HESI Maternity RN V1
Maternity Nursing Examination
Complete Questions & Answers (Verified)
2026/2027 Edition
Aligned with the Elsevier HESI Maternity RN exam blueprint
and current ACOG / AAP maternity guidelines
Section Domain Questions
1 Antepartum Nursing Q1–15
2 Intrapartum Nursing Q16–30
3 Postpartum and Newborn Nursing Q31–45
4 High-Risk Maternity and Integrated Scenarios Q46–55
TOTAL 55 Questions
Cognitive Distribution: 25% Recall | 50% Application | 25% Analysis
Format: 75% Scenario-Based | 25% Direct Recall
Prepared for Maternity Nursing Examination Candidates
Page 1 | Maternity RN Examination Preparation | © 2026/2027 Edition
,HESI Maternity RN V1 – 2026/2027 Edition 55 Verified Questions & Answers
Section 1: Antepartum Nursing (Q1–15)
Domain coverage: Prenatal Care | Fetal Development | High-Risk Pregnancy | Maternal Adaptations.
Cognitive mix: 25% recall | 50% application | 25% analysis.
Q1. A client at 8 weeks' gestation reports nausea and vomiting throughout the day. The
nurse recommends small, frequent meals of dry carbohydrates and avoidance of fatty
or spicy foods. The client asks when symptoms will likely resolve. The nurse's BEST
response is:
A. "Symptoms usually resolve by the 20th week of gestation."
B. "Symptoms typically resolve by the end of the first trimester, around 12–14 weeks."
[CORRECT]
C. "Symptoms will continue throughout the entire pregnancy."
D. "Symptoms typically worsen in the second trimester."
Correct Answer: B
Rationale:
Nausea and vomiting of pregnancy (NVP, 'morning sickness') typically begins around 4–6 weeks, peaks
at 8–12 weeks, and resolves by the end of the first trimester (12–14 weeks) as human chorionic
gonadotropin (hCG) levels decline. Persistent vomiting beyond the first trimester with weight loss,
ketonuria, and electrolyte imbalance suggests hyperemesis gravidarum and warrants medical
evaluation. Small, frequent dry carbohydrate meals, ginger, vitamin B6 (pyridoxine) 10–25 mg every 8
hours, and avoidance of triggers are first-line interventions.
Q2. A pregnant client at 24 weeks' gestation has a 1-hour glucose challenge test (GCT)
result of 145 mg/dL. What is the nurse's PRIORITY action?
A. Diagnose gestational diabetes mellitus (GDM) and begin insulin therapy
B. Schedule a 3-hour oral glucose tolerance test (OGTT) for diagnostic confirmation
[CORRECT]
C. Reassure the client that the value is within normal limits
D. Initiate metformin therapy immediately
Correct Answer: B
Rationale:
A 1-hour GCT value ≥130–140 mg/dL (thresholds vary by institution) is a positive screen requiring
diagnostic confirmation with a 3-hour 100g OGTT. Diagnosis of GDM requires two or more abnormal
values on the 3-hour OGTT (fasting ≥92, 1-hour ≥180, 2-hour ≥153, 3-hour ≥140 mg/dL per
Carpenter-Coustan). Initial management of GDM is medical nutrition therapy (MNT) and exercise;
insulin or oral agents (metformin, glyburide) are added if glycemic targets are not met. The nurse
should not diagnose GDM from a single screen value.
Page 2 | Maternity RN Examination Preparation | © 2026/2027 Edition
, HESI Maternity RN V1 – 2026/2027 Edition 55 Verified Questions & Answers
Q3. A client at 32 weeks' gestation presents with a blood pressure of 152/96 mmHg, 2+
proteinuria on dipstick, and a frontal headache. The nurse suspects preeclampsia.
Which laboratory finding would indicate progression to HELLP syndrome?
