HESI OB Maternity Version 2 V2 Exam 2026/2027 –
Verified Questions and Answers with Detailed
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Section 1: Antepartum (Prenatal Care & Complications) — 25 Questions
Q1: A nurse is caring for a client at 16 weeks gestation who asks when she should
expect to feel fetal movement. The nurse should explain that multiparous clients
typically perceive quickening at which time?
A. 14–16 weeks gestation [CORRECT]
B. 18–20 weeks gestation
C. 20–22 weeks gestation
D. 24–26 weeks gestation
Correct Answer: A
Rationale: Multiparous clients typically perceive quickening (fetal movement) between
14–16 weeks gestation due to prior uterine stretching and familiarity with the sensation,
while nulliparous clients usually feel movement at 18–20 weeks. This difference exists
because experienced mothers recognize subtle flutters earlier than first-time mothers.
Option B represents the nulliparous timeline, which is why it is incorrect for this
multiparous client.
Q2 (SATA): A nurse is reviewing prenatal laboratory results for a client at 28 weeks
gestation. Which findings require immediate follow-up? (Select all that apply.)
A. Hemoglobin 9.8 g/dL [CORRECT]
B. Hematocrit 32%
C. 1-hour glucose tolerance test 145 mg/dL [CORRECT]
D. Platelet count 120,000/mm³ [CORRECT]
,E. Rubella titer positive (immune)
Correct Answer: A, C, D
Rationale: Hemoglobin below 11 g/dL in the second trimester indicates anemia
requiring iron supplementation. A 1-hour glucose tolerance test ≥140 mg/dL requires
follow-up with a 3-hour glucose tolerance test to rule out gestational diabetes. Platelets
below 150,000/mm³ suggest gestational thrombocytopenia or potential HELLP
syndrome development requiring monitoring. Option B (hematocrit 32%) is within
normal physiological hemodilution range for pregnancy (32–42%). Option E indicates
immunity, which is desirable.
Q3 (Priority): The nurse in the prenatal clinic has four clients waiting. Which client
should the nurse assess FIRST?
A. A client at 38 weeks reporting decreased fetal movement over 24 hours [CORRECT]
B. A client at 12 weeks with nausea and vomiting
C. A client at 28 weeks with bilateral ankle edema
D. A client at 34 weeks requesting a tour of labor and delivery
Correct Answer: A
Rationale: Decreased fetal movement at term is a potential indicator of fetal
compromise or impending stillbirth, requiring immediate assessment with fetal heart
rate monitoring and possible biophysical profile. While nausea/vomiting (B) and edema
(C) warrant evaluation, they are not immediately threatening. Option A represents a
potential obstetric emergency, whereas the other options represent normal discomforts
or non-urgent requests that can be triaged to later priority.
Q4: A client at 32 weeks gestation has a blood pressure of 152/98 mmHg, proteinuria
2+, and reports epigastric pain. Which finding indicates progression to severe
preeclampsia?
A. Blood pressure elevation to 160/110 mmHg on recheck
B. Platelet count of 85,000/mm³ [CORRECT]
C. Weight gain of 3 pounds in one week
D. Urine protein increasing to 3+
,Correct Answer: B
Rationale: Thrombocytopenia (platelets <100,000/mm³) is a diagnostic criterion for
severe preeclampsia according to ACOG guidelines, indicating hematological
involvement and potential HELLP syndrome development. While blood pressure
≥160/110 mmHg (A) also indicates severity, a single reading requires confirmation. The
platelet count of 85,000/mm³ definitively establishes severe disease requiring
immediate intervention. Weight gain (C) and proteinuria progression (D) are concerning
but do not alone constitute severe features.
Q5: A nurse is teaching a client with Rh-negative blood about Rho(D) immune globulin
(RhoGAM). The nurse should include that this medication prevents which complication?
A. Hemolytic disease of the fetus and newborn in future pregnancies [CORRECT]
B. ABO incompatibility in the current pregnancy
C. Maternal sensitization to Kell antigen
D. Fetal hydrops in the current pregnancy only
Correct Answer: A
Rationale: Rho(D) immune globulin prevents maternal sensitization to the D antigen,
thereby preventing hemolytic disease of the fetus and newborn (HDFN) in subsequent
pregnancies if the fetus is Rh-positive. It is ineffective against ABO incompatibility (B) or
other antibodies (C). While it protects the current pregnancy if given after trauma or
procedures, its primary purpose is preventing isoimmunization for future gestations.
