HESI RN MATERNITY EXAM 2026/2027 | 155 VERIFIED QUESTIONS &
ANSWERS | ELSEVIER EVOLVE NCLEX-RN READINESS | INSTANT
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Introduction
This comprehensive practice exam is designed to prepare nursing students for the HESI RN Maternity
examination. The question bank covers the core domains tested on the exam, including antepartum
care, intrapartum care, postpartum care, newborn care, high-risk pregnancy complications, fetal
monitoring, obstetric medications, and women's health. Each question includes four answer choices, the
correct answer, and a detailed rationale explaining the clinical reasoning. References and source
citations have been omitted as requested.
Instructions: Choose the best answer for each question. Review the rationale after each answer to
reinforce your understanding of maternal-newborn nursing principles.
Section 1: Antepartum Care and Pregnancy Physiology (Questions 1–35)
1. A pregnant client reports nausea and vomiting during the first trimester. Which instruction should
the nurse provide?
A. Eat three large meals daily
B. Eat small, frequent meals and avoid greasy foods
C. Drink fluids with meals
D. Take iron supplements on an empty stomach
Correct Answer: B
Rationale: Small, frequent meals and avoiding greasy or spicy foods help reduce nausea and vomiting
during pregnancy. Drinking fluids with meals can worsen nausea, and iron supplements may exacerbate
gastrointestinal upset if taken on an empty stomach.
2. Which physiological change is expected during pregnancy?
A. Decreased blood volume
B. Decreased cardiac output
C. Increased blood volume and cardiac output
D. Increased blood pressure
Correct Answer: C
Rationale: Pregnancy causes increased blood volume (up to 50%) and cardiac output to meet the
metabolic demands of the fetus and support placental perfusion. Blood pressure typically remains stable
or decreases slightly during the second trimester.
,3. A client at 12 weeks gestation reports frequency of urination. What should the nurse explain?
A. This is abnormal and requires immediate evaluation
B. This is expected due to the enlarging uterus pressing on the bladder
C. This indicates a urinary tract infection
D. This will worsen throughout pregnancy
Correct Answer: B
Rationale: Urinary frequency is common in early pregnancy due to the enlarging uterus pressing on the
bladder and increased renal blood flow. It often subsides during the second trimester and may return in
the third trimester as the fetus descends.
4. What is the recommended weight gain for a woman with a normal prepregnancy BMI during
pregnancy?
A. 5–10 pounds
B. 11–20 pounds
C. 25–35 pounds
D. 40–50 pounds
Correct Answer: C
Rationale: For women with a normal prepregnancy BMI (18.5–24.9), the recommended weight gain is
25–35 pounds. Underweight women should gain more (28–40 pounds), and obese women should gain
less (11–20 pounds).
5. Which supplement is recommended during pregnancy to prevent neural tube defects?
A. Iron
B. Calcium
C. Folic acid
D. Vitamin D
Correct Answer: C
Rationale: Folic acid supplementation (400–800 mcg daily) is recommended before conception and
during early pregnancy to reduce the risk of neural tube defects such as spina bifida and anencephaly.
6. A client at 28 weeks gestation reports heartburn. Which instruction should the nurse provide?
A. Lie down immediately after eating
B. Eat small, frequent meals and avoid spicy foods
C. Drink large amounts of fluids with meals
D. Take NSAIDs for relief
Correct Answer: B
Rationale: Heartburn is common in pregnancy due to progesterone-induced relaxation of the lower
,esophageal sphincter and pressure from the enlarging uterus. Small, frequent meals, avoiding spicy
foods, and remaining upright after meals help reduce symptoms. NSAIDs should be avoided during
pregnancy unless prescribed.
7. What is the purpose of the alpha-fetoprotein (AFP) test?
A. To screen for neural tube defects and chromosomal abnormalities
B. To diagnose gestational diabetes
C. To assess fetal lung maturity
D. To evaluate maternal thyroid function
Correct Answer: A
Rationale: The AFP test is a maternal serum screening test performed between 15 and 20 weeks
gestation. Elevated AFP may indicate neural tube defects, while low AFP may suggest chromosomal
abnormalities such as Down syndrome.
8. A client at 36 weeks gestation reports difficulty breathing. What should the nurse explain?
A. This is abnormal and indicates heart failure
B. This is expected due to the uterus pressing on the diaphragm
C. This indicates a pulmonary embolism
D. This will worsen until delivery
Correct Answer: B
Rationale: Difficulty breathing is common in late pregnancy as the enlarging uterus presses upward on
the diaphragm, reducing lung expansion. Lightening (fetal descent) may relieve this symptom before
labor.
