2026/2027 HESI MATERNITY OB VERSION 7 | NGN
Newly Released | 150 Questions with Detailed Rationales
Next Generation NCLEX (NGN) Clinical Judgment Integration
Complete Maternal-Newborn Review
INSTRUCTIONS:
Select the single best answer for each question unless otherwise indicated.
Select-all-that-apply (SATA) questions require all correct options to be selected for full credit.
NGN case studies: Each item builds on the scenario; consider all information provided.
Time allotted: 3 hours (150 questions).
DOMAIN 1: ANTEPARTUM CARE & PRENATAL ASSESSMENT (Questions 1-15)
Q1: A 24-year-old primigravida at 10 weeks gestation presents for her initial prenatal visit. Her
BMI is 18. Based on the Institute of Medicine (IOM) guidelines, the nurse recommends a total
weight gain of:
A. 11-20 lbs.
B. [CORRECT] 28-40 lbs.
C. 15-25 lbs.
D. 25-35 lbs.
Correct Answer: B
Rationale: A BMI of 18 is classified as underweight (<18.5). The recommended weight gain for
underweight women is 28-40 lbs (12.5-18 kg).
Reference: IOM/NAS Weight Gain Recommendations (2025).
,Q2: A nurse is teaching a pregnant patient about the physiological changes of pregnancy. Which
cardiovascular change is expected?
A. Decrease in blood volume.
B. [CORRECT] Increase in cardiac output by 30-50%.
C. Increase in blood pressure.
D. Bradycardia.
Correct Answer: B
Rationale: Cardiac output increases significantly during pregnancy to perfuse the placenta.
Blood volume increases. Blood pressure typically decreases in the first two trimesters.
Q3: Which screening test is routinely offered to all pregnant women at 35-37 weeks gestation?
A. Glucose tolerance test.
B. [CORRECT] Group B Streptococcus (GBS) culture.
C. Alpha-fetoprotein (AFP).
D. Chorionic villus sampling.
Correct Answer: B
Rationale: GBS screening is standard at 35-37 weeks to determine the need for intrapartum
antibiotic prophylaxis.
Q4: A patient at 28 weeks gestation reports frequent leg cramps. Which intervention should the
nurse recommend?
A. Decrease fluid intake.
B. [CORRECT] Dorsiflex the foot and increase calcium intake.
C. Massage the calf vigorously.
D. Apply heat and rest in a supine position.
,Correct Answer: B
Rationale: Dorsiflexion stretches the muscle. Leg cramps are common and may be related to
calcium or magnesium imbalance. Supine position is contraindicated (aortocaval compression).
Q5: A nurse is counseling a patient regarding the MSAFP (Maternal Serum Alpha-Fetoprotein)
test. An elevated level is associated with:
A. Down syndrome.
B. [CORRECT] Open neural tube defects.
C. Trisomy 18.
D. Intrauterine growth restriction (IUGR).
Correct Answer: B
Rationale: Elevated MSAFP is associated with open neural tube defects (anencephaly, spina
bifida). Low levels are associated with chromosomal abnormalities like Down syndrome.
Q6: Which physiologic adaptation of pregnancy explains the increased risk of urinary tract
infections (UTIs)?
A. Increased bladder capacity.
B. [CORRECT] Ureteral dilation and decreased peristalsis due to progesterone.
C. Decreased glomerular filtration rate.
D. Increased urethral tone.
Correct Answer: B
Rationale: Progesterone causes smooth muscle relaxation, leading to ureteral dilation and
urinary stasis, which increases UTI risk (pyelonephritis).
Q7: (Select-All-That-Apply) Which of the following are presumptive signs of pregnancy? Select
all that apply.
, A. [CORRECT] Amenorrhea.
B. [CORRECT] Nausea.
C. [CORRECT] Breast tenderness.
D. Chadwick's sign.
Correct Answers: A, B, C
Rationale: Presumptive signs are subjective symptoms. Chadwick's sign (blue discoloration of
cervix) is a probable (objective) sign.
Q8: A patient at 38 weeks gestation reports a sudden gush of fluid. The nurse performs a
Nitrazine test. The paper turns blue. This indicates:
A. The fluid is urine.
B. [CORRECT] The fluid is amniotic fluid (alkaline).
C. The fluid is vaginal discharge.
D. The test is inconclusive.
Correct Answer: B
Rationale: Amniotic fluid has an alkaline pH (7.0-7.5), turning Nitrazine paper blue. Urine and
vaginal secretions are acidic.
Q9: A nurse is explaining the function of the placenta. Which hormone produced by the placenta
is responsible for maintaining the corpus luteum in early pregnancy?
