HESI Mother Baby

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Sample questions from HESI Mother Baby

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 24-year-old at 32 weeks of gestation arrives at obstetric triage after a sudden gush of bright red vaginal blood. She denies pain. Her abdomen is soft, BP is 112/70 mm Hg, pulse is 96/min, and fetal heart rate is 145/min. Which action should the nurse take first?

   • A.Perform a digital vaginal examination to assess cervical dilation.
   • B.Initiate fetal monitoring and prepare for ultrasonography.
   • C.Encourage ambulation to determine whether contractions develop.
   • D.Administer oxytocin to reduce uterine bleeding.

   Rationale: Painless, bright red bleeding suggests placenta previa, so fetal monitoring and ultrasound localization of the placenta are appropriate. A digital examination can disrupt a placenta covering the cervix and cause severe hemorrhage. Ambulation delays evaluation, and oxytocin is not indicated for unexplained antepartum bleeding. The exam takeaway is to avoid digital vaginal examination until placenta previa has been excluded.

2. 2.A 31-year-old at 35 weeks of gestation presents to the emergency department with constant abdominal pain and dark vaginal bleeding. Her uterus is rigid, BP is 88/54 mm Hg, pulse is 124/min, and fetal heart rate is 95/min. Which action has the highest priority?

   • A.Obtain a clean-catch urine specimen.
   • B.Perform a bedside test for ruptured membranes.
   • C.Activate the obstetric emergency response and establish large-bore IV access.
   • D.Place the patient in a chair to improve respiratory expansion.

   Rationale: A rigid, painful uterus with maternal shock and fetal bradycardia suggests placental abruption with significant hemorrhage. Emergency assistance and vascular access support resuscitation and urgent birth preparation. Urine collection and membrane testing delay treatment, while sitting in a chair does not address circulatory collapse. Visible bleeding can underestimate blood loss because hemorrhage may be concealed.

3. 3.A 29-year-old at 34 weeks of gestation is admitted with preeclampsia. Her BP is 168/112 mm Hg, platelets are 88,000/mm3, and she reports a severe headache and right upper quadrant pain. Which prescribed intervention should the nurse prioritize?

   • A.Begin magnesium sulfate therapy and institute seizure precautions.
   • B.Encourage a high-protein meal before further evaluation.
   • C.Place the patient supine for strict bed rest.
   • D.Delay treatment until a 24-hour urine collection is complete.

   Rationale: Severe hypertension, neurologic symptoms, thrombocytopenia, and right upper quadrant pain indicate preeclampsia with severe features and a high seizure risk. Magnesium sulfate prevents seizures, while prompt antihypertensive treatment and delivery planning are also needed. A meal does not address the emergency, supine positioning can reduce venous return, and treatment must not await a urine collection. Severe features determine urgency even without a completed proteinuria evaluation.

4. 4.A 27-year-old receiving magnesium sulfate after delivery becomes difficult to arouse. Her respiratory rate is 8/min, patellar reflexes are absent, and urine output has been 15 mL/hr for 2 hours. Which action should the nurse take first?

   • A.Increase the maintenance IV fluid rate without an order.
   • B.Continue the infusion and repeat the magnesium level in 1 hour.
   • C.Administer the next prescribed antihypertensive dose.
   • D.Stop the magnesium infusion and activate urgent assistance.

   Answer and rationale are in the full material.

5. 5.A 22-year-old at 11 weeks of gestation is hospitalized for persistent vomiting and a 6% loss of prepregnancy weight. Her pulse is 112/min, potassium is 3.0 mEq/L, and urine contains ketones. Which prescription should the nurse clarify?

   • A.Administer isotonic IV fluids.
   • B.Begin a dextrose-containing infusion before administering thiamine.
   • C.Administer a prescribed antiemetic.
   • D.Replace potassium after assessing renal function and urine output.

   Answer and rationale are in the full material.