HESI OB MATERNITY V2 Exam — 2026/2027 GUARANTEED A+ Questions & Answers Brand New Version
HESI OB MATERNITY Version 2 (V2) Exam
2026/2027 — GUARANTEED A+ Questions & Answers Included!!!
125 Questions • 7 Competency-Aligned Sections • Comprehensive Rationales
Aligned with current ACOG guidelines, AWHONN standards, and evidence-based maternity nursing practice
Total Questions 125 Multiple Choice (4 options, 1 correct)
Cognitive Levels 30% Recall • 50% Application • 20% Analysis
Item Style 75% Scenario-based • 25% Direct Recall
Coverage Antepartum, Complications, Intrapartum, Postpartum, Newborn, High-Risk, Women’s Health & Pharmacolog
Use Self-assessment, study, and GUARANTEED A+ exam readiness for HESI OB/Maternity V2
Section Overview
# Section Q Range Count
1 Antepartum Care and Assessment Q1–Q18 18
2 Complications of Pregnancy Q19–Q38 20
3 Intrapartum Care and Labor Management Q39–Q60 22
4 Postpartum Care and Complications Q61–Q80 20
5 Newborn Assessment and Care Q81–Q100 20
6 High-Risk Pregnancy and Perinatal Emergencies Q101–Q112 12
7 Women's Health, Pharmacology, and Professional Practice Q113–Q125 13
Instructions: Select the single best answer for each question. Rationales explain why the correct choice is best and
why other options are incorrect, including maternal-fetal physiology, pharmacology, and nursing priorities.
Section 1: Antepartum Care and Assessment
Competency 1: Prenatal care, GTPAL, Naegele's rule, fundal height, prenatal visits, maternal physiological and
psychological adaptations, prenatal nutrition, weight gain, and supplementation (folic acid, iron, calcium).
Aligned with HESI OB/Maternity V2 Blueprint • ACOG/AWHONN standards • Evidence-based maternity practice Page 1
,HESI OB MATERNITY V2 Exam — 2026/2027 GUARANTEED A+ Questions & Answers Brand New Version
Q1: A client at 12 weeks' gestation tells the nurse she has been pregnant 4 times: she delivered twins at 38
weeks (vaginally), had a miscarriage at 10 weeks, delivered a singleton at 36 weeks, and is currently pregnant.
Using GTPAL, what is her correct designation?
A. G4 T1 P1 A1 L2.
B. G4 T1 P1 A1 L3. [CORRECT]
C. G4 T2 P0 A1 L3.
D. G5 T1 P1 A1 L2.
Correct Answer: B
Rationale: Gravida (G) = number of pregnancies = 4. Term (T) = births at 37+ weeks = the 38-week twins = 1. Preterm (P) =
births 20-36+6 weeks = the 36-week singleton = 1. Abortions (A) = losses before 20 weeks = 1. Living children (L) = 2 (twins)
+ 1 (singleton) = 3. Therefore G4 T1 P1 A1 L3.
Q2: A client's last menstrual period (LMP) began on January 10. Using Naegele's rule, what is her estimated
date of delivery (EDD)?
A. October 17. [CORRECT]
B. October 10.
C. November 17.
D. September 17.
Correct Answer: A
Rationale: Naegele's rule: subtract 3 months from the LMP month and add 7 days to the LMP day. January 10 minus 3 months
= October; 10 + 7 days = 17. EDD = October 17. October 10 omits the +7 days; November 17 adds an extra month; September
17 subtracts 4 months.
Q3: A nurse measures the fundal height of a client at 28 weeks' gestation. The expected measurement (in cm)
is approximately:
A. 20 cm.
B. 24 cm.
C. 28 cm. [CORRECT]
D. 32 cm.
Correct Answer: C
Rationale: After 20 weeks, fundal height in centimeters should approximate gestational age in weeks (within 2 cm). At 28
weeks the expected measurement is approximately 28 cm. A measurement more than 2-3 cm below expectations may suggest
IUGR, oligohydramnios, or incorrect dates; above suggests multiple gestation, polyhydramnios, or large-for-gestational-age
fetus.