Q6 (Calculation): A client at 28 weeks with preterm labor is prescribed betamethasone
12 mg IM. The available vial contains 6 mg/mL. How many mL should the nurse
administer?
A. 1 mL
B. 1.5 mL
C. 2 mL [CORRECT]
D. 2.5 mL
Correct Answer: C
Rationale: Using dimensional analysis: 12 mg ÷ 6 mg/mL = 2 mL. Betamethasone is a
corticosteroid given to accelerate fetal lung maturity in preterm labor between 24–34
, weeks. The standard dosing is 12 mg IM every 24 hours for 2 doses. Administering only
1 mL (A) provides an underdose that compromises effectiveness, while 2.5 mL (D)
exceeds the ordered dose.
Q7: A nurse is performing Leopold maneuvers on a client at 36 weeks. During the first
maneuver, the nurse palpates a hard, round, movable mass at the fundus. What does
this finding indicate?
A. Breech presentation with fetal head at fundus
B. Cephalic presentation with fetal buttocks at fundus
C. Cephalic presentation with fetal head at fundus [CORRECT]
D. Transverse lie with shoulder at fundus
Correct Answer: C
Rationale: The first Leopold maneuver identifies the fetal part at the fundus. A hard,
round, movable mass indicates the fetal head (cephalic presentation), while a soft,
irregular mass suggests the breech. This confirms vertex presentation with the head
occupying the uterine fundus and the presenting part likely engaged in the pelvis.
Breech presentation (A) would present a soft, irregular breech at the fundus, not a hard,
round head.
Q8 (SATA): Which clients are at increased risk for placenta previa? (Select all that
apply.)
A. Previous cesarean section [CORRECT]
B. Multiparity (≥3 births) [CORRECT]
C. Advanced maternal age >35 [CORRECT]
D. Cigarette smoking [CORRECT]
E. Nulliparity
Correct Answer: A, B, C, D
Rationale: Risk factors for placenta previa include uterine scarring from previous
cesarean sections (A), multiparity (B), advanced maternal age (C), and smoking (D)
which causes placental hypertrophy and low implantation. Nulliparity (E) is protective,
as the risk increases with each previous pregnancy due to endometrial changes and
potential scarring.
Verified Questions and Answers with Detailed
Rationales – Guaranteed A+ – Pass Guaranteed –
A+ Graded
Section 1: Antepartum (Prenatal Care & Complications) — 25 Questions
Q1: A nurse is caring for a client at 16 weeks gestation who asks when she should
expect to feel fetal movement. The nurse should explain that multiparous clients
typically perceive quickening at which time?
A. 14–16 weeks gestation [CORRECT]
B. 18–20 weeks gestation
C. 20–22 weeks gestation
D. 24–26 weeks gestation
Correct Answer: A
Rationale: Multiparous clients typically perceive quickening (fetal movement) between
14–16 weeks gestation due to prior uterine stretching and familiarity with the sensation,
while nulliparous clients usually feel movement at 18–20 weeks. This difference exists
because experienced mothers recognize subtle flutters earlier than first-time mothers.
Option B represents the nulliparous timeline, which is why it is incorrect for this
multiparous client.
Q2 (SATA): A nurse is reviewing prenatal laboratory results for a client at 28 weeks
gestation. Which findings require immediate follow-up? (Select all that apply.)
A. Hemoglobin 9.8 g/dL [CORRECT]
B. Hematocrit 32%
C. 1-hour glucose tolerance test 145 mg/dL [CORRECT]
D. Platelet count 120,000/mm³ [CORRECT]
,E. Rubella titer positive (immune)
Correct Answer: A, C, D
Rationale: Hemoglobin below 11 g/dL in the second trimester indicates anemia
requiring iron supplementation. A 1-hour glucose tolerance test ≥140 mg/dL requires
follow-up with a 3-hour glucose tolerance test to rule out gestational diabetes. Platelets
below 150,000/mm³ suggest gestational thrombocytopenia or potential HELLP
syndrome development requiring monitoring. Option B (hematocrit 32%) is within
normal physiological hemodilution range for pregnancy (32–42%). Option E indicates
immunity, which is desirable.
Q3 (Priority): The nurse in the prenatal clinic has four clients waiting. Which client
should the nurse assess FIRST?
