V1 2026/2027 MATERNITY HESI RN 55,
COMPLETE QUESTIONS & ANSWERS (VERIFIED)
Aligned with the HESI RN Maternity Exam Blueprint, the NCLEX-RN Test Plan (Maternal-Newborn Nursing Content),
and Evidence-Based Perinatal Nursing Practice Standards (2026/2027 Edition)
Section 1: Antepartum Nursing Care
Q1: A nurse is assessing a client who may be pregnant. Which finding should the nurse
document as a positive (diagnostic) sign of pregnancy?
A. Amenorrhea and breast tenderness
B. A positive result on a home urine pregnancy test
C. Fetal movement palpated by the examining nurse [CORRECT]
D. Chadwick's sign of the cervix
Correct Answer: C
Rationale: Positive signs of pregnancy can be attributed only to the presence of a fetus and include
fetal movement palpated by an examiner, fetal heart tones detected by the examiner, and visualization
of the fetus by ultrasound. Amenorrhea, breast tenderness, and Chadwick's sign are presumptive signs
that may be caused by other conditions, and a urine hCG test is classified only as a probable sign. HESI
methodology requires the nurse to correctly categorize signs as presumptive, probable, or positive when
interpreting assessment data.
Q2: A client's last menstrual period (LMP) began on March 12. Using Naegele's rule, the nurse
should calculate the estimated date of birth (EDB) as which of the following?
A. December 5
B. December 19 [CORRECT]
C. December 26
D. January 19
Correct Answer: B
Rationale: Naegele's rule instructs the nurse to subtract 3 months from the first day of the LMP and
add 7 days, adjusting the year as needed. March 12 minus 3 months equals December 12, and adding 7
days yields December 19. The distractors reflect common calculation errors such as subtracting 3
months without adding 7 days or adding 14 days instead of 7.
HESI RN Maternity Examination Preparation 1
,V1 2026/2027 MATERNITY HESI RN 55 Complete Questions & Answers (Verified)
Q3: A nurse is performing a physical assessment on a client at 32 weeks of gestation. While the
client lies supine on the examination table, she suddenly becomes dizzy, pale, and hypotensive.
Which action should the nurse take first?
A. Obtain a complete set of vital signs
B. Assess deep tendon reflexes and clonus
C. Offer cool oral fluids to sip
D. Turn the client onto her left side [CORRECT]
Correct Answer: D
Rationale: These findings are classic for supine hypotensive syndrome, in which the gravid uterus
compresses the inferior vena cava, reducing venous return, cardiac output, and blood pressure. The
immediate intervention is to turn the client to a left lateral position (or tilt the table) to relieve caval
compression and restore perfusion to the mother and fetus. Assessment data such as vital signs are
collected after corrective positioning because the nurse already recognizes the cause of the symptoms.
Q4: A client at 16 weeks of gestation has a hemoglobin of 10.8 g/dL and has been prescribed an
oral iron supplement. Which instruction should the nurse include in the teaching plan?
A. Take the iron supplement with orange juice to enhance absorption [CORRECT]
B. Take the iron supplement with a glass of milk to prevent nausea
C. Take the iron supplement with an antacid to reduce gastrointestinal upset
D. Take a double dose the next day if a dose is missed
Correct Answer: A
Rationale: Vitamin C in orange juice converts dietary and supplemental iron to a form that is more
readily absorbed, so iron should be taken with a citrus source rather than with milk, tea, or antacids,
which significantly inhibit absorption. The nurse should also teach that stools will turn dark green or
black, constipation is common and should be managed with fluids and fiber, and double dosing is
unsafe. This reflects NCLEX-RN health promotion content on maternal nutritional supplementation.
HESI RN Maternity Examination Preparation 2
, V1 2026/2027 MATERNITY HESI RN 55 Complete Questions & Answers (Verified)
Q5: A 24-year-old client at 6 weeks of gestation tells the nurse that she has been taking
isotretinoin for severe acne and stopped it 2 days ago. Which response by the nurse is most
appropriate?
A. Isotretinoin is considered safe after the first trimester is completed
B. You may resume the medication once the first trimester is over
C. Isotretinoin is a known teratogen; notify your provider immediately so your plan of care
can be reviewed [CORRECT]
D. Topical acne medications are always more dangerous than oral medications
Correct Answer: C
Rationale: Isotretinoin is a pregnancy category X medication and a well-established teratogen
associated with major craniofacial, cardiac, thymic, and central nervous system malformations when
exposure occurs in early pregnancy. The correct nursing action is to ensure immediate provider
notification and counseling about fetal risk and ongoing monitoring. Resuming the drug later in
pregnancy is never appropriate, and the claim that topical agents are more dangerous is factually
incorrect.
Q6: A client at 17 weeks of gestation has a maternal serum alpha-fetoprotein (MSAFP) result
that is abnormally low. The nurse should recognize that this finding is most closely associated
with which condition?
A. Open neural tube defect
B. Down syndrome (trisomy 21) [CORRECT]
C. Abdominal wall defect (gastroschisis)
D. Multifetal gestation
Correct Answer: B
Rationale: An abnormally low MSAFP level is associated with an increased risk of chromosomal
anomalies, particularly Down syndrome (trisomy 21) and trisomy 18, and warrants follow-up with
cell-free DNA screening, targeted ultrasound, and possibly amniocentesis. Elevated levels, not low
levels, are associated with open neural tube defects, abdominal wall defects, and multifetal gestation.
This analysis-level distinction between high and low MSAFP is a frequently tested HESI maternity
concept.
