2026 HESI MATERNITY OB EXAM VERSION 2 | Actual Exam
Questions with Detailed Verified Answers | A+ Grade
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Section 1: Antepartum Care (Questions 1-12)
Q1: A 28-year-old primigravida at 10 weeks gestation presents for her first prenatal visit.
She reports moderate nausea and vomiting, especially in the morning. Which nursing
intervention should be prioritized to promote optimal maternal-fetal outcomes?
A. Prescribe antiemetic medication immediately to prevent dehydration
B. Advise the client to eat dry crackers before rising and avoid an empty stomach
[CORRECT]
C. Recommend complete bed rest until symptoms subside to conserve energy
D. Suggest eliminating all carbohydrates to reduce gastric irritation
Correct Answer: B
Rationale: Non-pharmacological interventions are first-line for mild-to-moderate nausea
and vomiting of pregnancy (NVP). Eating dry crackers before rising helps absorb gastric
acid and prevents hypoglycemia on an empty stomach, which exacerbates nausea.
Small, frequent meals are recommended. Option A is incorrect because
pharmacological intervention is reserved for severe NVP (hyperemesis gravidarum)
after failed dietary modifications. Option C is incorrect because bed rest is not indicated
for NVP and may worsen symptoms. Option D is incorrect because carbohydrates are
typically well-tolerated and provide necessary glucose; eliminating them could cause
ketosis and worsen nausea.
,Q2: A pregnant client at 16 weeks gestation asks the nurse about the purpose of the
maternal serum alpha-fetoprotein (MSAFP) screening test. Which response by the nurse
demonstrates accurate understanding?
A. "This test determines if your baby has Down syndrome with 100% accuracy"
B. "It screens for neural tube defects and certain chromosomal abnormalities, but
requires follow-up testing for confirmation" [CORRECT]
C. "This diagnostic test will tell us if you need to terminate the pregnancy"
D. "It measures your blood sugar levels to check for gestational diabetes"
Correct Answer: B
Rationale: MSAFP is a screening (not diagnostic) test performed between 15-22 weeks
gestation. Elevated levels are associated with open neural tube defects (anencephaly,
spina bifida), while low levels may indicate Down syndrome or trisomy 18. All positive
screening results require diagnostic follow-up (ultrasound, amniocentesis). Option A is
incorrect because MSAFP does not diagnose Down syndrome with certainty, and no
screening test is 100% accurate. Option C is incorrect because MSAFP is not diagnostic
and never used to counsel termination. Option D confuses MSAFP with glucose
screening for gestational diabetes.
Q3: During a prenatal visit at 24 weeks gestation, the nurse palpates the client's
abdomen and notes the fundal height measures 26 cm. Which action should the nurse
prioritize?
A. Immediately schedule an ultrasound to rule out fetal macrosomia
B. Document the finding as within normal limits and continue routine care [CORRECT]
C. Prepare the client for emergency delivery due to suspected polyhydramnios
D. Restrict the client's fluid intake to prevent further uterine enlargement
Correct Answer: B
,Rationale: Fundal height typically correlates with gestational age in weeks (±2 cm)
between 20-36 weeks. At 24 weeks, a measurement of 26 cm falls within the normal
range (22-26 cm). Variations can occur due to maternal body habitus, fetal position, or
amniotic fluid volume. Option A is premature without additional concerning findings.
Option C is inappropriate as this measurement does not indicate polyhydramnios
(typically associated with fundal height significantly greater than dates). Option D is
contraindicated as fluid restriction during pregnancy can lead to dehydration and
oligohydramnios.
Q4: A 32-year-old gravida 2, para 1 client at 28 weeks gestation has a hemoglobin of
10.2 g/dL and hematocrit of 31%. Which dietary counseling should the nurse provide?
