HESI RN Maternity Exam Questions & Answers 2026/2027
– 70 NGN Questions with Detailed Obstetric Nursing
Rationales
Resource Type: 70 Next Generation NCLEX (NGN) Style Exam Questions with Answers
& Detailed Rationales
Prepared For: HESI RN Maternity Exam
DOCUMENT INCLUDES:
● 70 Authentic NGN-Style Exam Questions
● 100% Verified Correct Answers
● Detailed Obstetric Nursing Rationales
● Covers Key Maternity Nursing Topics
TOPICS COVERED:
● Antepartum Nursing Care & Fetal Development
● Intrapartum & Labor Management
● Postpartum Hemorrhage & Complications
● Newborn Assessment & Care
● High-Risk Pregnancy & Gestational Conditions
● Reproductive & Women's Health Issues
PURPOSE: This comprehensive resource helps nursing students review core maternity
concepts, test clinical reasoning through NGN-style item types, and prepare effectively
for the HESI RN Maternity Exam with confidence.
,SECTION 1: Antepartum Nursing Care & Fetal Development
Question 1 (Extended Multiple Choice)
A 28-year-old primigravida at 10 weeks gestation presents to the prenatal clinic. The
nurse is reviewing expected maternal physiological adaptations. Which finding would
the nurse identify as a normal change of pregnancy?
A. Decreased cardiac output beginning in the first trimester
B. Increased glomerular filtration rate (GFR) and renal plasma flow
C. Decreased plasma volume throughout gestation
D. Increased hematocrit due to increased red blood cell production exceeding plasma
expansion
Correct Answer: B
Rationale: During pregnancy, GFR increases by approximately 50% and renal plasma
flow increases by up to 80% due to increased renal perfusion and vasodilation. This is a
normal physiological adaptation. Option A is incorrect because cardiac output increases
by 30-50% beginning in the first trimester, peaking at 28-32 weeks, not decreases.
Option C is incorrect because plasma volume increases by 40-50% during pregnancy,
reaching its peak at approximately 32 weeks. Option D is incorrect because although
red blood cell production increases, plasma volume expands at a greater rate, causing a
physiologic anemia of pregnancy with decreased hematocrit (typically 32-42% in
pregnancy).
Question 2 (Multiple Response – Select All That Apply)
,A nurse is educating a pregnant client about foods to avoid during pregnancy to reduce
the risk of listeriosis. Which foods should the nurse include in the teaching? (Select all
that apply.)
A. Unpasteurized soft cheeses (e.g., brie, feta, queso fresco)
B. Deli meats and hot dogs unless heated until steaming
C. Refrigerated smoked seafood
D. Pasteurized milk and yogurt
E. Thoroughly cooked chicken breast
Correct Answers: A, B, C
Rationale: Listeria monocytogenes can cross the placenta and cause miscarriage,
stillbirth, or neonatal infection. Unpasteurized soft cheeses (A), deli meats and hot dogs
not heated to steaming (B), and refrigerated smoked seafood (C) are all high-risk foods
for listeriosis and should be avoided. Pasteurized milk and yogurt (D) are safe to
consume during pregnancy. Thoroughly cooked chicken breast (E) is safe because
proper cooking temperatures kill Listeria.
Question 3 (Extended Multiple Choice)
A pregnant client at 16 weeks gestation asks the nurse about the purpose of the quad
marker screening test. The nurse explains that this screening assesses for which
conditions?
A. Neural tube defects, trisomy 18, and trisomy 21
B. Cystic fibrosis and sickle cell disease
C. Phenylketonuria and Tay-Sachs disease
D. Hemophilia A and Duchenne muscular dystrophy
Correct Answer: A
, Rationale: The quadruple (quad) marker screening test, typically performed between 15
and 22 weeks gestation, measures maternal serum levels of alpha-fetoprotein (AFP),
human chorionic gonadotropin (hCG), unconjugated estriol, and inhibin-A. It screens for
neural tube defects (elevated AFP), trisomy 18 (low levels of AFP, estriol, and hCG), and
trisomy 21/Down syndrome (low AFP, low estriol, elevated hCG, elevated inhibin-A).
Options B, C, and D describe genetic conditions that are not screened by the quad
marker test; these require carrier screening or diagnostic genetic testing.
Question 4 (Extended Drag & Drop – Ordering)
Place the following fetal developmental milestones in the correct chronological order
from earliest to latest gestational age.
Items to Order:
1. Fetal heart tones detectable by Doppler
2. Fetal movements felt by the mother (quickening)
3. Lanugo covers the fetal body
4. Fetal lungs capable of extrauterine survival
Correct Order: 1 → 3 → 2 → 4
Rationale: Fetal heart tones are detectable by Doppler at approximately 10-12 weeks
gestation (1). Lanugo, fine downy hair, covers the fetal body beginning around 16-20
weeks (3). Quickening, or the mother's perception of fetal movement, typically occurs
between 18-22 weeks in primigravidas and slightly earlier in multigravidas (2). Fetal
lungs are generally considered capable of extrauterine survival at approximately 24
weeks gestation, though surfactant production may not be adequate until 34-36 weeks
(4).