9. What is the recommended position for a pregnant client experiencing supine hypotension?
A. Supine with legs elevated
B. Left lateral position
C. Prone position
D. High Fowler's position
Correct Answer: B
Rationale: Supine hypotension occurs when the gravid uterus compresses the inferior vena cava,
reducing venous return and cardiac output. The left lateral position relieves this compression and
restores blood flow.
10. Which sign indicates possible ectopic pregnancy?
A. Painless vaginal bleeding
B. Unilateral lower abdominal pain with spotting
, C. Increased fetal movement
D. Braxton Hicks contractions
Correct Answer: B
Rationale: Ectopic pregnancy typically presents with unilateral lower abdominal pain, vaginal spotting,
and a positive pregnancy test. It is a medical emergency requiring prompt evaluation.
11. A client at 10 weeks gestation is Rh-negative. What intervention is recommended?
A. No intervention is needed
B. Administer Rho(D) immune globulin at 28 weeks and after delivery if the fetus is Rh-positive
C. Administer Rho(D) immune globulin only after delivery
D. Perform an amniocentesis
Correct Answer: B
Rationale: Rho(D) immune globulin (RhoGAM) is administered to Rh-negative mothers at 28 weeks
gestation and within 72 hours after delivery if the newborn is Rh-positive to prevent Rh sensitization.
12. What is the purpose of the glucose tolerance test during pregnancy?
A. To screen for gestational diabetes
B. To assess fetal lung maturity
C. To diagnose preeclampsia
D. To evaluate thyroid function
Correct Answer: A
Rationale: The glucose tolerance test is performed between 24 and 28 weeks gestation to screen for
gestational diabetes. It involves measuring blood glucose after a glucose load.
13. A client reports constipation during pregnancy. Which instruction should the nurse provide?
A. Increase fiber intake and fluids
B. Take laxatives daily
C. Decrease physical activity
D. Avoid all fruits and vegetables
Correct Answer: A
Rationale: Constipation is common in pregnancy due to progesterone-induced decreased bowel motility
and pressure from the uterus. Increasing fiber and fluids and regular exercise help prevent and manage
constipation.
14. What is quickening?
A. The first fetal movement felt by the mother
B. The first heartbeat heard by Doppler
ANSWERS | ELSEVIER EVOLVE NCLEX-RN READINESS | INSTANT
DOWNLOAD PDF
Introduction
This comprehensive practice exam is designed to prepare nursing students for the HESI RN Maternity
examination. The question bank covers the core domains tested on the exam, including antepartum
care, intrapartum care, postpartum care, newborn care, high-risk pregnancy complications, fetal
monitoring, obstetric medications, and women's health. Each question includes four answer choices, the
correct answer, and a detailed rationale explaining the clinical reasoning. References and source
citations have been omitted as requested.
Instructions: Choose the best answer for each question. Review the rationale after each answer to
reinforce your understanding of maternal-newborn nursing principles.
Section 1: Antepartum Care and Pregnancy Physiology (Questions 1–35)
1. A pregnant client reports nausea and vomiting during the first trimester. Which instruction should
the nurse provide?
A. Eat three large meals daily
B. Eat small, frequent meals and avoid greasy foods
C. Drink fluids with meals
D. Take iron supplements on an empty stomach
Correct Answer: B
Rationale: Small, frequent meals and avoiding greasy or spicy foods help reduce nausea and vomiting
during pregnancy. Drinking fluids with meals can worsen nausea, and iron supplements may exacerbate
gastrointestinal upset if taken on an empty stomach.
2. Which physiological change is expected during pregnancy?
A. Decreased blood volume
B. Decreased cardiac output
C. Increased blood volume and cardiac output
D. Increased blood pressure
Correct Answer: C
Rationale: Pregnancy causes increased blood volume (up to 50%) and cardiac output to meet the
metabolic demands of the fetus and support placental perfusion. Blood pressure typically remains stable
or decreases slightly during the second trimester.
,3. A client at 12 weeks gestation reports frequency of urination. What should the nurse explain?
A. This is abnormal and requires immediate evaluation
B. This is expected due to the enlarging uterus pressing on the bladder
C. This indicates a urinary tract infection
D. This will worsen throughout pregnancy
Correct Answer: B
Rationale: Urinary frequency is common in early pregnancy due to the enlarging uterus pressing on the
bladder and increased renal blood flow. It often subsides during the second trimester and may return in
the third trimester as the fetus descends.
