HESI Maternity & OB Test Bank
ACTUAL EXAM 2025 | 100
NCLEX-Style Questions | Rationales |
A+ Guaranteed Pass Prep | Verified
Q&A | Pass Guaranteed - A+ Graded
DOMAIN 1: ANTEPARTUM NURSING CARE
Q1: A 28-year-old G2P1 at 34 weeks gestation calls the clinic reporting a
sudden gush of fluid from the vagina. What is the nurse's priority instruction?
A. "Come to the clinic tomorrow morning for evaluation."
B. "Go to the emergency department immediately." [CORRECT]
C. "Monitor for contractions and call back if they start."
D. "Drink more fluids and rest with your feet elevated."
Correct Answer: B
Rationale: A sudden gush of fluid suggests premature rupture of membranes (PROM),
which requires immediate evaluation to assess for cord prolapse, infection risk, and
preterm labor. Delaying care (A) increases risks for chorioamnionitis and fetal distress.
Monitoring only (C) is insufficient, as complications can arise quickly. Resting (D) does not
address the urgency of the situation.
HESI Hint: PROM at <37 weeks is an OB emergency—always prioritize immediate
evaluation to prevent infection and fetal compromise.
Q2: A client at 10 weeks gestation has a GTPAL of 3-1-1-2-2. How many living
children does she have?
A. 1
B. 2 [CORRECT]
,C. 3
D. 4
Correct Answer: B
Rationale: GTPAL breakdown:
● G ravidity = 3 (total pregnancies)
● T erm = 1 (births ≥37 weeks)
● Preterm = 1 (births 20–36 weeks)
● Abortions/miscarriages = 1
● Living children = 2
HESI Hint: GTPAL is a high-yield concept—memorize the acronym and practice
calculating it!
Q3: A client's last menstrual period (LMP) was June 15, 2025. What is her
estimated date of delivery (EDD) using Naegele's rule?
A. March 1, 2026
B. March 8, 2026
C. March 22, 2026 [CORRECT]
D. April 5, 2026
Correct Answer: C
Rationale: Naegele's rule :
1. Subtract 3 months from LMP (June → March).
2. Add 7 days (March 15 + 7 = March 22).
3. Add 1 year (2025 → 2026).
EDD = March 22, 2026.
HESI Hint: Naegele’s rule is LMP – 3 months + 7 days + 1 year. Double-check
calculations!
Q4: A client at 20 weeks gestation has a fundal height of 18 cm. Which action
should the nurse take?
A. Document as normal.
B. Assess for oligohydramnios or fetal growth restriction. [CORRECT]
C. Schedule an immediate ultrasound.
D. Reassure the client that fundal height varies.
,Correct Answer: B
Rationale: At 20 weeks, fundal height should equal gestational age (±2 cm). A measurement
of 18 cm is below expected and may indicate oligohydramnios, fetal growth restriction, or
incorrect dates. Further assessment (B) is needed before scheduling an ultrasound (C).
Reassurance (D) is premature without evaluation.
HESI Hint: Fundal height < gestational age requires follow-up—consider ultrasound, fetal
well-being tests, or amniotic fluid assessment.
Q5: A client at 12 weeks gestation reports nausea and vomiting 3–4 times daily.
Which intervention should the nurse recommend?
A. "Eat three large meals per day."
B. "Try small, frequent meals and ginger tea." [CORRECT]
C. "Take prenatal vitamins on an empty stomach."
D. "Drink plenty of fluids with meals."
Correct Answer: B
Rationale: Small, frequent meals and ginger help manage nausea/vomiting of pregnancy
(NVP). Large meals (A) can worsen symptoms. Prenatal vitamins should be taken with food
(C). Fluids between meals (not with) reduce nausea (D).
HESI Hint: NVP peaks at 8–12 weeks—dietary modifications are first-line treatment.
Q6: A client at 28 weeks gestation is Rh-negative. When should she receive
RhoGAM?
A. At 20 weeks and postpartum
B. At 28 weeks and within 72 hours postpartum. [CORRECT]
C. Only if the baby is Rh-positive at birth.
D. At 36 weeks and 1 week postpartum.
Correct Answer: B
Rationale: RhoGAM is given at 28 weeks to prevent isoimmunization and within 72 hours
postpartum if the baby is Rh-positive. It is not delayed until birth (C) or given at 36 weeks (D).
