HESI Maternity OB Exam Versions 1, 2, and 3 |
Actual Exams with Verified Correct Answers |
Each Version Contains 55 Questions |
2025/2026 Edition
Section 1: Antepartum Care and Prenatal Assessment (Q1–Q30)
1. A pregnant client at 32 weeks gestation reports feeling dizzy and lightheaded
when lying on her back. Which action should the nurse take first?
A. Assist the client to a left lateral position
B. Notify the healthcare provider immediately
C. Obtain a blood pressure reading in the supine position
D. Instruct the client to remain on her back for 5 minutes
Answer: A
Rationale: Supine hypotensive syndrome occurs when the gravid uterus
compresses the inferior vena cava, reducing venous return. Repositioning to the
left lateral position relieves the pressure and restores cardiac output. Notifying
the provider is unnecessary before attempting repositioning.
2. A client at 10 weeks gestation reports nausea and vomiting. Which finding
requires immediate follow-up?
A. Nausea with vomiting once daily
B. Weight loss of 1 kg since conception
C. Vomiting 5–6 times per day with inability to keep fluids down
D. Breast tenderness and urinary frequency
Answer: C
Rationale: Hyperemesis gravidarum is characterized by severe, persistent
vomiting with dehydration and electrolyte imbalances. Vomiting once daily, mild
weight loss, and breast tenderness are expected findings in early pregnancy.
3. A nurse is calculating the GTPAL for a client who has been pregnant 4 times,
has 2 living children, had 1 preterm birth at 34 weeks, and 1 miscarriage at 10
weeks. What is the correct GTPAL?
,A. G4 T1 P1 A1 L2
B. G4 T2 P0 A1 L2
C. G4 T1 P2 A0 L2
D. G3 T1 P1 A1 L2
Answer: A
Rationale: GTPAL: Gravida (4 total pregnancies), Term (1 term birth), Preterm (1
preterm birth at 34 weeks), Abortions (1 miscarriage), Living children (2). The
miscarriage is counted as an abortion.
4. A client at 28 weeks gestation with a history of systemic lupus erythematosus
presents with hypertension. Which condition should the nurse suspect?
A. Gestational hypertension
B. Preeclampsia superimposed on chronic hypertension
C. Chronic hypertension
D. White coat hypertension
Answer: B
Rationale: Preeclampsia superimposed on chronic hypertension is characterized
by worsening hypertension and new-onset proteinuria or organ dysfunction after
20 weeks in a client with pre-existing hypertension.
5. A pregnant client at 36 weeks gestation reports a sudden gush of fluid from
the vagina. Which action should the nurse take first?
A. Perform a sterile vaginal exam
B. Assess the fetal heart rate
C. Test the fluid with nitrazine paper
D. Prepare for immediate delivery
Answer: B
Rationale: Rupture of membranes (ROM) requires immediate assessment of fetal
well-being. The priority is to assess the fetal heart rate for signs of distress or cord
prolapse. A sterile vaginal exam is contraindicated until fetal status is confirmed.
6. A nurse is teaching a pregnant client about fetal movement counting. Which
instruction is most appropriate?
A. "Count fetal movements for 2 hours after breakfast."
B. "You should feel at least 10 movements in 2 hours."
,C. "Count movements only when the baby is active."
D. "Fetal movement counting is only necessary after 36 weeks."
Answer: B
Rationale: The standard fetal movement count (kick count) recommends that the
client feel at least 10 movements within a 2-hour period. Counting should be
done at the same time each day, typically after meals when the fetus is most
active.
7. A client at 14 weeks gestation complains of a dull pain in the right lower
quadrant. Which finding is most concerning?
A. Mild abdominal discomfort with no other symptoms
B. Pain with rebound tenderness and fever
C. Round ligament pain with position changes
D. Mild nausea
Answer: B
Rationale: Right lower quadrant pain with rebound tenderness and fever suggests
appendicitis, which is a surgical emergency during pregnancy. Round ligament
pain is typically sharp and associated with movement.
