1
OB MATERNITY HESI EXIT VERSION 1-3
TEST BANK 2026 | NextGen Format | All
Brand New Questions | 100% Correct
Answers | Guaranteed A+ | Pass
VERSION 1 - 65 QUESTIONS - NEXTGEN FORMAT
V1-A: Antepartum Complications & Risk Assessment (Q1-20)
Q1. A pregnant patient at 28 weeks gestation presents with a blood pressure of
158/104 mmHg, 2+ proteinuria on dipstick, and reports a severe headache and visual
disturbances. Which nursing intervention is the priority?
A. Administer a loading dose of oral labetalol and discharge home with follow-up B.
Place the patient on bed rest in a left lateral position, initiate magnesium sulfate, and
notify the provider C. Perform a vaginal examination to assess cervical dilation D.
Administer ibuprofen 600 mg for the headache and reassess in 2 hours
B. Place the patient on bed rest in a left lateral position, initiate magnesium sulfate, and
notify the provider [CORRECT]
Rationale: These findings indicate severe preeclampsia; the priority is preventing
seizures with magnesium sulfate, optimizing placental perfusion with left lateral
positioning, and immediate provider notification. Oral antihypertensives alone (A) are
insufficient for severe features, vaginal exams (C) are contraindicated in active bleeding
or severe preeclampsia, and ibuprofen (D) is contraindicated in pregnancy and does not
address the underlying pathology.
"Correct Answer: B"
Q2. A patient with preeclampsia is receiving magnesium sulfate. Which assessment
finding requires immediate intervention?
A. Respiratory rate of 14 breaths/minute B. Deep tendon reflexes of 2+ C. Urine output
of 20 mL/hour for 2 consecutive hours D. Serum magnesium level of 5.2 mEq/L
C. Urine output of 20 mL/hour for 2 consecutive hours [CORRECT]
,2
Rationale: Magnesium is renally excreted; urine output <25-30 mL/hour indicates
potential toxicity risk due to accumulation and requires immediate evaluation, possible
dose reduction, or discontinuation. Respiratory rate 14 (A) is acceptable (>12), reflexes
2+ (B) are normal, and magnesium 5.2 (D) is therapeutic (therapeutic range 4-8 mEq/L,
toxicity >8-10).
"Correct Answer: C"
Q3. A patient at 32 weeks gestation reports decreased fetal movement. The nurse
performs a non-stress test (NST) and observes no accelerations in fetal heart rate over
40 minutes, but no decelerations are present. The fetus demonstrates moderate
baseline variability. How should the nurse classify this tracing?
A. Category I (normal) B. Category II (indeterminate) C. Category III (abnormal) D.
Category IV (non-reassuring)
B. Category II (indeterminate) [CORRECT]
Rationale: A non-reactive NST (absence of accelerations) with moderate baseline
variability and no decelerations meets Category II criteria; it is not normal (Category I
requires reactive NST or presence of accelerations), not Category III (which requires
absent variability plus recurrent late/variable decelerations or bradycardia), and
Category IV is not a recognized NICHD category.
"Correct Answer: B"
Q4. A patient at 24 weeks gestation is diagnosed with gestational diabetes mellitus
(GDM). Which fasting blood glucose target should the nurse reinforce during dietary
teaching?
A. <95 mg/dL B. <120 mg/dL C. <140 mg/dL D. <180 mg/dL
A. <95 mg/dL [CORRECT]
Rationale: ACOG recommends fasting glucose <95 mg/dL, 1-hour postprandial <140
mg/dL, and 2-hour postprandial <120 mg/dL for GDM management; <120 (B) is the 2-
hour target, <140 (C) is the 1-hour target, and <180 (D) is not a standard GDM target.
"Correct Answer: A"
,3
Q5. A pregnant patient at 18 weeks gestation reports painless vaginal bleeding after
intercourse. The ultrasound reveals a placenta completely covering the internal cervical
os. Which nursing instruction is the priority?
