HESI OB Maternity Version 1 V1 Exam 2026/2027 – All
55 Questions Brand New Questions and answers
Actual Screenshots Format – Verified Answers with
Detailed Rationales – Guaranteed A+ – Pass
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Section 1: Antepartum (14 Questions)
Q1: A 28-year-old client at 10 weeks gestation presents for her first prenatal visit. She
reports a history of two previous pregnancies: the first resulted in a spontaneous
abortion at 12 weeks, and the second resulted in a live birth at 38 weeks. The current
pregnancy is her third. Using GTPAL documentation, which statement by the nurse is
correct?
A. "Your GTPAL is G3 T1 P0 A1 L1."
B. "Your GTPAL is G2 T1 P0 A1 L1."
C. "Your GTPAL is G3 T1 P1 A0 L1." [CORRECT]
D. "Your GTPAL is G3 T0 P0 A2 L0."
Correct Answer: C
Rationale: GTPAL calculates gravida (current pregnancy = 3), term births (>37 weeks =
1), preterm births (20-37 weeks = 0), abortions (<20 weeks = 1), and living children (1).
The spontaneous abortion at 12 weeks counts toward Abortions, not Preterm. HESI
expects nurses to distinguish that any pregnancy ending before 20 weeks 0 days is
documented under "A" regardless of elective or spontaneous nature. Option A
,incorrectly places the abortion in Para, while B miscalculates gravida by excluding the
current pregnancy.
Q2 (SATA): The nurse is caring for a client at 8 weeks gestation with confirmed
Rh-negative blood type. Which interventions are indicated regarding Rh sensitization
prevention? (Select all that apply.)
A. Administer RhoGAM at 28 weeks gestation [CORRECT]
B. Administer RhoGAM within 72 hours of any invasive prenatal procedure
(amniocentesis, CVS) [CORRECT]
C. Obtain an indirect Coombs test (antibody screen) at the first prenatal visit [CORRECT]
D. Administer RhoGAM only if the father is Rh-positive
E. Administer RhoGAM immediately after delivery if the newborn is Rh-negative
F. Repeat RhoGAM dosage if given earlier in pregnancy and delivery occurs within 3
weeks of the last dose
Correct Answer: A, B, C
Rationale: Standard protocol requires RhoGAM at 28 weeks (antepartum dose), within
72 hours of potential fetal-maternal hemorrhage events, and postpartum if the infant is
Rh-positive (not negative, making E incorrect). An antibody screen must establish
baseline sensitization status (C). Option D is incorrect because paternity testing is not
standard practice; RhoGAM is given prophylactically regardless of presumed paternity.
Option F is incorrect because the standard 300 mcg dose covers up to 15mL fetal red
cell exposure and remains therapeutic for 12 weeks; redosing within 3 weeks is
unnecessary unless a large fetomaternal hemorrhage is suspected and quantified.
,Q3 (Priority): A client at 28 weeks gestation calls the clinic reporting sudden onset of
vaginal bleeding described as "bright red and heavy, but I have no pain at all." Which
action should the nurse take FIRST?
A. Instruct the client to come to the clinic immediately for a sterile vaginal exam
B. Assess fetal heart tones via Doppler and notify the provider [CORRECT]
C. Advise the client to monitor the bleeding for 2 hours and call back if it increases
D. Ask the client to check her temperature and report any fever
Correct Answer: B
Rationale: Painless, bright red bleeding in the third trimester indicates placenta previa
until proven otherwise; sterile vaginal exams are contraindicated due to risk of
exacerbating hemorrhage (making A dangerous). The HESI priority framework requires
immediate fetal assessment to determine viability and distress, followed by provider
notification for likely ultrasound confirmation. Temperature assessment (D) and
watchful waiting (C) delay critical interventions for potential massive hemorrhage. The
nurse must never perform or schedule a vaginal exam when placenta previa is
suspected.