A. Hemoglobin 12 g/dL, platelet count 250,000/mm³, LDH 200 U/L
B. Hemolysis (elevated LDH and bilirubin), platelet count <100,000/mm³, ALT 250 U/L
[CORRECT]
C. WBC 9,000/mm³, hematocrit 36%, normal liver enzymes
D. Hemoglobin 14 g/dL, platelet count 400,000/mm³, normal LDH
Correct Answer: B
Rationale:
HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe variant of
preeclampsia. Diagnostic criteria: hemolysis (LDH >600 U/L, total bilirubin ≥1.2 mg/dL, schistocytes
on smear), AST ≥70 U/L, and platelets <100,000/mm³. HELLP is a medical emergency requiring urgent
obstetric evaluation, magnesium sulfate for seizure prophylaxis, blood pressure control, and often
delivery. Maternal mortality reaches 25% without prompt treatment. The headache and elevated BP in
this client are concerning for severe preeclampsia progressing to HELLP.
Q4. A client at 36 weeks' gestation reports sudden onset of dark red vaginal bleeding
with no pain. Fetal heart rate is 144 bpm with moderate variability. The nurse suspects
placenta previa. Which nursing action is MOST appropriate?
A. Perform a vaginal examination to assess cervical dilation
B. Maintain bed rest in left lateral position, monitor bleeding and FHR continuously,
prepare for potential cesarean birth, and avoid vaginal manipulation [CORRECT]
C. Administer oxytocin to induce labor immediately
D. Encourage ambulation to promote labor onset
Correct Answer: B
Rationale:
Painless bright red vaginal bleeding in the third trimester is the hallmark of placenta previa (placenta
implanted over the internal cervical os). Vaginal examination is contraindicated because it can
provoke catastrophic hemorrhage. Management includes bed rest (left lateral position), continuous
FHR and uterine activity monitoring, pad count, IV access, type and crossmatch, and preparation for
cesarean birth if bleeding is significant or pregnancy is at term. ACOG recommends delivery at 36+0 to
37+6 weeks for asymptomatic previa with stable margins.
Page 3 | Maternity RN Examination Preparation | © 2026/2027 Edition
Maternity Nursing Examination
Complete Questions & Answers (Verified)
2026/2027 Edition
Aligned with the Elsevier HESI Maternity RN exam blueprint
and current ACOG / AAP maternity guidelines
Section Domain Questions
1 Antepartum Nursing Q1–15
2 Intrapartum Nursing Q16–30
3 Postpartum and Newborn Nursing Q31–45
4 High-Risk Maternity and Integrated Scenarios Q46–55
TOTAL 55 Questions
Cognitive Distribution: 25% Recall | 50% Application | 25% Analysis
Format: 75% Scenario-Based | 25% Direct Recall
Prepared for Maternity Nursing Examination Candidates
Page 1 | Maternity RN Examination Preparation | © 2026/2027 Edition
,HESI Maternity RN V1 – 2026/2027 Edition 55 Verified Questions & Answers
Section 1: Antepartum Nursing (Q1–15)
Domain coverage: Prenatal Care | Fetal Development | High-Risk Pregnancy | Maternal Adaptations.
Cognitive mix: 25% recall | 50% application | 25% analysis.
Q1. A client at 8 weeks' gestation reports nausea and vomiting throughout the day. The
nurse recommends small, frequent meals of dry carbohydrates and avoidance of fatty
or spicy foods. The client asks when symptoms will likely resolve. The nurse's BEST
response is:
A. "Symptoms usually resolve by the 20th week of gestation."
B. "Symptoms typically resolve by the end of the first trimester, around 12–14 weeks."
[CORRECT]
C. "Symptoms will continue throughout the entire pregnancy."
D. "Symptoms typically worsen in the second trimester."
Correct Answer: B
Rationale:
Nausea and vomiting of pregnancy (NVP, 'morning sickness') typically begins around 4–6 weeks, peaks
at 8–12 weeks, and resolves by the end of the first trimester (12–14 weeks) as human chorionic
gonadotropin (hCG) levels decline. Persistent vomiting beyond the first trimester with weight loss,
ketonuria, and electrolyte imbalance suggests hyperemesis gravidarum and warrants medical
evaluation. Small, frequent dry carbohydrate meals, ginger, vitamin B6 (pyridoxine) 10–25 mg every 8
hours, and avoidance of triggers are first-line interventions.