A. "You may continue sexual activity but use a condom to prevent infection." B. "You
must maintain pelvic rest and report any bleeding immediately; a cesarean delivery will
likely be necessary." C. "You should perform kick counts daily and return only if
bleeding becomes heavy." D. "Bed rest is no longer recommended; you may resume
normal activities."
B. "You must maintain pelvic rest and report any bleeding immediately; a cesarean
delivery will likely be necessary." [CORRECT]
Rationale: Complete placenta previa requires pelvic rest (no intercourse, no vaginal
exams) and cesarean delivery due to the risk of catastrophic hemorrhage; sexual
activity (A) is contraindicated, kick counts alone (C) are insufficient, and normal
activities (D) are dangerous with complete previa.
"Correct Answer: B"
Q6. A pregnant patient at 12 weeks gestation has a history of deep vein thrombosis. The
provider orders enoxaparin prophylaxis. Which instruction should the nurse include?
A. "You should switch to warfarin after the first trimester because it is safer." B.
"Enoxaparin does not cross the placenta and is safe during pregnancy; you will need to
discontinue it at the onset of labor." C. "You may discontinue the enoxaparin once you
reach 28 weeks gestation." D. "Switch to aspirin 81 mg daily because it provides
equivalent anticoagulation."
B. "Enoxaparin does not cross the placenta and is safe during pregnancy; you will need
to discontinue it at the onset of labor." [CORRECT]
Rationale: Low molecular weight heparin (enoxaparin) does not cross the placenta and
is the anticoagulant of choice in pregnancy; it must be held before delivery to reduce
bleeding risk. Warfarin (A) is teratogenic, discontinuation at 28 weeks (C) is premature,
and aspirin (D) is not therapeutic anticoagulation.
"Correct Answer: B"
Q7. A patient at 20 weeks gestation is Rh-negative and has a positive antibody screen.
The nurse understands that which intervention is indicated?
, 4
A. Administer Rho(D) immune globulin (RhoGAM) 300 mcg IM B. Perform antibody
titers and refer to maternal-fetal medicine for further evaluation C. Administer a second
dose of RhoGAM in 4 weeks D. No intervention is needed because RhoGAM is only given
postpartum
B. Perform antibody titers and refer to maternal-fetal medicine for further evaluation
[CORRECT]
Rationale: A positive antibody screen in an Rh-negative patient indicates
alloimmunization (active antibody production); RhoGAM (A, C) is ineffective once
sensitization has occurred and is only for prevention. Antibody titers and specialist
referral are required to monitor for hemolytic disease of the fetus/newborn.
"Correct Answer: B"
Q8. A patient at 16 weeks gestation reports severe nausea and vomiting, has lost 8
pounds in 2 weeks, and shows signs of dehydration. Which intervention is the priority?
A. Recommend ginger supplements and small frequent meals B. Administer IV fluids,
antiemetics, and thiamine before dextrose-containing fluids C. Prescribe ondansetron 4
mg orally every 6 hours and discharge home D. Perform an immediate upper endoscopy
to rule out gastrointestinal pathology
B. Administer IV fluids, antiemetics, and thiamine before dextrose-containing fluids
[CORRECT]
Rationale: Hyperemesis gravidarum with weight loss and dehydration requires IV
rehydration; thiamine must precede dextrose to prevent Wernicke encephalopathy.
Ginger and diet changes (A) are insufficient for severe cases, oral antiemetics alone (C)
are inadequate with dehydration, and endoscopy (D) is not the priority.
"Correct Answer: B"
Q9. A patient at 34 weeks gestation with a BMI of 42 is scheduled for a non-stress test.
Which modification should the nurse anticipate?