Q4: A client with pregestational diabetes (Type 1) is planning pregnancy. The nurse
reviews key preconception counseling points. Which client statement indicates
understanding of glycemic control goals?
A. "I should maintain my fasting blood glucose between 90-100 mg/dL throughout
pregnancy."
B. "My HbA1c should be less than 6.5% before conception and during the first trimester."
[CORRECT]
C. "I can continue my ACE inhibitor since it protects my kidneys during pregnancy."
, D. "Insulin requirements typically decrease during pregnancy, so I should reduce my
doses now."
Correct Answer: B
Rationale: Preconception HbA1c goals are <6.5% (ideally <6.0%) to reduce congenital
anomaly risk. Fasting glucose targets are actually 60-99 mg/dL (making A too high), and
ACE inhibitors are teratogenic and must be discontinued preconception (C). Insulin
requirements increase progressively during pregnancy due to placental hormones
creating insulin resistance—typically doubling by third trimester (D is dangerously
incorrect). HESI tests knowledge that tight glycemic control must be achieved before
conception to prevent neural tube and cardiac defects.
Q5: A client at 18 weeks gestation asks about recommended weight gain. Her
pre-pregnancy BMI was 23 kg/m² (normal weight). Which response by the nurse is
accurate?
A. "You should gain approximately 15-25 pounds total."
B. "You should gain approximately 25-35 pounds total." [CORRECT]
C. "You should gain approximately 1-2 pounds per week throughout the pregnancy."
D. "You should gain approximately 28-40 pounds total."
Correct Answer: B
Rationale: Normal BMI (18.5-24.9) correlates with 25-35 lb total gain (11.5-16 kg).
Underweight clients need 28-40 lbs (D); overweight 15-25 lbs (A). Weight gain is not
uniform—first trimester requires 1-5 lbs total, then 0.8-1 lb/week in second/third
trimesters (making C incorrect for average weekly gain throughout). HESI expects recall
of IOM guidelines and recognition that excessive or insufficient gain increases risks for
preeclampsia, macrosomia, or preterm birth.
55 Questions Brand New Questions and answers
Actual Screenshots Format – Verified Answers with
Detailed Rationales – Guaranteed A+ – Pass
Guaranteed
Section 1: Antepartum (14 Questions)
Q1: A 28-year-old client at 10 weeks gestation presents for her first prenatal visit. She
reports a history of two previous pregnancies: the first resulted in a spontaneous
abortion at 12 weeks, and the second resulted in a live birth at 38 weeks. The current
pregnancy is her third. Using GTPAL documentation, which statement by the nurse is
correct?
A. "Your GTPAL is G3 T1 P0 A1 L1."
B. "Your GTPAL is G2 T1 P0 A1 L1."
C. "Your GTPAL is G3 T1 P1 A0 L1." [CORRECT]
D. "Your GTPAL is G3 T0 P0 A2 L0."
Correct Answer: C
Rationale: GTPAL calculates gravida (current pregnancy = 3), term births (>37 weeks =
1), preterm births (20-37 weeks = 0), abortions (<20 weeks = 1), and living children (1).
The spontaneous abortion at 12 weeks counts toward Abortions, not Preterm. HESI
expects nurses to distinguish that any pregnancy ending before 20 weeks 0 days is
documented under "A" regardless of elective or spontaneous nature. Option A
,incorrectly places the abortion in Para, while B miscalculates gravida by excluding the
current pregnancy.
Q2 (SATA): The nurse is caring for a client at 8 weeks gestation with confirmed
Rh-negative blood type. Which interventions are indicated regarding Rh sensitization
prevention? (Select all that apply.)
