,OB HESI Maternity 2026 & 2023 Exam Versions 1-3 — Comprehensive
Study Guide
55 Questions Per Version with Correct Answers & Rationales
Section I: Antepartum Nursing (Questions 1–15)
Q1. A pregnant client at 32 weeks gestation reports feeling dizzy and lightheaded when lying on her
back. What is the nurse's priority intervention?
• A. Reassure the client that this is a normal finding of pregnancy
• B. Assist the client to a left lateral recumbent position
• C. Elevate the client's legs above the level of the heart
• D. Administer oxygen via nasal cannula at 2 L/min
Correct Answer: B — Assist the client to a left lateral recumbent position
Rationale: Supine hypotension (supine hypotensive syndrome) occurs when the gravid uterus
compresses the inferior vena cava, decreasing venous return and cardiac output, leading to hypotension
and dizziness. The priority intervention is to position the client in the left lateral recumbent position,
which relieves the compression and restores venous return. Reassuring the client without acting is
inadequate; elevating legs does not address the IVC compression; and oxygen is not the priority when
the problem is mechanical compression of the vena cava.
Q2. A nurse is reviewing laboratory results for a client at 28 weeks gestation. Which finding is
considered a normal physiologic change during pregnancy?
• A. Hemoglobin 14.2 g/dL
• B. Blood urea nitrogen (BUN) 18 mg/dL
• C. Hemoglobin 10.8 g/dL
• D. Creatinine 1.4 mg/dL
Correct Answer: C — Hemoglobin 10.8 g/dL
Rationale: During pregnancy, plasma volume increases by 30–50% while red blood cell mass increases
only 20–30%, creating a dilutional effect known as physiologic anemia of pregnancy. Normal hemoglobin
values in the third trimester are 10.5–11 g/dL, making 10.8 g/dL a normal expected finding. A
hemoglobin of 14.2 g/dL would be abnormally high for the third trimester. BUN and creatinine decrease
during pregnancy due to increased renal blood flow and GFR, with normal BUN at 5–10 mg/dL and
creatinine at 0.4–0.8 mg/dL.
Q3. A pregnant client's last menstrual period (LMP) began on May 2. Using Naegele's Rule, what is the
estimated date of birth (EDB)?
• A. January 25
, • B. February 2
• C. February 9
• D. February 16
Correct Answer: C — February 9
Rationale: Naegele's Rule requires subtracting three months from the first day of the LMP (February 2)
and then adding seven days to arrive at the estimated due date.
Q4. A client who had her first baby 3 months ago and is breastfeeding her infant tells the nurse that she
is currently using the same diaphragm that she used before becoming pregnant. Which information
should the nurse provide this client?
• A. After ceasing breastfeeding, the diaphragm should be resized.
• B. Avoid intercourse during ovulation until the size of the diaphragm has been evaluated.
• C. If no more than 20 pounds was gained during pregnancy, the diaphragm is safe to use.
• D. Use an alternate form of contraceptive until a new diaphragm is obtained.
Correct Answer: D — Use an alternate form of contraceptive until a new diaphragm is obtained.
Rationale: The diaphragm must be refitted after childbirth because the size of the vaginal canal and
pelvic floor muscles may have changed. The client should not use the same diaphragm until a new one is
properly fitted.
Q5. A 25-year-old client has a positive pregnancy test. One year ago she had a spontaneous abortion at
3 months of gestation. What is the correct description of this client that should be documented in the
medical record?
• A. Gravida 2, para 0
• B. Gravida 1, para 0
• C. Gravida 2, para 1
• D. Gravida 1, para 1
Correct Answer: A — Gravida 2, para 0
Rationale: This is the client's second pregnancy (gravida 2). The spontaneous abortion occurred at 3
months (12 weeks), so she is para 0 because parity cannot be increased unless delivery occurs at 20
weeks of gestation or beyond.