A. The NST is not indicated in patients with elevated BMI B. External fetal monitoring
may be technically difficult; ultrasound guidance or internal monitoring may be needed
C. The patient should fast for 8 hours before the NST D. The NST should be performed
weekly rather than biweekly
OB MATERNITY HESI EXIT VERSION 1-3
TEST BANK 2026 | NextGen Format | All
Brand New Questions | 100% Correct
Answers | Guaranteed A+ | Pass
VERSION 1 - 65 QUESTIONS - NEXTGEN FORMAT
V1-A: Antepartum Complications & Risk Assessment (Q1-20)
Q1. A pregnant patient at 28 weeks gestation presents with a blood pressure of
158/104 mmHg, 2+ proteinuria on dipstick, and reports a severe headache and visual
disturbances. Which nursing intervention is the priority?
A. Administer a loading dose of oral labetalol and discharge home with follow-up B.
Place the patient on bed rest in a left lateral position, initiate magnesium sulfate, and
notify the provider C. Perform a vaginal examination to assess cervical dilation D.
Administer ibuprofen 600 mg for the headache and reassess in 2 hours
B. Place the patient on bed rest in a left lateral position, initiate magnesium sulfate, and
notify the provider [CORRECT]
Rationale: These findings indicate severe preeclampsia; the priority is preventing
seizures with magnesium sulfate, optimizing placental perfusion with left lateral
positioning, and immediate provider notification. Oral antihypertensives alone (A) are
insufficient for severe features, vaginal exams (C) are contraindicated in active bleeding
or severe preeclampsia, and ibuprofen (D) is contraindicated in pregnancy and does not
address the underlying pathology.
"Correct Answer: B"
Q2. A patient with preeclampsia is receiving magnesium sulfate. Which assessment
finding requires immediate intervention?
A. Respiratory rate of 14 breaths/minute B. Deep tendon reflexes of 2+ C. Urine output
of 20 mL/hour for 2 consecutive hours D. Serum magnesium level of 5.2 mEq/L
C. Urine output of 20 mL/hour for 2 consecutive hours [CORRECT]
,2
Rationale: Magnesium is renally excreted; urine output <25-30 mL/hour indicates
potential toxicity risk due to accumulation and requires immediate evaluation, possible
dose reduction, or discontinuation. Respiratory rate 14 (A) is acceptable (>12), reflexes
2+ (B) are normal, and magnesium 5.2 (D) is therapeutic (therapeutic range 4-8 mEq/L,
toxicity >8-10).
"Correct Answer: C"
Q3. A patient at 32 weeks gestation reports decreased fetal movement. The nurse
performs a non-stress test (NST) and observes no accelerations in fetal heart rate over
40 minutes, but no decelerations are present. The fetus demonstrates moderate
baseline variability. How should the nurse classify this tracing?
A. Category I (normal) B. Category II (indeterminate) C. Category III (abnormal) D.
Category IV (non-reassuring)
B. Category II (indeterminate) [CORRECT]
Rationale: A non-reactive NST (absence of accelerations) with moderate baseline
variability and no decelerations meets Category II criteria; it is not normal (Category I
requires reactive NST or presence of accelerations), not Category III (which requires
absent variability plus recurrent late/variable decelerations or bradycardia), and
Category IV is not a recognized NICHD category.
"Correct Answer: B"
Q4. A patient at 24 weeks gestation is diagnosed with gestational diabetes mellitus
(GDM). Which fasting blood glucose target should the nurse reinforce during dietary
teaching?
A. <95 mg/dL B. <120 mg/dL C. <140 mg/dL D. <180 mg/dL
A. <95 mg/dL [CORRECT]
Rationale: ACOG recommends fasting glucose <95 mg/dL, 1-hour postprandial <140
mg/dL, and 2-hour postprandial <120 mg/dL for GDM management; <120 (B) is the 2-
hour target, <140 (C) is the 1-hour target, and <180 (D) is not a standard GDM target.
"Correct Answer: A"
,3
Q5. A pregnant patient at 18 weeks gestation reports painless vaginal bleeding after
intercourse. The ultrasound reveals a placenta completely covering the internal cervical
os. Which nursing instruction is the priority?
