2026 HESI MATERNITY OB VERSION 1,2 AND 3|MATERNITY OB
VERSION 3 ACTUAL EXAM EACH EXAM CONTAINS 55 QUESTIONS
AND CORRECT ANSWERS |A+ GRADE
1|Page
,2026 HESI MATERNITY OB VERSION 1, 2 AND 3 | MATERNITY OB VERSION 3 ACTUAL EXAM
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
SECTION 1: Antepartum Care and Prenatal Assessment
Questions 1–25
Q1. A primigravida at 10 weeks' gestation asks the nurse when she should expect to feel fetal
movement for the first time. Which response by the nurse is most accurate?
A. "You should feel movement by 12 weeks."
B. "Quickening is typically felt between 16 and 20 weeks."
C. "Fetal movement is usually felt after 24 weeks in a first pregnancy."
D. "You will feel movement immediately after conception."
Correct Answer: B. "Quickening is typically felt between 16 and 20 weeks."
Rationale: Quickening, the first perception of fetal movement, is typically experienced by
primigravidas between 16 and 20 weeks' gestation. Multiparous women may feel it earlier, around
14 to 16 weeks. Feeling movement at 12 weeks or immediately after conception is not
physiologically possible, and 24 weeks is later than the expected range for a first pregnancy.
Q2. A pregnant client at 28 weeks' gestation is scheduled for a glucose challenge test. She asks
the nurse why this test is necessary. Which explanation by the nurse is best?
A. "It determines if you have anemia."
B. "It screens for gestational diabetes, which can develop in pregnancy."
C. "It checks your baby's lung maturity."
D. "It measures your thyroid function."
Correct Answer: B. "It screens for gestational diabetes, which can develop in pregnancy."
Rationale: The glucose challenge test is a screening tool for gestational diabetes mellitus (GDM),
typically performed between 24 and 28 weeks' gestation. It does not assess anemia, fetal lung
maturity, or thyroid function. Gestational diabetes can lead to macrosomia, shoulder dystocia, and
neonatal hypoglycemia if undiagnosed.
2|Page
, Q3. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period began on March 10, 2026. Using Naegele's rule, what is the EDD?
A. December 3, 2026
B. December 17, 2026
C. January 3, 2027
D. December 10, 2026
Correct Answer: B. December 17, 2026
Rationale: Naegele's rule calculates the EDD by subtracting 3 months from the first day of the
last menstrual period and adding 7 days, then adding 1 year. March 10 minus 3 months is December
10; adding 7 days yields December 17, 2026. This method assumes a 28-day cycle with ovulation on
day 14.
Q4. A client at 36 weeks' gestation presents with a blood pressure of 158/102 mm Hg, 3+
proteinuria, and reports of severe headache and visual disturbances. Which condition should the
nurse suspect?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia with severe features
D. Eclampsia
Correct Answer: C. Preeclampsia with severe features
Rationale: Preeclampsia with severe features is characterized by blood pressure ≥160/110 mm
Hg, proteinuria, and symptoms such as severe headache and visual disturbances. Eclampsia involves
seizures, which are not present here. Chronic hypertension predates pregnancy, and gestational
hypertension lacks proteinuria and severe features.
Q5. A nurse is reviewing the prenatal record of a client at 16 weeks' gestation. Which fundal
height finding would the nurse expect?
A. Fundus palpable at the symphysis pubis
B. Fundus midway between symphysis pubis and umbilicus
C. Fundus at the umbilicus
D. Fundus 3 cm above the umbilicus
Correct Answer: B. Fundus midway between symphysis pubis and umbilicus
Rationale: At 16 weeks' gestation, the fundus is typically located midway between the symphysis
pubis and the umbilicus. At 12 weeks, the fundus is at the symphysis pubis; at 20 weeks, it reaches
the umbilicus; and at 36 weeks, it is near the xiphoid process.
Q6. A pregnant client asks the nurse about the purpose of alpha-fetoprotein (AFP) testing. Which
statement by the nurse is correct?
3|Page
, A. "It detects fetal chromosomal abnormalities with 100% accuracy."
B. "It screens for neural tube defects and abdominal wall defects."
C. "It determines the baby's gender."
D. "It diagnoses cystic fibrosis."
Correct Answer: B. "It screens for neural tube defects and abdominal wall defects."
