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HESI OB MATERNITY VERSION 1 (V1) — COMPREHENSIVE
PRACTICE EXAMINATION 2026/2027 COMPLETE (150)
CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
MATERNITY
Prepare effectively for the HESI OB Maternity Version 1 (V1) Exam with this focused
study resource. It supports review of antepartum care, labor and delivery, maternal
and fetal assessment, postpartum care, newborn care, and common obstetric
complications. Use the material to reinforce your maternity nursing knowledge, review
high-yield topics, and identify areas that may require additional study. This resource is
suited for nursing students, OB/maternity nursing learners, and candidates preparing
for HESI maternity assessments.
MULTIPLE CHOICE.
SECTION 1: ANTEPARTUM (PRENATAL) CARE (Questions 1–30)
1. A 28-year-old client at 10 weeks gestation presents for her first prenatal
visit. She reports a history of two previous pregnancies: the first resulted
in a spontaneous abortion at 12 weeks, and the second resulted in a live
birth at 38 weeks. The current pregnancy is her third. Using GTPAL
documentation, which statement by the nurse is correct?
• A. "Your GTPAL is G3 T1 P0 A1 L1."
• B. "Your GTPAL is G2 T1 P0 A1 L1."
• C. "Your GTPAL is G3 T1 P0 A1 L1."
• D. "Your GTPAL is G3 T0 P0 A2 L0."
Answer: C. "Your GTPAL is G3 T1 P0 A1 L1."
Rationale: GTPAL stands for: (G) Gravida (total number of pregnancies,
including current = 3), (T) Term births (pregnancies delivered at 37 weeks
or beyond = 1), (P) Preterm births (pregnancies delivered 20–37 weeks = 0),
(A) Abortions (pregnancies ending before 20 weeks = 1), (L) Living children
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(1). The spontaneous abortion at 12 weeks counts toward "A" (Abortions),
not "P" (Preterm).
2. A nurse is caring for a client at 8 weeks gestation with confirmed Rh-
negative blood type. Which interventions are indicated regarding Rh
sensitization prevention? (Select all that apply.)
• A. Administer RhoGAM at 28 weeks gestation
• B. Administer RhoGAM within 72 hours of any invasive prenatal
procedure (amniocentesis, CVS)
• C. Obtain an indirect Coombs test (antibody screen) at the first prenatal
visit
• D. Administer RhoGAM only if the father is Rh-positive
• E. Administer RhoGAM immediately after delivery if the newborn is Rh-
negative
• F. Repeat RhoGAM dosage if given earlier in pregnancy and delivery
occurs within 3 weeks of the last dose
Answer: A, B, C
Rationale: Standard protocol requires RhoGAM at 28 weeks (antepartum
dose), within 72 hours of potential fetal-maternal hemorrhage events, and
postpartum if the infant is Rh-positive (not negative). An antibody screen
must establish baseline sensitization status. RhoGAM is given
prophylactically regardless of presumed paternity. The standard 300 mcg
dose covers up to 15 mL fetal red cell exposure and remains therapeutic
for 12 weeks.
3. A client at 28 weeks gestation calls the clinic reporting sudden onset of
vaginal bleeding described as "bright red and heavy, but I have no pain at
all." Which action should the nurse take FIRST?
• A. Instruct the client to come to the clinic immediately for a sterile
vaginal exam
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• B. Assess fetal heart tones via Doppler and notify the provider
• C. Advise the client to monitor the bleeding for 2 hours and call back if it
increases
• D. Ask the client to check her temperature and report any fever
Answer: B. Assess fetal heart tones via Doppler and notify the provider
Rationale: Painless, bright red vaginal bleeding in the third trimester is a
classic sign of placenta previa. The priority is to assess fetal well-being
and notify the provider. A vaginal examination is contraindicated in
suspected placenta previa due to the risk of causing severe hemorrhage.
4. A client at 36 weeks gestation presents with a blood pressure of 168/102
mm Hg, 3+ proteinuria, and reports a severe headache and epigastric
pain. Which action should the nurse take first?
