HESI Maternity OB Actual Exam 2026 | Versions 1, 2, & 3 | Questions
with Verified Answers | 100% Correct | Pass Guaranteed
Q001: A 32-year-old G2P1 at 28 weeks gestation presents to the clinic with a 2-hour history of
vaginal bleeding described as "bright red and sudden." She denies pain or uterine tenderness. Her
vital signs are stable, and fetal heart rate is 140 bpm with moderate variability. PICTURE
DESCRIPTION: Ultrasound image shows a complete placenta previa with the placenta
completely covering the internal cervical os; the fetal head is floating above the placenta.
A. Expectant management with bed rest and close monitoring
B. Immediate cesarean section
C. Oxytocin induction
D. Artificial rupture of membranes
ANSWER: A
Q002: A 26-year-old G1P0 at 39 weeks is admitted in active labor. Her cervix is 8 cm dilated,
90% effaced, and the fetus is at 0 station. She reports intense rectal pressure. PICTURE
DESCRIPTION: Fetal monitoring strip shows early decelerations beginning at the onset of
contractions and returning to baseline by the end, with a stable baseline of 135 bpm.
A. Prepare for immediate cesarean section
B. Encourage pushing with contractions
C. Continue monitoring and support labor progression
D. Administer terbutaline to stop contractions
ANSWER: C
Q003: A 29-year-old G3P2 at 34 weeks presents with severe headache, blurred vision, and
epigastric pain. BP is 165/105 mmHg, proteinuria 3+, and platelets 95,000/µL. PICTURE
DESCRIPTION: Liver ultrasound shows subcapsular hematoma with fluid collection beneath the
liver capsule.
A. Administer magnesium sulfate and prepare for delivery
B. Discharge home with bed rest instructions
C. Start oral labetalol and recheck in 24 hours
D. Perform amniocentesis for fetal lung maturity
ANSWER: A
,Q004: A 31-year-old G1P0 at 41 weeks is undergoing induction. After 12 hours of oxytocin,
contractions are every 2 minutes lasting 90 seconds. Fetal heart rate shows late decelerations to
110 bpm. PICTURE DESCRIPTION: Fetal monitor strip shows uterine contractions peaking at
80 mmHg with late decelerations beginning after the peak and slowly returning to baseline.
A. Increase oxytocin dosage
B. Stop oxytocin and position patient laterally
C. Perform artificial rupture of membranes
D. Administer terbutaline
ANSWER: B
Q005: A 24-year-old G2P1 delivers vaginally. The placenta delivers spontaneously, but the
patient continues to bleed heavily. The fundus is boggy and deviated to the right. PICTURE
DESCRIPTION: Postpartum abdomen shows uterus palpable above the umbilicus, soft and
displaced to the right side; blood clots visible on perineal pad.
A. Massage the fundus and administer oxytocin
B. Prepare for hysterectomy
C. Insert Foley catheter
D. Administer methylergonovine
ANSWER: A
Q006: A 28-year-old G1P0 at 16 weeks presents for routine prenatal visit. She reports feeling
"fluttering" movements. PICTURE DESCRIPTION: Doppler ultrasound shows fetal heart rate of
150 bpm with active limb movements visible; fetus measures appropriate for gestational age.
A. Explain this is normal quickening
B. Order immediate ultrasound for growth assessment
C. Refer to maternal-fetal medicine
D. Schedule glucose tolerance test
ANSWER: A
Q007: A 35-year-old G3P2 at 38 weeks presents with decreased fetal movement. Non-stress test
shows no accelerations in 40 minutes with baseline 145 bpm. PICTURE DESCRIPTION: Fetal
monitor strip shows flat baseline variability with no accelerations despite fetal stimulation;
occasional mild variable decelerations present.
