Hesi Maternity OB Exam Version 1, 2 & 3 — Maternal-
Newborn Practice Exams (2026 Aligned) Actual Exam
2026/2027 | Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
---
# VERSION 1
## Antepartum Care and Maternal-Fetal Assessment — Prenatal Visits, Screening, and Fetal
Well-Being
Q1: A client's last menstrual period began on March 15. Using Naegele's rule, what expected
due date should the nurse document?
A. December 8
B. December 22 [CORRECT]
C. December 29
D. January 5
Correct Answer: B
Rationale: The best answer follows Naegele's rule — subtract three months from the LMP
and add seven days — which turns March 15 into December 22. This matches the standard
calculation taught in prenatal assessment.
Q2: At her first prenatal visit, a client is currently pregnant. She previously delivered twins at
34 weeks (both living) and has a 3-year-old born at 39 weeks. How should the nurse
document her GTPAL?
A. 3-1-1-0-2 [CORRECT]
B. 3-2-0-0-3
C. 2-1-1-0-2
D. 3-1-1-1-2
Correct Answer: A
Rationale: This choice is correct because the twin pregnancy counts once as preterm but
twice as living children, the 39-week birth counts as term, and the current pregnancy makes
gravida 3. This matches the principle that GTPAL counts pregnancies, not individual infants.
Q3: During a prenatal teaching session, the nurse is reviewing signs of pregnancy with a
client. Which finding is classified as a positive sign of pregnancy?
A. Quickening felt at 19 weeks
B. Chadwick's sign on examination
C. A positive home urine pregnancy test
D. Fetal parts visualized on ultrasound [CORRECT]
Correct Answer: D
,Rationale: The best answer is ultrasound visualization of the fetus, because positive signs
are direct evidence of the fetus itself and cannot be caused by any other condition. The
other findings can have nonpregnancy explanations.
Q4: A client at 30 weeks says her baby "seems quieter at night" and asks how to monitor
fetal movement at home. Which instruction is best?
A. "The baby should move every single hour without exception."
B. "Count until you feel 10 movements; they should occur within 2 hours." [CORRECT]
C. "Only count movements that occur during daylight hours."
D. "Movement normally decreases as the due date approaches."
Correct Answer: B
Rationale: This choice is correct because 10 movements within 2 hours is the reassuring
benchmark, and any less should be reported. It also avoids reinforcing the dangerous belief
that movement naturally slows near term.
Q5: A nonstress test is performed on a client at 34 weeks. The tracing shows two
accelerations of 20 bpm above baseline, each lasting 20 seconds, within 20 minutes. How
should the nurse interpret this result?
A. Nonreactive and requiring repeat tomorrow
B. Suspicious for fetal anemia
C. Reactive, indicating fetal well-being [CORRECT]
D. Suggestive of cord compression
Correct Answer: C
Rationale: The best answer is a reactive tracing, because two qualifying accelerations within
20 minutes after 32 weeks indicate a well-oxygenated fetal autonomic system. This aligns
with standard NST interpretation criteria.
Q6: A nurse measures a client's fundal height at a 20-week prenatal visit. Where should the
top of the fundus be palpated?
A. At the xiphoid process
B. Midway between symphysis and umbilicus
C. Just above the symphysis pubis
D. At the level of the umbilicus [CORRECT]
Correct Answer: D
Rationale: This choice is correct because the fundus reaches the umbilicus at about 20
weeks, then rises roughly 1 cm per week until term. This matches the principle of
predictable fundal height growth across pregnancy.
Q7: At a 28-week visit, which client report should the nurse escalate to the provider
immediately?
A. "My ankles swell by the end of the day."
B. "I have a bad headache and saw dark spots in my vision this morning." [CORRECT]
C. "I urinate more often than before pregnancy."
D. "I felt tightening in my belly after walking."
Correct Answer: B
,Rationale: The best answer is headache with visual changes, because these are classic
warning signs of worsening preeclampsia after 20 weeks and demand immediate evaluation.
The other symptoms are common, expected discomforts of the second and third trimesters.
