1
OB MATERNITY HESI EXIT Actual Exam
2026/2027 3 Versions Complete Questions
and Verified Answers NextGen NGN Format
Pass Guaranteed - A+ Graded
VERSION 1 - SECTION 1: ANTEPARTUM CARE (Questions 1-20)
Q1 (Version 1): A 28-week pregnant client presents to the clinic with complaints of a persistent
headache, blurred vision, and epigastric pain. Her blood pressure is 158/96 mmHg, and urine
dipstick reveals 2+ protein. Which order should the nurse anticipate from the healthcare provider
FIRST?
A. Administer labetalol 20 mg IV push
B. Obtain a 24-hour urine collection for protein
C. Prepare the client for immediate cesarean section
D. Administer magnesium sulfate IV loading dose. [CORRECT]
Correct Answer: D
Rationale: The client's symptoms (headache, blurred vision, epigastric pain) along with elevated
BP and proteinuria indicate severe preeclampsia. Magnesium sulfate is the priority intervention
for seizure prophylaxis in severe preeclampsia to prevent eclampsia (D). While antihypertensives
(A) may be needed, seizure prevention takes priority. A 24-hour urine (B) confirms diagnosis but
does not address immediate safety. Cesarean section (C) is not indicated without additional
factors.
Q2 (Version 1): A nurse is teaching a client at 12 weeks gestation about managing nausea and
vomiting. Which statement by the client indicates understanding of appropriate self-care
measures?
A. "I should avoid eating dry crackers before getting out of bed in the morning"
B. "Eating small, frequent meals will help reduce nausea." [CORRECT]
C. "I need to drink all my fluids with meals to stay hydrated"
D. "Lying down immediately after eating will prevent vomiting"
Correct Answer: B
,2
Rationale: Small, frequent meals help prevent an empty stomach and reduce nausea (B). Dry
crackers before rising (A) is actually recommended, not avoided. Drinking fluids with meals (C)
can worsen nausea; fluids should be taken between meals. Lying down after eating (D) can
increase reflux and nausea; remaining upright is preferred.
Q3 (Version 1): A 24-year-old client at 16 weeks gestation asks the nurse about appropriate
weight gain during pregnancy. The client's pre-pregnancy BMI was 22 (normal weight). What is
the recommended total weight gain for this client?
A. 11-20 pounds (5-9 kg)
B. 15-25 pounds (7-11.5 kg)
C. 25-35 pounds (11.5-16 kg). [CORRECT]
D. 28-40 pounds (12.5-18 kg)
Correct Answer: C
Rationale: For clients with a normal pre-pregnancy BMI (18.5-24.9), the Institute of Medicine
recommends a total weight gain of 25-35 pounds (11.5-16 kg) (C). Underweight clients (BMI
<18.5) should gain 28-40 pounds (D). Overweight clients (BMI 25-29.9) should gain 15-25
pounds (B). Obese clients (BMI ≥30) should gain 11-20 pounds (A).
Q4 (Version 1): A nurse is caring for a client at 32 weeks gestation with suspected placenta
previa. Which finding would the nurse expect to assess?
A. Painful vaginal bleeding with a soft, relaxed uterus
B. Sudden onset of severe abdominal pain and board-like rigidity
C. Painless, bright red vaginal bleeding. [CORRECT]
D. Dark red bleeding accompanied by intense uterine contractions
Correct Answer: C
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding (C) due to
placental implantation over the cervical os. Painful bleeding with uterine rigidity (A, D) suggests
placental abruption. Sudden severe abdominal pain with board-like rigidity (B) indicates
concealed abruption with possible DIC.
Q5 (Version 1): A client at 28 weeks gestation with gestational diabetes is being taught about
dietary management. Which statement by the client indicates a need for further teaching?