HESI RN Maternity Examination Preparation 3
COMPLETE QUESTIONS & ANSWERS (VERIFIED)
Aligned with the HESI RN Maternity Exam Blueprint, the NCLEX-RN Test Plan (Maternal-Newborn Nursing Content),
and Evidence-Based Perinatal Nursing Practice Standards (2026/2027 Edition)
Section 1: Antepartum Nursing Care
Q1: A nurse is assessing a client who may be pregnant. Which finding should the nurse
document as a positive (diagnostic) sign of pregnancy?
A. Amenorrhea and breast tenderness
B. A positive result on a home urine pregnancy test
C. Fetal movement palpated by the examining nurse [CORRECT]
D. Chadwick's sign of the cervix
Correct Answer: C
Rationale: Positive signs of pregnancy can be attributed only to the presence of a fetus and include
fetal movement palpated by an examiner, fetal heart tones detected by the examiner, and visualization
of the fetus by ultrasound. Amenorrhea, breast tenderness, and Chadwick's sign are presumptive signs
that may be caused by other conditions, and a urine hCG test is classified only as a probable sign. HESI
methodology requires the nurse to correctly categorize signs as presumptive, probable, or positive when
interpreting assessment data.
Q2: A client's last menstrual period (LMP) began on March 12. Using Naegele's rule, the nurse
should calculate the estimated date of birth (EDB) as which of the following?
A. December 5
B. December 19 [CORRECT]
C. December 26
D. January 19
Correct Answer: B
Rationale: Naegele's rule instructs the nurse to subtract 3 months from the first day of the LMP and
add 7 days, adjusting the year as needed. March 12 minus 3 months equals December 12, and adding 7
days yields December 19. The distractors reflect common calculation errors such as subtracting 3
months without adding 7 days or adding 14 days instead of 7.
HESI RN Maternity Examination Preparation 1
,V1 2026/2027 MATERNITY HESI RN 55 Complete Questions & Answers (Verified)
Q3: A nurse is performing a physical assessment on a client at 32 weeks of gestation. While the
client lies supine on the examination table, she suddenly becomes dizzy, pale, and hypotensive.
Which action should the nurse take first?
A. Obtain a complete set of vital signs
B. Assess deep tendon reflexes and clonus
C. Offer cool oral fluids to sip
D. Turn the client onto her left side [CORRECT]
Correct Answer: D
Rationale: These findings are classic for supine hypotensive syndrome, in which the gravid uterus
compresses the inferior vena cava, reducing venous return, cardiac output, and blood pressure. The
immediate intervention is to turn the client to a left lateral position (or tilt the table) to relieve caval
compression and restore perfusion to the mother and fetus. Assessment data such as vital signs are
collected after corrective positioning because the nurse already recognizes the cause of the symptoms.
Q4: A client at 16 weeks of gestation has a hemoglobin of 10.8 g/dL and has been prescribed an
oral iron supplement. Which instruction should the nurse include in the teaching plan?
A. Take the iron supplement with orange juice to enhance absorption [CORRECT]
B. Take the iron supplement with a glass of milk to prevent nausea
C. Take the iron supplement with an antacid to reduce gastrointestinal upset
D. Take a double dose the next day if a dose is missed
Correct Answer: A
Rationale: Vitamin C in orange juice converts dietary and supplemental iron to a form that is more
readily absorbed, so iron should be taken with a citrus source rather than with milk, tea, or antacids,
which significantly inhibit absorption. The nurse should also teach that stools will turn dark green or
black, constipation is common and should be managed with fluids and fiber, and double dosing is
unsafe. This reflects NCLEX-RN health promotion content on maternal nutritional supplementation.
HESI RN Maternity Examination Preparation 2
, V1 2026/2027 MATERNITY HESI RN 55 Complete Questions & Answers (Verified)
Q5: A 24-year-old client at 6 weeks of gestation tells the nurse that she has been taking
isotretinoin for severe acne and stopped it 2 days ago. Which response by the nurse is most
appropriate?
A. Isotretinoin is considered safe after the first trimester is completed
B. You may resume the medication once the first trimester is over
C. Isotretinoin is a known teratogen; notify your provider immediately so your plan of care
can be reviewed [CORRECT]
D. Topical acne medications are always more dangerous than oral medications
Correct Answer: C
Rationale: Isotretinoin is a pregnancy category X medication and a well-established teratogen
associated with major craniofacial, cardiac, thymic, and central nervous system malformations when
exposure occurs in early pregnancy. The correct nursing action is to ensure immediate provider
notification and counseling about fetal risk and ongoing monitoring. Resuming the drug later in
pregnancy is never appropriate, and the claim that topical agents are more dangerous is factually
incorrect.
Q6: A client at 17 weeks of gestation has a maternal serum alpha-fetoprotein (MSAFP) result
that is abnormally low. The nurse should recognize that this finding is most closely associated
with which condition?
A. Open neural tube defect
B. Down syndrome (trisomy 21) [CORRECT]
C. Abdominal wall defect (gastroschisis)
D. Multifetal gestation
Correct Answer: B
Rationale: An abnormally low MSAFP level is associated with an increased risk of chromosomal
anomalies, particularly Down syndrome (trisomy 21) and trisomy 18, and warrants follow-up with
cell-free DNA screening, targeted ultrasound, and possibly amniocentesis. Elevated levels, not low
levels, are associated with open neural tube defects, abdominal wall defects, and multifetal gestation.
This analysis-level distinction between high and low MSAFP is a frequently tested HESI maternity
concept.
HESI RN Maternity Examination Preparation 3