Q8: A client with a prepregnancy BMI of 23 asks how much total weight she should gain
during this pregnancy. Which answer is accurate?
A. 15–20 pounds
B. 20–25 pounds
C. 25–35 pounds [CORRECT]
D. 35–45 pounds
Correct Answer: C
Rationale: This choice is correct because a normal BMI carries a recommended total gain of
25–35 pounds, which supports fetal growth without increasing complications. The narrower
or wider ranges apply to other BMI categories.
Q9: Review this prenatal lab summary from a 12-week visit:
| Test | Result |
|---|---|
| Blood type | O positive |
| Antibody screen | Negative |
| Rubella titer | Nonimmune |
| HBsAg | Negative |
| Hemoglobin | 11.2 g/dL |
Which action should the nurse anticipate?
A. Repeat the rubella titer in 6 weeks
B. Administer the MMR vaccine at the next visit
C. Plan rubella immunization in the postpartum period [CORRECT]
D. Order an additional hemoglobin check at 20 weeks
Correct Answer: C
Rationale: The best answer is postpartum immunization, because the rubella vaccine is live
and cannot be given during pregnancy, but it is safely administered after birth with
breastfeeding continuing as normal. The remaining labs are acceptable for pregnancy.
Q10: A primigravida at 14 weeks is upset that she has not felt the baby move yet. What is
the nurse's best response?
A. "First-time mothers usually feel movement between 18 and 20 weeks." [CORRECT]
B. "You should be feeling movement by now; we'll check today."
C. "Movement usually begins after 24 weeks in a first pregnancy."
D. "Not feeling movement this early is a danger sign we must evaluate."
Correct Answer: A
Rationale: This choice is correct because quickening in a first pregnancy is typically
appreciated at 18–20 weeks, so 14 weeks is too early for concern. This reassures the client
with an accurate timeline rather than alarm.
## Intrapartum Care and Labor Management — Labor Progress, Fetal Monitoring, and Birth
, Q11: A client at term reports contractions that have grown stronger, longer, and closer
together over 3 hours, including while she walks. Which finding confirms true labor?
A. Discomfort that improves with position changes
B. Contractions felt mainly in the lower abdomen
C. Progressive cervical dilation and effacement [CORRECT]
D. Irregular contractions lasting 30 seconds or less
Correct Answer: C
Rationale: The best answer is progressive cervical change, because true labor is defined by
dilation and effacement that continue regardless of activity or rest. The other findings
describe Braxton Hicks or false labor patterns.
Q12: During an oxytocin induction, the monitor shows late decelerations with each
contraction. What is the nurse's first action?
A. Increase the oxytocin rate slightly
B. Discontinue the oxytocin infusion [CORRECT]
C. Offer an oral analgesic
D. Position the client flat on her back
Correct Answer: B
Rationale: This choice is correct because late decelerations reflect uteroplacental
insufficiency, and the oxytocin is the most likely contributing factor the nurse can remove
immediately. Repositioning and oxygen follow as additional interventions.
Q13: A laboring client's fetal monitor shows abrupt, V-shaped decelerations beginning and
ending suddenly. The nurse recognizes cord compression and anticipates which first
intervention?
A. Change the mother's position to relieve cord pressure [CORRECT]
B. Begin an amnioinfusion immediately
C. Increase the rate of the oxytocin drip
D. Apply oxygen at 2 L by nasal cannula
Correct Answer: A
Rationale: This aligns with the principle that simple positional change is the first response to
variable decelerations, with amnioinfusion reserved for persistent or recurrent patterns.
Low-flow oxygen would not be the priority here.
Q14: During pushing in the second stage, the nurse notes early decelerations mirroring the
contractions. The student nurse asks what causes this pattern. The correct explanation is:
A. Compression of the umbilical cord
B. Reduced placental blood flow
C. Maternal repositioning during contractions
D. Compression of the fetal head [CORRECT]
Correct Answer: D
Rationale: This choice is correct because early decelerations result from vagal stimulation
caused by head compression and are expected, benign findings during active pushing. This
matches the pattern's mirror-image timing with contractions.