8. A nurse is assessing a pregnant client with hyperemesis gravidarum. Which
laboratory value requires immediate intervention?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Hemoglobin 11.5 g/dL
D. BUN 12 mg/dL
Answer: B
Rationale: Hypokalemia (potassium <3.0 mEq/L) can cause cardiac dysrhythmias
and requires immediate intervention. Normal potassium is 3.5–5.0 mEq/L.
9. A client at 38 weeks gestation who works as a secretary reports swelling in
her feet. Which instruction is most appropriate?
A. "Elevate your feet several times during the day."
B. "Reduce your fluid intake to decrease swelling."
C. "This is a sign of preeclampsia and requires immediate evaluation."
D. "Swelling in the feet is never normal during pregnancy."
, Answer: A
Rationale: Dependent edema is a common finding in late pregnancy due to
venous stasis from the gravid uterus. Elevating the feet promotes venous return.
Reducing fluids is not recommended, and mild foot swelling alone does not
indicate preeclampsia.
10. A pregnant client is prescribed folic acid. Which statement indicates correct
understanding?
A. "I should take folic acid only during the first trimester."
B. "Folic acid helps prevent neural tube defects."
C. "I should avoid foods fortified with folic acid."
D. "Folic acid is only needed if I have a family history of birth defects."
Answer: B
Rationale: Folic acid is essential for preventing neural tube defects and should be
taken before conception and throughout pregnancy. All women of childbearing
age should consume adequate folic acid.
11. A nurse is assessing a client at 34 weeks gestation who reports painless
vaginal bleeding. Which action should the nurse take first?
A. Perform a sterile vaginal exam
B. Assess fetal heart rate and maternal vital signs
C. Prepare for emergency cesarean section
D. Administer tocolytic therapy
Answer: B
Rationale: Painless vaginal bleeding in the third trimester suggests placenta
previa. Vaginal exam is contraindicated because it can cause severe hemorrhage.
The priority is fetal and maternal assessment.
12. A client at 20 weeks gestation is scheduled for a maternal serum alpha-
fetoprotein (MSAFP) test. Which condition does this test screen for?
A. Gestational diabetes
B. Neural tube defects
C. Group B streptococcus
D. Preeclampsia
Actual Exams with Verified Correct Answers |
Each Version Contains 55 Questions |
2025/2026 Edition
Section 1: Antepartum Care and Prenatal Assessment (Q1–Q30)
1. A pregnant client at 32 weeks gestation reports feeling dizzy and lightheaded
when lying on her back. Which action should the nurse take first?
A. Assist the client to a left lateral position
B. Notify the healthcare provider immediately
C. Obtain a blood pressure reading in the supine position
D. Instruct the client to remain on her back for 5 minutes
Answer: A
Rationale: Supine hypotensive syndrome occurs when the gravid uterus
compresses the inferior vena cava, reducing venous return. Repositioning to the
left lateral position relieves the pressure and restores cardiac output. Notifying
the provider is unnecessary before attempting repositioning.
2. A client at 10 weeks gestation reports nausea and vomiting. Which finding
requires immediate follow-up?
A. Nausea with vomiting once daily
B. Weight loss of 1 kg since conception
C. Vomiting 5–6 times per day with inability to keep fluids down
D. Breast tenderness and urinary frequency
Answer: C
Rationale: Hyperemesis gravidarum is characterized by severe, persistent
vomiting with dehydration and electrolyte imbalances. Vomiting once daily, mild
weight loss, and breast tenderness are expected findings in early pregnancy.
3. A nurse is calculating the GTPAL for a client who has been pregnant 4 times,
has 2 living children, had 1 preterm birth at 34 weeks, and 1 miscarriage at 10
weeks. What is the correct GTPAL?
,A. G4 T1 P1 A1 L2
B. G4 T2 P0 A1 L2
C. G4 T1 P2 A0 L2
D. G3 T1 P1 A1 L2
Answer: A
Rationale: GTPAL: Gravida (4 total pregnancies), Term (1 term birth), Preterm (1
preterm birth at 34 weeks), Abortions (1 miscarriage), Living children (2). The
miscarriage is counted as an abortion.
4. A client at 28 weeks gestation with a history of systemic lupus erythematosus
presents with hypertension. Which condition should the nurse suspect?