Rationale: Alpha-fetoprotein is a screening test that can indicate an increased risk of neural tube
defects (e.g., spina bifida, anencephaly) and abdominal wall defects (e.g., omphalocele,
gastroschisis). It is not diagnostic, does not determine gender, and does not diagnose cystic fibrosis.
Q7. A nurse is assessing a client at 32 weeks' gestation who reports occasional episodes of
painless uterine tightening. Which action by the nurse is most appropriate?
A. Notify the provider immediately for preterm labor.
B. Reassure the client that these are likely Braxton Hicks contractions.
C. Administer terbutaline as ordered.
D. Prepare the client for immediate delivery.
Correct Answer: B. Reassure the client that these are likely Braxton Hicks contractions.
Rationale: Braxton Hicks contractions are irregular, painless uterine tightenings that occur
throughout pregnancy and are normal. They do not indicate preterm labor unless they become
regular, painful, or are accompanied by cervical changes. Immediate intervention is not warranted
for occasional painless tightening.
Q8. A client at 12 weeks' gestation reports nausea and vomiting. Which dietary recommendation
by the nurse is most appropriate?
A. "Eat three large meals per day."
B. "Drink fluids only with meals."
C. "Eat small, frequent meals and dry crackers before rising."
D. "Avoid all carbohydrates."
Correct Answer: C. "Eat small, frequent meals and dry crackers before rising."
Rationale: Small, frequent meals and dry crackers before rising help manage morning sickness by
preventing an empty stomach and stabilizing blood glucose. Large meals can worsen nausea, fluids
with meals can increase gastric distention, and carbohydrates are often well tolerated and should
not be eliminated.
Q9. A nurse is performing a prenatal assessment on a client at 20 weeks' gestation. Which
finding should the nurse report to the provider immediately?
A. Fetal heart rate of 140 beats per minute
B. Fundal height of 20 cm
C. Sudden gush of fluid from the vagina
D. Mild ankle edema
4|Page
VERSION 3 ACTUAL EXAM EACH EXAM CONTAINS 55 QUESTIONS
AND CORRECT ANSWERS |A+ GRADE
1|Page
,2026 HESI MATERNITY OB VERSION 1, 2 AND 3 | MATERNITY OB VERSION 3 ACTUAL EXAM
2026/2027 Examination
Total Questions: 200
Instructions:
• Answer all questions.
• Select the single best answer.
• Each question has four answer choices: A, B, C, and D.
• Select only ONE answer for each question.
SECTION 1: Antepartum Care and Prenatal Assessment
Questions 1–25
Q1. A primigravida at 10 weeks' gestation asks the nurse when she should expect to feel fetal
movement for the first time. Which response by the nurse is most accurate?
A. "You should feel movement by 12 weeks."
B. "Quickening is typically felt between 16 and 20 weeks."
C. "Fetal movement is usually felt after 24 weeks in a first pregnancy."
D. "You will feel movement immediately after conception."
Correct Answer: B. "Quickening is typically felt between 16 and 20 weeks."
Rationale: Quickening, the first perception of fetal movement, is typically experienced by
primigravidas between 16 and 20 weeks' gestation. Multiparous women may feel it earlier, around
14 to 16 weeks. Feeling movement at 12 weeks or immediately after conception is not
physiologically possible, and 24 weeks is later than the expected range for a first pregnancy.
Q2. A pregnant client at 28 weeks' gestation is scheduled for a glucose challenge test. She asks
the nurse why this test is necessary. Which explanation by the nurse is best?
A. "It determines if you have anemia."
B. "It screens for gestational diabetes, which can develop in pregnancy."
C. "It checks your baby's lung maturity."
D. "It measures your thyroid function."
Correct Answer: B. "It screens for gestational diabetes, which can develop in pregnancy."
Rationale: The glucose challenge test is a screening tool for gestational diabetes mellitus (GDM),
typically performed between 24 and 28 weeks' gestation. It does not assess anemia, fetal lung
maturity, or thyroid function. Gestational diabetes can lead to macrosomia, shoulder dystocia, and
neonatal hypoglycemia if undiagnosed.
