HESI RN: Maternity
Test Bank 2026/2027
OB PED HESI Test Bank - Updated Edition
Comprehensive Maternity & Pediatric Nursing Examination Preparation
Total Questions 110 Multiple Choice Questions
Sections 8 Sections covering Antepartum, Intrapartum, Postpartum/Newborn,
Pediatric Growth, Pediatric Illnesses, Pediatric Pharmacology, Pediatric
Emergencies, and Integrated OB/PED Scenarios
Cognitive Distribution 25% Recall | 50% Application | 25% Analysis
Question Style 75% Scenario-based (incl. NGN-style) | 25% Direct recall
Standards Alignment ACOG 2026 | AAP 2026 | HESI RN Examination Blueprint | NGN (Next
Generation NCLEX)
Each Question Includes Question stem, 4 options (A-D), Correct answer marked, Detailed
HESI-specific rationale
About this Test Bank: This comprehensive 110-question examination is designed to align with the 2026-2027
HESI RN Maternity and Pediatric Nursing testing standards. The test bank integrates current ACOG (American
College of Obstetricians and Gynecologists) and AAP (American Academy of Pediatrics) clinical guidelines.
Each question is constructed using HESI-style distractors representing common examination pitfalls, including
incorrect fetal monitoring interpretation, pediatric developmental milestone confusion, postpartum complication
mismanagement, medication dosing errors, and prioritization mistakes. Next Generation NCLEX (NGN) clinical
judgment scenarios are incorporated throughout, particularly in the integrated OB/PED section, to develop the
clinical reasoning skills necessary for safe maternal-child nursing practice.
Sectio
Topic Questions
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,HESI RN Maternity & Pediatric Nursing Test Bank 2026/2027 110 Questions
1 Antepartum Nursing Q1 - Q20
2 Intrapartum Nursing Q21 - Q35
3 Postpartum & Newborn Nursing Q36 - Q55
4 Pediatric Growth & Development Q56 - Q65
5 Pediatric Common Illnesses Q66 - Q80
6 Pediatric Pharmacology & Nursing Care Q81 - Q88
7 Pediatric Emergencies & Chronic Conditions Q89 - Q95
8 Integrated OB/PED Scenarios & Clinical Judgment Q96 - Q110
Prepared for HESI RN Maternity & Pediatric Nursing Examination Preparation
2026/2027 Updated Edition | Aligned with ACOG, AAP, and HESI Standards
Page 2 | Aligned with 2026-2027 HESI RN Standards (ACOG/AAP)
,HESI RN Maternity & Pediatric Nursing Test Bank 2026/2027 110 Questions
Section 1: Antepartum Nursing | Prenatal Care, Fetal Development,
High-Risk Pregnancy, & Maternal Adaptations (Q1 - Q20)
Q1: A 28-year-old primigravida at 12 weeks gestation presents to the prenatal clinic for her first visit. She
asks the nurse about the recommended weight gain during her singleton pregnancy with a normal
pre-pregnancy BMI of 22. Which response by the nurse is most appropriate according to current ACOG
guidelines?
A. You should gain approximately 15-20 pounds total during your pregnancy.
B. You should gain approximately 25-35 pounds total during your pregnancy. [CORRECT]
C. You should gain approximately 35-45 pounds total during your pregnancy.
D. You should gain approximately 10-15 pounds total during your pregnancy.
Correct Answer: B
Rationale:
For a woman with a normal pre-pregnancy BMI (18.5-24.9), the Institute of Medicine and ACOG recommend a
total weight gain of 25-35 pounds (11.3-15.9 kg) for a singleton pregnancy. Option A (15-20 lbs) is recommended
for women with BMI ≥30 (obese). Option C (35-45 lbs) exceeds recommendations for normal BMI and is closer to
recommendations for underweight women (28-40 lbs). Option D (10-15 lbs) is insufficient for adequate fetal
growth and is below even the obese category recommendation. Adequate weight gain supports fetal development,
amniotic fluid volume, and placental function.
Q2: A pregnant client at 24 weeks gestation calls the clinic reporting a severe, throbbing headache that has
not responded to acetaminophen, along with visual disturbances described as "seeing spots." What is the
priority nursing action?