A. "I should eat three large meals daily to keep my blood sugar stable"
B. "I need to limit my carbohydrate intake to 40-45% of total calories." [CORRECT]
,3
C. "I will check my blood glucose 2 hours after meals"
D. "I should include protein with each snack to prevent hypoglycemia"
Correct Answer: A
Rationale: Clients with gestational diabetes should eat three moderate meals and three snacks,
not three large meals (A), to maintain stable blood glucose. Limiting carbohydrates to 40-45%
(B), checking postprandial glucose (C), and including protein with snacks (D) are all appropriate
self-management strategies.
Q6 (Version 1): A nurse is assessing a client at 20 weeks gestation using Leopold's maneuvers.
The nurse palpates a hard, round, movable object in the fundus and a soft, irregular mass in the
lower abdomen. Where should the nurse place the Doppler to best auscultate the fetal heart rate?
A. Right lower quadrant of maternal abdomen
B. Left lower quadrant of maternal abdomen
C. Right upper quadrant of maternal abdomen. [CORRECT]
D. Midline above the symphysis pubis
Correct Answer: C
Rationale: The findings indicate a breech presentation (head in fundus, buttocks in lower
abdomen). In breech presentation, the fetal back is typically located in the right or left upper
quadrant, so the Doppler should be placed in the right upper quadrant (C) to auscultate FHR
through the fetal back where sound transmission is best.
Q7 (Version 1): A client at 35 weeks gestation is undergoing a nonstress test (NST). The tracing
shows a baseline fetal heart rate of 145 bpm with moderate variability and two accelerations of
15 bpm lasting 15 seconds each over 20 minutes. How should the nurse interpret this finding?
A. Nonreactive NST requiring further testing
B. Reactive NST indicating fetal well-being. [CORRECT]
C. Suspicious NST requiring immediate intervention
D. Inconclusive NST requiring repeat in 1 hour
Correct Answer: B
Rationale: A reactive NST is defined as two or more accelerations of at least 15 bpm above
baseline lasting at least 15 seconds within a 20-minute period, with moderate variability and
normal baseline (B). This tracing meets all criteria for reassuring fetal status. Nonreactive (A)
would show fewer than two accelerations. Suspicious (C) would require immediate evaluation
for fetal compromise.
, 4
Q8 (Version 1): A nurse is caring for a client at 30 weeks gestation with preterm labor. The
healthcare provider orders betamethasone 12 mg IM. What is the primary purpose of this
medication?
A. To stop uterine contractions and prevent labor progression
B. To accelerate fetal lung maturity and reduce respiratory distress syndrome risk. [CORRECT]
C. To treat suspected intrauterine infection causing preterm labor
D. To promote fetal growth and prevent intrauterine growth restriction
Correct Answer: B
Rationale: Betamethasone is a corticosteroid administered to pregnant clients between 24-34
weeks gestation at risk for preterm delivery to accelerate fetal lung maturity and reduce the
incidence and severity of respiratory distress syndrome (B). Tocolytics (A) stop contractions.
Antibiotics (C) treat infection. Betamethasone does not promote growth (D).
Q9 (Version 1): A client at 18 weeks gestation is Rh-negative with a negative antibody screen.
Her partner is Rh-positive. What intervention should the nurse anticipate?
A. Immediate administration of RhoGAM (Rh immune globulin)
B. Administration of RhoGAM at 28 weeks gestation and postpartum. [CORRECT]
C. Amniocentesis to determine fetal blood type
D. No intervention needed until delivery
Correct Answer: B
Rationale: Unsensitized Rh-negative clients should receive RhoGAM at approximately 28 weeks
gestation and within 72 hours postpartum if the infant is Rh-positive (B). RhoGAM is also given
after any sensitizing event (amniocentesis, bleeding, trauma). Immediate administration (A) is
not indicated without a sensitizing event. Amniocentesis (C) is unnecessary. No intervention (D)
would risk alloimmunization.
Q10 (Version 1): A nurse is assessing a client at 24 weeks gestation with hyperemesis
gravidarum. Which laboratory finding would be the priority concern requiring immediate
intervention?