Aligned with HESI OB/Maternity V2 Blueprint • ACOG/AWHONN standards • Evidence-based maternity practice Page 2
,HESI OB MATERNITY V2 Exam — 2026/2027 GUARANTEED A+ Questions & Answers Brand New Version
Q4: A pregnant client asks why folic acid supplementation is recommended. The nurse's best response is that
folic acid:
A. Prevents maternal anemia only.
B. Reduces the risk of neural tube defects such as spina bifida and anencephaly when taken before conception
and during early pregnancy. [CORRECT]
C. Promotes fetal weight gain in the third trimester.
D. Reduces pregnancy-induced nausea.
Correct Answer: B
Rationale: Folic acid (400-800 mcg daily; 4 mg for high-risk women) significantly reduces neural tube defects (spina bifida,
anencephaly) when taken preconceptionally and in early pregnancy, as the neural tube closes by day 28 post-conception. It
also supports erythropoiesis but its primary prenatal indication is neural tube defect prevention.
Q5: A client at 16 weeks' gestation has a hemoglobin of 10.5 g/dL. The nurse understands that physiologic
anemia of pregnancy is caused by:
A. Decreased iron intake.
B. Plasma volume expansion that exceeds the increase in red blood cell mass, causing a hemodilution effect.
[CORRECT]
C. Active hemorrhage.
D. Vitamin B12 deficiency.
Correct Answer: B
Rationale: Physiologic anemia of pregnancy results from plasma volume expanding more rapidly than red blood cell mass
(hemodilution), peaking around 28-32 weeks. Hgb <11 g/dL in first/third trimester or <10.5 g/dL in second trimester suggests
true anemia requiring supplementation. It is not due to hemorrhage or B12 deficiency alone.
Q6: A pregnant client at 32 weeks asks about recommended weight gain. She is of normal pre-pregnancy BMI
(18.5-24.9). Per current IOM guidelines, her total recommended weight gain is:
A. 15-25 lb (6.8-11.3 kg).
B. 25-35 lb (11.3-15.9 kg). [CORRECT]
C. 28-40 lb (12.7-18.1 kg).
D. 11-20 lb (5.0-9.1 kg).
Correct Answer: B
Rationale: For normal BMI (18.5-24.9), the IOM recommends 25-35 lb (11.3-15.9 kg) total gain, about 1 lb/week in the
second and third trimesters. Underweight (BMI <18.5) is 28-40 lb; overweight (25.0-29.9) is 15-25 lb; obese (30+) is 11-20 lb.
Aligned with HESI OB/Maternity V2 Blueprint • ACOG/AWHONN standards • Evidence-based maternity practice Page 3
, HESI OB MATERNITY V2 Exam — 2026/2027 GUARANTEED A+ Questions & Answers Brand New Version
Q7: A client at 8 weeks' gestation reports nausea and vomiting of pregnancy (NVP). The nurse's first-line
recommendation should be:
A. Prescribe ondansetron immediately.
B. Recommend non-pharmacologic measures: small frequent meals, ginger, vitamin B6 (pyridoxine), and
avoiding triggers. [CORRECT]
C. Advise nothing by mouth until vomiting resolves.
D. Recommend discontinuing prenatal vitamins permanently.
Correct Answer: B
Rationale: First-line management of NVP includes lifestyle measures: small frequent meals, bland foods, ginger, vitamin B6
(pyridoxine 10-25 mg TID), and trigger avoidance. Pharmacologic agents (e.g., doxylamine-pyridoxine, ondansetron) are
added if non-pharmacologic measures fail. NPO and stopping prenatal vitamins are inappropriate.