A. Administer RhoGAM at 28 weeks gestation [CORRECT]
B. Administer RhoGAM within 72 hours of any invasive prenatal procedure
(amniocentesis, CVS) [CORRECT]
C. Obtain an indirect Coombs test (antibody screen) at the first prenatal visit [CORRECT]
D. Administer RhoGAM only if the father is Rh-positive
E. Administer RhoGAM immediately after delivery if the newborn is Rh-negative
F. Repeat RhoGAM dosage if given earlier in pregnancy and delivery occurs within 3
weeks of the last dose
Correct Answer: A, B, C
Rationale: Standard protocol requires RhoGAM at 28 weeks (antepartum dose), within
72 hours of potential fetal-maternal hemorrhage events, and postpartum if the infant is
Rh-positive (not negative, making E incorrect). An antibody screen must establish
baseline sensitization status (C). Option D is incorrect because paternity testing is not
standard practice; RhoGAM is given prophylactically regardless of presumed paternity.
Option F is incorrect because the standard 300 mcg dose covers up to 15mL fetal red
cell exposure and remains therapeutic for 12 weeks; redosing within 3 weeks is
unnecessary unless a large fetomaternal hemorrhage is suspected and quantified.
,Q3 (Priority): A client at 28 weeks gestation calls the clinic reporting sudden onset of
vaginal bleeding described as "bright red and heavy, but I have no pain at all." Which
action should the nurse take FIRST?
A. Instruct the client to come to the clinic immediately for a sterile vaginal exam
B. Assess fetal heart tones via Doppler and notify the provider [CORRECT]
C. Advise the client to monitor the bleeding for 2 hours and call back if it increases
D. Ask the client to check her temperature and report any fever
Correct Answer: B
Rationale: Painless, bright red bleeding in the third trimester indicates placenta previa
until proven otherwise; sterile vaginal exams are contraindicated due to risk of
exacerbating hemorrhage (making A dangerous). The HESI priority framework requires
immediate fetal assessment to determine viability and distress, followed by provider
notification for likely ultrasound confirmation. Temperature assessment (D) and
watchful waiting (C) delay critical interventions for potential massive hemorrhage. The
nurse must never perform or schedule a vaginal exam when placenta previa is
suspected.
Q4: A client with pregestational diabetes (Type 1) is planning pregnancy. The nurse
reviews key preconception counseling points. Which client statement indicates
understanding of glycemic control goals?
A. "I should maintain my fasting blood glucose between 90-100 mg/dL throughout
pregnancy."
B. "My HbA1c should be less than 6.5% before conception and during the first trimester."
[CORRECT]
C. "I can continue my ACE inhibitor since it protects my kidneys during pregnancy."
, D. "Insulin requirements typically decrease during pregnancy, so I should reduce my
doses now."
Correct Answer: B
Rationale: Preconception HbA1c goals are <6.5% (ideally <6.0%) to reduce congenital
anomaly risk. Fasting glucose targets are actually 60-99 mg/dL (making A too high), and
ACE inhibitors are teratogenic and must be discontinued preconception (C). Insulin
requirements increase progressively during pregnancy due to placental hormones
creating insulin resistance—typically doubling by third trimester (D is dangerously
incorrect). HESI tests knowledge that tight glycemic control must be achieved before
conception to prevent neural tube and cardiac defects.
Q5: A client at 18 weeks gestation asks about recommended weight gain. Her
pre-pregnancy BMI was 23 kg/m² (normal weight). Which response by the nurse is
accurate?
A. "You should gain approximately 15-25 pounds total."
B. "You should gain approximately 25-35 pounds total." [CORRECT]
C. "You should gain approximately 1-2 pounds per week throughout the pregnancy."
D. "You should gain approximately 28-40 pounds total."
Correct Answer: B
Rationale: Normal BMI (18.5-24.9) correlates with 25-35 lb total gain (11.5-16 kg).
Underweight clients need 28-40 lbs (D); overweight 15-25 lbs (A). Weight gain is not
uniform—first trimester requires 1-5 lbs total, then 0.8-1 lb/week in second/third
trimesters (making C incorrect for average weekly gain throughout). HESI expects recall
of IOM guidelines and recognition that excessive or insufficient gain increases risks for
preeclampsia, macrosomia, or preterm birth.
