OB HESI MATERNITY 2026 VERSION 1, 2 AND 3
AND 2023 2 LATEST VERSIONS|MATERNITY OB
VERSION 3 ACTUAL EXAM EACH EXAM
CONTAINS 55 QUESTIONS AND CORRECT
ANSWERS|AGRADE QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
PDF.
Core Domains:
• Antepartum Care and Complications
• Intrapartum Care and Fetal Monitoring
• Postpartum Assessment and Complications
• Newborn Assessment and Care
• High-Risk Pregnancy and Obstetric Emergencies
• Pharmacology in Maternity Care
• Ethical and Legal Principles in Maternal-Child Nursing
• Family-Centered Care and Client Education
Introduction:
The Obstetric and Maternity HESI examination is designed to assess the
comprehensive knowledge and clinical judgment required for safe nursing
practice in maternal-child healthcare settings. The examination evaluates
foundational theory, applied professional knowledge, regulatory compliance,
and ethical standards essential for managing the childbearing family. The test
structure incorporates multiple-choice and scenario-based questions that
,emphasize real-world application, critical thinking, and clinical decision-
making. Candidates are expected to demonstrate competency in antepartum,
intrapartum, postpartum, and newborn care, with a focus on prioritization
and patient safety.
SECTION ONE: QUESTIONS 1–100
1. A nurse is assessing a client at 34 weeks gestation who reports a
sudden gush of fluid from the vagina. Which action should the nurse
take first?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Document the color and amount of fluid
C. Check the fetal heart rate
D. Prepare the client for an immediate cesarean delivery
Correct answer: C
RATIONALE: The priority nursing action when a client reports
spontaneous rupture of membranes is to assess fetal well-being by checking
the fetal heart rate. Umbilical cord prolapse is a risk following rupture of
membranes, and fetal bradycardia may indicate cord compression. Vaginal
examination is contraindicated until cord prolapse is ruled out.
2. A client at 28 weeks gestation with a history of systemic lupus
erythematosus presents with hypertension, proteinuria (3+ on
dipstick), and elevated liver enzymes. Which pathophysiology is most
consistent with this presentation?
A. Exacerbation of lupus nephritis due to increased glomerular filtration rate
B. HELLP syndrome secondary to microangiopathic hemolysis
C. Superimposed preeclampsia with features of thrombotic microangiopathy
D. Acute fatty liver of pregnancy with hepatic encephalopathy
, Correct answer: C
RATIONALE: Superimposed preeclampsia is common in women with
lupus and presents with hypertension, proteinuria, and elevated liver
enzymes. HELLP syndrome typically includes hemolysis and low platelets,
which are not stated here. Lupus nephritis may cause proteinuria but not
hypertension in this context.
3. A nurse is teaching a client at 10 weeks gestation about fetal
development. Which statement indicates that teaching has been
effective?
A. "My baby's heart is fully developed and can be heard with a regular
stethoscope."
B. "My baby's major organs are forming, and I should avoid all medications."
C. "My baby is making breathing movements and has fingerprints."
D. "My baby is storing fat and I should increase my calorie intake."
Correct answer: B
RATIONALE: At 10 weeks gestation, the fetus is in the embryonic stage
transitioning to fetal stage, and major organ systems are forming
(organogenesis). This is the most critical period for teratogenic exposure. A
regular stethoscope cannot detect fetal heart tones until 20 weeks. Breathing
movements and fingerprints develop later. Fat storage occurs primarily in the
third trimester.
4. A client at 36 weeks gestation with type 1 diabetes mellitus has a
glycosylated hemoglobin (HbA1c) of 8.2%. Which fetal complication is
most likely to be detected on a detailed ultrasound?
A. Sacral agenesis
B. Diaphragmatic hernia
, C. Transposition of the great arteries
D. Duodenal atresia
Correct answer: A
RATIONALE: Poor glycemic control in early pregnancy (elevated HbA1c)
is associated with caudal regression syndrome, including sacral agenesis.
Diaphragmatic hernia and transposition of the great arteries are not
specifically linked to maternal diabetes. Duodenal atresia is associated with
polyhydramnios but not specifically with HbA1c levels.
5. A nurse is caring for a client in the first stage of labor who is
experiencing intense back pain with each contraction. Which fetal
position is most consistent with this finding?
A. Occiput anterior
B. Occiput posterior
C. Breech
D. Transverse lie
Correct answer: B
RATIONALE: Occiput posterior position is associated with intense back
labor because the fetal occiput presses against the maternal sacrum. Occiput
anterior is the most common and least painful position. Breech and
transverse lie are malpresentations that may require cesarean delivery.
6. A nurse is assessing a newborn 1 hour after birth. Which finding
should the nurse report immediately to the healthcare provider?