A. Advise the client to increase fluid intake and rest in a quiet, dark room.
B. Instruct the client to monitor her blood pressure at home and call back if it is elevated.
C. Have the client come to the clinic immediately for evaluation of possible preeclampsia.
[CORRECT]
D. Suggest taking a higher dose of acetaminophen and reassessing in 2 hours.
Correct Answer: C
Rationale:
A severe headache unresponsive to acetaminophen combined with visual disturbances (scotoma) at 24 weeks
gestation are classic signs of preeclampsia with severe features, a life-threatening complication requiring
immediate evaluation. The nurse must prioritize maternal and fetal safety by having the client evaluated
immediately rather than delaying care. Option A delays necessary evaluation. Option B is unsafe because home
monitoring delays definitive diagnosis and management. Option D is contraindicated as exceeding acetaminophen
dosing can cause hepatotoxicity, and preeclampsia requires medical evaluation, not increased analgesia.
Preeclampsia can rapidly progress to eclampsia, causing seizures, stroke, or maternal/fetal death.
Q3: A client at 18 weeks gestation undergoes a maternal serum alpha-fetoprotein (MSAFP) screening test.
The results show an elevated MSAFP level. The nurse understands that an elevated MSAFP is most
commonly associated with which condition?
A. Down syndrome (Trisomy 21)
B. Neural tube defects such as spina bifida [CORRECT]
C. Gestational diabetes mellitus
D. Intrauterine growth restriction (IUGR)
Page 3 | Aligned with 2026-2027 HESI RN Standards (ACOG/AAP)
, HESI RN Maternity & Pediatric Nursing Test Bank 2026/2027 110 Questions
Correct Answer: B
Rationale:
Elevated maternal serum alpha-fetoprotein (MSAFP) is most commonly associated with open neural tube defects
such as spina bifida and anencephaly, as AFP leaks from the fetal circulation into the amniotic fluid and maternal
bloodstream when there is an opening in the fetal body wall or neural tube. Option A is incorrect because Down
syndrome is associated with decreased (not elevated) MSAFP. Option C is incorrect because gestational diabetes is
not screened via MSAFP; it is screened with glucose tolerance testing. Option D may occur with IUGR but is not
the most common association. Elevated MSAFP can also indicate multiple gestation, incorrect gestational age,
fetal abdominal wall defects (gastroschisis, omphalocele), or fetal demise, requiring follow-up diagnostic
ultrasound and possible amniocentesis.
Q4: A nurse is caring for a client at 32 weeks gestation who has been diagnosed with placenta previa after
experiencing painless vaginal bleeding. Which nursing intervention is the highest priority?
A. Perform a vaginal examination to assess cervical dilation.
B. Monitor fetal heart rate and maternal vital signs closely. [CORRECT]
C. Encourage ambulation to promote uterine circulation.
D. Apply an ice pack to the perineum to reduce bleeding.
Correct Answer: B
Rationale:
With placenta previa, the placenta implants low in the uterus, partially or completely covering the cervical os,
causing painless bright red vaginal bleeding. The priority is to monitor fetal heart rate and maternal vital signs
continuously to detect hemorrhage, fetal distress, or shock. Option A is absolutely contraindicated; any vaginal
examination can precipitate catastrophic hemorrhage by disrupting the placenta. Option C is contraindicated as
activity can worsen bleeding; bed rest with limited activity is typically prescribed. Option D is inappropriate as the
bleeding is from inside the uterus, not perineal trauma. Management includes bed rest, pelvic rest, IV access, type
and crossmatch, continuous fetal monitoring, and preparation for possible cesarean delivery if bleeding is severe.
Q5: A pregnant client at 28 weeks gestation is diagnosed with gestational diabetes mellitus (GDM) after a
3-hour oral glucose tolerance test. The nurse is teaching the client about self-management. Which client
statement indicates the teaching has been effective?
A. I will check my blood glucose once a week before breakfast.
B. I should consume a diet high in simple carbohydrates for quick energy.
C. I will monitor my blood glucose levels before meals and at bedtime. [CORRECT]
D. I can stop monitoring once I deliver my baby.
Correct Answer: C
Rationale:
Clients with gestational diabetes should monitor blood glucose at least four times daily: fasting (before breakfast)
and after each meal, plus at bedtime as prescribed. This frequency allows for evaluation of dietary and exercise
effectiveness and guides insulin therapy if needed. Option A is inadequate; weekly monitoring does not provide
enough data for safe management. Option B is incorrect because simple carbohydrates cause rapid glucose spikes;
complex carbohydrates with fiber and protein are recommended. Option D is incorrect because women with GDM
have a 35-60% chance of developing type 2 diabetes within 10-20 years, requiring postpartum glucose testing at
4-12 weeks and ongoing screening. Tight glucose control reduces macrosomia, neonatal hypoglycemia, and
cesarean delivery risks.