A. Continue monitoring for another hour
B. Schedule biophysical profile
C. Prepare for immediate delivery
D. Send patient home with kick counts
ANSWER: C
, Q008: A 30-year-old G1P0 with gestational diabetes at 32 weeks presents with fasting glucose
105 mg/dL post-diet control. PICTURE DESCRIPTION: Ultrasound shows estimated fetal
weight 2800g (90th percentile), increased abdominal circumference, and polyhydramnios with
amniotic fluid index 28 cm.
A. Start insulin therapy
B. Increase dietary restrictions
C. Schedule immediate delivery
D. Begin oral metformin
ANSWER: A
Q009: A 27-year-old G2P1 at 40 weeks is pushing. After delivery of the fetal head, the chin
retracts and does not restitute. The fetal head remains tightly applied to the maternal perineum.
PICTURE DESCRIPTION: Delivery scene shows fetal head delivered but shoulders impacted
above pelvic brim; turtle sign present with head retracted against perineum.
A. Apply suprapubic pressure and McRoberts maneuver
B. Immediate fundal pressure
C. Rotate to hands-and-knees position
D. Perform Zavanelli maneuver
ANSWER: A
Q010: A 33-year-old G1P0 at 36 weeks presents with severe itching, especially on palms and
soles. Labs show bile acids 45 µmol/L, ALT 180 U/L. PICTURE DESCRIPTION: Liver
ultrasound appears normal; skin examination shows excoriation marks on arms and legs from
scratching, no rash present.
A. Diagnose cholestasis and schedule delivery at 37 weeks
B. Prescribe topical steroid cream
C. Recommend antihistamines only
D. Discharge with reassurance
ANSWER: A
Q011: A 25-year-old G3P2 at 30 weeks presents with contractions every 5 minutes. Cervix is 3
cm dilated, 80% effaced. PICTURE DESCRIPTION: Transvaginal ultrasound shows cervical
length 18 mm with funneling; fetal fibronectin test positive.
A. Administer betamethasone and magnesium sulfate
B. Send home with bed rest
C. Perform cerclage placement
D. Start oral nifedipine only
ANSWER: A
with Verified Answers | 100% Correct | Pass Guaranteed
Q001: A 32-year-old G2P1 at 28 weeks gestation presents to the clinic with a 2-hour history of
vaginal bleeding described as "bright red and sudden." She denies pain or uterine tenderness. Her
vital signs are stable, and fetal heart rate is 140 bpm with moderate variability. PICTURE
DESCRIPTION: Ultrasound image shows a complete placenta previa with the placenta
completely covering the internal cervical os; the fetal head is floating above the placenta.
A. Expectant management with bed rest and close monitoring
B. Immediate cesarean section
C. Oxytocin induction
D. Artificial rupture of membranes
ANSWER: A
Q002: A 26-year-old G1P0 at 39 weeks is admitted in active labor. Her cervix is 8 cm dilated,
90% effaced, and the fetus is at 0 station. She reports intense rectal pressure. PICTURE
DESCRIPTION: Fetal monitoring strip shows early decelerations beginning at the onset of
contractions and returning to baseline by the end, with a stable baseline of 135 bpm.
A. Prepare for immediate cesarean section
B. Encourage pushing with contractions
C. Continue monitoring and support labor progression
D. Administer terbutaline to stop contractions
ANSWER: C
Q003: A 29-year-old G3P2 at 34 weeks presents with severe headache, blurred vision, and
epigastric pain. BP is 165/105 mmHg, proteinuria 3+, and platelets 95,000/µL. PICTURE
DESCRIPTION: Liver ultrasound shows subcapsular hematoma with fluid collection beneath the
liver capsule.
A. Administer magnesium sulfate and prepare for delivery
B. Discharge home with bed rest instructions
C. Start oral labetalol and recheck in 24 hours
D. Perform amniocentesis for fetal lung maturity
ANSWER: A
,Q004: A 31-year-old G1P0 at 41 weeks is undergoing induction. After 12 hours of oxytocin,
contractions are every 2 minutes lasting 90 seconds. Fetal heart rate shows late decelerations to
110 bpm. PICTURE DESCRIPTION: Fetal monitor strip shows uterine contractions peaking at
80 mmHg with late decelerations beginning after the peak and slowly returning to baseline.