Q8: A pregnant client asks about foods to avoid during pregnancy. The nurse correctly advises avoiding:
A. Pasteurized milk and pasteurized cheese.
B. Unpasteurized soft cheeses (e.g., brie, feta, blue-veined), raw or undercooked meat/fish, high-mercury fish
(shark, swordfish, king mackerel), and unpasteurized juice. [CORRECT]
C. All seafood and all dairy products.
D. Cooked eggs and well-done meat.
Correct Answer: B
Rationale: Avoid unpasteurized soft cheeses (Listeria risk), raw/undercooked meat and fish (Toxoplasma, bacteria),
high-mercury fish (neurotoxicity), and unpasteurized juice. Pasteurized dairy and well-cooked eggs and meats are safe.
Q9: A client at 24 weeks' gestation reports constipation. The nurse recommends all of the following EXCEPT:
A. Increase fiber (whole grains, fruits, vegetables).
B. Increase fluids to 8-10 glasses/day.
C. Use daily stimulant laxatives long-term. [CORRECT]
D. Encourage regular moderate exercise.
Correct Answer: C
Rationale: Constipation in pregnancy is managed with fiber, fluids, and exercise. Iron supplementation can worsen
constipation. Stimulant laxatives should not be used long-term because they can cause electrolyte imbalance and dependence;
bulk-forming agents (e.g., psyllium) are preferred.
Q10: A client at 36 weeks' gestation has heartburn (pyrosis). Which physiologic change primarily contributes
to this symptom?
A. Decreased progesterone causing rapid gastric emptying.
B. Progesterone relaxing the lower esophageal sphincter and the enlarging uterus displacing the stomach
upward. [CORRECT]
C. Increased stomach acid production.
D. Decreased intra-abdominal pressure.
Correct Answer: B
Rationale: Progesterone relaxes smooth muscle, including the lower esophageal sphincter, allowing reflux; the enlarging
uterus displaces the stomach upward, worsening pyrosis. Management includes small meals, avoiding spicy/fatty foods,
remaining upright after eating, and approved antacids (calcium carbonate).
Aligned with HESI OB/Maternity V2 Blueprint • ACOG/AWHONN standards • Evidence-based maternity practice Page 4
HESI OB MATERNITY Version 2 (V2) Exam
2026/2027 — GUARANTEED A+ Questions & Answers Included!!!
125 Questions • 7 Competency-Aligned Sections • Comprehensive Rationales
Aligned with current ACOG guidelines, AWHONN standards, and evidence-based maternity nursing practice
Total Questions 125 Multiple Choice (4 options, 1 correct)
Cognitive Levels 30% Recall • 50% Application • 20% Analysis
Item Style 75% Scenario-based • 25% Direct Recall
Coverage Antepartum, Complications, Intrapartum, Postpartum, Newborn, High-Risk, Women’s Health & Pharmacolog
Use Self-assessment, study, and GUARANTEED A+ exam readiness for HESI OB/Maternity V2
Section Overview
# Section Q Range Count
1 Antepartum Care and Assessment Q1–Q18 18
2 Complications of Pregnancy Q19–Q38 20
3 Intrapartum Care and Labor Management Q39–Q60 22
4 Postpartum Care and Complications Q61–Q80 20
5 Newborn Assessment and Care Q81–Q100 20
6 High-Risk Pregnancy and Perinatal Emergencies Q101–Q112 12
7 Women's Health, Pharmacology, and Professional Practice Q113–Q125 13
Instructions: Select the single best answer for each question. Rationales explain why the correct choice is best and
why other options are incorrect, including maternal-fetal physiology, pharmacology, and nursing priorities.
Section 1: Antepartum Care and Assessment
Competency 1: Prenatal care, GTPAL, Naegele's rule, fundal height, prenatal visits, maternal physiological and
psychological adaptations, prenatal nutrition, weight gain, and supplementation (folic acid, iron, calcium).
