HESI OB MATERNITY V1 EXAMINATION
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Comprehensive Obstetric & Newborn Care
Competency Assessment
2026/2027 Academic Year
Elsevier Evolve / Maternal-Child Nursing Standards
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75 Multiple-Choice Questions | Testing Time: 105 Minutes
Computer-Based | Elsevier Evolve Platform | Passing Score: 850 HESI or 75-80%
, HESI OB Maternity V1 Exam | 2026/2027
EXAMINATION INSTRUCTIONS AND SPECIFICATIONS
• Total Questions: 75 multiple-choice questions (MCQ) per HESI OB Maternity V1 specifications
• Format: Single-best-answer MCQ with four options (A, B, C, D); select-all-that-apply (SATA) items
clearly marked
• Testing Time: 105 minutes, computer-based, proctored via Elsevier Evolve platform or institutional
LMS
• Passing Score: 850 HESI score or 75-80% (56-60/75 correct) required for program progression
• Content Distribution: Antepartum Care (20%), Intrapartum Care (27%), Postpartum Care (20%),
Newborn Care (20%), High-Risk Pregnancy & Pharmacology (13%)
Domains Covered:
1. Antepartum Care & Fetal Development (15 questions, 20%)
2. Intrapartum Care & Labor Management (20 questions, 27%)
3. Postpartum Care & Maternal Recovery (15 questions, 20%)
4. Newborn Assessment & Care (15 questions, 20%)
5. High-Risk Pregnancy & Pharmacology (10 questions, 13%)
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EXAMINATION OVERVIEW
Domain Questions Key Topics Weight
Antepartum Care & Fetal 15 Prenatal Assessment, Fetal Growth/Development, 20%
Development Danger Signs, Prenatal Testing, Nutrition,
Discomforts of Pregnancy
Intrapartum Care & Labor 20 Stages of Labor, Fetal Heart Rate Monitoring, 27%
Management Pain Management, Nursing Interventions,
Complications of Labor
Postpartum Care & 15 Uterine Involution, Lochia Assessment, 20%
Maternal Recovery Breastfeeding Support, Postpartum
Complications, Mental Health Screening
Newborn Assessment & 15 APGAR Scoring, Physical Assessment, 20%
Care Thermoregulation, Feeding, Jaundice, Newborn
Screening
High-Risk Pregnancy & 10 Preeclampsia, Gestational Diabetes, Preterm 13%
Pharmacology Labor, Medication Safety, Tocolytics, Magnesium
Sulfate Monitoring
DOMAIN 1: ANTEPARTUM CARE & FETAL DEVELOPMENT
Questions 1–2, 11–23 | Weight: 20%
This domain evaluates competency in prenatal assessment, fetal growth and development across
trimesters, danger signs requiring immediate reporting, prenatal diagnostic testing (amniocentesis, CVS,
MSAFP), nutritional requirements, common discomforts of pregnancy, Rh sensitization, gravida/para
terminology, and gestational age calculation using Naegele's rule.
1. A pregnant client at 28 weeks gestation reports experiencing occasional mild, irregular
uterine contractions that resolve with rest and hydration. What is the most appropriate
nursing response?
A. Instruct the client to go to the hospital immediately for evaluation of preterm labor
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, HESI OB Maternity V1 Exam | 2026/2027
B. Reassure the client that these are likely Braxton Hicks contractions, advise rest and hydration, and
instruct to report if contractions become regular, painful, or increase in frequency
C. Administer a tocolytic medication immediately
D. Schedule an immediate non-stress test
Correct Answer: B
Rationale: Braxton Hicks contractions are normal, irregular, painless uterine contractions that occur
throughout pregnancy and typically resolve with rest and hydration. The appropriate nursing response
is reassurance and education about warning signs of preterm labor (regular contractions, pelvic
pressure, low back pain, change in vaginal discharge). Immediate hospital evaluation (A), tocolytics
(C), or non-stress testing (D) are not indicated for occasional, irregular contractions without other signs
of preterm labor.