A. "Increase your intake of iron-rich foods and continue your prenatal vitamin"
[CORRECT]
B. "This is a normal physiological change; no dietary modifications are needed"
C. "You need to stop taking your prenatal vitamin as it causes constipation"
D. "Begin a strict vegetarian diet to improve your blood values"
Correct Answer: A
Rationale: During pregnancy, physiological anemia occurs due to increased plasma
volume expanding more rapidly than red blood cell mass. However, hemoglobin <11
g/dL in the second trimester indicates iron deficiency anemia requiring intervention. The
nurse should recommend iron-rich foods (red meat, leafy greens, fortified cereals) and
ensure continued prenatal vitamin intake. Option B is incorrect because while mild
hemodilution is normal, these values indicate true anemia requiring treatment. Option C
is dangerous as prenatal vitamins contain essential folic acid and iron. Option D is
incorrect because while plant-based iron sources exist, bioavailability is lower than
heme iron from animal sources.
, Q5: A client at 32 weeks gestation reports sudden onset of painless vaginal bleeding.
The nurse notes the client is hemodynamically stable with a fetal heart rate of 140 bpm.
Which nursing diagnosis should be prioritized?
A. Risk for impaired fetal gas exchange related to placental abruption
B. Fear related to threat to maternal and fetal well-being
C. Risk for deficient fluid volume related to bleeding [CORRECT]
D. Acute pain related to uterine contractions
Correct Answer: C
Rationale: Painless bleeding in the third trimester is characteristic of placenta previa.
While the client is currently stable, ongoing bleeding poses risk for hemorrhage and
hypovolemic shock. Prioritizing fluid volume status addresses the immediate
physiological threat. Option A is incorrect because placental abruption typically
presents with painful bleeding and uterine tenderness. Option B, while valid, is
psychosocial and secondary to physiological priorities. Option D is inappropriate as the
bleeding is described as painless, ruling out contractions as the primary issue.
Q6: The nurse is teaching a pregnant client about the warning signs of preeclampsia.
Which statement by the client indicates understanding of the material?
A. "I should call my doctor if I notice swelling in my ankles at the end of the day"
B. "Severe headaches and visual changes require immediate medical attention"
[CORRECT]
C. "Mild upper right quadrant pain is normal and doesn't need reporting"
D. "A sudden weight gain of 5 pounds in one week is expected in the third trimester"
Correct Answer: B
Rationale: Severe headaches, visual disturbances (scotomata, blurred vision), and
epigastric/RUQ pain are hallmark symptoms of severe preeclampsia, indicating cerebral
Questions with Detailed Verified Answers | A+ Grade
Assured | Pass Guaranteed - A+ Graded
Section 1: Antepartum Care (Questions 1-12)
Q1: A 28-year-old primigravida at 10 weeks gestation presents for her first prenatal visit.
She reports moderate nausea and vomiting, especially in the morning. Which nursing
intervention should be prioritized to promote optimal maternal-fetal outcomes?
A. Prescribe antiemetic medication immediately to prevent dehydration
B. Advise the client to eat dry crackers before rising and avoid an empty stomach
[CORRECT]
C. Recommend complete bed rest until symptoms subside to conserve energy
D. Suggest eliminating all carbohydrates to reduce gastric irritation
Correct Answer: B
Rationale: Non-pharmacological interventions are first-line for mild-to-moderate nausea
and vomiting of pregnancy (NVP). Eating dry crackers before rising helps absorb gastric
acid and prevents hypoglycemia on an empty stomach, which exacerbates nausea.
Small, frequent meals are recommended. Option A is incorrect because
pharmacological intervention is reserved for severe NVP (hyperemesis gravidarum)
after failed dietary modifications. Option C is incorrect because bed rest is not indicated
for NVP and may worsen symptoms. Option D is incorrect because carbohydrates are
typically well-tolerated and provide necessary glucose; eliminating them could cause
ketosis and worsen nausea.
,Q2: A pregnant client at 16 weeks gestation asks the nurse about the purpose of the
maternal serum alpha-fetoprotein (MSAFP) screening test. Which response by the nurse
demonstrates accurate understanding?
A. "This test determines if your baby has Down syndrome with 100% accuracy"
B. "It screens for neural tube defects and certain chromosomal abnormalities, but
requires follow-up testing for confirmation" [CORRECT]
C. "This diagnostic test will tell us if you need to terminate the pregnancy"
D. "It measures your blood sugar levels to check for gestational diabetes"
Correct Answer: B
Rationale: MSAFP is a screening (not diagnostic) test performed between 15-22 weeks
gestation. Elevated levels are associated with open neural tube defects (anencephaly,
spina bifida), while low levels may indicate Down syndrome or trisomy 18. All positive
screening results require diagnostic follow-up (ultrasound, amniocentesis). Option A is
incorrect because MSAFP does not diagnose Down syndrome with certainty, and no
screening test is 100% accurate. Option C is incorrect because MSAFP is not diagnostic
and never used to counsel termination. Option D confuses MSAFP with glucose
screening for gestational diabetes.
