HESI MATERNITY OB EXAM VERSION 3 ACTUAL
EXAM PREP 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES |TOP
RATED VERSION FOR 2026 BY EXPERTS |NEW AND
REVISED
HESI Maternity OB Exam Version 3 – Practice Exam
PART 1: ANTEPARTUM CARE
1. A nurse is counseling a couple who has sought information about conceiving.
For teaching purposes, the nurse should know that ovulation usually occurs:
A) Immediately after menstruation.
B) Immediately before menstruation.
C) Two weeks before menstruation.
D) Three weeks before menstruation.
Correct Answer: C) Two weeks before menstruation
Rationale: Ovulation typically occurs 14 days (two weeks) before the next
menstrual period, regardless of cycle length. The luteal phase is constant at
approximately 14 days .
2. Ovulation occurs how many days before the next menstrual period (i.e.,
between ovulation and the beginning of the next menstrual cycle, there are how
many days)?
,A) 7 days
B) 10 days
C) 12 days
D) 14 days
Correct Answer: D) 14 days
Rationale: The interval from ovulation to the start of the next menses (the luteal
phase) is consistently about 14 days, unless otherwise altered by hormonal
conditions .
3. A woman at 12 weeks gestation has the following maternal history: a healthy
2-year-old daughter, a miscarriage at 10 weeks, an elective abortion at 6 weeks
(4 years earlier). What is her GTPAL?
A) G=4, T=1, P=0, A=2, L=1
B) G=4, T=1, P=0, A=1, L=1
C) G=3, T=1, P=0, A=2, L=1
D) G=3, T=1, P=0, A=2, L=0
Correct Answer: A) G=4, T=1, P=0, A=2, L=1
Rationale: Gravida (G) = total number of pregnancies = 4 (current + 2-year-old
daughter + miscarriage + abortion). Term = 1 (2-year-old daughter). Preterm = 0.
Abortions = 2 (miscarriage + elective abortion). Living = 1 .
4. Maternal serum alpha-fetoprotein (MSAFP) screening is typically performed
at what gestational age?
A) 8-10 weeks
B) 11-13 weeks
C) 15-20 weeks
D) 24-28 weeks
Correct Answer: C) 15-20 weeks
,Rationale: MSAFP screening is performed between 15-20 weeks gestation to
screen for neural tube defects and other fetal anomalies .
5. A client at 28 weeks gestation with a history of systemic lupus erythematosus
presents with elevated blood pressure (148/92 mmHg) and new-onset
proteinuria (300 mg/24h). Laboratory results show decreased complement
levels (C3, C4) and elevated anti-dsDNA antibodies. Which of the following is the
most appropriate next step in management?
A) Initiate labetalol for blood pressure control and schedule induction at 37
weeks.
B) Start hydroxychloroquine and low-dose aspirin, and monitor for lupus flare.
C) Administer betamethasone and plan delivery if fetal lung maturity is confirmed.
D) Perform renal biopsy to differentiate lupus nephritis from preeclampsia.
Correct Answer: B) Start hydroxychloroquine and low-dose aspirin, and monitor
for lupus flare.
Rationale: The presentation suggests a lupus flare with possible lupus nephritis,
not preeclampsia (low complement, elevated anti-dsDNA). Hydroxychloroquine is
first-line for lupus in pregnancy to prevent flares; low-dose aspirin reduces
preeclampsia risk .
6. A patient with a singleton pregnancy undergoes first-trimester combined
screening. The results show: nuchal translucency (NT) = 3.8 mm (>99th
percentile), PAPP-A = 0.25 MoM, free β-hCG = 4.5 MoM. Which of the following
is the most likely diagnosis?
A) Trisomy 18
B) Trisomy 21
C) Turner syndrome
D) Triploidy
Correct Answer: B) Trisomy 21
, Rationale: The pattern of increased NT, low PAPP-A, and high free β-hCG is classic
for trisomy 21. Trisomy 18 typically shows low PAPP-A and low free β-hCG. Turner
syndrome often presents with large NT but normal analytes. Triploidy usually
shows extremely low β-hCG and PAPP-A .
7. A client at 30 weeks gestation reports that she has not felt the baby move in
the last 24 hours. Concerned she arrives in a panic at the obstetric clinic where
she is immediately sent to the hospital. Which assessment warrants immediate
intervention by the nurse?
A) Fetal Heart rate 60 beats per minute
B) Ruptured amniotic membrane
C) Onset of uterine contractions
D) Leaking amniotic fluid
Correct Answer: A) Fetal Heart rate 60 beats per minute
Rationale: A fetal heart rate of 60 bpm is severe bradycardia and indicates fetal
distress requiring immediate intervention. Maternal report of decreased fetal
movement warrants further assessment, but FHR 60 bpm is the most urgent
finding .
8. A client at 31 weeks gestation with a fundal height measurement of 25 cm is
scheduled for a series of ultrasounds to be performed every two weeks. Which
explanation should the nurse provide?
A) Assessment for congenital anomalies.
B) Recalculation of gestational age.
C) Evaluation of fetal growth.
D) Determination of fetal presentation.