A. Heart rate of 120 beats per minute
B. Respiratory rate of 70 breaths per minute with grunting
C. Axillary temperature of 97.8°F (36.6°C)
D. Passage of meconium
AND 2023 2 LATEST VERSIONS|MATERNITY OB
VERSION 3 ACTUAL EXAM EACH EXAM
CONTAINS 55 QUESTIONS AND CORRECT
ANSWERS|AGRADE QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
PDF.
Core Domains:
• Antepartum Care and Complications
• Intrapartum Care and Fetal Monitoring
• Postpartum Assessment and Complications
• Newborn Assessment and Care
• High-Risk Pregnancy and Obstetric Emergencies
• Pharmacology in Maternity Care
• Ethical and Legal Principles in Maternal-Child Nursing
• Family-Centered Care and Client Education
Introduction:
The Obstetric and Maternity HESI examination is designed to assess the
comprehensive knowledge and clinical judgment required for safe nursing
practice in maternal-child healthcare settings. The examination evaluates
foundational theory, applied professional knowledge, regulatory compliance,
and ethical standards essential for managing the childbearing family. The test
structure incorporates multiple-choice and scenario-based questions that
,emphasize real-world application, critical thinking, and clinical decision-
making. Candidates are expected to demonstrate competency in antepartum,
intrapartum, postpartum, and newborn care, with a focus on prioritization
and patient safety.
SECTION ONE: QUESTIONS 1–100
1. A nurse is assessing a client at 34 weeks gestation who reports a
sudden gush of fluid from the vagina. Which action should the nurse
take first?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Document the color and amount of fluid
C. Check the fetal heart rate
D. Prepare the client for an immediate cesarean delivery
Correct answer: C
RATIONALE: The priority nursing action when a client reports
spontaneous rupture of membranes is to assess fetal well-being by checking
the fetal heart rate. Umbilical cord prolapse is a risk following rupture of
membranes, and fetal bradycardia may indicate cord compression. Vaginal
examination is contraindicated until cord prolapse is ruled out.
2. A client at 28 weeks gestation with a history of systemic lupus
erythematosus presents with hypertension, proteinuria (3+ on
dipstick), and elevated liver enzymes. Which pathophysiology is most
consistent with this presentation?
A. Exacerbation of lupus nephritis due to increased glomerular filtration rate
B. HELLP syndrome secondary to microangiopathic hemolysis
C. Superimposed preeclampsia with features of thrombotic microangiopathy
D. Acute fatty liver of pregnancy with hepatic encephalopathy
, Correct answer: C
RATIONALE: Superimposed preeclampsia is common in women with
lupus and presents with hypertension, proteinuria, and elevated liver
enzymes. HELLP syndrome typically includes hemolysis and low platelets,
which are not stated here. Lupus nephritis may cause proteinuria but not
hypertension in this context.
3. A nurse is teaching a client at 10 weeks gestation about fetal
development. Which statement indicates that teaching has been
effective?
A. "My baby's heart is fully developed and can be heard with a regular
stethoscope."
B. "My baby's major organs are forming, and I should avoid all medications."
C. "My baby is making breathing movements and has fingerprints."
D. "My baby is storing fat and I should increase my calorie intake."
Correct answer: B
RATIONALE: At 10 weeks gestation, the fetus is in the embryonic stage
transitioning to fetal stage, and major organ systems are forming
(organogenesis). This is the most critical period for teratogenic exposure. A
regular stethoscope cannot detect fetal heart tones until 20 weeks. Breathing
movements and fingerprints develop later. Fat storage occurs primarily in the
third trimester.
4. A client at 36 weeks gestation with type 1 diabetes mellitus has a
glycosylated hemoglobin (HbA1c) of 8.2%. Which fetal complication is
most likely to be detected on a detailed ultrasound?
A. Sacral agenesis
B. Diaphragmatic hernia
, C. Transposition of the great arteries
D. Duodenal atresia
Correct answer: A
RATIONALE: Poor glycemic control in early pregnancy (elevated HbA1c)
is associated with caudal regression syndrome, including sacral agenesis.
Diaphragmatic hernia and transposition of the great arteries are not
specifically linked to maternal diabetes. Duodenal atresia is associated with
polyhydramnios but not specifically with HbA1c levels.
5. A nurse is caring for a client in the first stage of labor who is
experiencing intense back pain with each contraction. Which fetal
position is most consistent with this finding?
A. Occiput anterior
B. Occiput posterior
C. Breech
D. Transverse lie
Correct answer: B
RATIONALE: Occiput posterior position is associated with intense back
labor because the fetal occiput presses against the maternal sacrum. Occiput
anterior is the most common and least painful position. Breech and
transverse lie are malpresentations that may require cesarean delivery.
6. A nurse is assessing a newborn 1 hour after birth. Which finding
should the nurse report immediately to the healthcare provider?
A. Heart rate of 120 beats per minute
B. Respiratory rate of 70 breaths per minute with grunting
C. Axillary temperature of 97.8°F (36.6°C)
D. Passage of meconium
