2026 HESI MATERNITY OB EXAM VERSION 3 | All 55
Questions with Correct Answers & Detailed Rationales |
Score 1292 Level | Pass Guaranteed - A+ Graded
Section 1: Antepartum Care (12 Questions)
Q1: A nurse is caring for a client at 28 weeks gestation who reports severe headaches,
visual disturbances, and epigastric pain. Her blood pressure is 162/104 mmHg, and she
has 3+ proteinuria. Which assessment finding requires the nurse's immediate
intervention?
A. The client reports decreased fetal movement over the past 24 hours
B. The client has gained 2 pounds since her last prenatal visit one week ago
C. The client exhibits hyperreflexia with clonus present
D. The client complains of mild ankle edema that resolves with rest
Correct Answer: C
Rationale: This client is exhibiting classic signs of severe preeclampsia. Hyperreflexia
with clonus indicates central nervous system irritability and impending seizure activity
(eclampsia), which represents a life-threatening emergency requiring immediate
magnesium sulfate administration and seizure precautions.
Why incorrect options are wrong:
● A: While decreased fetal movement requires assessment, it does not represent
the same immediate life threat as seizure activity
● B: Weight gain is expected in pregnancy; rapid weight gain can indicate fluid
retention in preeclampsia but is not as immediately dangerous as clonus
● D: Mild dependent edema is a normal physiological change in pregnancy and not
a sign of severe preeclampsia
,Q2: A pregnant client at 18 weeks gestation asks the nurse about the purpose of the
alpha-fetoprotein (AFP) screening test she will have at her next visit. Which response by
the nurse is most accurate?
A. "This test will determine if your baby has Down syndrome"
B. "This blood test screens for neural tube defects and certain chromosomal
abnormalities"
C. "This test can definitively diagnose spina bifida in your baby"
D. "You need this test because you are over 35 years old"
Correct Answer: B
Rationale: Maternal serum AFP screening, typically performed between 15-22 weeks
gestation, is a screening (not diagnostic) tool that detects elevated levels associated
with open neural tube defects (anencephaly, spina bifida) and decreased levels
associated with Down syndrome (trisomy 21) and Edwards syndrome (trisomy 18). It is
offered to all pregnant women regardless of age.
Why incorrect options are wrong:
● A: AFP screening is not specific for Down syndrome; low AFP combined with
other markers may suggest increased risk, but cell-free DNA testing is more
specific
● C: AFP is a screening test only; elevated levels require follow-up with targeted
ultrasound and possibly amniocentesis for definitive diagnosis
● D: AFP screening is offered universally, not based solely on maternal age
Q3: A nurse is assessing a client at her first prenatal visit. The client reports her last
menstrual period began on March 10, 2026. Using Naegele's rule, what is the client's
estimated date of delivery (EDD)?
A. December 3, 2026
B. December 10, 2026
,C. December 17, 2026
D. January 3, 2027
Correct Answer: C
Rationale: Naegele's rule calculates EDD by adding 7 days to the first day of the last
menstrual period, subtracting 3 months, and adding 1 year. March 10 + 7 days = March
17; subtract 3 months = December 17; add 1 year = December 17, 2026. This provides
an estimated gestational age of 40 weeks.
Why incorrect options are wrong:
● A: Incorrect calculation; may have forgotten to add 7 days or made month
calculation error
● B: Represents adding 9 months without the 7-day adjustment
● D: Represents adding 10 months instead of adjusting correctly with Naegele's
rule
Q4: A client at 32 weeks gestation with gestational diabetes mellitus (GDM) has a
fasting blood glucose of 142 mg/dL and a 2-hour postprandial glucose of 198 mg/dL.
Which nursing intervention is the priority?
A. Instruct the client to increase her carbohydrate intake at breakfast
B. Notify the healthcare provider of the elevated glucose levels
C. Encourage the client to drink more water to dilute the glucose
D. Reassure the client that these values are normal for third trimester
Correct Answer: B
Rationale: The American College of Obstetricians and Gynecologists (ACOG)
recommends fasting glucose <95 mg/dL and 2-hour postprandial glucose <120 mg/dL
for GDM management. These significantly elevated values indicate poor glycemic
control requiring immediate provider notification for possible insulin therapy initiation or
, adjustment. Uncontrolled GDM increases risks for macrosomia, birth trauma, neonatal
hypoglycemia, and stillbirth.
Why incorrect options are wrong:
● A: Increasing carbohydrates would further elevate glucose levels and worsen
glycemic control
● C: While hydration is important, it does not address the underlying hyperglycemia
requiring medical intervention
● D: These values are dangerously elevated, not normal, and require immediate
intervention
Q5: A nurse is teaching a pregnant client about physiological anemia of pregnancy.
Which statement by the client indicates understanding of this condition?
A. "I need to take iron supplements because my blood volume increases more than my
red blood cell production"
B. "My hemoglobin will naturally rise to 14 g/dL by the third trimester"
C. "I should avoid iron-rich foods to prevent my blood from getting too thick"
D. "Physiological anemia means I have a vitamin B12 deficiency"
Correct Answer: A
Rationale: Physiological anemia of pregnancy occurs because plasma volume increases
by 40-50% while red blood cell mass increases by only 20-30%, resulting in
hemodilution. Normal hemoglobin in pregnancy ranges from 11-13 g/dL (slightly lower
than non-pregnant values). Iron supplementation is routinely recommended to support
the increased red blood cell production needed for maternal and fetal oxygen transport.
