HESI RN MATERNITY
Maternity HESI RN V1
2026/2027 Edition
Official Practice Exam - Complete Questions & Answers (Verified)
Antepartum | Intrapartum | Postpartum | Newborn | High-Risk Pregnancy
Questions Minutes Passing Score Format
55 90 80% Multiple Choice
TABLE OF CONTENTS
Section 1: Antepartum Nursing Care Q1-Q12
Section 2: Intrapartum Nursing Care Q13-Q24
Section 3: Postpartum Nursing Care Q25-Q35
Section 4: Newborn Nursing Care Q36-Q45
Section
EXAM 5: High-Risk Pregnancy & Complications
INSTRUCTIONS Q46-Q55
1. This exam consists of 55 multiple-choice questions across 5 sections. You have 90 minutes to complete all
questions.
2. Each question has four answer choices (A, B, C, D). Select the single best answer for each question.
3. A passing score of 80% (44 out of 55 questions correct) is required to pass this exam.
4. Read each question carefully. Every question begins with a realistic clinical scenario relevant to maternity nursing.
5. After completing the exam, review the answer key and detailed rationales provided at the end of this document.
6. The correct answer for each question is printed in green immediately below the question, followed by a detailed
rationale.
7. This practice exam is designed to mirror the content, format, and difficulty of the actual Maternity HESI RN V1 Exam.
8. Do not use any reference materials during the exam. Time yourself to simulate actual testing conditions.
Maternity HESI V1 - 2026/2027 | Passing Score: 80% | Page 1
,Section 1: Antepartum Nursing Care 12 Questions
Q1 Question 1 of 55
A 26-year-old primigravida at 12 weeks gestation presents for her initial prenatal visit. She reports
taking levothyroxine 75 mcg daily for hypothyroidism diagnosed three years ago. The nurse should
advise the patient that her levothyroxine dose will likely need to be increased because
A. placental hormones increase thyroid-binding globulin levels, reducing free thyroxine
available to the mother and fetus
B. the fetal thyroid begins producing hormone at 12 weeks and competes with maternal uptake
C. pregnancy accelerates metabolism and clears all medications faster than in the non-pregnant state
D. hypothyroidism naturally worsens during pregnancy regardless of pre-pregnancy management
Correct Answer: A
Rationale:
Placental estrogen increases thyroid-binding globulin, which binds more free T4 and reduces the available active
hormone. This physiologic change typically requires a 30 to 50 percent dose increase in levothyroxine during
pregnancy. The fetal thyroid does not compete for maternal hormone, and while metabolism does change, the
specific mechanism involves binding globulin elevation.
Q2 Question 2 of 55
A 30-year-old woman at 20 weeks gestation has a maternal serum alpha-fetoprotein (MSAFP) level
that is 2.5 multiples of the median (MoM). The nurse understands that an elevated MSAFP is
associated with which condition?
A. Down syndrome and other trisomy conditions
B. Neural tube defects such as spina bifida or anencephaly
C. Gestational diabetes mellitus developing in the third trimester
D. Placenta previa identified during routine ultrasound
Correct Answer: B
Rationale:
Elevated MSAFP (above 2.0 to 2.5 MoM) is associated with open neural tube defects such as spina bifida and
anencephaly, where fetal proteins leak into the maternal circulation. Down syndrome is associated with
decreased MSAFP. Gestational diabetes and placenta previa are not detected through MSAFP screening.
, Section 1: Antepartum Nursing Care Continued
Q3 Question 3 of 55
A pregnant client at 16 weeks gestation asks why she is being offered a quad screen test. The
nurse explains that this blood test screens for
A. genetic conditions that can be cured if detected early in the first trimester
B. fetal organ development and placental function through comprehensive metabolic analysis
C. chromosomal abnormalities and open neural tube defects by measuring four maternal
serum markers
D. maternal infections that could be transmitted to the fetus during vaginal delivery
Correct Answer: C
Rationale:
The quad screen measures maternal serum levels of alpha-fetoprotein, human chorionic gonadotropin,
unconjugated estriol, and inhibin-A to estimate the risk of Down syndrome, trisomy 18, and neural tube defects.
It is a screening tool that indicates risk, not a diagnostic test, and it does not detect infections or assess organ
function directly.
Q4 Question 4 of 55
A 28-year-old at 24 weeks gestation reports sudden onset of severe headache, visual
disturbances, and epigastric pain. Her blood pressure is 162/110 mmHg, and a urine dipstick
shows 3+ protein. The nurse recognizes these findings are most consistent with
A. gestational hypertension that will resolve with bed rest and fluid restriction
B. migraine headache exacerbated by the hormonal changes of pregnancy
C. a normal physiologic response to advancing gestational age in a primigravida
D. preeclampsia with severe features requiring immediate medical intervention
Correct Answer: D
Rationale:
Severe headache, visual disturbances, and epigastric pain combined with blood pressure of 160/110 or higher
and significant proteinuria are diagnostic of preeclampsia with severe features. This is a medical emergency
requiring immediate treatment to prevent progression to eclampsia. Gestational hypertension lacks proteinuria
and severe symptoms, and these findings are not consistent with migraine or normal pregnancy changes.