A. Gestational hypertension
B. Preeclampsia superimposed on chronic hypertension
C. Chronic hypertension
D. White coat hypertension
Answer: B
Rationale: Preeclampsia superimposed on chronic hypertension is characterized
by worsening hypertension and new-onset proteinuria or organ dysfunction after
20 weeks in a client with pre-existing hypertension.
5. A pregnant client at 36 weeks gestation reports a sudden gush of fluid from
the vagina. Which action should the nurse take first?
A. Perform a sterile vaginal exam
B. Assess the fetal heart rate
C. Test the fluid with nitrazine paper
D. Prepare for immediate delivery
Answer: B
Rationale: Rupture of membranes (ROM) requires immediate assessment of fetal
well-being. The priority is to assess the fetal heart rate for signs of distress or cord
prolapse. A sterile vaginal exam is contraindicated until fetal status is confirmed.
6. A nurse is teaching a pregnant client about fetal movement counting. Which
instruction is most appropriate?
A. "Count fetal movements for 2 hours after breakfast."
B. "You should feel at least 10 movements in 2 hours."
,C. "Count movements only when the baby is active."
D. "Fetal movement counting is only necessary after 36 weeks."
Answer: B
Rationale: The standard fetal movement count (kick count) recommends that the
client feel at least 10 movements within a 2-hour period. Counting should be
done at the same time each day, typically after meals when the fetus is most
active.
7. A client at 14 weeks gestation complains of a dull pain in the right lower
quadrant. Which finding is most concerning?
A. Mild abdominal discomfort with no other symptoms
B. Pain with rebound tenderness and fever
C. Round ligament pain with position changes
D. Mild nausea
Answer: B
Rationale: Right lower quadrant pain with rebound tenderness and fever suggests
appendicitis, which is a surgical emergency during pregnancy. Round ligament
pain is typically sharp and associated with movement.
8. A nurse is assessing a pregnant client with hyperemesis gravidarum. Which
laboratory value requires immediate intervention?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Hemoglobin 11.5 g/dL
D. BUN 12 mg/dL
Answer: B
Rationale: Hypokalemia (potassium <3.0 mEq/L) can cause cardiac dysrhythmias
and requires immediate intervention. Normal potassium is 3.5–5.0 mEq/L.
9. A client at 38 weeks gestation who works as a secretary reports swelling in
her feet. Which instruction is most appropriate?
A. "Elevate your feet several times during the day."
B. "Reduce your fluid intake to decrease swelling."
C. "This is a sign of preeclampsia and requires immediate evaluation."
D. "Swelling in the feet is never normal during pregnancy."
, Answer: A
Rationale: Dependent edema is a common finding in late pregnancy due to
venous stasis from the gravid uterus. Elevating the feet promotes venous return.
Reducing fluids is not recommended, and mild foot swelling alone does not
indicate preeclampsia.
10. A pregnant client is prescribed folic acid. Which statement indicates correct
understanding?
A. "I should take folic acid only during the first trimester."
B. "Folic acid helps prevent neural tube defects."
C. "I should avoid foods fortified with folic acid."
D. "Folic acid is only needed if I have a family history of birth defects."
Answer: B
Rationale: Folic acid is essential for preventing neural tube defects and should be
taken before conception and throughout pregnancy. All women of childbearing
age should consume adequate folic acid.
11. A nurse is assessing a client at 34 weeks gestation who reports painless
vaginal bleeding. Which action should the nurse take first?
A. Perform a sterile vaginal exam
B. Assess fetal heart rate and maternal vital signs
C. Prepare for emergency cesarean section
D. Administer tocolytic therapy
Answer: B
Rationale: Painless vaginal bleeding in the third trimester suggests placenta
previa. Vaginal exam is contraindicated because it can cause severe hemorrhage.
The priority is fetal and maternal assessment.
12. A client at 20 weeks gestation is scheduled for a maternal serum alpha-
fetoprotein (MSAFP) test. Which condition does this test screen for?
A. Gestational diabetes
B. Neural tube defects
C. Group B streptococcus
D. Preeclampsia