4. What is the recommended weight gain for a woman with a normal prepregnancy BMI during
pregnancy?
A. 5–10 pounds
B. 11–20 pounds
C. 25–35 pounds
D. 40–50 pounds
Correct Answer: C
Rationale: For women with a normal prepregnancy BMI (18.5–24.9), the recommended weight gain is
25–35 pounds. Underweight women should gain more (28–40 pounds), and obese women should gain
less (11–20 pounds).
5. Which supplement is recommended during pregnancy to prevent neural tube defects?
A. Iron
B. Calcium
C. Folic acid
D. Vitamin D
Correct Answer: C
Rationale: Folic acid supplementation (400–800 mcg daily) is recommended before conception and
during early pregnancy to reduce the risk of neural tube defects such as spina bifida and anencephaly.
6. A client at 28 weeks gestation reports heartburn. Which instruction should the nurse provide?
A. Lie down immediately after eating
B. Eat small, frequent meals and avoid spicy foods
C. Drink large amounts of fluids with meals
D. Take NSAIDs for relief
Correct Answer: B
Rationale: Heartburn is common in pregnancy due to progesterone-induced relaxation of the lower
,esophageal sphincter and pressure from the enlarging uterus. Small, frequent meals, avoiding spicy
foods, and remaining upright after meals help reduce symptoms. NSAIDs should be avoided during
pregnancy unless prescribed.
7. What is the purpose of the alpha-fetoprotein (AFP) test?
A. To screen for neural tube defects and chromosomal abnormalities
B. To diagnose gestational diabetes
C. To assess fetal lung maturity
D. To evaluate maternal thyroid function
Correct Answer: A
Rationale: The AFP test is a maternal serum screening test performed between 15 and 20 weeks
gestation. Elevated AFP may indicate neural tube defects, while low AFP may suggest chromosomal
abnormalities such as Down syndrome.
8. A client at 36 weeks gestation reports difficulty breathing. What should the nurse explain?
A. This is abnormal and indicates heart failure
B. This is expected due to the uterus pressing on the diaphragm
C. This indicates a pulmonary embolism
D. This will worsen until delivery
Correct Answer: B
Rationale: Difficulty breathing is common in late pregnancy as the enlarging uterus presses upward on
the diaphragm, reducing lung expansion. Lightening (fetal descent) may relieve this symptom before
labor.
9. What is the recommended position for a pregnant client experiencing supine hypotension?
A. Supine with legs elevated
B. Left lateral position
C. Prone position
D. High Fowler's position
Correct Answer: B
Rationale: Supine hypotension occurs when the gravid uterus compresses the inferior vena cava,
reducing venous return and cardiac output. The left lateral position relieves this compression and
restores blood flow.
10. Which sign indicates possible ectopic pregnancy?
A. Painless vaginal bleeding
B. Unilateral lower abdominal pain with spotting
, C. Increased fetal movement
D. Braxton Hicks contractions
Correct Answer: B
Rationale: Ectopic pregnancy typically presents with unilateral lower abdominal pain, vaginal spotting,
and a positive pregnancy test. It is a medical emergency requiring prompt evaluation.
11. A client at 10 weeks gestation is Rh-negative. What intervention is recommended?
A. No intervention is needed
B. Administer Rho(D) immune globulin at 28 weeks and after delivery if the fetus is Rh-positive
C. Administer Rho(D) immune globulin only after delivery
D. Perform an amniocentesis
Correct Answer: B
Rationale: Rho(D) immune globulin (RhoGAM) is administered to Rh-negative mothers at 28 weeks
gestation and within 72 hours after delivery if the newborn is Rh-positive to prevent Rh sensitization.
12. What is the purpose of the glucose tolerance test during pregnancy?
A. To screen for gestational diabetes
B. To assess fetal lung maturity
C. To diagnose preeclampsia
D. To evaluate thyroid function
Correct Answer: A
Rationale: The glucose tolerance test is performed between 24 and 28 weeks gestation to screen for
gestational diabetes. It involves measuring blood glucose after a glucose load.
13. A client reports constipation during pregnancy. Which instruction should the nurse provide?
A. Increase fiber intake and fluids
B. Take laxatives daily
C. Decrease physical activity
D. Avoid all fruits and vegetables
Correct Answer: A
Rationale: Constipation is common in pregnancy due to progesterone-induced decreased bowel motility
and pressure from the uterus. Increasing fiber and fluids and regular exercise help prevent and manage
constipation.
14. What is quickening?
A. The first fetal movement felt by the mother
B. The first heartbeat heard by Doppler