Newborn Practice Exams (2026 Aligned) Actual Exam
2026/2027 | Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
---
# VERSION 1
## Antepartum Care and Maternal-Fetal Assessment — Prenatal Visits, Screening, and Fetal
Well-Being
Q1: A client's last menstrual period began on March 15. Using Naegele's rule, what expected
due date should the nurse document?
A. December 8
B. December 22 [CORRECT]
C. December 29
D. January 5
Correct Answer: B
Rationale: The best answer follows Naegele's rule — subtract three months from the LMP
and add seven days — which turns March 15 into December 22. This matches the standard
calculation taught in prenatal assessment.
Q2: At her first prenatal visit, a client is currently pregnant. She previously delivered twins at
34 weeks (both living) and has a 3-year-old born at 39 weeks. How should the nurse
document her GTPAL?
A. 3-1-1-0-2 [CORRECT]
B. 3-2-0-0-3
C. 2-1-1-0-2
D. 3-1-1-1-2
Correct Answer: A
Rationale: This choice is correct because the twin pregnancy counts once as preterm but
twice as living children, the 39-week birth counts as term, and the current pregnancy makes
gravida 3. This matches the principle that GTPAL counts pregnancies, not individual infants.
Q3: During a prenatal teaching session, the nurse is reviewing signs of pregnancy with a
client. Which finding is classified as a positive sign of pregnancy?
A. Quickening felt at 19 weeks
B. Chadwick's sign on examination
C. A positive home urine pregnancy test
D. Fetal parts visualized on ultrasound [CORRECT]
Correct Answer: D
,Rationale: The best answer is ultrasound visualization of the fetus, because positive signs
are direct evidence of the fetus itself and cannot be caused by any other condition. The
other findings can have nonpregnancy explanations.
Q4: A client at 30 weeks says her baby "seems quieter at night" and asks how to monitor
fetal movement at home. Which instruction is best?
A. "The baby should move every single hour without exception."
B. "Count until you feel 10 movements; they should occur within 2 hours." [CORRECT]
C. "Only count movements that occur during daylight hours."
D. "Movement normally decreases as the due date approaches."
Correct Answer: B
Rationale: This choice is correct because 10 movements within 2 hours is the reassuring
benchmark, and any less should be reported. It also avoids reinforcing the dangerous belief
that movement naturally slows near term.
Q5: A nonstress test is performed on a client at 34 weeks. The tracing shows two
accelerations of 20 bpm above baseline, each lasting 20 seconds, within 20 minutes. How
should the nurse interpret this result?
A. Nonreactive and requiring repeat tomorrow
B. Suspicious for fetal anemia
C. Reactive, indicating fetal well-being [CORRECT]
D. Suggestive of cord compression
Correct Answer: C
Rationale: The best answer is a reactive tracing, because two qualifying accelerations within
20 minutes after 32 weeks indicate a well-oxygenated fetal autonomic system. This aligns
with standard NST interpretation criteria.
Q6: A nurse measures a client's fundal height at a 20-week prenatal visit. Where should the
top of the fundus be palpated?
A. At the xiphoid process
B. Midway between symphysis and umbilicus
C. Just above the symphysis pubis
D. At the level of the umbilicus [CORRECT]
Correct Answer: D
Rationale: This choice is correct because the fundus reaches the umbilicus at about 20
weeks, then rises roughly 1 cm per week until term. This matches the principle of
predictable fundal height growth across pregnancy.
Q7: At a 28-week visit, which client report should the nurse escalate to the provider
immediately?
A. "My ankles swell by the end of the day."
B. "I have a bad headache and saw dark spots in my vision this morning." [CORRECT]
C. "I urinate more often than before pregnancy."
D. "I felt tightening in my belly after walking."
Correct Answer: B
,Rationale: The best answer is headache with visual changes, because these are classic
warning signs of worsening preeclampsia after 20 weeks and demand immediate evaluation.
The other symptoms are common, expected discomforts of the second and third trimesters.