Aligned with HESI OB/Maternity V2 Blueprint • ACOG/AWHONN standards • Evidence-based maternity practice Page 1
,HESI OB MATERNITY V2 Exam — 2026/2027 GUARANTEED A+ Questions & Answers Brand New Version
Q1: A client at 12 weeks' gestation tells the nurse she has been pregnant 4 times: she delivered twins at 38
weeks (vaginally), had a miscarriage at 10 weeks, delivered a singleton at 36 weeks, and is currently pregnant.
Using GTPAL, what is her correct designation?
A. G4 T1 P1 A1 L2.
B. G4 T1 P1 A1 L3. [CORRECT]
C. G4 T2 P0 A1 L3.
D. G5 T1 P1 A1 L2.
Correct Answer: B
Rationale: Gravida (G) = number of pregnancies = 4. Term (T) = births at 37+ weeks = the 38-week twins = 1. Preterm (P) =
births 20-36+6 weeks = the 36-week singleton = 1. Abortions (A) = losses before 20 weeks = 1. Living children (L) = 2 (twins)
+ 1 (singleton) = 3. Therefore G4 T1 P1 A1 L3.
Q2: A client's last menstrual period (LMP) began on January 10. Using Naegele's rule, what is her estimated
date of delivery (EDD)?
A. October 17. [CORRECT]
B. October 10.
C. November 17.
D. September 17.
Correct Answer: A
Rationale: Naegele's rule: subtract 3 months from the LMP month and add 7 days to the LMP day. January 10 minus 3 months
= October; 10 + 7 days = 17. EDD = October 17. October 10 omits the +7 days; November 17 adds an extra month; September
17 subtracts 4 months.
Q3: A nurse measures the fundal height of a client at 28 weeks' gestation. The expected measurement (in cm)
is approximately:
A. 20 cm.
B. 24 cm.
C. 28 cm. [CORRECT]
D. 32 cm.
Correct Answer: C
Rationale: After 20 weeks, fundal height in centimeters should approximate gestational age in weeks (within 2 cm). At 28
weeks the expected measurement is approximately 28 cm. A measurement more than 2-3 cm below expectations may suggest
IUGR, oligohydramnios, or incorrect dates; above suggests multiple gestation, polyhydramnios, or large-for-gestational-age
fetus.
Aligned with HESI OB/Maternity V2 Blueprint • ACOG/AWHONN standards • Evidence-based maternity practice Page 2
,HESI OB MATERNITY V2 Exam — 2026/2027 GUARANTEED A+ Questions & Answers Brand New Version
Q4: A pregnant client asks why folic acid supplementation is recommended. The nurse's best response is that
folic acid:
A. Prevents maternal anemia only.
B. Reduces the risk of neural tube defects such as spina bifida and anencephaly when taken before conception
and during early pregnancy. [CORRECT]
C. Promotes fetal weight gain in the third trimester.
D. Reduces pregnancy-induced nausea.
Correct Answer: B
Rationale: Folic acid (400-800 mcg daily; 4 mg for high-risk women) significantly reduces neural tube defects (spina bifida,
anencephaly) when taken preconceptionally and in early pregnancy, as the neural tube closes by day 28 post-conception. It
also supports erythropoiesis but its primary prenatal indication is neural tube defect prevention.
Q5: A client at 16 weeks' gestation has a hemoglobin of 10.5 g/dL. The nurse understands that physiologic
anemia of pregnancy is caused by:
A. Decreased iron intake.
B. Plasma volume expansion that exceeds the increase in red blood cell mass, causing a hemodilution effect.
[CORRECT]
C. Active hemorrhage.
D. Vitamin B12 deficiency.
Correct Answer: B
Rationale: Physiologic anemia of pregnancy results from plasma volume expanding more rapidly than red blood cell mass
(hemodilution), peaking around 28-32 weeks. Hgb <11 g/dL in first/third trimester or <10.5 g/dL in second trimester suggests
true anemia requiring supplementation. It is not due to hemorrhage or B12 deficiency alone.
