline
d. Indomethacin
Correct answer: a. Oxytocin
Rationale:
Oxytocin stimulates uterine smooth muscle contraction and is the first-line medication for uterine
atony to control postpartum hemorrhage. Nifedipine and terbutaline relax uterine muscles and
are used to prevent preterm labor, not control bleeding. Indomethacin is a tocolytic used to delay
preterm labor, not a uterotonic.
A nurse is reviewing lab results for a pregnant client. Which finding should the nurse report
immediately to the primary health care provider?
a. Hemoglobin 11 g/dL
b. Fasting glucose 118 mg/dL
c. White blood cell count 11,000/mm³
d. Blood pressure 142/94 mm Hg
Correct answer: d. Blood pressure 142/94 mm Hg
,Rationale:
A blood pressure of 142/94 mm Hg indicates potential gestational hypertension or preeclampsia,
requiring further evaluation. Mild anemia (Hgb 11 g/dL) and slight leukocytosis (11,000/mm³)
are normal in pregnancy. A fasting glucose of 118 mg/dL is mildly elevated but not immediately
critical.
A nurse is teaching a client in the first trimester about managing morning sickness. Which
statement indicates that the client needs further instruction?
a. "I’ll eat small, frequent meals throughout the day."
b. "I’ll drink a glass of water with each meal."
c. "I’ll eat dry crackers before getting out of bed."
d. "I’ll avoid greasy or spicy foods."
Correct answer: b. "I’ll drink a glass of water with each meal."
Rationale:
Drinking fluids with meals can distend the stomach and worsen nausea. Fluids should be taken
between meals instead. Eating small, frequent meals, avoiding greasy or spicy foods, and eating
dry crackers before rising all help reduce morning sickness.
A nurse is caring for a client at 28 weeks gestation who reports leg cramps at night. Which
recommendation is appropriate?
a. Increase calcium and reduce phosphorus intake.
b. Reduce intake of foods rich in potassium.
c. Apply cold compresses to the legs before bed.
d. Decrease fluid intake before bedtime.
Correct answer: a. Increase calcium and reduce phosphorus intake.
Rationale:
Leg cramps during pregnancy are often caused by low calcium and high phosphorus levels.
Increasing dietary calcium (milk, leafy greens) and reducing phosphorus (carbonated drinks) can
help. Potassium has no role in this condition, and cold compresses or decreased fluid intake are
not effective remedies.
A nurse is assessing a postpartum client 2 hours after delivery. The fundus is boggy, and there is
excessive lochia rubra. Which initial action should the nurse take?
a. Call the obstetrician immediately.
b. Start an IV infusion of oxytocin.
c. Massage the fundus firmly.
d. Insert a urinary catheter.
Correct answer: c. Massage the fundus firmly.
, Rationale:
A boggy uterus indicates uterine atony, the most common cause of postpartum hemorrhage. The
nurse should first massage the fundus to stimulate uterine contraction. If the uterus remains
boggy, oxytocin may be given. Calling the provider or inserting a catheter are secondary
interventions.
A client who recently delivered twins by cesarean section is prescribed ibuprofen for pain
management. Which client history requires the nurse to question the order?
a. History of asthma
b. History of migraine headaches
c. History of seasonal allergies
d. History of anemia
Correct answer: a. History of asthma
Rationale:
NSAIDs like ibuprofen may cause bronchospasm in clients with asthma and should be used
cautiously or avoided. Migraine, seasonal allergies, and anemia do not contraindicate ibuprofen
use unless specific complications exist.
A nurse is reinforcing teaching to a postpartum woman prescribed oral iron supplements. Which
statement by the client indicates correct understanding?
a. "I should take my iron with milk to prevent stomach upset."
b. "I should avoid vitamin C when taking my iron tablets."
c. "I should take my iron with orange juice for better absorption."
d. "I’ll lie down right after taking my iron tablet to prevent nausea."
Correct answer: c. "I should take my iron with orange juice for better absorption."
Rationale:
Vitamin C enhances iron absorption. Milk and antacids decrease absorption. Clients should
remain upright for at least 30 minutes after taking iron to prevent esophageal irritation.
A nurse is caring for a pregnant client receiving magnesium sulfate for severe preeclampsia.
Which finding requires immediate intervention?
a. Urine output of 30 mL/hr
b. Deep tendon reflexes 1+
c. Respiratory rate of 10 breaths/min
d. Warm, flushed skin
Correct answer: c. Respiratory rate of 10 breaths/min
Prep and Study Companion 2025
A client in the third trimester of pregnancy is experiencing shortness of breath when lying flat.
Which position should the nurse recommend to promote optimal breathing?
a. Supine with a small pillow under the head
b. Trendelenburg position
c. Sitting with the head and chest elevated
d. Right lateral position
Correct answer: c. Sitting with the head and chest elevated
Rationale:
The enlarging uterus presses on the diaphragm during the third trimester, leading to shortness of
breath when the client lies flat. Sitting upright or elevating the head and chest facilitates lung
expansion and eases breathing. The supine and Trendelenburg positions worsen pressure on the
diaphragm and inferior vena cava. Right lateral positioning does not relieve dyspnea effectively.