A. Estrogen.
B. Progesterone.
C. [CORRECT] Human Chorionic Gonadotropin (hCG).
D. Human Placental Lactogen (hPL).
Correct Answer: C
Newly Released | 150 Questions with Detailed Rationales
Next Generation NCLEX (NGN) Clinical Judgment Integration
Complete Maternal-Newborn Review
INSTRUCTIONS:
Select the single best answer for each question unless otherwise indicated.
Select-all-that-apply (SATA) questions require all correct options to be selected for full credit.
NGN case studies: Each item builds on the scenario; consider all information provided.
Time allotted: 3 hours (150 questions).
DOMAIN 1: ANTEPARTUM CARE & PRENATAL ASSESSMENT (Questions 1-15)
Q1: A 24-year-old primigravida at 10 weeks gestation presents for her initial prenatal visit. Her
BMI is 18. Based on the Institute of Medicine (IOM) guidelines, the nurse recommends a total
weight gain of:
A. 11-20 lbs.
B. [CORRECT] 28-40 lbs.
C. 15-25 lbs.
D. 25-35 lbs.
Correct Answer: B
Rationale: A BMI of 18 is classified as underweight (<18.5). The recommended weight gain for
underweight women is 28-40 lbs (12.5-18 kg).
Reference: IOM/NAS Weight Gain Recommendations (2025).
,Q2: A nurse is teaching a pregnant patient about the physiological changes of pregnancy. Which
cardiovascular change is expected?
A. Decrease in blood volume.
B. [CORRECT] Increase in cardiac output by 30-50%.
C. Increase in blood pressure.
D. Bradycardia.
Correct Answer: B
Rationale: Cardiac output increases significantly during pregnancy to perfuse the placenta.
Blood volume increases. Blood pressure typically decreases in the first two trimesters.
Q3: Which screening test is routinely offered to all pregnant women at 35-37 weeks gestation?
A. Glucose tolerance test.
B. [CORRECT] Group B Streptococcus (GBS) culture.
C. Alpha-fetoprotein (AFP).
D. Chorionic villus sampling.
Correct Answer: B
Rationale: GBS screening is standard at 35-37 weeks to determine the need for intrapartum
antibiotic prophylaxis.
Q4: A patient at 28 weeks gestation reports frequent leg cramps. Which intervention should the
nurse recommend?
A. Decrease fluid intake.
B. [CORRECT] Dorsiflex the foot and increase calcium intake.
C. Massage the calf vigorously.
D. Apply heat and rest in a supine position.
,Correct Answer: B
Rationale: Dorsiflexion stretches the muscle. Leg cramps are common and may be related to
calcium or magnesium imbalance. Supine position is contraindicated (aortocaval compression).
Q5: A nurse is counseling a patient regarding the MSAFP (Maternal Serum Alpha-Fetoprotein)
test. An elevated level is associated with:
A. Down syndrome.
B. [CORRECT] Open neural tube defects.
C. Trisomy 18.
D. Intrauterine growth restriction (IUGR).
Correct Answer: B
Rationale: Elevated MSAFP is associated with open neural tube defects (anencephaly, spina
bifida). Low levels are associated with chromosomal abnormalities like Down syndrome.
Q6: Which physiologic adaptation of pregnancy explains the increased risk of urinary tract
infections (UTIs)?
A. Increased bladder capacity.
B. [CORRECT] Ureteral dilation and decreased peristalsis due to progesterone.
C. Decreased glomerular filtration rate.
D. Increased urethral tone.
Correct Answer: B
Rationale: Progesterone causes smooth muscle relaxation, leading to ureteral dilation and
urinary stasis, which increases UTI risk (pyelonephritis).
Q7: (Select-All-That-Apply) Which of the following are presumptive signs of pregnancy? Select
all that apply.
, A. [CORRECT] Amenorrhea.
B. [CORRECT] Nausea.
C. [CORRECT] Breast tenderness.
D. Chadwick's sign.
Correct Answers: A, B, C
Rationale: Presumptive signs are subjective symptoms. Chadwick's sign (blue discoloration of
cervix) is a probable (objective) sign.
Q8: A patient at 38 weeks gestation reports a sudden gush of fluid. The nurse performs a
Nitrazine test. The paper turns blue. This indicates:
A. The fluid is urine.
B. [CORRECT] The fluid is amniotic fluid (alkaline).
C. The fluid is vaginal discharge.
D. The test is inconclusive.
Correct Answer: B
Rationale: Amniotic fluid has an alkaline pH (7.0-7.5), turning Nitrazine paper blue. Urine and
vaginal secretions are acidic.
Q9: A nurse is explaining the function of the placenta. Which hormone produced by the placenta
is responsible for maintaining the corpus luteum in early pregnancy?
A. Estrogen.
B. Progesterone.
C. [CORRECT] Human Chorionic Gonadotropin (hCG).
D. Human Placental Lactogen (hPL).
Correct Answer: C
