ELSEVIER EVOLVE | HEALTH EDUCATION SYSTEMS, INC. (HESI)
HESI RN Maternity | NCLEX-RN Readiness Competency Assessment
Professional Registered Nursing | 2026/2027 Edition
HESI MATERNITY
2026/2027 EXAM
Verified Questions • Complete Answer Key • Detailed Rationales
INSTITUTION | Elsevier Evolve | Health Education Systems, Inc. (HESI)
PROGRAM | HESI RN Maternity
COURSE CODE | HESI-MAT
EXAM TITLE | HESI MATERNITY EXAM 2026/2027 | Verified Questions
COURSE TITLE | HESI RN Maternity Nursing Comprehensive Examination
ACADEMIC YEAR | 2026/2027
TOTAL QUESTIONS | 155 Questions
CORE DOMAINS | 6 Domains
PASSING STANDARD | 850 HESI / 75-80%
Core Domains: Antepartum Care & Complications • Intrapartum Care & Fetal Monitoring • Postpartum Care & Complications • Newborn
Assessment & Care • High-Risk Pregnancy & Medical Complications • Reproductive Health & Women's Health
2026/2027 Edition — Aligned with the Elsevier Evolve HESI RN Maternity Exam Blueprint, NCSBN Clinical Judgment Measurement Model, and
evidence-based maternal-newborn nursing standards
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HESI-MAT | 2026/2027
ACTUAL QUESTIONS
Domain 1: Antepartum Care & Complications
Question 1. What is the recommended daily folic acid intake for women of childbearing age to reduce
the risk of neural tube defects?
A. 400 mcg
B. 100 mcg
C. 1,000 mcg
D. 50 mcg
Correct Answer: A
Rationale: Current guidelines recommend 400 mcg of folic acid daily for women capable of becoming pregnant to reduce neural tube defect risk.
Question 2. Which finding during a prenatal visit is most concerning for possible preeclampsia?
A. Mild ankle edema at 36 weeks
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B. Blood pressure of 128/78 mm Hg without proteinuria
C. Blood pressure of 148/96 mm Hg with proteinuria
D. Weight gain of 1 pound in one week
Correct Answer: C
Rationale: Hypertension with proteinuria is a hallmark of preeclampsia and requires further evaluation.
Question 3. A client at 28 weeks gestation reports decreased fetal movement. What is the nurse’s
priority action?
A. Instruct the client to perform a fetal kick count and notify the provider if fewer than 10 movements in 2 hours
B. Reassure the client that decreased movement is normal in the third trimester
C. Schedule a routine ultrasound for the following week
D. Advise the client to increase caffeine intake
Correct Answer: A
Rationale: Decreased fetal movement requires prompt assessment; kick counts are a first-line evaluation tool.
Question 4. Which laboratory result is expected in a client with gestational diabetes mellitus?
A. Low hemoglobin A1c
B. Elevated fasting blood glucose and abnormal glucose tolerance test
C. Decreased serum insulin levels only
D. Normal random blood glucose throughout pregnancy
Correct Answer: B
Rationale: Gestational diabetes is diagnosed by elevated fasting glucose or abnormal results on a glucose challenge or tolerance test.
Question 5. What is the primary purpose of Rho(D) immune globulin administration during
pregnancy?
A. To prevent all forms of neonatal jaundice
B. To treat active hemolytic disease of the newborn
C. To increase maternal antibody production
D. To prevent maternal sensitization to Rh-positive fetal blood cells
Correct Answer: D
Rationale: Rho(D) immune globulin prevents the Rh-negative mother from forming antibodies against Rh-positive fetal cells.
Question 6. A client at 32 weeks gestation has a fundal height measurement of 28 cm. What does this
finding most likely indicate?
A. Normal fetal growth
B. Possible intrauterine growth restriction or oligohydramnios
C. Possible macrosomia
D. Multiple gestation
Correct Answer: B
Rationale: Fundal height that is significantly less than gestational age suggests possible growth restriction or reduced amniotic fluid.
Question 7. Which instruction is most appropriate for a client experiencing mild pregnancy-induced
nausea?
A. Lie flat immediately after eating
B. Skip breakfast and eat one large meal at midday
C. Eat small, frequent meals and avoid triggers such as strong odors
D. Restrict all fluid intake until evening
Correct Answer: C
Rationale: Small, frequent meals and avoidance of triggers are evidence-based strategies for managing pregnancy-related nausea.
Question 8. What is the most accurate method for determining gestational age in the first trimester?
A. Maternal weight gain
B. Date of quickening
C. Fundal height measurement
D. Ultrasound measurement of crown-rump length
Correct Answer: D
Rationale: First-trimester crown-rump length on ultrasound provides the most accurate dating of pregnancy.
Question 9. A client reports bright red, painless vaginal bleeding at 30 weeks gestation. Which
condition should the nurse suspect first?
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A. Placenta previa
B. Placental abruption
C. Uterine rupture
D. Vasa previa only
Correct Answer: A
Rationale: Painless bright-red bleeding in the second or third trimester is classic for placenta previa.
Question 10. Which finding is most consistent with a diagnosis of hyperemesis gravidarum?
A. Occasional vomiting after large meals
B. Mild morning nausea that resolves by 12 weeks
C. Persistent vomiting with weight loss, dehydration, and electrolyte imbalance
D. Heartburn without weight loss
Correct Answer: C
Rationale: Hyperemesis gravidarum is characterized by severe, persistent vomiting leading to metabolic disturbance.
Question 11. What is the purpose of measuring alpha-fetoprotein (AFP) levels during pregnancy?
A. To screen for neural tube defects and certain chromosomal abnormalities
B. To diagnose gestational diabetes
C. To confirm fetal lung maturity
D. To measure maternal blood type only
Correct Answer: A
Rationale: Maternal serum AFP is used as a screening tool for open neural tube defects and may also indicate risk for aneuploidy.
Question 12. A client at 24 weeks gestation has a 1-hour glucose challenge test result of 155 mg/dL.
What is the next step?
A. Repeat the 1-hour test in one week
B. Diagnose gestational diabetes immediately
C. Perform a 3-hour glucose tolerance test for diagnostic confirmation
D. Begin insulin therapy without further testing
Correct Answer: C
Rationale: An abnormal 1-hour screen is followed by a diagnostic 3-hour glucose tolerance test.
Question 13. Which vaccine is contraindicated during pregnancy?
A. Hepatitis B vaccine
B. Inactivated influenza vaccine
C. Tetanus-diphtheria-pertussis (Tdap)
D. Live attenuated vaccines such as MMR and varicella
Correct Answer: D
Rationale: Live vaccines are generally avoided during pregnancy because of theoretical fetal risk.
Question 14. What is the expected weight gain for a client with a normal pre-pregnancy BMI?
A. 25 to 35 pounds
B. 11 to 20 pounds
C. 40 to 50 pounds
D. 5 to 10 pounds
Correct Answer: A
Rationale: Guidelines recommend 25–35 pounds of total weight gain for women with a normal pre-pregnancy BMI.
Question 15. A client reports severe headache, visual changes, and epigastric pain at 34 weeks. What is
the priority nursing action?
A. Encourage ambulation to relieve discomfort
B. Administer acetaminophen and reassess in one hour
C. Assess blood pressure and notify the provider immediately
D. Document the findings and continue routine care
Correct Answer: C
Rationale: These symptoms suggest severe preeclampsia and require immediate evaluation and intervention.
Question 16. Which finding indicates a reactive nonstress test?
A. Absence of accelerations over 40 minutes
B. Two or more accelerations of at least 15 bpm lasting 15 seconds within a 20-minute period
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