HESI Hint: RhoGAM timing is critical—28 weeks and postpartum are non-negotiable !
Q7: A client at 16 weeks gestation has a 1-hour glucose tolerance test (GTT)
result of 150 mg/dL. What is the nurse's next action?
, A. Diagnose gestational diabetes (GDM).
B. Schedule a 3-hour GTT. [CORRECT]
C. Recommend dietary changes only.
D. Repeat the 1-hour GTT in 1 week.
Correct Answer: B
Rationale: A 1-hour GTT ≥140 mg/dL requires a 3-hour GTT for diagnosis. GDM is not
diagnosed based on the 1-hour test alone (A). Dietary changes (C) and repeating the 1-hour
test (D) are inappropriate without confirmation.
HESI Hint: 1-hour GTT ≥140 mg/dL → 3-hour GTT for diagnosis.
Q8: A client at 32 weeks gestation reports decreased fetal movement. What is
the nurse's priority action?
A. Reassure the client that fetal activity varies.
B. Instruct the client to perform kick counts and report if <10 movements in 2 hours.
[CORRECT]
C. Schedule a non-stress test (NST) for next week.
D. Administer oxygen via nasal cannula.
Correct Answer: B
Rationale: Decreased fetal movement may indicate fetal distress and requires immediate
kick counts. If <10 movements in 2 hours, the client should seek care promptly. Reassurance
(A) is unsafe without assessment. Delaying NST (C) or administering O₂ (D) is premature.
HESI Hint: <10 movements in 2 hours = EMERGENCY—refer for NST/biophysical profile
(BPP).
Q9: A client at 36 weeks gestation reports severe headache, blurred vision, and
epigastric pain. What is the nurse's priority action?
A. Administer acetaminophen for headache.
B. Assess blood pressure and proteinuria for preeclampsia. [CORRECT]
C. Encourage rest and hydration.
D. Schedule a routine prenatal visit.
Correct Answer: B
Rationale: Severe headache, visual changes, and epigastric pain are classic signs of
preeclampsia. Immediate BP check and proteinuria assessment are critical. Acetaminophen
(A), rest (C), or routine visits (D) delay urgent care.
HESI Hint: Preeclampsia signs = EMERGENCY—BP, proteinuria, and fetal assessment
are priorities.
ACTUAL EXAM 2025 | 100
NCLEX-Style Questions | Rationales |
A+ Guaranteed Pass Prep | Verified
Q&A | Pass Guaranteed - A+ Graded
DOMAIN 1: ANTEPARTUM NURSING CARE
Q1: A 28-year-old G2P1 at 34 weeks gestation calls the clinic reporting a
sudden gush of fluid from the vagina. What is the nurse's priority instruction?
A. "Come to the clinic tomorrow morning for evaluation."
B. "Go to the emergency department immediately." [CORRECT]
C. "Monitor for contractions and call back if they start."
D. "Drink more fluids and rest with your feet elevated."
Correct Answer: B
Rationale: A sudden gush of fluid suggests premature rupture of membranes (PROM),
which requires immediate evaluation to assess for cord prolapse, infection risk, and
preterm labor. Delaying care (A) increases risks for chorioamnionitis and fetal distress.
Monitoring only (C) is insufficient, as complications can arise quickly. Resting (D) does not
address the urgency of the situation.
HESI Hint: PROM at <37 weeks is an OB emergency—always prioritize immediate
evaluation to prevent infection and fetal compromise.
Q2: A client at 10 weeks gestation has a GTPAL of 3-1-1-2-2. How many living
children does she have?
A. 1
B. 2 [CORRECT]
,C. 3
D. 4
Correct Answer: B
Rationale: GTPAL breakdown:
● G ravidity = 3 (total pregnancies)
● T erm = 1 (births ≥37 weeks)
● Preterm = 1 (births 20–36 weeks)
● Abortions/miscarriages = 1
● Living children = 2
HESI Hint: GTPAL is a high-yield concept—memorize the acronym and practice
calculating it!
Q3: A client's last menstrual period (LMP) was June 15, 2025. What is her
estimated date of delivery (EDD) using Naegele's rule?
A. March 1, 2026
B. March 8, 2026
C. March 22, 2026 [CORRECT]
D. April 5, 2026
Correct Answer: C
Rationale: Naegele's rule :
1. Subtract 3 months from LMP (June → March).
2. Add 7 days (March 15 + 7 = March 22).
3. Add 1 year (2025 → 2026).
EDD = March 22, 2026.
