HESI OB/GYN Exam mEd SurG
[2026/2027] updatEd VErSION |
VErIfIEd QuEStIONS & dEtaIlEd
ratIONalES alrEadY GradEd a+
Section 1: Antepartum Care & Fetal Development (Questions 1-20)
1. A nurse in an infertility clinic is providing care to a couple who has been unable to conceive
for 18 months. Which of the following data should be included in the assessment? (Select all
that apply.)
A) Occupation
B) Menstrual history
C) Childhood infectious diseases
D) History of falls
E) Recent blood transfusions
Answer: A, B, C
Rationale: Occupational hazards include exposure to teratogenic substances in the workplace
(A). Menstrual history can identify hormone-related patterns such as anovulation (B). Childhood
infectious diseases can identify if the male partner had mumps, which can affect fertility (C).
History of falls (D) and recent blood transfusions (E) are not relevant to infertility assessment .
2. A nurse is caring for a client who is pregnant and states that her last menstrual period was
April 1st. Which of the following is the client's estimated date of delivery (EDD)?
A) January 8
B) January 15
C) February 8
D) February 15
1
, Answer: A
Rationale: Naegele's rule: subtract 3 months from the first day of the last menstrual period and
add 7 days. April 1st minus 3 months = January 1st, plus 7 days = January 8th. This method
assumes a 28-day cycle. If the client has irregular cycles, ultrasound dating is more accurate .
3. A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy.
The client's health record includes this data: G3 T1 P0 A1 L1. How should the nurse interpret
this information? (Select all that apply.)
A) Client has delivered one newborn at term
B) Client has experienced no preterm labor
C) Client has been through active labor twice
D) Client has had two prior pregnancies
E) Client has one living child
Answer: A, B, D, E
Rationale: G3 = 3 pregnancies total (including current); T1 = 1 term birth; P0 = 0 preterm births;
A1 = 1 abortion/miscarriage; L1 = 1 living child. This indicates the client is currently pregnant,
has had two prior pregnancies, delivered one at term, has one living child, and had one
miscarriage. GTPAL is a key obstetric history assessment tool .
4. A nurse is reviewing the health record of a client who is pregnant. The provider indicated
the client exhibits probable signs of pregnancy. Which of the following findings should the
nurse expect? (Select all that apply.)
A) Montgomery's glands
B) Goodell's sign
C) Ballottement
D) Chadwick's sign
E) Quickening
Answer: B, C, D
Rationale: Probable signs of pregnancy are objective signs detected by the examiner: Goodell's
sign (softening of cervix), Ballottement (rebound of fetus), and Chadwick's sign (bluish
discoloration of cervix/vagina). Montgomery's glands (enlarged areolar glands) and quickening
(fetal movement felt by mother) are presumptive signs (subjective). Positive signs include fetal
heart tone, ultrasound visualization, and fetal movement felt by examiner .
2
, 5. A nurse is teaching a client who is at 8 weeks of gestation about nutrition during pregnancy.
Which of the following statements should the nurse include in the teaching?
A) "You should consume 2 cups of milk daily."
B) "You should consume 4 ounces of grains each day."
C) "You should consume 2 cups of vegetables each day."
D) "You should consume 6 ounces of protein foods each day."
Answer: D
Rationale: Pregnant clients should consume 5.5 to 6.5 ounces of protein foods daily, selecting
lean meats, poultry, eggs, legumes, and nuts. Dairy intake should be 3 cups (A), grains 6-8
ounces (B), and vegetables 2.5-3 cups (C). Folic acid and iron supplementation are also essential
during pregnancy .
6. A nurse is teaching a client who is at 10 weeks of gestation about nutrition during
pregnancy. Which of the following statements by the client indicates an understanding of the
teaching?
A) "I should increase my protein intake to 60 grams each day."
B) "I should drink 2 liters of water each day."
C) "I should increase my overall daily caloric intake by 300 calories."
D) "I should take 600 micrograms of folic acid each day."
Answer: D
Rationale: Pregnant clients should increase folic acid intake to 600 mcg daily to help prevent
neural tube defects. Protein intake should increase to 71 grams daily during the second and
third trimesters (A). Water intake should be 3 liters daily (B). Caloric increases should be 340
calories in the second trimester and 452 in the third trimester (C). Iron supplementation (27 mg)
is also recommended .