• A. Administer hydralazine as prescribed
• B. Place the client in a left lateral position
• C. Assess deep tendon reflexes
• D. Prepare for immediate cesarean birth
Answer: B. Place the client in a left lateral position
Rationale: The client is exhibiting signs of severe preeclampsia with
imminent risk of eclampsia. The priority action is to place the client in a
left lateral position to improve venous return, increase cardiac output,
and enhance uteroplacental perfusion. This non-invasive intervention
supports maternal-fetal well-being while preparing for further
interventions. Antihypertensive medication may be indicated but
positioning is the immediate priority.
5. A client at 32 weeks gestation presents with painless, bright red vaginal
bleeding. The uterus is soft and non-tender. Fetal heart rate is 150 bpm
with moderate variability. Which is the priority nursing action?
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• A. Perform a sterile vaginal examination to assess cervical dilation
• B. Prepare the client for immediate induction of labor
• C. Place the client on continuous fetal monitoring and initiate IV
access
• D. Administer betamethasone 12 mg IM
Answer: C. Place the client on continuous fetal monitoring and initiate IV
access
Rationale: The presentation (painless, bright red bleeding, soft non-
tender uterus) is classic for placenta previa. The priority is to establish
continuous fetal monitoring to assess fetal well-being and initiate IV
access for potential fluid or blood product administration. Digital vaginal
examination is contraindicated in suspected placenta previa as it may
disrupt the placenta and cause catastrophic hemorrhage.
6. A nurse is providing education to a client with gestational diabetes at 28
weeks gestation. Which statement by the client indicates a need for
further teaching?
• A. "I will check my blood glucose levels four times daily."
• B. "I need to increase my calorie intake because I am eating for two."
• C. "I should report any episodes of hypoglycemia to my provider."
• D. "I will monitor my baby's movements daily."
Answer: B. "I need to increase my calorie intake because I am eating for
two."
Rationale: Clients with gestational diabetes do not need to "eat for two."
Caloric requirements increase by approximately 300–400 calories per day
in the second and third trimesters, but excessive caloric intake can
worsen hyperglycemia. Blood glucose monitoring four times daily (fasting
and postprandial) is standard.
HESI OB MATERNITY VERSION 1 (V1) — COMPREHENSIVE
PRACTICE EXAMINATION 2026/2027 COMPLETE (150)
CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
MATERNITY
Prepare effectively for the HESI OB Maternity Version 1 (V1) Exam with this focused
study resource. It supports review of antepartum care, labor and delivery, maternal
and fetal assessment, postpartum care, newborn care, and common obstetric
complications. Use the material to reinforce your maternity nursing knowledge, review
high-yield topics, and identify areas that may require additional study. This resource is
suited for nursing students, OB/maternity nursing learners, and candidates preparing
for HESI maternity assessments.
MULTIPLE CHOICE.
SECTION 1: ANTEPARTUM (PRENATAL) CARE (Questions 1–30)
1. A 28-year-old client at 10 weeks gestation presents for her first prenatal
visit. She reports a history of two previous pregnancies: the first resulted
in a spontaneous abortion at 12 weeks, and the second resulted in a live
birth at 38 weeks. The current pregnancy is her third. Using GTPAL
documentation, which statement by the nurse is correct?
• A. "Your GTPAL is G3 T1 P0 A1 L1."
• B. "Your GTPAL is G2 T1 P0 A1 L1."
• C. "Your GTPAL is G3 T1 P0 A1 L1."
• D. "Your GTPAL is G3 T0 P0 A2 L0."
Answer: C. "Your GTPAL is G3 T1 P0 A1 L1."
Rationale: GTPAL stands for: (G) Gravida (total number of pregnancies,
including current = 3), (T) Term births (pregnancies delivered at 37 weeks
or beyond = 1), (P) Preterm births (pregnancies delivered 20–37 weeks = 0),
(A) Abortions (pregnancies ending before 20 weeks = 1), (L) Living children
, Page 2 of 71
(1). The spontaneous abortion at 12 weeks counts toward "A" (Abortions),
not "P" (Preterm).
2. A nurse is caring for a client at 8 weeks gestation with confirmed Rh-
negative blood type. Which interventions are indicated regarding Rh
sensitization prevention? (Select all that apply.)