Page 4 | Aligned with 2026-2027 HESI RN Standards (ACOG/AAP)
Test Bank 2026/2027
OB PED HESI Test Bank - Updated Edition
Comprehensive Maternity & Pediatric Nursing Examination Preparation
Total Questions 110 Multiple Choice Questions
Sections 8 Sections covering Antepartum, Intrapartum, Postpartum/Newborn,
Pediatric Growth, Pediatric Illnesses, Pediatric Pharmacology, Pediatric
Emergencies, and Integrated OB/PED Scenarios
Cognitive Distribution 25% Recall | 50% Application | 25% Analysis
Question Style 75% Scenario-based (incl. NGN-style) | 25% Direct recall
Standards Alignment ACOG 2026 | AAP 2026 | HESI RN Examination Blueprint | NGN (Next
Generation NCLEX)
Each Question Includes Question stem, 4 options (A-D), Correct answer marked, Detailed
HESI-specific rationale
About this Test Bank: This comprehensive 110-question examination is designed to align with the 2026-2027
HESI RN Maternity and Pediatric Nursing testing standards. The test bank integrates current ACOG (American
College of Obstetricians and Gynecologists) and AAP (American Academy of Pediatrics) clinical guidelines.
Each question is constructed using HESI-style distractors representing common examination pitfalls, including
incorrect fetal monitoring interpretation, pediatric developmental milestone confusion, postpartum complication
mismanagement, medication dosing errors, and prioritization mistakes. Next Generation NCLEX (NGN) clinical
judgment scenarios are incorporated throughout, particularly in the integrated OB/PED section, to develop the
clinical reasoning skills necessary for safe maternal-child nursing practice.
Sectio
Topic Questions
n
,HESI RN Maternity & Pediatric Nursing Test Bank 2026/2027 110 Questions
1 Antepartum Nursing Q1 - Q20
2 Intrapartum Nursing Q21 - Q35
3 Postpartum & Newborn Nursing Q36 - Q55
4 Pediatric Growth & Development Q56 - Q65
5 Pediatric Common Illnesses Q66 - Q80
6 Pediatric Pharmacology & Nursing Care Q81 - Q88
7 Pediatric Emergencies & Chronic Conditions Q89 - Q95
8 Integrated OB/PED Scenarios & Clinical Judgment Q96 - Q110
Prepared for HESI RN Maternity & Pediatric Nursing Examination Preparation
2026/2027 Updated Edition | Aligned with ACOG, AAP, and HESI Standards
Page 2 | Aligned with 2026-2027 HESI RN Standards (ACOG/AAP)
,HESI RN Maternity & Pediatric Nursing Test Bank 2026/2027 110 Questions
Section 1: Antepartum Nursing | Prenatal Care, Fetal Development,
High-Risk Pregnancy, & Maternal Adaptations (Q1 - Q20)
Q1: A 28-year-old primigravida at 12 weeks gestation presents to the prenatal clinic for her first visit. She
asks the nurse about the recommended weight gain during her singleton pregnancy with a normal
pre-pregnancy BMI of 22. Which response by the nurse is most appropriate according to current ACOG
guidelines?
A. You should gain approximately 15-20 pounds total during your pregnancy.
B. You should gain approximately 25-35 pounds total during your pregnancy. [CORRECT]
C. You should gain approximately 35-45 pounds total during your pregnancy.
D. You should gain approximately 10-15 pounds total during your pregnancy.
Correct Answer: B
Rationale:
For a woman with a normal pre-pregnancy BMI (18.5-24.9), the Institute of Medicine and ACOG recommend a
total weight gain of 25-35 pounds (11.3-15.9 kg) for a singleton pregnancy. Option A (15-20 lbs) is recommended
for women with BMI ≥30 (obese). Option C (35-45 lbs) exceeds recommendations for normal BMI and is closer to
recommendations for underweight women (28-40 lbs). Option D (10-15 lbs) is insufficient for adequate fetal
growth and is below even the obese category recommendation. Adequate weight gain supports fetal development,
amniotic fluid volume, and placental function.
Q2: A pregnant client at 24 weeks gestation calls the clinic reporting a severe, throbbing headache that has
not responded to acetaminophen, along with visual disturbances described as "seeing spots." What is the
priority nursing action?