Q6: A pregnant client at 32 weeks asks about recommended weight gain. She is of normal pre-pregnancy BMI
(18.5-24.9). Per current IOM guidelines, her total recommended weight gain is:
A. 15-25 lb (6.8-11.3 kg).
B. 25-35 lb (11.3-15.9 kg). [CORRECT]
C. 28-40 lb (12.7-18.1 kg).
D. 11-20 lb (5.0-9.1 kg).
Correct Answer: B
Rationale: For normal BMI (18.5-24.9), the IOM recommends 25-35 lb (11.3-15.9 kg) total gain, about 1 lb/week in the
second and third trimesters. Underweight (BMI <18.5) is 28-40 lb; overweight (25.0-29.9) is 15-25 lb; obese (30+) is 11-20 lb.
Aligned with HESI OB/Maternity V2 Blueprint • ACOG/AWHONN standards • Evidence-based maternity practice Page 3
, HESI OB MATERNITY V2 Exam — 2026/2027 GUARANTEED A+ Questions & Answers Brand New Version
Q7: A client at 8 weeks' gestation reports nausea and vomiting of pregnancy (NVP). The nurse's first-line
recommendation should be:
A. Prescribe ondansetron immediately.
B. Recommend non-pharmacologic measures: small frequent meals, ginger, vitamin B6 (pyridoxine), and
avoiding triggers. [CORRECT]
C. Advise nothing by mouth until vomiting resolves.
D. Recommend discontinuing prenatal vitamins permanently.
Correct Answer: B
Rationale: First-line management of NVP includes lifestyle measures: small frequent meals, bland foods, ginger, vitamin B6
(pyridoxine 10-25 mg TID), and trigger avoidance. Pharmacologic agents (e.g., doxylamine-pyridoxine, ondansetron) are
added if non-pharmacologic measures fail. NPO and stopping prenatal vitamins are inappropriate.
Q8: A pregnant client asks about foods to avoid during pregnancy. The nurse correctly advises avoiding:
A. Pasteurized milk and pasteurized cheese.
B. Unpasteurized soft cheeses (e.g., brie, feta, blue-veined), raw or undercooked meat/fish, high-mercury fish
(shark, swordfish, king mackerel), and unpasteurized juice. [CORRECT]
C. All seafood and all dairy products.
D. Cooked eggs and well-done meat.
Correct Answer: B
Rationale: Avoid unpasteurized soft cheeses (Listeria risk), raw/undercooked meat and fish (Toxoplasma, bacteria),
high-mercury fish (neurotoxicity), and unpasteurized juice. Pasteurized dairy and well-cooked eggs and meats are safe.
Q9: A client at 24 weeks' gestation reports constipation. The nurse recommends all of the following EXCEPT:
A. Increase fiber (whole grains, fruits, vegetables).
B. Increase fluids to 8-10 glasses/day.
C. Use daily stimulant laxatives long-term. [CORRECT]
D. Encourage regular moderate exercise.
Correct Answer: C
Rationale: Constipation in pregnancy is managed with fiber, fluids, and exercise. Iron supplementation can worsen
constipation. Stimulant laxatives should not be used long-term because they can cause electrolyte imbalance and dependence;
bulk-forming agents (e.g., psyllium) are preferred.
Q10: A client at 36 weeks' gestation has heartburn (pyrosis). Which physiologic change primarily contributes
to this symptom?
A. Decreased progesterone causing rapid gastric emptying.
B. Progesterone relaxing the lower esophageal sphincter and the enlarging uterus displacing the stomach
upward. [CORRECT]
C. Increased stomach acid production.
D. Decreased intra-abdominal pressure.
Correct Answer: B
Rationale: Progesterone relaxes smooth muscle, including the lower esophageal sphincter, allowing reflux; the enlarging
uterus displaces the stomach upward, worsening pyrosis. Management includes small meals, avoiding spicy/fatty foods,
remaining upright after eating, and approved antacids (calcium carbonate).
Aligned with HESI OB/Maternity V2 Blueprint • ACOG/AWHONN standards • Evidence-based maternity practice Page 4