• A. Administer RhoGAM at 28 weeks gestation
• B. Administer RhoGAM within 72 hours of any invasive prenatal
procedure (amniocentesis, CVS)
• C. Obtain an indirect Coombs test (antibody screen) at the first prenatal
visit
• D. Administer RhoGAM only if the father is Rh-positive
• E. Administer RhoGAM immediately after delivery if the newborn is Rh-
negative
• F. Repeat RhoGAM dosage if given earlier in pregnancy and delivery
occurs within 3 weeks of the last dose
Answer: A, B, C
Rationale: Standard protocol requires RhoGAM at 28 weeks (antepartum
dose), within 72 hours of potential fetal-maternal hemorrhage events, and
postpartum if the infant is Rh-positive (not negative). An antibody screen
must establish baseline sensitization status. RhoGAM is given
prophylactically regardless of presumed paternity. The standard 300 mcg
dose covers up to 15 mL fetal red cell exposure and remains therapeutic
for 12 weeks.
3. A client at 28 weeks gestation calls the clinic reporting sudden onset of
vaginal bleeding described as "bright red and heavy, but I have no pain at
all." Which action should the nurse take FIRST?
• A. Instruct the client to come to the clinic immediately for a sterile
vaginal exam
, Page 3 of 71
• B. Assess fetal heart tones via Doppler and notify the provider
• C. Advise the client to monitor the bleeding for 2 hours and call back if it
increases
• D. Ask the client to check her temperature and report any fever
Answer: B. Assess fetal heart tones via Doppler and notify the provider
Rationale: Painless, bright red vaginal bleeding in the third trimester is a
classic sign of placenta previa. The priority is to assess fetal well-being
and notify the provider. A vaginal examination is contraindicated in
suspected placenta previa due to the risk of causing severe hemorrhage.
4. A client at 36 weeks gestation presents with a blood pressure of 168/102
mm Hg, 3+ proteinuria, and reports a severe headache and epigastric
pain. Which action should the nurse take first?
• A. Administer hydralazine as prescribed
• B. Place the client in a left lateral position
• C. Assess deep tendon reflexes
• D. Prepare for immediate cesarean birth
Answer: B. Place the client in a left lateral position
Rationale: The client is exhibiting signs of severe preeclampsia with
imminent risk of eclampsia. The priority action is to place the client in a
left lateral position to improve venous return, increase cardiac output,
and enhance uteroplacental perfusion. This non-invasive intervention
supports maternal-fetal well-being while preparing for further
interventions. Antihypertensive medication may be indicated but
positioning is the immediate priority.
5. A client at 32 weeks gestation presents with painless, bright red vaginal
bleeding. The uterus is soft and non-tender. Fetal heart rate is 150 bpm
with moderate variability. Which is the priority nursing action?
, Page 4 of 71
• A. Perform a sterile vaginal examination to assess cervical dilation
• B. Prepare the client for immediate induction of labor
• C. Place the client on continuous fetal monitoring and initiate IV
access
• D. Administer betamethasone 12 mg IM
Answer: C. Place the client on continuous fetal monitoring and initiate IV
access
Rationale: The presentation (painless, bright red bleeding, soft non-
tender uterus) is classic for placenta previa. The priority is to establish
continuous fetal monitoring to assess fetal well-being and initiate IV
access for potential fluid or blood product administration. Digital vaginal
examination is contraindicated in suspected placenta previa as it may
disrupt the placenta and cause catastrophic hemorrhage.
6. A nurse is providing education to a client with gestational diabetes at 28
weeks gestation. Which statement by the client indicates a need for
further teaching?
• A. "I will check my blood glucose levels four times daily."
• B. "I need to increase my calorie intake because I am eating for two."
• C. "I should report any episodes of hypoglycemia to my provider."
• D. "I will monitor my baby's movements daily."
Answer: B. "I need to increase my calorie intake because I am eating for
two."
Rationale: Clients with gestational diabetes do not need to "eat for two."
Caloric requirements increase by approximately 300–400 calories per day
in the second and third trimesters, but excessive caloric intake can
worsen hyperglycemia. Blood glucose monitoring four times daily (fasting
and postprandial) is standard.