2. (SATA) Which findings are considered danger signs in pregnancy that require
immediate reporting to the healthcare provider? (Select All That Apply)
☐ A. Vaginal bleeding
☐ B. Severe headache unrelieved by rest or acetaminophen
☐ C. Mild ankle edema at the end of the day
☐ D. Visual changes such as blurred vision or seeing spots
Correct Answer: A, B, D
Rationale: Danger signs in pregnancy requiring immediate reporting include: vaginal bleeding (A—
may indicate placenta previa, abruption, or miscarriage); severe headache unrelieved by
rest/acetaminophen (B—may indicate preeclampsia); and visual changes (D—may indicate
preeclampsia with cerebral involvement). Mild ankle edema at the end of the day (C) is a common,
normal finding in pregnancy due to increased venous pressure and fluid retention; it becomes
concerning if sudden, severe, or accompanied by facial/hand edema.
11. A 26-year-old primigravida presents for her initial prenatal visit at 10 weeks gestation.
Which assessment finding documented during this visit would the nurse identify as most
critical to evaluate further?
A. Blood pressure of 118/76 mmHg
B. Hemoglobin level of 10.2 g/dL
C. Rubella titer indicating non-immunity
D. Weight gain of 3 pounds since conception
Correct Answer: C
Rationale: Rubella non-immunity is the most critical finding requiring further evaluation and education
at the initial prenatal visit. Congenital rubella syndrome can cause severe fetal anomalies including
deafness, cardiac defects, and intellectual disability, with the highest risk during the first trimester. The
client must be counseled to avoid exposure and receive the MMR vaccine postpartum, as live vaccines
are contraindicated during pregnancy. A hemoglobin of 10.2 g/dL (B) reflects physiologic hemodilution
of pregnancy and is expected. Blood pressure of 118/76 (A) and 3-pound weight gain (D) are within
normal parameters for early pregnancy.
12. During an initial prenatal visit at 8 weeks gestation, the nurse reviews the client's
history. The client reports a previous pregnancy that ended in a spontaneous abortion at 12
weeks, one living child born at 39 weeks, and no other pregnancies. Using the GTPAL
system, how should the nurse document this client's obstetric history?
A. G2 T1 P0 A1 L1
B. G3 T1 P0 A1 L1
C. G3 T0 P1 A1 L1
D. G2 T0 P1 A1 L1
Correct Answer: B
Rationale: The GTPAL system documents: Gravida (total pregnancies), Term births (37+ weeks),
Preterm births (before 37 weeks), Abortions (spontaneous or induced before 20 weeks), and Living
Page 3
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
Comprehensive Obstetric & Newborn Care
Competency Assessment
2026/2027 Academic Year
Elsevier Evolve / Maternal-Child Nursing Standards
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
75 Multiple-Choice Questions | Testing Time: 105 Minutes
Computer-Based | Elsevier Evolve Platform | Passing Score: 850 HESI or 75-80%
, HESI OB Maternity V1 Exam | 2026/2027
EXAMINATION INSTRUCTIONS AND SPECIFICATIONS
• Total Questions: 75 multiple-choice questions (MCQ) per HESI OB Maternity V1 specifications
• Format: Single-best-answer MCQ with four options (A, B, C, D); select-all-that-apply (SATA) items
clearly marked
• Testing Time: 105 minutes, computer-based, proctored via Elsevier Evolve platform or institutional
LMS
• Passing Score: 850 HESI score or 75-80% (56-60/75 correct) required for program progression
• Content Distribution: Antepartum Care (20%), Intrapartum Care (27%), Postpartum Care (20%),
Newborn Care (20%), High-Risk Pregnancy & Pharmacology (13%)
Domains Covered:
1. Antepartum Care & Fetal Development (15 questions, 20%)
2. Intrapartum Care & Labor Management (20 questions, 27%)
3. Postpartum Care & Maternal Recovery (15 questions, 20%)
4. Newborn Assessment & Care (15 questions, 20%)
5. High-Risk Pregnancy & Pharmacology (10 questions, 13%)
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━━━━━━━━━━━━
EXAMINATION OVERVIEW
Domain Questions Key Topics Weight
Antepartum Care & Fetal 15 Prenatal Assessment, Fetal Growth/Development, 20%
Development Danger Signs, Prenatal Testing, Nutrition,
Discomforts of Pregnancy
Intrapartum Care & Labor 20 Stages of Labor, Fetal Heart Rate Monitoring, 27%
Management Pain Management, Nursing Interventions,
Complications of Labor
Postpartum Care & 15 Uterine Involution, Lochia Assessment, 20%
Maternal Recovery Breastfeeding Support, Postpartum
Complications, Mental Health Screening
Newborn Assessment & 15 APGAR Scoring, Physical Assessment, 20%
Care Thermoregulation, Feeding, Jaundice, Newborn
Screening
High-Risk Pregnancy & 10 Preeclampsia, Gestational Diabetes, Preterm 13%
Pharmacology Labor, Medication Safety, Tocolytics, Magnesium
Sulfate Monitoring
DOMAIN 1: ANTEPARTUM CARE & FETAL DEVELOPMENT
Questions 1–2, 11–23 | Weight: 20%
This domain evaluates competency in prenatal assessment, fetal growth and development across
trimesters, danger signs requiring immediate reporting, prenatal diagnostic testing (amniocentesis, CVS,
MSAFP), nutritional requirements, common discomforts of pregnancy, Rh sensitization, gravida/para
terminology, and gestational age calculation using Naegele's rule.