A. Hemoglobin 10.5 g/dL
B. Potassium 2.8 mEq/L. [CORRECT]
C. White blood cell count 12,000/mm³
D. Blood glucose 140 mg/dL
OB MATERNITY HESI EXIT Actual Exam
2026/2027 3 Versions Complete Questions
and Verified Answers NextGen NGN Format
Pass Guaranteed - A+ Graded
VERSION 1 - SECTION 1: ANTEPARTUM CARE (Questions 1-20)
Q1 (Version 1): A 28-week pregnant client presents to the clinic with complaints of a persistent
headache, blurred vision, and epigastric pain. Her blood pressure is 158/96 mmHg, and urine
dipstick reveals 2+ protein. Which order should the nurse anticipate from the healthcare provider
FIRST?
A. Administer labetalol 20 mg IV push
B. Obtain a 24-hour urine collection for protein
C. Prepare the client for immediate cesarean section
D. Administer magnesium sulfate IV loading dose. [CORRECT]
Correct Answer: D
Rationale: The client's symptoms (headache, blurred vision, epigastric pain) along with elevated
BP and proteinuria indicate severe preeclampsia. Magnesium sulfate is the priority intervention
for seizure prophylaxis in severe preeclampsia to prevent eclampsia (D). While antihypertensives
(A) may be needed, seizure prevention takes priority. A 24-hour urine (B) confirms diagnosis but
does not address immediate safety. Cesarean section (C) is not indicated without additional
factors.
Q2 (Version 1): A nurse is teaching a client at 12 weeks gestation about managing nausea and
vomiting. Which statement by the client indicates understanding of appropriate self-care
measures?
A. "I should avoid eating dry crackers before getting out of bed in the morning"
B. "Eating small, frequent meals will help reduce nausea." [CORRECT]
C. "I need to drink all my fluids with meals to stay hydrated"
D. "Lying down immediately after eating will prevent vomiting"
Correct Answer: B
,2
Rationale: Small, frequent meals help prevent an empty stomach and reduce nausea (B). Dry
crackers before rising (A) is actually recommended, not avoided. Drinking fluids with meals (C)
can worsen nausea; fluids should be taken between meals. Lying down after eating (D) can
increase reflux and nausea; remaining upright is preferred.
Q3 (Version 1): A 24-year-old client at 16 weeks gestation asks the nurse about appropriate
weight gain during pregnancy. The client's pre-pregnancy BMI was 22 (normal weight). What is
the recommended total weight gain for this client?
A. 11-20 pounds (5-9 kg)
B. 15-25 pounds (7-11.5 kg)
C. 25-35 pounds (11.5-16 kg). [CORRECT]
D. 28-40 pounds (12.5-18 kg)
Correct Answer: C
Rationale: For clients with a normal pre-pregnancy BMI (18.5-24.9), the Institute of Medicine
recommends a total weight gain of 25-35 pounds (11.5-16 kg) (C). Underweight clients (BMI
<18.5) should gain 28-40 pounds (D). Overweight clients (BMI 25-29.9) should gain 15-25
pounds (B). Obese clients (BMI ≥30) should gain 11-20 pounds (A).
Q4 (Version 1): A nurse is caring for a client at 32 weeks gestation with suspected placenta
previa. Which finding would the nurse expect to assess?
A. Painful vaginal bleeding with a soft, relaxed uterus
B. Sudden onset of severe abdominal pain and board-like rigidity
C. Painless, bright red vaginal bleeding. [CORRECT]
D. Dark red bleeding accompanied by intense uterine contractions
Correct Answer: C
Rationale: Placenta previa is characterized by painless, bright red vaginal bleeding (C) due to
placental implantation over the cervical os. Painful bleeding with uterine rigidity (A, D) suggests
placental abruption. Sudden severe abdominal pain with board-like rigidity (B) indicates
concealed abruption with possible DIC.
Q5 (Version 1): A client at 28 weeks gestation with gestational diabetes is being taught about
dietary management. Which statement by the client indicates a need for further teaching?