2|Page
, Q3. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period began on March 10, 2026. Using Naegele's rule, what is the EDD?
A. December 3, 2026
B. December 17, 2026
C. January 3, 2027
D. December 10, 2026
Correct Answer: B. December 17, 2026
Rationale: Naegele's rule calculates the EDD by subtracting 3 months from the first day of the
last menstrual period and adding 7 days, then adding 1 year. March 10 minus 3 months is December
10; adding 7 days yields December 17, 2026. This method assumes a 28-day cycle with ovulation on
day 14.
Q4. A client at 36 weeks' gestation presents with a blood pressure of 158/102 mm Hg, 3+
proteinuria, and reports of severe headache and visual disturbances. Which condition should the
nurse suspect?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia with severe features
D. Eclampsia
Correct Answer: C. Preeclampsia with severe features
Rationale: Preeclampsia with severe features is characterized by blood pressure ≥160/110 mm
Hg, proteinuria, and symptoms such as severe headache and visual disturbances. Eclampsia involves
seizures, which are not present here. Chronic hypertension predates pregnancy, and gestational
hypertension lacks proteinuria and severe features.
Q5. A nurse is reviewing the prenatal record of a client at 16 weeks' gestation. Which fundal
height finding would the nurse expect?
A. Fundus palpable at the symphysis pubis
B. Fundus midway between symphysis pubis and umbilicus
C. Fundus at the umbilicus
D. Fundus 3 cm above the umbilicus
Correct Answer: B. Fundus midway between symphysis pubis and umbilicus
Rationale: At 16 weeks' gestation, the fundus is typically located midway between the symphysis
pubis and the umbilicus. At 12 weeks, the fundus is at the symphysis pubis; at 20 weeks, it reaches
the umbilicus; and at 36 weeks, it is near the xiphoid process.
Q6. A pregnant client asks the nurse about the purpose of alpha-fetoprotein (AFP) testing. Which
statement by the nurse is correct?
3|Page
, A. "It detects fetal chromosomal abnormalities with 100% accuracy."
B. "It screens for neural tube defects and abdominal wall defects."
C. "It determines the baby's gender."
D. "It diagnoses cystic fibrosis."
Correct Answer: B. "It screens for neural tube defects and abdominal wall defects."
Rationale: Alpha-fetoprotein is a screening test that can indicate an increased risk of neural tube
defects (e.g., spina bifida, anencephaly) and abdominal wall defects (e.g., omphalocele,
gastroschisis). It is not diagnostic, does not determine gender, and does not diagnose cystic fibrosis.
Q7. A nurse is assessing a client at 32 weeks' gestation who reports occasional episodes of
painless uterine tightening. Which action by the nurse is most appropriate?
A. Notify the provider immediately for preterm labor.
B. Reassure the client that these are likely Braxton Hicks contractions.
C. Administer terbutaline as ordered.
D. Prepare the client for immediate delivery.
Correct Answer: B. Reassure the client that these are likely Braxton Hicks contractions.
Rationale: Braxton Hicks contractions are irregular, painless uterine tightenings that occur
throughout pregnancy and are normal. They do not indicate preterm labor unless they become
regular, painful, or are accompanied by cervical changes. Immediate intervention is not warranted
for occasional painless tightening.
Q8. A client at 12 weeks' gestation reports nausea and vomiting. Which dietary recommendation
by the nurse is most appropriate?
A. "Eat three large meals per day."
B. "Drink fluids only with meals."
C. "Eat small, frequent meals and dry crackers before rising."
D. "Avoid all carbohydrates."
Correct Answer: C. "Eat small, frequent meals and dry crackers before rising."
Rationale: Small, frequent meals and dry crackers before rising help manage morning sickness by
preventing an empty stomach and stabilizing blood glucose. Large meals can worsen nausea, fluids
with meals can increase gastric distention, and carbohydrates are often well tolerated and should
not be eliminated.
Q9. A nurse is performing a prenatal assessment on a client at 20 weeks' gestation. Which
finding should the nurse report to the provider immediately?
A. Fetal heart rate of 140 beats per minute
B. Fundal height of 20 cm
C. Sudden gush of fluid from the vagina
D. Mild ankle edema
4|Page