Q3: During a prenatal visit at 24 weeks gestation, the nurse palpates the client's
abdomen and notes the fundal height measures 26 cm. Which action should the nurse
prioritize?
A. Immediately schedule an ultrasound to rule out fetal macrosomia
B. Document the finding as within normal limits and continue routine care [CORRECT]
C. Prepare the client for emergency delivery due to suspected polyhydramnios
D. Restrict the client's fluid intake to prevent further uterine enlargement
Correct Answer: B
,Rationale: Fundal height typically correlates with gestational age in weeks (±2 cm)
between 20-36 weeks. At 24 weeks, a measurement of 26 cm falls within the normal
range (22-26 cm). Variations can occur due to maternal body habitus, fetal position, or
amniotic fluid volume. Option A is premature without additional concerning findings.
Option C is inappropriate as this measurement does not indicate polyhydramnios
(typically associated with fundal height significantly greater than dates). Option D is
contraindicated as fluid restriction during pregnancy can lead to dehydration and
oligohydramnios.
Q4: A 32-year-old gravida 2, para 1 client at 28 weeks gestation has a hemoglobin of
10.2 g/dL and hematocrit of 31%. Which dietary counseling should the nurse provide?
A. "Increase your intake of iron-rich foods and continue your prenatal vitamin"
[CORRECT]
B. "This is a normal physiological change; no dietary modifications are needed"
C. "You need to stop taking your prenatal vitamin as it causes constipation"
D. "Begin a strict vegetarian diet to improve your blood values"
Correct Answer: A
Rationale: During pregnancy, physiological anemia occurs due to increased plasma
volume expanding more rapidly than red blood cell mass. However, hemoglobin <11
g/dL in the second trimester indicates iron deficiency anemia requiring intervention. The
nurse should recommend iron-rich foods (red meat, leafy greens, fortified cereals) and
ensure continued prenatal vitamin intake. Option B is incorrect because while mild
hemodilution is normal, these values indicate true anemia requiring treatment. Option C
is dangerous as prenatal vitamins contain essential folic acid and iron. Option D is
incorrect because while plant-based iron sources exist, bioavailability is lower than
heme iron from animal sources.
, Q5: A client at 32 weeks gestation reports sudden onset of painless vaginal bleeding.
The nurse notes the client is hemodynamically stable with a fetal heart rate of 140 bpm.
Which nursing diagnosis should be prioritized?
A. Risk for impaired fetal gas exchange related to placental abruption
B. Fear related to threat to maternal and fetal well-being
C. Risk for deficient fluid volume related to bleeding [CORRECT]
D. Acute pain related to uterine contractions
Correct Answer: C
Rationale: Painless bleeding in the third trimester is characteristic of placenta previa.
While the client is currently stable, ongoing bleeding poses risk for hemorrhage and
hypovolemic shock. Prioritizing fluid volume status addresses the immediate
physiological threat. Option A is incorrect because placental abruption typically
presents with painful bleeding and uterine tenderness. Option B, while valid, is
psychosocial and secondary to physiological priorities. Option D is inappropriate as the
bleeding is described as painless, ruling out contractions as the primary issue.
Q6: The nurse is teaching a pregnant client about the warning signs of preeclampsia.
Which statement by the client indicates understanding of the material?
A. "I should call my doctor if I notice swelling in my ankles at the end of the day"
B. "Severe headaches and visual changes require immediate medical attention"
[CORRECT]
C. "Mild upper right quadrant pain is normal and doesn't need reporting"
D. "A sudden weight gain of 5 pounds in one week is expected in the third trimester"
Correct Answer: B
Rationale: Severe headaches, visual disturbances (scotomata, blurred vision), and
epigastric/RUQ pain are hallmark symptoms of severe preeclampsia, indicating cerebral