A. Increase oxytocin dosage
B. Stop oxytocin and position patient laterally
C. Perform artificial rupture of membranes
D. Administer terbutaline
ANSWER: B
Q005: A 24-year-old G2P1 delivers vaginally. The placenta delivers spontaneously, but the
patient continues to bleed heavily. The fundus is boggy and deviated to the right. PICTURE
DESCRIPTION: Postpartum abdomen shows uterus palpable above the umbilicus, soft and
displaced to the right side; blood clots visible on perineal pad.
A. Massage the fundus and administer oxytocin
B. Prepare for hysterectomy
C. Insert Foley catheter
D. Administer methylergonovine
ANSWER: A
Q006: A 28-year-old G1P0 at 16 weeks presents for routine prenatal visit. She reports feeling
"fluttering" movements. PICTURE DESCRIPTION: Doppler ultrasound shows fetal heart rate of
150 bpm with active limb movements visible; fetus measures appropriate for gestational age.
A. Explain this is normal quickening
B. Order immediate ultrasound for growth assessment
C. Refer to maternal-fetal medicine
D. Schedule glucose tolerance test
ANSWER: A
Q007: A 35-year-old G3P2 at 38 weeks presents with decreased fetal movement. Non-stress test
shows no accelerations in 40 minutes with baseline 145 bpm. PICTURE DESCRIPTION: Fetal
monitor strip shows flat baseline variability with no accelerations despite fetal stimulation;
occasional mild variable decelerations present.
A. Continue monitoring for another hour
B. Schedule biophysical profile
C. Prepare for immediate delivery
D. Send patient home with kick counts
ANSWER: C
, Q008: A 30-year-old G1P0 with gestational diabetes at 32 weeks presents with fasting glucose
105 mg/dL post-diet control. PICTURE DESCRIPTION: Ultrasound shows estimated fetal
weight 2800g (90th percentile), increased abdominal circumference, and polyhydramnios with
amniotic fluid index 28 cm.
A. Start insulin therapy
B. Increase dietary restrictions
C. Schedule immediate delivery
D. Begin oral metformin
ANSWER: A
Q009: A 27-year-old G2P1 at 40 weeks is pushing. After delivery of the fetal head, the chin
retracts and does not restitute. The fetal head remains tightly applied to the maternal perineum.
PICTURE DESCRIPTION: Delivery scene shows fetal head delivered but shoulders impacted
above pelvic brim; turtle sign present with head retracted against perineum.
A. Apply suprapubic pressure and McRoberts maneuver
B. Immediate fundal pressure
C. Rotate to hands-and-knees position
D. Perform Zavanelli maneuver
ANSWER: A
Q010: A 33-year-old G1P0 at 36 weeks presents with severe itching, especially on palms and
soles. Labs show bile acids 45 µmol/L, ALT 180 U/L. PICTURE DESCRIPTION: Liver
ultrasound appears normal; skin examination shows excoriation marks on arms and legs from
scratching, no rash present.
A. Diagnose cholestasis and schedule delivery at 37 weeks
B. Prescribe topical steroid cream
C. Recommend antihistamines only
D. Discharge with reassurance
ANSWER: A
Q011: A 25-year-old G3P2 at 30 weeks presents with contractions every 5 minutes. Cervix is 3
cm dilated, 80% effaced. PICTURE DESCRIPTION: Transvaginal ultrasound shows cervical
length 18 mm with funneling; fetal fibronectin test positive.
A. Administer betamethasone and magnesium sulfate
B. Send home with bed rest
C. Perform cerclage placement
D. Start oral nifedipine only
ANSWER: A