A. "You may continue sexual activity but use a condom to prevent infection." B. "You
must maintain pelvic rest and report any bleeding immediately; a cesarean delivery will
likely be necessary." C. "You should perform kick counts daily and return only if
bleeding becomes heavy." D. "Bed rest is no longer recommended; you may resume
normal activities."
B. "You must maintain pelvic rest and report any bleeding immediately; a cesarean
delivery will likely be necessary." [CORRECT]
Rationale: Complete placenta previa requires pelvic rest (no intercourse, no vaginal
exams) and cesarean delivery due to the risk of catastrophic hemorrhage; sexual
activity (A) is contraindicated, kick counts alone (C) are insufficient, and normal
activities (D) are dangerous with complete previa.
"Correct Answer: B"
Q6. A pregnant patient at 12 weeks gestation has a history of deep vein thrombosis. The
provider orders enoxaparin prophylaxis. Which instruction should the nurse include?
A. "You should switch to warfarin after the first trimester because it is safer." B.
"Enoxaparin does not cross the placenta and is safe during pregnancy; you will need to
discontinue it at the onset of labor." C. "You may discontinue the enoxaparin once you
reach 28 weeks gestation." D. "Switch to aspirin 81 mg daily because it provides
equivalent anticoagulation."
B. "Enoxaparin does not cross the placenta and is safe during pregnancy; you will need
to discontinue it at the onset of labor." [CORRECT]
Rationale: Low molecular weight heparin (enoxaparin) does not cross the placenta and
is the anticoagulant of choice in pregnancy; it must be held before delivery to reduce
bleeding risk. Warfarin (A) is teratogenic, discontinuation at 28 weeks (C) is premature,
and aspirin (D) is not therapeutic anticoagulation.
"Correct Answer: B"
Q7. A patient at 20 weeks gestation is Rh-negative and has a positive antibody screen.
The nurse understands that which intervention is indicated?
, 4
A. Administer Rho(D) immune globulin (RhoGAM) 300 mcg IM B. Perform antibody
titers and refer to maternal-fetal medicine for further evaluation C. Administer a second
dose of RhoGAM in 4 weeks D. No intervention is needed because RhoGAM is only given
postpartum
B. Perform antibody titers and refer to maternal-fetal medicine for further evaluation
[CORRECT]
Rationale: A positive antibody screen in an Rh-negative patient indicates
alloimmunization (active antibody production); RhoGAM (A, C) is ineffective once
sensitization has occurred and is only for prevention. Antibody titers and specialist
referral are required to monitor for hemolytic disease of the fetus/newborn.
"Correct Answer: B"
Q8. A patient at 16 weeks gestation reports severe nausea and vomiting, has lost 8
pounds in 2 weeks, and shows signs of dehydration. Which intervention is the priority?
A. Recommend ginger supplements and small frequent meals B. Administer IV fluids,
antiemetics, and thiamine before dextrose-containing fluids C. Prescribe ondansetron 4
mg orally every 6 hours and discharge home D. Perform an immediate upper endoscopy
to rule out gastrointestinal pathology
B. Administer IV fluids, antiemetics, and thiamine before dextrose-containing fluids
[CORRECT]
Rationale: Hyperemesis gravidarum with weight loss and dehydration requires IV
rehydration; thiamine must precede dextrose to prevent Wernicke encephalopathy.
Ginger and diet changes (A) are insufficient for severe cases, oral antiemetics alone (C)
are inadequate with dehydration, and endoscopy (D) is not the priority.
"Correct Answer: B"
Q9. A patient at 34 weeks gestation with a BMI of 42 is scheduled for a non-stress test.
Which modification should the nurse anticipate?
A. The NST is not indicated in patients with elevated BMI B. External fetal monitoring
may be technically difficult; ultrasound guidance or internal monitoring may be needed
C. The patient should fast for 8 hours before the NST D. The NST should be performed
weekly rather than biweekly