Q6. During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus. When
compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who have:
• A. Higher birth weights
• B. Lower birth weights
Study Guide
55 Questions Per Version with Correct Answers & Rationales
Section I: Antepartum Nursing (Questions 1–15)
Q1. A pregnant client at 32 weeks gestation reports feeling dizzy and lightheaded when lying on her
back. What is the nurse's priority intervention?
• A. Reassure the client that this is a normal finding of pregnancy
• B. Assist the client to a left lateral recumbent position
• C. Elevate the client's legs above the level of the heart
• D. Administer oxygen via nasal cannula at 2 L/min
Correct Answer: B — Assist the client to a left lateral recumbent position
Rationale: Supine hypotension (supine hypotensive syndrome) occurs when the gravid uterus
compresses the inferior vena cava, decreasing venous return and cardiac output, leading to hypotension
and dizziness. The priority intervention is to position the client in the left lateral recumbent position,
which relieves the compression and restores venous return. Reassuring the client without acting is
inadequate; elevating legs does not address the IVC compression; and oxygen is not the priority when
the problem is mechanical compression of the vena cava.
Q2. A nurse is reviewing laboratory results for a client at 28 weeks gestation. Which finding is
considered a normal physiologic change during pregnancy?
• A. Hemoglobin 14.2 g/dL
• B. Blood urea nitrogen (BUN) 18 mg/dL
• C. Hemoglobin 10.8 g/dL
• D. Creatinine 1.4 mg/dL
Correct Answer: C — Hemoglobin 10.8 g/dL
Rationale: During pregnancy, plasma volume increases by 30–50% while red blood cell mass increases
only 20–30%, creating a dilutional effect known as physiologic anemia of pregnancy. Normal hemoglobin
values in the third trimester are 10.5–11 g/dL, making 10.8 g/dL a normal expected finding. A
hemoglobin of 14.2 g/dL would be abnormally high for the third trimester. BUN and creatinine decrease
during pregnancy due to increased renal blood flow and GFR, with normal BUN at 5–10 mg/dL and
creatinine at 0.4–0.8 mg/dL.
Q3. A pregnant client's last menstrual period (LMP) began on May 2. Using Naegele's Rule, what is the
estimated date of birth (EDB)?
• A. January 25
, • B. February 2
• C. February 9
• D. February 16
Correct Answer: C — February 9
Rationale: Naegele's Rule requires subtracting three months from the first day of the LMP (February 2)
and then adding seven days to arrive at the estimated due date.
Q4. A client who had her first baby 3 months ago and is breastfeeding her infant tells the nurse that she
is currently using the same diaphragm that she used before becoming pregnant. Which information
should the nurse provide this client?
• A. After ceasing breastfeeding, the diaphragm should be resized.
• B. Avoid intercourse during ovulation until the size of the diaphragm has been evaluated.
• C. If no more than 20 pounds was gained during pregnancy, the diaphragm is safe to use.
• D. Use an alternate form of contraceptive until a new diaphragm is obtained.
Correct Answer: D — Use an alternate form of contraceptive until a new diaphragm is obtained.
Rationale: The diaphragm must be refitted after childbirth because the size of the vaginal canal and
pelvic floor muscles may have changed. The client should not use the same diaphragm until a new one is
properly fitted.
Q5. A 25-year-old client has a positive pregnancy test. One year ago she had a spontaneous abortion at
3 months of gestation. What is the correct description of this client that should be documented in the
medical record?
• A. Gravida 2, para 0
• B. Gravida 1, para 0
• C. Gravida 2, para 1
• D. Gravida 1, para 1
Correct Answer: A — Gravida 2, para 0
Rationale: This is the client's second pregnancy (gravida 2). The spontaneous abortion occurred at 3
months (12 weeks), so she is para 0 because parity cannot be increased unless delivery occurs at 20
weeks of gestation or beyond.
Q6. During a prenatal visit, the nurse discusses with a client the effects of smoking on the fetus. When
compared with nonsmokers, mothers who smoke during pregnancy tend to produce infants who have:
• A. Higher birth weights
• B. Lower birth weights
