2026 HESI MATERNITY OB EXAM VERSION 1 | Latest All 55
Questions & Correct Answers | Already Graded A+ (Score
1292) | Pass Guaranteed - A+ Graded
Section 1: Antepartum Care (12 Questions)
Q1: A 28-year-old client at 8 weeks gestation presents for her first prenatal visit. She
reports a history of phenylketonuria (PKU) that was well-controlled before pregnancy.
Which dietary instruction is most important for the nurse to provide?
A. Increase protein intake to support fetal growth and development
B. Maintain the low-phenylalanine diet throughout pregnancy to prevent fetal teratogenic
effects [CORRECT]
C. Discontinue the special diet since maternal PKU does not affect the fetus
D. Add phenylalanine supplements to ensure adequate amino acid intake
Correct Answer: B
Rationale: Women with PKU must maintain strict dietary control of phenylalanine before
conception and throughout pregnancy. Elevated maternal phenylalanine levels are
teratogenic, causing microcephaly, intellectual disability, congenital heart defects, and
growth restriction in the fetus. The low-phenylalanine diet must be continued, not
discontinued. Increasing protein or adding phenylalanine supplements would be
dangerous as they would elevate phenylalanine levels. The goal is to keep phenylalanine
levels between 120-360 μmol/L (2-6 mg/dL) throughout pregnancy.
,Q2: A 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 is most
accurate?
A. "This test detects chromosomal abnormalities such as Down syndrome with high
accuracy"
B. "This screening identifies open neural tube defects and certain other anomalies;
abnormal results require follow-up testing [CORRECT]"
C. "This test confirms the presence of gestational diabetes in the second trimester"
D. "This screening evaluates placental function and fetal well-being"
Correct Answer: B
Rationale: MSAFP screening, performed between 15-22 weeks gestation, is a screening
(not diagnostic) test for open neural tube defects (elevated AFP) and certain
chromosomal abnormalities like Down syndrome (low AFP). It is not
diagnostic—abnormal results require follow-up with ultrasound and possibly
amniocentesis. It does not detect gestational diabetes (screened at 24-28 weeks) or
evaluate placental function. The nurse must emphasize that this is a screening test, not
a definitive diagnosis.
Q3: During a prenatal visit at 24 weeks gestation, a client reports experiencing
occasional irregular, painless uterine contractions. The fetal heart rate is 150 bpm.
Which nursing intervention is most appropriate?
A. Immediately prepare for emergency cesarean delivery
,B. Reassure the client that these are likely Braxton Hicks contractions and teach
differentiation from true labor [CORRECT]
C. Administer terbutaline subcutaneously to suppress preterm labor
D. Place the client on strict bed rest for the remainder of the pregnancy
Correct Answer: B
Rationale: Braxton Hicks contractions are irregular, painless uterine contractions that
begin as early as the second trimester and increase in frequency toward term. They are
typically irregular, do not increase in intensity, and resolve with position changes or
hydration. True labor contractions are regular, increase in frequency and intensity, and
do not resolve with rest. The fetal heart rate of 150 bpm is normal (110-160 bpm). No
emergency intervention is needed. Terbutaline is contraindicated without confirmed
preterm labor, and strict bed rest is inappropriate for normal physiological contractions.
Q4: A pregnant client at 32 weeks gestation is diagnosed with iron-deficiency anemia
with a hemoglobin of 9.8 g/dL. Which client statement indicates a need for further
teaching?
A. "I will take my iron supplement with orange juice to enhance absorption"
B. "I need to increase my intake of leafy green vegetables and red meat"
C. "I can stop taking the iron pills once my energy levels improve [CORRECT]"
D. "I should expect my stools to become darker while taking iron"
Correct Answer: C
, Rationale: Iron supplementation must continue throughout pregnancy and often into the
postpartum period to rebuild iron stores and support ongoing hematopoiesis. Stopping
iron when symptoms improve is incorrect because hemoglobin levels may still be
suboptimal and iron stores depleted. Taking iron with vitamin C (orange juice) enhances
absorption. Dietary sources of iron are appropriate adjuncts. Dark stools are a normal,
harmless side effect of iron supplementation. The nurse must emphasize adherence to
the full prescribed course.
Q5: A 35-year-old client at 18 weeks gestation is concerned about her advanced
maternal age. Which screening option should the nurse discuss first?
A. Immediate termination of pregnancy due to high risk of chromosomal abnormalities
B. Cell-free fetal DNA testing, which can be performed as early as 10 weeks gestation
[CORRECT]
C. Amniocentesis, which is the only definitive test available
D. No screening is necessary since maternal age is no longer a significant risk factor
Correct Answer: B
Rationale: Cell-free fetal DNA (cffDNA) testing is a non-invasive prenatal screening test
that analyzes fetal DNA in maternal blood to screen for common chromosomal
abnormalities (trisomy 21, 18, 13) and can be performed as early as 10 weeks
gestation. It has high sensitivity and specificity with no risk to the fetus. While
amniocentesis is diagnostic, it carries a small risk of miscarriage and is typically offered
after screening results or for high-risk indications. Advanced maternal age (≥35)
remains a significant risk factor for chromosomal abnormalities. Termination is never
presented as the first option.