7. A nurse is caring for a client who is at 14 weeks gestation and has hyperemesis gravidarum.
The nurse should identify that which of the following are risk factors for this client? (Select all
that apply.)
A) Obesity
B) Multifetal pregnancy
C) Maternal age greater than 40
D) Migraine headache
E) Oligohydramnios
3
, Answer: A, B, D
Rationale: Risk factors for hyperemesis gravidarum include obesity, multifetal pregnancy,
migraine headaches, and maternal age less than 30. Oligohydramnios (E) is not a risk factor for
this condition. Hyperemesis gravidarum can lead to dehydration, electrolyte imbalances, and
weight loss. Treatment includes IV fluids, antiemetics, and nutritional support .
8. A nurse in a prenatal clinic is caring for four clients. Which of the following clients' weight
gain should the nurse report to the provider?
A) 1.8 kg (4 lb) weight gain and is in her first trimester
B) 3.6 kg (8 lb) weight gain and is in her first trimester
C) 6.8 kg (15 lb) weight gain and in her first & second trimester
D) 11.3 kg (25 lb) weight gain and in her first, second & third trimester
Answer: B
Rationale: The expected weight gain in the first trimester is 2-6 lb (0.9-2.7 kg). An 8 lb (3.6 kg)
gain in the first trimester exceeds expectations and should be reported. Option A is within the
expected range; Option C is appropriate for first and second trimester combined; Option D is
within the recommended 25-35 lb total gain. Excessive weight gain increases risks of gestational
diabetes and preeclampsia .
9. A nurse is caring for a client at 34 weeks of gestation who reports a sudden gush of vaginal
fluid. Which of the following actions should the nurse take first?
A) Perform a vaginal examination to check for dilation
B) Test the fluid with nitrazine paper
C) Assess the fetal heart rate pattern
D) Check the client's temperature
Answer: C
Rationale: The priority action following rupture of membranes is to assess the fetal heart rate
(FHR) to ensure fetal well-being and rule out umbilical cord prolapse, which is a medical
emergency. The nurse should then test the fluid (B) to confirm rupture, but FHR assessment is
the priority. Vaginal exams (A) should be avoided to prevent infection; temperature (D) should
be monitored for signs of infection .
4
[2026/2027] updatEd VErSION |
VErIfIEd QuEStIONS & dEtaIlEd
ratIONalES alrEadY GradEd a+
Section 1: Antepartum Care & Fetal Development (Questions 1-20)
1. A nurse in an infertility clinic is providing care to a couple who has been unable to conceive
for 18 months. Which of the following data should be included in the assessment? (Select all
that apply.)
A) Occupation
B) Menstrual history
C) Childhood infectious diseases
D) History of falls
E) Recent blood transfusions
Answer: A, B, C
Rationale: Occupational hazards include exposure to teratogenic substances in the workplace
(A). Menstrual history can identify hormone-related patterns such as anovulation (B). Childhood
infectious diseases can identify if the male partner had mumps, which can affect fertility (C).
History of falls (D) and recent blood transfusions (E) are not relevant to infertility assessment .
2. A nurse is caring for a client who is pregnant and states that her last menstrual period was
April 1st. Which of the following is the client's estimated date of delivery (EDD)?
A) January 8
B) January 15
C) February 8
D) February 15
1
, Answer: A
Rationale: Naegele's rule: subtract 3 months from the first day of the last menstrual period and
add 7 days. April 1st minus 3 months = January 1st, plus 7 days = January 8th. This method
assumes a 28-day cycle. If the client has irregular cycles, ultrasound dating is more accurate .
3. A nurse in a prenatal clinic is caring for a client who is in the first trimester of pregnancy.
The client's health record includes this data: G3 T1 P0 A1 L1. How should the nurse interpret
this information? (Select all that apply.)
A) Client has delivered one newborn at term
B) Client has experienced no preterm labor
C) Client has been through active labor twice
D) Client has had two prior pregnancies
E) Client has one living child
Answer: A, B, D, E
Rationale: G3 = 3 pregnancies total (including current); T1 = 1 term birth; P0 = 0 preterm births;
A1 = 1 abortion/miscarriage; L1 = 1 living child. This indicates the client is currently pregnant,
has had two prior pregnancies, delivered one at term, has one living child, and had one
miscarriage. GTPAL is a key obstetric history assessment tool .