A. A client at 38 weeks reporting decreased fetal movement over 24 hours [CORRECT]
B. A client at 12 weeks with nausea and vomiting
C. A client at 28 weeks with bilateral ankle edema
D. A client at 34 weeks requesting a tour of labor and delivery
Correct Answer: A
Rationale: Decreased fetal movement at term is a potential indicator of fetal
compromise or impending stillbirth, requiring immediate assessment with fetal heart
rate monitoring and possible biophysical profile. While nausea/vomiting (B) and edema
(C) warrant evaluation, they are not immediately threatening. Option A represents a
potential obstetric emergency, whereas the other options represent normal discomforts
or non-urgent requests that can be triaged to later priority.
Q4: A client at 32 weeks gestation has a blood pressure of 152/98 mmHg, proteinuria
2+, and reports epigastric pain. Which finding indicates progression to severe
preeclampsia?
A. Blood pressure elevation to 160/110 mmHg on recheck
B. Platelet count of 85,000/mm³ [CORRECT]
C. Weight gain of 3 pounds in one week
D. Urine protein increasing to 3+
,Correct Answer: B
Rationale: Thrombocytopenia (platelets <100,000/mm³) is a diagnostic criterion for
severe preeclampsia according to ACOG guidelines, indicating hematological
involvement and potential HELLP syndrome development. While blood pressure
≥160/110 mmHg (A) also indicates severity, a single reading requires confirmation. The
platelet count of 85,000/mm³ definitively establishes severe disease requiring
immediate intervention. Weight gain (C) and proteinuria progression (D) are concerning
but do not alone constitute severe features.
Q5: A nurse is teaching a client with Rh-negative blood about Rho(D) immune globulin
(RhoGAM). The nurse should include that this medication prevents which complication?
A. Hemolytic disease of the fetus and newborn in future pregnancies [CORRECT]
B. ABO incompatibility in the current pregnancy
C. Maternal sensitization to Kell antigen
D. Fetal hydrops in the current pregnancy only
Correct Answer: A
Rationale: Rho(D) immune globulin prevents maternal sensitization to the D antigen,
thereby preventing hemolytic disease of the fetus and newborn (HDFN) in subsequent
pregnancies if the fetus is Rh-positive. It is ineffective against ABO incompatibility (B) or
other antibodies (C). While it protects the current pregnancy if given after trauma or
procedures, its primary purpose is preventing isoimmunization for future gestations.
Q6 (Calculation): A client at 28 weeks with preterm labor is prescribed betamethasone
12 mg IM. The available vial contains 6 mg/mL. How many mL should the nurse
administer?
A. 1 mL
B. 1.5 mL
C. 2 mL [CORRECT]
D. 2.5 mL
Correct Answer: C
Rationale: Using dimensional analysis: 12 mg ÷ 6 mg/mL = 2 mL. Betamethasone is a
corticosteroid given to accelerate fetal lung maturity in preterm labor between 24–34
, weeks. The standard dosing is 12 mg IM every 24 hours for 2 doses. Administering only
1 mL (A) provides an underdose that compromises effectiveness, while 2.5 mL (D)
exceeds the ordered dose.
Q7: A nurse is performing Leopold maneuvers on a client at 36 weeks. During the first
maneuver, the nurse palpates a hard, round, movable mass at the fundus. What does
this finding indicate?
A. Breech presentation with fetal head at fundus
B. Cephalic presentation with fetal buttocks at fundus
C. Cephalic presentation with fetal head at fundus [CORRECT]
D. Transverse lie with shoulder at fundus
Correct Answer: C
Rationale: The first Leopold maneuver identifies the fetal part at the fundus. A hard,
round, movable mass indicates the fetal head (cephalic presentation), while a soft,
irregular mass suggests the breech. This confirms vertex presentation with the head
occupying the uterine fundus and the presenting part likely engaged in the pelvis.
Breech presentation (A) would present a soft, irregular breech at the fundus, not a hard,
round head.
Q8 (SATA): Which clients are at increased risk for placenta previa? (Select all that
apply.)
A. Previous cesarean section [CORRECT]
B. Multiparity (≥3 births) [CORRECT]
C. Advanced maternal age >35 [CORRECT]
D. Cigarette smoking [CORRECT]
E. Nulliparity
Correct Answer: A, B, C, D
Rationale: Risk factors for placenta previa include uterine scarring from previous
cesarean sections (A), multiparity (B), advanced maternal age (C), and smoking (D)
which causes placental hypertrophy and low implantation. Nulliparity (E) is protective,
as the risk increases with each previous pregnancy due to endometrial changes and
potential scarring.