Maternity HESI V1 - 2026/2027 | Passing Score: 80% | Page 3
Maternity HESI RN V1
2026/2027 Edition
Official Practice Exam - Complete Questions & Answers (Verified)
Antepartum | Intrapartum | Postpartum | Newborn | High-Risk Pregnancy
Questions Minutes Passing Score Format
55 90 80% Multiple Choice
TABLE OF CONTENTS
Section 1: Antepartum Nursing Care Q1-Q12
Section 2: Intrapartum Nursing Care Q13-Q24
Section 3: Postpartum Nursing Care Q25-Q35
Section 4: Newborn Nursing Care Q36-Q45
Section
EXAM 5: High-Risk Pregnancy & Complications
INSTRUCTIONS Q46-Q55
1. This exam consists of 55 multiple-choice questions across 5 sections. You have 90 minutes to complete all
questions.
2. Each question has four answer choices (A, B, C, D). Select the single best answer for each question.
3. A passing score of 80% (44 out of 55 questions correct) is required to pass this exam.
4. Read each question carefully. Every question begins with a realistic clinical scenario relevant to maternity nursing.
5. After completing the exam, review the answer key and detailed rationales provided at the end of this document.
6. The correct answer for each question is printed in green immediately below the question, followed by a detailed
rationale.
7. This practice exam is designed to mirror the content, format, and difficulty of the actual Maternity HESI RN V1 Exam.
8. Do not use any reference materials during the exam. Time yourself to simulate actual testing conditions.
Maternity HESI V1 - 2026/2027 | Passing Score: 80% | Page 1
,Section 1: Antepartum Nursing Care 12 Questions
Q1 Question 1 of 55
A 26-year-old primigravida at 12 weeks gestation presents for her initial prenatal visit. She reports
taking levothyroxine 75 mcg daily for hypothyroidism diagnosed three years ago. The nurse should
advise the patient that her levothyroxine dose will likely need to be increased because
A. placental hormones increase thyroid-binding globulin levels, reducing free thyroxine
available to the mother and fetus
B. the fetal thyroid begins producing hormone at 12 weeks and competes with maternal uptake
C. pregnancy accelerates metabolism and clears all medications faster than in the non-pregnant state
D. hypothyroidism naturally worsens during pregnancy regardless of pre-pregnancy management
Correct Answer: A
Rationale:
Placental estrogen increases thyroid-binding globulin, which binds more free T4 and reduces the available active
hormone. This physiologic change typically requires a 30 to 50 percent dose increase in levothyroxine during
pregnancy. The fetal thyroid does not compete for maternal hormone, and while metabolism does change, the
specific mechanism involves binding globulin elevation.
Q2 Question 2 of 55
A 30-year-old woman at 20 weeks gestation has a maternal serum alpha-fetoprotein (MSAFP) level
that is 2.5 multiples of the median (MoM). The nurse understands that an elevated MSAFP is
associated with which condition?
A. Down syndrome and other trisomy conditions
B. Neural tube defects such as spina bifida or anencephaly
C. Gestational diabetes mellitus developing in the third trimester
D. Placenta previa identified during routine ultrasound
Correct Answer: B
Rationale:
Elevated MSAFP (above 2.0 to 2.5 MoM) is associated with open neural tube defects such as spina bifida and
anencephaly, where fetal proteins leak into the maternal circulation. Down syndrome is associated with
decreased MSAFP. Gestational diabetes and placenta previa are not detected through MSAFP screening.
, Section 1: Antepartum Nursing Care Continued
Q3 Question 3 of 55
A pregnant client at 16 weeks gestation asks why she is being offered a quad screen test. The
nurse explains that this blood test screens for
A. genetic conditions that can be cured if detected early in the first trimester
B. fetal organ development and placental function through comprehensive metabolic analysis
C. chromosomal abnormalities and open neural tube defects by measuring four maternal
serum markers
D. maternal infections that could be transmitted to the fetus during vaginal delivery
Correct Answer: C
Rationale:
The quad screen measures maternal serum levels of alpha-fetoprotein, human chorionic gonadotropin,
unconjugated estriol, and inhibin-A to estimate the risk of Down syndrome, trisomy 18, and neural tube defects.
It is a screening tool that indicates risk, not a diagnostic test, and it does not detect infections or assess organ
function directly.
Q4 Question 4 of 55
A 28-year-old at 24 weeks gestation reports sudden onset of severe headache, visual
disturbances, and epigastric pain. Her blood pressure is 162/110 mmHg, and a urine dipstick
shows 3+ protein. The nurse recognizes these findings are most consistent with
A. gestational hypertension that will resolve with bed rest and fluid restriction
B. migraine headache exacerbated by the hormonal changes of pregnancy
C. a normal physiologic response to advancing gestational age in a primigravida
D. preeclampsia with severe features requiring immediate medical intervention
Correct Answer: D
Rationale:
Severe headache, visual disturbances, and epigastric pain combined with blood pressure of 160/110 or higher
and significant proteinuria are diagnostic of preeclampsia with severe features. This is a medical emergency
requiring immediate treatment to prevent progression to eclampsia. Gestational hypertension lacks proteinuria
and severe symptoms, and these findings are not consistent with migraine or normal pregnancy changes.
Maternity HESI V1 - 2026/2027 | Passing Score: 80% | Page 3