Correct Answer: C) Evaluation of fetal growth
EXAM PREP 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES |TOP
RATED VERSION FOR 2026 BY EXPERTS |NEW AND
REVISED
HESI Maternity OB Exam Version 3 – Practice Exam
PART 1: ANTEPARTUM CARE
1. A nurse is counseling a couple who has sought information about conceiving.
For teaching purposes, the nurse should know that ovulation usually occurs:
A) Immediately after menstruation.
B) Immediately before menstruation.
C) Two weeks before menstruation.
D) Three weeks before menstruation.
Correct Answer: C) Two weeks before menstruation
Rationale: Ovulation typically occurs 14 days (two weeks) before the next
menstrual period, regardless of cycle length. The luteal phase is constant at
approximately 14 days .
2. Ovulation occurs how many days before the next menstrual period (i.e.,
between ovulation and the beginning of the next menstrual cycle, there are how
many days)?
,A) 7 days
B) 10 days
C) 12 days
D) 14 days
Correct Answer: D) 14 days
Rationale: The interval from ovulation to the start of the next menses (the luteal
phase) is consistently about 14 days, unless otherwise altered by hormonal
conditions .
3. A woman at 12 weeks gestation has the following maternal history: a healthy
2-year-old daughter, a miscarriage at 10 weeks, an elective abortion at 6 weeks
(4 years earlier). What is her GTPAL?
A) G=4, T=1, P=0, A=2, L=1
B) G=4, T=1, P=0, A=1, L=1
C) G=3, T=1, P=0, A=2, L=1
D) G=3, T=1, P=0, A=2, L=0
Correct Answer: A) G=4, T=1, P=0, A=2, L=1
Rationale: Gravida (G) = total number of pregnancies = 4 (current + 2-year-old
daughter + miscarriage + abortion). Term = 1 (2-year-old daughter). Preterm = 0.
Abortions = 2 (miscarriage + elective abortion). Living = 1 .
4. Maternal serum alpha-fetoprotein (MSAFP) screening is typically performed
at what gestational age?
A) 8-10 weeks
B) 11-13 weeks
C) 15-20 weeks
D) 24-28 weeks
Correct Answer: C) 15-20 weeks
,Rationale: MSAFP screening is performed between 15-20 weeks gestation to
screen for neural tube defects and other fetal anomalies .
5. A client at 28 weeks gestation with a history of systemic lupus erythematosus
presents with elevated blood pressure (148/92 mmHg) and new-onset
proteinuria (300 mg/24h). Laboratory results show decreased complement
levels (C3, C4) and elevated anti-dsDNA antibodies. Which of the following is the
most appropriate next step in management?
A) Initiate labetalol for blood pressure control and schedule induction at 37
weeks.
B) Start hydroxychloroquine and low-dose aspirin, and monitor for lupus flare.
C) Administer betamethasone and plan delivery if fetal lung maturity is confirmed.
D) Perform renal biopsy to differentiate lupus nephritis from preeclampsia.
Correct Answer: B) Start hydroxychloroquine and low-dose aspirin, and monitor
for lupus flare.
Rationale: The presentation suggests a lupus flare with possible lupus nephritis,
not preeclampsia (low complement, elevated anti-dsDNA). Hydroxychloroquine is
first-line for lupus in pregnancy to prevent flares; low-dose aspirin reduces
preeclampsia risk .
6. A patient with a singleton pregnancy undergoes first-trimester combined
screening. The results show: nuchal translucency (NT) = 3.8 mm (>99th
percentile), PAPP-A = 0.25 MoM, free β-hCG = 4.5 MoM. Which of the following
is the most likely diagnosis?
A) Trisomy 18
B) Trisomy 21
C) Turner syndrome
D) Triploidy
Correct Answer: B) Trisomy 21
, Rationale: The pattern of increased NT, low PAPP-A, and high free β-hCG is classic
for trisomy 21. Trisomy 18 typically shows low PAPP-A and low free β-hCG. Turner
syndrome often presents with large NT but normal analytes. Triploidy usually
shows extremely low β-hCG and PAPP-A .
7. A client at 30 weeks gestation reports that she has not felt the baby move in
the last 24 hours. Concerned she arrives in a panic at the obstetric clinic where
she is immediately sent to the hospital. Which assessment warrants immediate
intervention by the nurse?
A) Fetal Heart rate 60 beats per minute
B) Ruptured amniotic membrane
C) Onset of uterine contractions
D) Leaking amniotic fluid
Correct Answer: A) Fetal Heart rate 60 beats per minute
Rationale: A fetal heart rate of 60 bpm is severe bradycardia and indicates fetal
distress requiring immediate intervention. Maternal report of decreased fetal
movement warrants further assessment, but FHR 60 bpm is the most urgent
finding .
8. A client at 31 weeks gestation with a fundal height measurement of 25 cm is
scheduled for a series of ultrasounds to be performed every two weeks. Which
explanation should the nurse provide?
A) Assessment for congenital anomalies.
B) Recalculation of gestational age.
C) Evaluation of fetal growth.
D) Determination of fetal presentation.
Correct Answer: C) Evaluation of fetal growth