4. A nurse is reviewing the health record of a client who is pregnant. The provider indicated
the client exhibits probable signs of pregnancy. Which of the following findings should the
nurse expect? (Select all that apply.)
A) Montgomery's glands
B) Goodell's sign
C) Ballottement
D) Chadwick's sign
E) Quickening
Answer: B, C, D
Rationale: Probable signs of pregnancy are objective signs detected by the examiner: Goodell's
sign (softening of cervix), Ballottement (rebound of fetus), and Chadwick's sign (bluish
discoloration of cervix/vagina). Montgomery's glands (enlarged areolar glands) and quickening
(fetal movement felt by mother) are presumptive signs (subjective). Positive signs include fetal
heart tone, ultrasound visualization, and fetal movement felt by examiner .
2
, 5. A nurse is teaching a client who is at 8 weeks of gestation about nutrition during pregnancy.
Which of the following statements should the nurse include in the teaching?
A) "You should consume 2 cups of milk daily."
B) "You should consume 4 ounces of grains each day."
C) "You should consume 2 cups of vegetables each day."
D) "You should consume 6 ounces of protein foods each day."
Answer: D
Rationale: Pregnant clients should consume 5.5 to 6.5 ounces of protein foods daily, selecting
lean meats, poultry, eggs, legumes, and nuts. Dairy intake should be 3 cups (A), grains 6-8
ounces (B), and vegetables 2.5-3 cups (C). Folic acid and iron supplementation are also essential
during pregnancy .
6. A nurse is teaching a client who is at 10 weeks of gestation about nutrition during
pregnancy. Which of the following statements by the client indicates an understanding of the
teaching?
A) "I should increase my protein intake to 60 grams each day."
B) "I should drink 2 liters of water each day."
C) "I should increase my overall daily caloric intake by 300 calories."
D) "I should take 600 micrograms of folic acid each day."
Answer: D
Rationale: Pregnant clients should increase folic acid intake to 600 mcg daily to help prevent
neural tube defects. Protein intake should increase to 71 grams daily during the second and
third trimesters (A). Water intake should be 3 liters daily (B). Caloric increases should be 340
calories in the second trimester and 452 in the third trimester (C). Iron supplementation (27 mg)
is also recommended .
7. A nurse is caring for a client who is at 14 weeks gestation and has hyperemesis gravidarum.
The nurse should identify that which of the following are risk factors for this client? (Select all
that apply.)
A) Obesity
B) Multifetal pregnancy
C) Maternal age greater than 40
D) Migraine headache
E) Oligohydramnios
3
, Answer: A, B, D
Rationale: Risk factors for hyperemesis gravidarum include obesity, multifetal pregnancy,
migraine headaches, and maternal age less than 30. Oligohydramnios (E) is not a risk factor for
this condition. Hyperemesis gravidarum can lead to dehydration, electrolyte imbalances, and
weight loss. Treatment includes IV fluids, antiemetics, and nutritional support .
8. A nurse in a prenatal clinic is caring for four clients. Which of the following clients' weight
gain should the nurse report to the provider?
A) 1.8 kg (4 lb) weight gain and is in her first trimester
B) 3.6 kg (8 lb) weight gain and is in her first trimester
C) 6.8 kg (15 lb) weight gain and in her first & second trimester
D) 11.3 kg (25 lb) weight gain and in her first, second & third trimester
Answer: B
Rationale: The expected weight gain in the first trimester is 2-6 lb (0.9-2.7 kg). An 8 lb (3.6 kg)
gain in the first trimester exceeds expectations and should be reported. Option A is within the
expected range; Option C is appropriate for first and second trimester combined; Option D is
within the recommended 25-35 lb total gain. Excessive weight gain increases risks of gestational
diabetes and preeclampsia .
9. A nurse is caring for a client at 34 weeks of gestation who reports a sudden gush of vaginal
fluid. Which of the following actions should the nurse take first?
A) Perform a vaginal examination to check for dilation
B) Test the fluid with nitrazine paper
C) Assess the fetal heart rate pattern
D) Check the client's temperature
Answer: C
Rationale: The priority action following rupture of membranes is to assess the fetal heart rate
(FHR) to ensure fetal well-being and rule out umbilical cord prolapse, which is a medical
emergency. The nurse should then test the fluid (B) to confirm rupture, but FHR assessment is
the priority. Vaginal exams (A) should be avoided to prevent infection; temperature (D) should
be monitored for signs of infection .
4
