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OB/Maternity HESI Exam Prep Guide 2026–2027 – Actual Exam Questions with Complete Solutions

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This document is a comprehensive OB/Maternity HESI exam preparation guide containing actual-style exam questions with detailed rationales and step-by-step clinical explanations. It covers the full obstetrical continuum, including antepartum care, intrapartum and fetal monitoring, pregnancy complications, postpartum nursing, and newborn assessment, aligned with current HESI testing standards. The guide is designed as a pro-level review resource for nursing students preparing for HESI maternity exams, final exams, and nursing school assessments.

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December 15, 2025
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Written in
2025/2026
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OB/MATERNITY HESI ASSIGNMENT
EXAM: ACTUAL EXAM QUESTIONS
WITH COMPLETE SOLUTION GUIDE
(2026/2027)
Authored By: Senior Educational Content Developer & Nursing Curriculum Specialist Verified
By: Clinical Nursing Board Review Panel Version: Pro-Level Certified Guide (Latest Clinical
Protocols)


TABLE OF CONTENTS
1.​ Front Matter
○​ Clinical Glossary: High-Yield Terminology
○​ Essential Formula Sheet & Calculation Protocols
○​ Topic Index & Concept Map: The Obstetrical Continuum
2.​ Section I: Antepartum & Prenatal Care (Questions 1–12)
3.​ Section II: Intrapartum & Fetal Monitoring (Questions 13–25)
4.​ Section III: Complications of Pregnancy (Questions 26–37)
5.​ Section IV: Postpartum Care & Complications (Questions 38–46)
6.​ Section V: Newborn Assessment & Care (Questions 47–55)




FRONT MATTER
Clinical Glossary: High-Yield Terminology

,To facilitate mastery of the HESI Obstetric content, the following glossary provides precise
clinical definitions necessary for deciphering complex question stems. Understanding these
terms prevents misinterpretation of distractors.
Term Clinical Definition HESI Relevance
Gravida The total number of times a Critical for GTPAL calculations.
woman has been pregnant, Often confused with Para.
regardless of the outcome or
duration, including the current
pregnancy.
Para The number of births conducted Determines obstetric history.
after 20 weeks gestation, Twins/multiples count as one
regardless of whether the infant parous event.
was born alive or stillborn.
Fundus The upper, rounded part of the Key assessment point for
uterus. Its height and firmness hemorrhage (boggy vs. firm)
are critical indicators of fetal and fetal growth (cm = weeks).
growth during pregnancy and
uterine involution postpartum.
Lochia Postpartum vaginal discharge Staging is used to identify
consisting of blood, mucus, and infection or delayed involution.
placental tissue. Classified as
Rubra (red, days 1-3), Serosa
(pink/brown, days 4-10), and
Alba (white/yellow, days 11-21).
Acrocyanosis Peripheral blueness of the Distractor for "respiratory
hands and feet in a newborn; distress." Differentiate from
considered a normal finding in central cyanosis.
the first 24-48 hours due to
immature circulation and
vasomotor instability.
Quickening The first perception of fetal A presumptive sign of
movement by the mother, pregnancy. Used to verify
typically occurring between gestational age.
16–20 weeks gestation.
Lightening The descent of the fetal head Indicates impending labor (2
into the pelvis, often resulting in weeks prior in primiparas).
easier breathing for the mother
but increased urinary
frequency.
Effacement The thinning and shortening of Component of the Bishop
the cervix during the first stage Score.
of labor, expressed as a
percentage (0% to 100%).
Station The relationship of the Determines labor progression
presenting fetal part to an and safety for amniotomy.
imaginary line drawn between
the maternal ischial spines (0

, Term Clinical Definition HESI Relevance
station). Above spines is
negative (-); below is positive
(+).
Essential Formula Sheet & Calculation Protocols
A. Naegele’s Rule (Estimated Date of Delivery)

Used to calculate the Estimated Date of Confinement (EDC) or Delivery (EDD) based on the
First Day of the Last Menstrual Period (LMP).
Step Action Example (LMP: Sept 10)
1 Identify First Day of LMP September 10
2 Subtract 3 Months June (9 - 3 = 6)
3 Add 7 Days 17 (10 + 7 = 17)
4 Add 1 Year (if needed) Next Year
Result EDD June 17
**

B. GTPAL System (Obstetric History)

A detailed method for recording pregnancy history that provides a comprehensive risk profile.
Letter Represents Key Calculation Rule
G Gravida Total number of pregnancies
(including current).
T Term Births at 37+ weeks gestation.
P Preterm Births between 20 and 36.6
weeks gestation.
A Abortions Pregnancies ending before 20
weeks (spontaneous or
induced).
L Living Current number of living
children.
Expert Note: Multiple births (twins/triplets) count as 1 for G, T, or P, but as 2 (or more) for L.

C. Magnesium Sulfate Calculations

Critical for Preeclampsia and Preterm Labor management. The therapeutic window is narrow,
requiring precise dosage.
●​ Loading Dose: 4–6 g IV over 15–30 minutes.
●​ Maintenance Dose: 1–3 g/hour via infusion pump.
●​ Therapeutic Serum Range: 4–7 mg/dL.
●​ Toxicity Threshold: > 8 mg/dL (Loss of DTRs often occurs first).

D. APGAR Scoring (Newborn Assessment)

Performed at 1 and 5 minutes of life to assess transition to extrauterine life.
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