HESI Hint: Naegele’s rule is LMP – 3 months + 7 days + 1 year. Double-check
calculations!
Q4: A client at 20 weeks gestation has a fundal height of 18 cm. Which action
should the nurse take?
A. Document as normal.
B. Assess for oligohydramnios or fetal growth restriction. [CORRECT]
C. Schedule an immediate ultrasound.
D. Reassure the client that fundal height varies.
,Correct Answer: B
Rationale: At 20 weeks, fundal height should equal gestational age (±2 cm). A measurement
of 18 cm is below expected and may indicate oligohydramnios, fetal growth restriction, or
incorrect dates. Further assessment (B) is needed before scheduling an ultrasound (C).
Reassurance (D) is premature without evaluation.
HESI Hint: Fundal height < gestational age requires follow-up—consider ultrasound, fetal
well-being tests, or amniotic fluid assessment.
Q5: A client at 12 weeks gestation reports nausea and vomiting 3–4 times daily.
Which intervention should the nurse recommend?
A. "Eat three large meals per day."
B. "Try small, frequent meals and ginger tea." [CORRECT]
C. "Take prenatal vitamins on an empty stomach."
D. "Drink plenty of fluids with meals."
Correct Answer: B
Rationale: Small, frequent meals and ginger help manage nausea/vomiting of pregnancy
(NVP). Large meals (A) can worsen symptoms. Prenatal vitamins should be taken with food
(C). Fluids between meals (not with) reduce nausea (D).
HESI Hint: NVP peaks at 8–12 weeks—dietary modifications are first-line treatment.
Q6: A client at 28 weeks gestation is Rh-negative. When should she receive
RhoGAM?
A. At 20 weeks and postpartum
B. At 28 weeks and within 72 hours postpartum. [CORRECT]
C. Only if the baby is Rh-positive at birth.
D. At 36 weeks and 1 week postpartum.
Correct Answer: B
Rationale: RhoGAM is given at 28 weeks to prevent isoimmunization and within 72 hours
postpartum if the baby is Rh-positive. It is not delayed until birth (C) or given at 36 weeks (D).
HESI Hint: RhoGAM timing is critical—28 weeks and postpartum are non-negotiable !
Q7: A client at 16 weeks gestation has a 1-hour glucose tolerance test (GTT)
result of 150 mg/dL. What is the nurse's next action?
, A. Diagnose gestational diabetes (GDM).
B. Schedule a 3-hour GTT. [CORRECT]
C. Recommend dietary changes only.
D. Repeat the 1-hour GTT in 1 week.
Correct Answer: B
Rationale: A 1-hour GTT ≥140 mg/dL requires a 3-hour GTT for diagnosis. GDM is not
diagnosed based on the 1-hour test alone (A). Dietary changes (C) and repeating the 1-hour
test (D) are inappropriate without confirmation.
HESI Hint: 1-hour GTT ≥140 mg/dL → 3-hour GTT for diagnosis.
Q8: A client at 32 weeks gestation reports decreased fetal movement. What is
the nurse's priority action?
A. Reassure the client that fetal activity varies.
B. Instruct the client to perform kick counts and report if <10 movements in 2 hours.
[CORRECT]
C. Schedule a non-stress test (NST) for next week.
D. Administer oxygen via nasal cannula.
Correct Answer: B
Rationale: Decreased fetal movement may indicate fetal distress and requires immediate
kick counts. If <10 movements in 2 hours, the client should seek care promptly. Reassurance
(A) is unsafe without assessment. Delaying NST (C) or administering O₂ (D) is premature.
HESI Hint: <10 movements in 2 hours = EMERGENCY—refer for NST/biophysical profile
(BPP).
Q9: A client at 36 weeks gestation reports severe headache, blurred vision, and
epigastric pain. What is the nurse's priority action?
A. Administer acetaminophen for headache.
B. Assess blood pressure and proteinuria for preeclampsia. [CORRECT]
C. Encourage rest and hydration.
D. Schedule a routine prenatal visit.
Correct Answer: B
Rationale: Severe headache, visual changes, and epigastric pain are classic signs of
preeclampsia. Immediate BP check and proteinuria assessment are critical. Acetaminophen
(A), rest (C), or routine visits (D) delay urgent care.
HESI Hint: Preeclampsia signs = EMERGENCY—BP, proteinuria, and fetal assessment
are priorities.