Q2. A pregnant client at 24 weeks' gestation has a 1-hour glucose challenge test (GCT)
result of 145 mg/dL. What is the nurse's PRIORITY action?
A. Diagnose gestational diabetes mellitus (GDM) and begin insulin therapy
B. Schedule a 3-hour oral glucose tolerance test (OGTT) for diagnostic confirmation
[CORRECT]
C. Reassure the client that the value is within normal limits
D. Initiate metformin therapy immediately
Correct Answer: B
Rationale:
A 1-hour GCT value ≥130–140 mg/dL (thresholds vary by institution) is a positive screen requiring
diagnostic confirmation with a 3-hour 100g OGTT. Diagnosis of GDM requires two or more abnormal
values on the 3-hour OGTT (fasting ≥92, 1-hour ≥180, 2-hour ≥153, 3-hour ≥140 mg/dL per
Carpenter-Coustan). Initial management of GDM is medical nutrition therapy (MNT) and exercise;
insulin or oral agents (metformin, glyburide) are added if glycemic targets are not met. The nurse
should not diagnose GDM from a single screen value.
Page 2 | Maternity RN Examination Preparation | © 2026/2027 Edition
, HESI Maternity RN V1 – 2026/2027 Edition 55 Verified Questions & Answers
Q3. A client at 32 weeks' gestation presents with a blood pressure of 152/96 mmHg, 2+
proteinuria on dipstick, and a frontal headache. The nurse suspects preeclampsia.
Which laboratory finding would indicate progression to HELLP syndrome?
A. Hemoglobin 12 g/dL, platelet count 250,000/mm³, LDH 200 U/L
B. Hemolysis (elevated LDH and bilirubin), platelet count <100,000/mm³, ALT 250 U/L
[CORRECT]
C. WBC 9,000/mm³, hematocrit 36%, normal liver enzymes
D. Hemoglobin 14 g/dL, platelet count 400,000/mm³, normal LDH
Correct Answer: B
Rationale:
HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe variant of
preeclampsia. Diagnostic criteria: hemolysis (LDH >600 U/L, total bilirubin ≥1.2 mg/dL, schistocytes
on smear), AST ≥70 U/L, and platelets <100,000/mm³. HELLP is a medical emergency requiring urgent
obstetric evaluation, magnesium sulfate for seizure prophylaxis, blood pressure control, and often
delivery. Maternal mortality reaches 25% without prompt treatment. The headache and elevated BP in
this client are concerning for severe preeclampsia progressing to HELLP.
Q4. A client at 36 weeks' gestation reports sudden onset of dark red vaginal bleeding
with no pain. Fetal heart rate is 144 bpm with moderate variability. The nurse suspects
placenta previa. Which nursing action is MOST appropriate?
A. Perform a vaginal examination to assess cervical dilation
B. Maintain bed rest in left lateral position, monitor bleeding and FHR continuously,
prepare for potential cesarean birth, and avoid vaginal manipulation [CORRECT]
C. Administer oxytocin to induce labor immediately
D. Encourage ambulation to promote labor onset
Correct Answer: B
Rationale:
Painless bright red vaginal bleeding in the third trimester is the hallmark of placenta previa (placenta
implanted over the internal cervical os). Vaginal examination is contraindicated because it can
provoke catastrophic hemorrhage. Management includes bed rest (left lateral position), continuous
FHR and uterine activity monitoring, pad count, IV access, type and crossmatch, and preparation for
cesarean birth if bleeding is significant or pregnancy is at term. ACOG recommends delivery at 36+0 to
37+6 weeks for asymptomatic previa with stable margins.
Page 3 | Maternity RN Examination Preparation | © 2026/2027 Edition