Question 5 (Extended Multiple Choice)
– 70 NGN Questions with Detailed Obstetric Nursing
Rationales
Resource Type: 70 Next Generation NCLEX (NGN) Style Exam Questions with Answers
& Detailed Rationales
Prepared For: HESI RN Maternity Exam
DOCUMENT INCLUDES:
● 70 Authentic NGN-Style Exam Questions
● 100% Verified Correct Answers
● Detailed Obstetric Nursing Rationales
● Covers Key Maternity Nursing Topics
TOPICS COVERED:
● Antepartum Nursing Care & Fetal Development
● Intrapartum & Labor Management
● Postpartum Hemorrhage & Complications
● Newborn Assessment & Care
● High-Risk Pregnancy & Gestational Conditions
● Reproductive & Women's Health Issues
PURPOSE: This comprehensive resource helps nursing students review core maternity
concepts, test clinical reasoning through NGN-style item types, and prepare effectively
for the HESI RN Maternity Exam with confidence.
,SECTION 1: Antepartum Nursing Care & Fetal Development
Question 1 (Extended Multiple Choice)
A 28-year-old primigravida at 10 weeks gestation presents to the prenatal clinic. The
nurse is reviewing expected maternal physiological adaptations. Which finding would
the nurse identify as a normal change of pregnancy?
A. Decreased cardiac output beginning in the first trimester
B. Increased glomerular filtration rate (GFR) and renal plasma flow
C. Decreased plasma volume throughout gestation
D. Increased hematocrit due to increased red blood cell production exceeding plasma
expansion
Correct Answer: B
Rationale: During pregnancy, GFR increases by approximately 50% and renal plasma
flow increases by up to 80% due to increased renal perfusion and vasodilation. This is a
normal physiological adaptation. Option A is incorrect because cardiac output increases
by 30-50% beginning in the first trimester, peaking at 28-32 weeks, not decreases.
Option C is incorrect because plasma volume increases by 40-50% during pregnancy,
reaching its peak at approximately 32 weeks. Option D is incorrect because although
red blood cell production increases, plasma volume expands at a greater rate, causing a
physiologic anemia of pregnancy with decreased hematocrit (typically 32-42% in
pregnancy).
Question 2 (Multiple Response – Select All That Apply)
,A nurse is educating a pregnant client about foods to avoid during pregnancy to reduce
the risk of listeriosis. Which foods should the nurse include in the teaching? (Select all
that apply.)
A. Unpasteurized soft cheeses (e.g., brie, feta, queso fresco)
B. Deli meats and hot dogs unless heated until steaming
C. Refrigerated smoked seafood
D. Pasteurized milk and yogurt
E. Thoroughly cooked chicken breast
Correct Answers: A, B, C
Rationale: Listeria monocytogenes can cross the placenta and cause miscarriage,
stillbirth, or neonatal infection. Unpasteurized soft cheeses (A), deli meats and hot dogs
not heated to steaming (B), and refrigerated smoked seafood (C) are all high-risk foods
for listeriosis and should be avoided. Pasteurized milk and yogurt (D) are safe to
consume during pregnancy. Thoroughly cooked chicken breast (E) is safe because
proper cooking temperatures kill Listeria.
Question 3 (Extended Multiple Choice)
A pregnant client at 16 weeks gestation asks the nurse about the purpose of the quad
marker screening test. The nurse explains that this screening assesses for which
conditions?
A. Neural tube defects, trisomy 18, and trisomy 21
B. Cystic fibrosis and sickle cell disease
C. Phenylketonuria and Tay-Sachs disease
D. Hemophilia A and Duchenne muscular dystrophy
Correct Answer: A
, Rationale: The quadruple (quad) marker screening test, typically performed between 15
and 22 weeks gestation, measures maternal serum levels of alpha-fetoprotein (AFP),
human chorionic gonadotropin (hCG), unconjugated estriol, and inhibin-A. It screens for
neural tube defects (elevated AFP), trisomy 18 (low levels of AFP, estriol, and hCG), and
trisomy 21/Down syndrome (low AFP, low estriol, elevated hCG, elevated inhibin-A).
Options B, C, and D describe genetic conditions that are not screened by the quad
marker test; these require carrier screening or diagnostic genetic testing.
Question 4 (Extended Drag & Drop – Ordering)
Place the following fetal developmental milestones in the correct chronological order
from earliest to latest gestational age.
Items to Order:
1. Fetal heart tones detectable by Doppler
2. Fetal movements felt by the mother (quickening)
3. Lanugo covers the fetal body
4. Fetal lungs capable of extrauterine survival
Correct Order: 1 → 3 → 2 → 4
Rationale: Fetal heart tones are detectable by Doppler at approximately 10-12 weeks
gestation (1). Lanugo, fine downy hair, covers the fetal body beginning around 16-20
weeks (3). Quickening, or the mother's perception of fetal movement, typically occurs
between 18-22 weeks in primigravidas and slightly earlier in multigravidas (2). Fetal
lungs are generally considered capable of extrauterine survival at approximately 24
weeks gestation, though surfactant production may not be adequate until 34-36 weeks
(4).
Question 5 (Extended Multiple Choice)