Q8: A client with a prepregnancy BMI of 23 asks how much total weight she should gain
during this pregnancy. Which answer is accurate?
A. 15–20 pounds
B. 20–25 pounds
C. 25–35 pounds [CORRECT]
D. 35–45 pounds
Correct Answer: C
Rationale: This choice is correct because a normal BMI carries a recommended total gain of
25–35 pounds, which supports fetal growth without increasing complications. The narrower
or wider ranges apply to other BMI categories.
Q9: Review this prenatal lab summary from a 12-week visit:
| Test | Result |
|---|---|
| Blood type | O positive |
| Antibody screen | Negative |
| Rubella titer | Nonimmune |
| HBsAg | Negative |
| Hemoglobin | 11.2 g/dL |
Which action should the nurse anticipate?
A. Repeat the rubella titer in 6 weeks
B. Administer the MMR vaccine at the next visit
C. Plan rubella immunization in the postpartum period [CORRECT]
D. Order an additional hemoglobin check at 20 weeks
Correct Answer: C
Rationale: The best answer is postpartum immunization, because the rubella vaccine is live
and cannot be given during pregnancy, but it is safely administered after birth with
breastfeeding continuing as normal. The remaining labs are acceptable for pregnancy.
Q10: A primigravida at 14 weeks is upset that she has not felt the baby move yet. What is
the nurse's best response?
A. "First-time mothers usually feel movement between 18 and 20 weeks." [CORRECT]
B. "You should be feeling movement by now; we'll check today."
C. "Movement usually begins after 24 weeks in a first pregnancy."
D. "Not feeling movement this early is a danger sign we must evaluate."
Correct Answer: A
Rationale: This choice is correct because quickening in a first pregnancy is typically
appreciated at 18–20 weeks, so 14 weeks is too early for concern. This reassures the client
with an accurate timeline rather than alarm.
## Intrapartum Care and Labor Management — Labor Progress, Fetal Monitoring, and Birth
, Q11: A client at term reports contractions that have grown stronger, longer, and closer
together over 3 hours, including while she walks. Which finding confirms true labor?
A. Discomfort that improves with position changes
B. Contractions felt mainly in the lower abdomen
C. Progressive cervical dilation and effacement [CORRECT]
D. Irregular contractions lasting 30 seconds or less
Correct Answer: C
Rationale: The best answer is progressive cervical change, because true labor is defined by
dilation and effacement that continue regardless of activity or rest. The other findings
describe Braxton Hicks or false labor patterns.
Q12: During an oxytocin induction, the monitor shows late decelerations with each
contraction. What is the nurse's first action?
A. Increase the oxytocin rate slightly
B. Discontinue the oxytocin infusion [CORRECT]
C. Offer an oral analgesic
D. Position the client flat on her back
Correct Answer: B
Rationale: This choice is correct because late decelerations reflect uteroplacental
insufficiency, and the oxytocin is the most likely contributing factor the nurse can remove
immediately. Repositioning and oxygen follow as additional interventions.
Q13: A laboring client's fetal monitor shows abrupt, V-shaped decelerations beginning and
ending suddenly. The nurse recognizes cord compression and anticipates which first
intervention?
A. Change the mother's position to relieve cord pressure [CORRECT]
B. Begin an amnioinfusion immediately
C. Increase the rate of the oxytocin drip
D. Apply oxygen at 2 L by nasal cannula
Correct Answer: A
Rationale: This aligns with the principle that simple positional change is the first response to
variable decelerations, with amnioinfusion reserved for persistent or recurrent patterns.
Low-flow oxygen would not be the priority here.
Q14: During pushing in the second stage, the nurse notes early decelerations mirroring the
contractions. The student nurse asks what causes this pattern. The correct explanation is:
A. Compression of the umbilical cord
B. Reduced placental blood flow
C. Maternal repositioning during contractions
D. Compression of the fetal head [CORRECT]
Correct Answer: D
Rationale: This choice is correct because early decelerations result from vagal stimulation
caused by head compression and are expected, benign findings during active pushing. This
matches the pattern's mirror-image timing with contractions.