A nurse is caring for a postpartum client who is experiencing uterine atony. Which medication
should the nurse anticipate administering to control bleeding?
a. Oxytocin
b. Nifedipine
c. Terbutaline
d. Indomethacin
Correct answer: a. Oxytocin
Rationale:
Oxytocin stimulates uterine smooth muscle contraction and is the first-line medication for uterine
atony to control postpartum hemorrhage. Nifedipine and terbutaline relax uterine muscles and
are used to prevent preterm labor, not control bleeding. Indomethacin is a tocolytic used to delay
preterm labor, not a uterotonic.
A nurse is reviewing lab results for a pregnant client. Which finding should the nurse report
immediately to the primary health care provider?
a. Hemoglobin 11 g/dL
b. Fasting glucose 118 mg/dL
c. White blood cell count 11,000/mm³
d. Blood pressure 142/94 mm Hg
Correct answer: d. Blood pressure 142/94 mm Hg
,Rationale:
A blood pressure of 142/94 mm Hg indicates potential gestational hypertension or preeclampsia,
requiring further evaluation. Mild anemia (Hgb 11 g/dL) and slight leukocytosis (11,000/mm³)
are normal in pregnancy. A fasting glucose of 118 mg/dL is mildly elevated but not immediately
critical.
A nurse is teaching a client in the first trimester about managing morning sickness. Which
statement indicates that the client needs further instruction?
a. "I’ll eat small, frequent meals throughout the day."
b. "I’ll drink a glass of water with each meal."
c. "I’ll eat dry crackers before getting out of bed."
d. "I’ll avoid greasy or spicy foods."
Correct answer: b. "I’ll drink a glass of water with each meal."
Rationale:
Drinking fluids with meals can distend the stomach and worsen nausea. Fluids should be taken
between meals instead. Eating small, frequent meals, avoiding greasy or spicy foods, and eating
dry crackers before rising all help reduce morning sickness.
A nurse is caring for a client at 28 weeks gestation who reports leg cramps at night. Which
recommendation is appropriate?
a. Increase calcium and reduce phosphorus intake.
b. Reduce intake of foods rich in potassium.
c. Apply cold compresses to the legs before bed.
d. Decrease fluid intake before bedtime.
Correct answer: a. Increase calcium and reduce phosphorus intake.
Rationale:
Leg cramps during pregnancy are often caused by low calcium and high phosphorus levels.
Increasing dietary calcium (milk, leafy greens) and reducing phosphorus (carbonated drinks) can
help. Potassium has no role in this condition, and cold compresses or decreased fluid intake are
not effective remedies.
A nurse is assessing a postpartum client 2 hours after delivery. The fundus is boggy, and there is
excessive lochia rubra. Which initial action should the nurse take?
a. Call the obstetrician immediately.
b. Start an IV infusion of oxytocin.
c. Massage the fundus firmly.
d. Insert a urinary catheter.
Correct answer: c. Massage the fundus firmly.
, Rationale:
A boggy uterus indicates uterine atony, the most common cause of postpartum hemorrhage. The
nurse should first massage the fundus to stimulate uterine contraction. If the uterus remains
boggy, oxytocin may be given. Calling the provider or inserting a catheter are secondary
interventions.
A client who recently delivered twins by cesarean section is prescribed ibuprofen for pain
management. Which client history requires the nurse to question the order?
a. History of asthma
b. History of migraine headaches
c. History of seasonal allergies
d. History of anemia
Correct answer: a. History of asthma
Rationale:
NSAIDs like ibuprofen may cause bronchospasm in clients with asthma and should be used
cautiously or avoided. Migraine, seasonal allergies, and anemia do not contraindicate ibuprofen
use unless specific complications exist.
A nurse is reinforcing teaching to a postpartum woman prescribed oral iron supplements. Which
statement by the client indicates correct understanding?
a. "I should take my iron with milk to prevent stomach upset."
b. "I should avoid vitamin C when taking my iron tablets."
c. "I should take my iron with orange juice for better absorption."
d. "I’ll lie down right after taking my iron tablet to prevent nausea."
Correct answer: c. "I should take my iron with orange juice for better absorption."
Rationale:
Vitamin C enhances iron absorption. Milk and antacids decrease absorption. Clients should
remain upright for at least 30 minutes after taking iron to prevent esophageal irritation.
A nurse is caring for a pregnant client receiving magnesium sulfate for severe preeclampsia.
Which finding requires immediate intervention?
a. Urine output of 30 mL/hr
b. Deep tendon reflexes 1+
c. Respiratory rate of 10 breaths/min
d. Warm, flushed skin
Correct answer: c. Respiratory rate of 10 breaths/min