1. A pregnant client at 28 weeks gestation reports experiencing occasional mild, irregular
uterine contractions that resolve with rest and hydration. What is the most appropriate
nursing response?
A. Instruct the client to go to the hospital immediately for evaluation of preterm labor
Page 2
, HESI OB Maternity V1 Exam | 2026/2027
B. Reassure the client that these are likely Braxton Hicks contractions, advise rest and hydration, and
instruct to report if contractions become regular, painful, or increase in frequency
C. Administer a tocolytic medication immediately
D. Schedule an immediate non-stress test
Correct Answer: B
Rationale: Braxton Hicks contractions are normal, irregular, painless uterine contractions that occur
throughout pregnancy and typically resolve with rest and hydration. The appropriate nursing response
is reassurance and education about warning signs of preterm labor (regular contractions, pelvic
pressure, low back pain, change in vaginal discharge). Immediate hospital evaluation (A), tocolytics
(C), or non-stress testing (D) are not indicated for occasional, irregular contractions without other signs
of preterm labor.
2. (SATA) Which findings are considered danger signs in pregnancy that require
immediate reporting to the healthcare provider? (Select All That Apply)
☐ A. Vaginal bleeding
☐ B. Severe headache unrelieved by rest or acetaminophen
☐ C. Mild ankle edema at the end of the day
☐ D. Visual changes such as blurred vision or seeing spots
Correct Answer: A, B, D
Rationale: Danger signs in pregnancy requiring immediate reporting include: vaginal bleeding (A—
may indicate placenta previa, abruption, or miscarriage); severe headache unrelieved by
rest/acetaminophen (B—may indicate preeclampsia); and visual changes (D—may indicate
preeclampsia with cerebral involvement). Mild ankle edema at the end of the day (C) is a common,
normal finding in pregnancy due to increased venous pressure and fluid retention; it becomes
concerning if sudden, severe, or accompanied by facial/hand edema.
11. A 26-year-old primigravida presents for her initial prenatal visit at 10 weeks gestation.
Which assessment finding documented during this visit would the nurse identify as most
critical to evaluate further?
A. Blood pressure of 118/76 mmHg
B. Hemoglobin level of 10.2 g/dL
C. Rubella titer indicating non-immunity
D. Weight gain of 3 pounds since conception
Correct Answer: C
Rationale: Rubella non-immunity is the most critical finding requiring further evaluation and education
at the initial prenatal visit. Congenital rubella syndrome can cause severe fetal anomalies including
deafness, cardiac defects, and intellectual disability, with the highest risk during the first trimester. The
client must be counseled to avoid exposure and receive the MMR vaccine postpartum, as live vaccines
are contraindicated during pregnancy. A hemoglobin of 10.2 g/dL (B) reflects physiologic hemodilution
of pregnancy and is expected. Blood pressure of 118/76 (A) and 3-pound weight gain (D) are within
normal parameters for early pregnancy.
12. During an initial prenatal visit at 8 weeks gestation, the nurse reviews the client's
history. The client reports a previous pregnancy that ended in a spontaneous abortion at 12
weeks, one living child born at 39 weeks, and no other pregnancies. Using the GTPAL
system, how should the nurse document this client's obstetric history?
A. G2 T1 P0 A1 L1
B. G3 T1 P0 A1 L1
C. G3 T0 P1 A1 L1
D. G2 T0 P1 A1 L1
Correct Answer: B
Rationale: The GTPAL system documents: Gravida (total pregnancies), Term births (37+ weeks),
Preterm births (before 37 weeks), Abortions (spontaneous or induced before 20 weeks), and Living
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