Why incorrect options are wrong:
● B: Hemoglobin normally decreases in pregnancy due to hemodilution; 14 g/dL
would be unusually high
● C: Iron-rich foods are encouraged, not avoided, to support erythropoiesis
Questions with Correct Answers & Detailed Rationales |
Score 1292 Level | Pass Guaranteed - A+ Graded
Section 1: Antepartum Care (12 Questions)
Q1: A nurse is caring for a client at 28 weeks gestation who reports severe headaches,
visual disturbances, and epigastric pain. Her blood pressure is 162/104 mmHg, and she
has 3+ proteinuria. Which assessment finding requires the nurse's immediate
intervention?
A. The client reports decreased fetal movement over the past 24 hours
B. The client has gained 2 pounds since her last prenatal visit one week ago
C. The client exhibits hyperreflexia with clonus present
D. The client complains of mild ankle edema that resolves with rest
Correct Answer: C
Rationale: This client is exhibiting classic signs of severe preeclampsia. Hyperreflexia
with clonus indicates central nervous system irritability and impending seizure activity
(eclampsia), which represents a life-threatening emergency requiring immediate
magnesium sulfate administration and seizure precautions.
Why incorrect options are wrong:
● A: While decreased fetal movement requires assessment, it does not represent
the same immediate life threat as seizure activity
● B: Weight gain is expected in pregnancy; rapid weight gain can indicate fluid
retention in preeclampsia but is not as immediately dangerous as clonus
● D: Mild dependent edema is a normal physiological change in pregnancy and not
a sign of severe preeclampsia
,Q2: A pregnant client at 18 weeks gestation asks the nurse about the purpose of the
alpha-fetoprotein (AFP) screening test she will have at her next visit. Which response by
the nurse is most accurate?
A. "This test will determine if your baby has Down syndrome"
B. "This blood test screens for neural tube defects and certain chromosomal
abnormalities"
C. "This test can definitively diagnose spina bifida in your baby"
D. "You need this test because you are over 35 years old"
Correct Answer: B
Rationale: Maternal serum AFP screening, typically performed between 15-22 weeks
gestation, is a screening (not diagnostic) tool that detects elevated levels associated
with open neural tube defects (anencephaly, spina bifida) and decreased levels
associated with Down syndrome (trisomy 21) and Edwards syndrome (trisomy 18). It is
offered to all pregnant women regardless of age.
Why incorrect options are wrong:
● A: AFP screening is not specific for Down syndrome; low AFP combined with
other markers may suggest increased risk, but cell-free DNA testing is more
specific
● C: AFP is a screening test only; elevated levels require follow-up with targeted
ultrasound and possibly amniocentesis for definitive diagnosis
● D: AFP screening is offered universally, not based solely on maternal age
Q3: A nurse is assessing a client at her first prenatal visit. The client reports her last
menstrual period began on March 10, 2026. Using Naegele's rule, what is the client's
estimated date of delivery (EDD)?
A. December 3, 2026
B. December 10, 2026
,C. December 17, 2026
D. January 3, 2027
Correct Answer: C
Rationale: Naegele's rule calculates EDD by adding 7 days to the first day of the last
menstrual period, subtracting 3 months, and adding 1 year. March 10 + 7 days = March
17; subtract 3 months = December 17; add 1 year = December 17, 2026. This provides
an estimated gestational age of 40 weeks.
Why incorrect options are wrong:
● A: Incorrect calculation; may have forgotten to add 7 days or made month
calculation error
● B: Represents adding 9 months without the 7-day adjustment
● D: Represents adding 10 months instead of adjusting correctly with Naegele's
rule
Q4: A client at 32 weeks gestation with gestational diabetes mellitus (GDM) has a
fasting blood glucose of 142 mg/dL and a 2-hour postprandial glucose of 198 mg/dL.
Which nursing intervention is the priority?
A. Instruct the client to increase her carbohydrate intake at breakfast
B. Notify the healthcare provider of the elevated glucose levels
C. Encourage the client to drink more water to dilute the glucose
D. Reassure the client that these values are normal for third trimester
Correct Answer: B
Rationale: The American College of Obstetricians and Gynecologists (ACOG)
recommends fasting glucose <95 mg/dL and 2-hour postprandial glucose <120 mg/dL
for GDM management. These significantly elevated values indicate poor glycemic
control requiring immediate provider notification for possible insulin therapy initiation or
, adjustment. Uncontrolled GDM increases risks for macrosomia, birth trauma, neonatal
hypoglycemia, and stillbirth.
Why incorrect options are wrong:
● A: Increasing carbohydrates would further elevate glucose levels and worsen
glycemic control
● C: While hydration is important, it does not address the underlying hyperglycemia
requiring medical intervention
● D: These values are dangerously elevated, not normal, and require immediate
intervention
Q5: A nurse is teaching a pregnant client about physiological anemia of pregnancy.
Which statement by the client indicates understanding of this condition?
A. "I need to take iron supplements because my blood volume increases more than my
red blood cell production"
B. "My hemoglobin will naturally rise to 14 g/dL by the third trimester"
C. "I should avoid iron-rich foods to prevent my blood from getting too thick"
D. "Physiological anemia means I have a vitamin B12 deficiency"
Correct Answer: A
Rationale: Physiological anemia of pregnancy occurs because plasma volume increases
by 40-50% while red blood cell mass increases by only 20-30%, resulting in
hemodilution. Normal hemoglobin in pregnancy ranges from 11-13 g/dL (slightly lower
than non-pregnant values). Iron supplementation is routinely recommended to support
the increased red blood cell production needed for maternal and fetal oxygen transport.
Why incorrect options are wrong:
● B: Hemoglobin normally decreases in pregnancy due to hemodilution; 14 g/dL
would be unusually high
● C: Iron-rich foods are encouraged, not avoided, to support erythropoiesis