Questions & Correct Answers | Already Graded A+ (Score
1292) | Pass Guaranteed - A+ Graded
Section 1: Antepartum Care (12 Questions)
Q1: A 28-year-old client at 8 weeks gestation presents for her first prenatal visit. She
reports a history of phenylketonuria (PKU) that was well-controlled before pregnancy.
Which dietary instruction is most important for the nurse to provide?
A. Increase protein intake to support fetal growth and development
B. Maintain the low-phenylalanine diet throughout pregnancy to prevent fetal teratogenic
effects [CORRECT]
C. Discontinue the special diet since maternal PKU does not affect the fetus
D. Add phenylalanine supplements to ensure adequate amino acid intake
Correct Answer: B
Rationale: Women with PKU must maintain strict dietary control of phenylalanine before
conception and throughout pregnancy. Elevated maternal phenylalanine levels are
teratogenic, causing microcephaly, intellectual disability, congenital heart defects, and
growth restriction in the fetus. The low-phenylalanine diet must be continued, not
discontinued. Increasing protein or adding phenylalanine supplements would be
dangerous as they would elevate phenylalanine levels. The goal is to keep phenylalanine
levels between 120-360 μmol/L (2-6 mg/dL) throughout pregnancy.
,Q2: A 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 is most
accurate?
A. "This test detects chromosomal abnormalities such as Down syndrome with high
accuracy"
B. "This screening identifies open neural tube defects and certain other anomalies;
abnormal results require follow-up testing [CORRECT]"
C. "This test confirms the presence of gestational diabetes in the second trimester"
D. "This screening evaluates placental function and fetal well-being"
Correct Answer: B
Rationale: MSAFP screening, performed between 15-22 weeks gestation, is a screening
(not diagnostic) test for open neural tube defects (elevated AFP) and certain
chromosomal abnormalities like Down syndrome (low AFP). It is not
diagnostic—abnormal results require follow-up with ultrasound and possibly
amniocentesis. It does not detect gestational diabetes (screened at 24-28 weeks) or
evaluate placental function. The nurse must emphasize that this is a screening test, not
a definitive diagnosis.
Q3: During a prenatal visit at 24 weeks gestation, a client reports experiencing
occasional irregular, painless uterine contractions. The fetal heart rate is 150 bpm.
Which nursing intervention is most appropriate?
A. Immediately prepare for emergency cesarean delivery
,B. Reassure the client that these are likely Braxton Hicks contractions and teach
differentiation from true labor [CORRECT]
C. Administer terbutaline subcutaneously to suppress preterm labor
D. Place the client on strict bed rest for the remainder of the pregnancy
Correct Answer: B
Rationale: Braxton Hicks contractions are irregular, painless uterine contractions that
begin as early as the second trimester and increase in frequency toward term. They are
typically irregular, do not increase in intensity, and resolve with position changes or
hydration. True labor contractions are regular, increase in frequency and intensity, and
do not resolve with rest. The fetal heart rate of 150 bpm is normal (110-160 bpm). No
emergency intervention is needed. Terbutaline is contraindicated without confirmed
preterm labor, and strict bed rest is inappropriate for normal physiological contractions.
Q4: A pregnant client at 32 weeks gestation is diagnosed with iron-deficiency anemia
with a hemoglobin of 9.8 g/dL. Which client statement indicates a need for further
teaching?
A. "I will take my iron supplement with orange juice to enhance absorption"
B. "I need to increase my intake of leafy green vegetables and red meat"
C. "I can stop taking the iron pills once my energy levels improve [CORRECT]"
D. "I should expect my stools to become darker while taking iron"
Correct Answer: C
, Rationale: Iron supplementation must continue throughout pregnancy and often into the
postpartum period to rebuild iron stores and support ongoing hematopoiesis. Stopping
iron when symptoms improve is incorrect because hemoglobin levels may still be
suboptimal and iron stores depleted. Taking iron with vitamin C (orange juice) enhances
absorption. Dietary sources of iron are appropriate adjuncts. Dark stools are a normal,
harmless side effect of iron supplementation. The nurse must emphasize adherence to
the full prescribed course.
Q5: A 35-year-old client at 18 weeks gestation is concerned about her advanced
maternal age. Which screening option should the nurse discuss first?
A. Immediate termination of pregnancy due to high risk of chromosomal abnormalities
B. Cell-free fetal DNA testing, which can be performed as early as 10 weeks gestation
[CORRECT]
C. Amniocentesis, which is the only definitive test available
D. No screening is necessary since maternal age is no longer a significant risk factor
Correct Answer: B
Rationale: Cell-free fetal DNA (cffDNA) testing is a non-invasive prenatal screening test
that analyzes fetal DNA in maternal blood to screen for common chromosomal
abnormalities (trisomy 21, 18, 13) and can be performed as early as 10 weeks
gestation. It has high sensitivity and specificity with no risk to the fetus. While
amniocentesis is diagnostic, it carries a small risk of miscarriage and is typically offered
after screening results or for high-risk indications. Advanced maternal age (≥35)
remains a significant risk factor for chromosomal abnormalities. Termination is never
presented as the first option.