A. "I should eat three large meals daily to keep my blood sugar stable"
B. "I need to limit my carbohydrate intake to 40-45% of total calories." [CORRECT]
,3
C. "I will check my blood glucose 2 hours after meals"
D. "I should include protein with each snack to prevent hypoglycemia"
Correct Answer: A
Rationale: Clients with gestational diabetes should eat three moderate meals and three snacks,
not three large meals (A), to maintain stable blood glucose. Limiting carbohydrates to 40-45%
(B), checking postprandial glucose (C), and including protein with snacks (D) are all appropriate
self-management strategies.
Q6 (Version 1): A nurse is assessing a client at 20 weeks gestation using Leopold's maneuvers.
The nurse palpates a hard, round, movable object in the fundus and a soft, irregular mass in the
lower abdomen. Where should the nurse place the Doppler to best auscultate the fetal heart rate?
A. Right lower quadrant of maternal abdomen
B. Left lower quadrant of maternal abdomen
C. Right upper quadrant of maternal abdomen. [CORRECT]
D. Midline above the symphysis pubis
Correct Answer: C
Rationale: The findings indicate a breech presentation (head in fundus, buttocks in lower
abdomen). In breech presentation, the fetal back is typically located in the right or left upper
quadrant, so the Doppler should be placed in the right upper quadrant (C) to auscultate FHR
through the fetal back where sound transmission is best.
Q7 (Version 1): A client at 35 weeks gestation is undergoing a nonstress test (NST). The tracing
shows a baseline fetal heart rate of 145 bpm with moderate variability and two accelerations of
15 bpm lasting 15 seconds each over 20 minutes. How should the nurse interpret this finding?
A. Nonreactive NST requiring further testing
B. Reactive NST indicating fetal well-being. [CORRECT]
C. Suspicious NST requiring immediate intervention
D. Inconclusive NST requiring repeat in 1 hour
Correct Answer: B
Rationale: A reactive NST is defined as two or more accelerations of at least 15 bpm above
baseline lasting at least 15 seconds within a 20-minute period, with moderate variability and
normal baseline (B). This tracing meets all criteria for reassuring fetal status. Nonreactive (A)
would show fewer than two accelerations. Suspicious (C) would require immediate evaluation
for fetal compromise.
, 4
Q8 (Version 1): A nurse is caring for a client at 30 weeks gestation with preterm labor. The
healthcare provider orders betamethasone 12 mg IM. What is the primary purpose of this
medication?
A. To stop uterine contractions and prevent labor progression
B. To accelerate fetal lung maturity and reduce respiratory distress syndrome risk. [CORRECT]
C. To treat suspected intrauterine infection causing preterm labor
D. To promote fetal growth and prevent intrauterine growth restriction
Correct Answer: B
Rationale: Betamethasone is a corticosteroid administered to pregnant clients between 24-34
weeks gestation at risk for preterm delivery to accelerate fetal lung maturity and reduce the
incidence and severity of respiratory distress syndrome (B). Tocolytics (A) stop contractions.
Antibiotics (C) treat infection. Betamethasone does not promote growth (D).
Q9 (Version 1): A client at 18 weeks gestation is Rh-negative with a negative antibody screen.
Her partner is Rh-positive. What intervention should the nurse anticipate?
A. Immediate administration of RhoGAM (Rh immune globulin)
B. Administration of RhoGAM at 28 weeks gestation and postpartum. [CORRECT]
C. Amniocentesis to determine fetal blood type
D. No intervention needed until delivery
Correct Answer: B
Rationale: Unsensitized Rh-negative clients should receive RhoGAM at approximately 28 weeks
gestation and within 72 hours postpartum if the infant is Rh-positive (B). RhoGAM is also given
after any sensitizing event (amniocentesis, bleeding, trauma). Immediate administration (A) is
not indicated without a sensitizing event. Amniocentesis (C) is unnecessary. No intervention (D)
would risk alloimmunization.
Q10 (Version 1): A nurse is assessing a client at 24 weeks gestation with hyperemesis
gravidarum. Which laboratory finding would be the priority concern requiring immediate
intervention?
A. Hemoglobin 10.5 g/dL
B. Potassium 2.8 mEq/L. [CORRECT]
C. White blood cell count 12,000/mm³
D. Blood glucose 140 mg/dL