A. Advise the client to increase fluid intake and rest in a quiet, dark room.
B. Instruct the client to monitor her blood pressure at home and call back if it is elevated.
C. Have the client come to the clinic immediately for evaluation of possible preeclampsia.
[CORRECT]
D. Suggest taking a higher dose of acetaminophen and reassessing in 2 hours.
Correct Answer: C
Rationale:
A severe headache unresponsive to acetaminophen combined with visual disturbances (scotoma) at 24 weeks
gestation are classic signs of preeclampsia with severe features, a life-threatening complication requiring
immediate evaluation. The nurse must prioritize maternal and fetal safety by having the client evaluated
immediately rather than delaying care. Option A delays necessary evaluation. Option B is unsafe because home
monitoring delays definitive diagnosis and management. Option D is contraindicated as exceeding acetaminophen
dosing can cause hepatotoxicity, and preeclampsia requires medical evaluation, not increased analgesia.
Preeclampsia can rapidly progress to eclampsia, causing seizures, stroke, or maternal/fetal death.
Q3: A client at 18 weeks gestation undergoes a maternal serum alpha-fetoprotein (MSAFP) screening test.
The results show an elevated MSAFP level. The nurse understands that an elevated MSAFP is most
commonly associated with which condition?
A. Down syndrome (Trisomy 21)
B. Neural tube defects such as spina bifida [CORRECT]
C. Gestational diabetes mellitus
D. Intrauterine growth restriction (IUGR)
Page 3 | Aligned with 2026-2027 HESI RN Standards (ACOG/AAP)
, HESI RN Maternity & Pediatric Nursing Test Bank 2026/2027 110 Questions
Correct Answer: B
Rationale:
Elevated maternal serum alpha-fetoprotein (MSAFP) is most commonly associated with open neural tube defects
such as spina bifida and anencephaly, as AFP leaks from the fetal circulation into the amniotic fluid and maternal
bloodstream when there is an opening in the fetal body wall or neural tube. Option A is incorrect because Down
syndrome is associated with decreased (not elevated) MSAFP. Option C is incorrect because gestational diabetes is
not screened via MSAFP; it is screened with glucose tolerance testing. Option D may occur with IUGR but is not
the most common association. Elevated MSAFP can also indicate multiple gestation, incorrect gestational age,
fetal abdominal wall defects (gastroschisis, omphalocele), or fetal demise, requiring follow-up diagnostic
ultrasound and possible amniocentesis.
Q4: A nurse is caring for a client at 32 weeks gestation who has been diagnosed with placenta previa after
experiencing painless vaginal bleeding. Which nursing intervention is the highest priority?
A. Perform a vaginal examination to assess cervical dilation.
B. Monitor fetal heart rate and maternal vital signs closely. [CORRECT]
C. Encourage ambulation to promote uterine circulation.
D. Apply an ice pack to the perineum to reduce bleeding.
Correct Answer: B
Rationale:
With placenta previa, the placenta implants low in the uterus, partially or completely covering the cervical os,
causing painless bright red vaginal bleeding. The priority is to monitor fetal heart rate and maternal vital signs
continuously to detect hemorrhage, fetal distress, or shock. Option A is absolutely contraindicated; any vaginal
examination can precipitate catastrophic hemorrhage by disrupting the placenta. Option C is contraindicated as
activity can worsen bleeding; bed rest with limited activity is typically prescribed. Option D is inappropriate as the
bleeding is from inside the uterus, not perineal trauma. Management includes bed rest, pelvic rest, IV access, type
and crossmatch, continuous fetal monitoring, and preparation for possible cesarean delivery if bleeding is severe.
Q5: A pregnant client at 28 weeks gestation is diagnosed with gestational diabetes mellitus (GDM) after a
3-hour oral glucose tolerance test. The nurse is teaching the client about self-management. Which client
statement indicates the teaching has been effective?
A. I will check my blood glucose once a week before breakfast.
B. I should consume a diet high in simple carbohydrates for quick energy.
C. I will monitor my blood glucose levels before meals and at bedtime. [CORRECT]
D. I can stop monitoring once I deliver my baby.
Correct Answer: C
Rationale:
Clients with gestational diabetes should monitor blood glucose at least four times daily: fasting (before breakfast)
and after each meal, plus at bedtime as prescribed. This frequency allows for evaluation of dietary and exercise
effectiveness and guides insulin therapy if needed. Option A is inadequate; weekly monitoring does not provide
enough data for safe management. Option B is incorrect because simple carbohydrates cause rapid glucose spikes;
complex carbohydrates with fiber and protein are recommended. Option D is incorrect because women with GDM
have a 35-60% chance of developing type 2 diabetes within 10-20 years, requiring postpartum glucose testing at
4-12 weeks and ongoing screening. Tight glucose control reduces macrosomia, neonatal hypoglycemia, and
cesarean delivery risks.
Page 4 | Aligned with 2026-2027 HESI RN Standards (ACOG/AAP)
