1
HESI Maternity OB Exam 2026/2027 Actual
Exam - Complete Questions with Detailed
Rationales | 100% Verified Graded A+ Pass
Guaranteed - A+ Graded
[VERSION 1 - Complete Exam]
Section 1: Antepartum Care & Pregnancy Complications
Q1: A 28-year-old G1P0 at 28 weeks' gestation presents for a routine prenatal visit. Her blood
pressure is 148/94 mmHg, and she has 2+ proteinuria on urine dipstick. She reports a mild
frontal headache but no visual disturbances. Which of the following actions by the nurse is the
priority?
A. Administer acetaminophen for the headache and reassess in 1 hour.
B. Obtain a prescription for an antihypertensive medication and schedule a follow-up in one
week.
C. Prepare the client for immediate hospital admission and initiation of magnesium sulfate.
D. Instruct the client to perform daily fetal kick counts and restrict her fluid intake.
C. Prepare the client for immediate hospital admission and initiation of magnesium sulfate.
[CORRECT]
Correct Answer: C
Rationale: The client's blood pressure and new-onset headache with proteinuria indicate
gestational hypertension with severe features (preeclampsia), requiring immediate hospitalization
for magnesium sulfate to prevent eclampsia. Sending the client home or just treating the
headache is dangerous, as preeclampsia can rapidly progress to seizures or stroke.
Q2: A pregnant client at 24 weeks' gestation is scheduled for a 1-hour glucose tolerance test
(GCT). Which of the following instructions should the nurse provide to the client regarding this
screening?
A. "Fast for at least 12 hours before the test and only drink water."
B. "Eat a high-protein breakfast before arriving and avoid carbohydrates."
C. "Drink the glucose solution within a 5-minute window and remain seated during the test."
,2
D. "You do not need to restrict your diet beforehand, but avoid taking your prenatal vitamin that
morning."
C. "Drink the glucose solution within a 5-minute window and remain seated during the test."
[CORRECT]
Correct Answer: C
Rationale: The 1-hour GCT does not require fasting; the client should maintain a normal diet but
avoid high-sugar meals immediately prior. The glucose solution must be consumed quickly
(usually within 5 minutes), and the client should remain sedentary to prevent falsely elevated
blood glucose results from muscular activity.
Q3: [IMAGE DESCRIPTION: A transvaginal ultrasound image showing the placenta completely
covering the internal cervical os, with the fetus located in the fundal area.] A 32-year-old G3P2 at
30 weeks' gestation undergoes a routine ultrasound. Based on the findings in the image, which of
the following nursing interventions is most appropriate?
A. Prepare the client for an immediate cesarean section delivery.
B. Instruct the client to avoid sexual intercourse and vaginal examinations.
C. Perform a digital cervical exam to assess for cervical dilation.
D. Educate the client on the use of misoprostol for cervical ripening.
B. Instruct the client to avoid sexual intercourse and vaginal examinations. [CORRECT]
Correct Answer: B
Rationale: The image depicts placenta previa, where the placenta covers the cervical os. Digital
vaginal exams or any activity that disrupts the cervix (intercourse) are strictly contraindicated
due to the high risk of massive hemorrhage. Immediate delivery is not indicated at 30 weeks
without active bleeding, and misoprostol is contraindicated as it can trigger bleeding.
Q4: A nurse is assessing a client at 10 weeks' gestation who reports severe nausea and vomiting
three to four times a day. The client's weight is 3 lbs less than her pre-pregnancy weight, and her
urine dipstick shows ketones. Which condition does this presentation most likely indicate?
A. Pyelonephritis
B. Hyperemesis gravidarum
C. Gestational hypertension
,3
D. Placental abruption
B. Hyperemesis gravidarum [CORRECT]
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by severe, intractable nausea and vomiting
leading to dehydration, weight loss (greater than 5% of pre-pregnancy weight), and metabolic
imbalances such as ketonuria. It differs from typical pregnancy nausea by its severity and
associated metabolic derangements.
Q5: A 34-year-old G2P1 at 18 weeks' gestation has an ultrasound that reveals a shortened
cervical length of 18 mm. The client has no contractions or bleeding. Which of the following
medical interventions should the nurse anticipate preparing the client for?
A. Administration of betamethasone
B. Placement of a cervical cerclage
C. Emergency cesarean delivery
D. Initiation of oxytocin induction
B. Placement of a cervical cerclage [CORRECT]
Correct Answer: B
Rationale: A short cervix (<25 mm) in the second trimester without active labor is a primary
indication for a cervical cerclage, a procedure where the cervix is stitched closed to prevent
premature cervical dilation and preterm birth. Betamethasone is given later (24-34 weeks) if
preterm labor is imminent, and delivery is not indicated.
Q6: A client at 8 weeks' gestation presents to the emergency department with vaginal bleeding
and mild cramping. Her cervix is closed. An ultrasound confirms a fetal heart rate of 140 bpm.
Which type of miscarriage is the client experiencing?
A. Inevitable abortion
B. Threatened abortion
C. Incomplete abortion
D. Missed abortion
B. Threatened abortion [CORRECT]
, 4
Correct Answer: B
Rationale: A threatened abortion is characterized by vaginal bleeding and cramping in the first
trimester with a closed cervix and a viable fetus (confirmed by fetal heart tones). An inevitable
abortion involves an open cervix, while an incomplete abortion involves partial expulsion of
products of conception.
Q7: A 26-year-old client at 12 weeks' gestation presents with sudden, severe right lower quadrant
abdominal pain, vaginal spotting, and signs of hypovolemic shock. Which of the following is the
priority nursing action?
A. Administer a PRN dose of ondansetron for nausea.
B. Prepare the client for an immediate pelvic ultrasound.
C. Initiate a large-bore IV and prepare for emergency surgery.
D. Draw blood for a type and screen and wait for results.
C. Initiate a large-bore IV and prepare for emergency surgery. [CORRECT]
Correct Answer: C
Rationale: The client's presentation is classic for a ruptured ectopic pregnancy with hypovolemic
shock. The absolute priority is volume resuscitation via large-bore IVs and immediate surgical
intervention (laparotomy or laparoscopy) to stop the life-threatening intra-abdominal
hemorrhage. Delaying for imaging or labs is fatal.
Q8: A nurse is providing genetic counseling to a 38-year-old G1P0 at 12 weeks' gestation. The
client asks about the purpose of chorionic villus sampling (CVS). Which response by the nurse is
accurate?
A. "It detects neural tube defects such as spina bifida."
B. "It can diagnose chromosomal abnormalities like Down syndrome early in the first trimester."
C. "It measures the level of alpha-fetoprotein in your blood."
D. "It evaluates the amniotic fluid for fetal lung maturity."
B. "It can diagnose chromosomal abnormalities like Down syndrome early in the first trimester."
[CORRECT]
Correct Answer: B
HESI Maternity OB Exam 2026/2027 Actual
Exam - Complete Questions with Detailed
Rationales | 100% Verified Graded A+ Pass
Guaranteed - A+ Graded
[VERSION 1 - Complete Exam]
Section 1: Antepartum Care & Pregnancy Complications
Q1: A 28-year-old G1P0 at 28 weeks' gestation presents for a routine prenatal visit. Her blood
pressure is 148/94 mmHg, and she has 2+ proteinuria on urine dipstick. She reports a mild
frontal headache but no visual disturbances. Which of the following actions by the nurse is the
priority?
A. Administer acetaminophen for the headache and reassess in 1 hour.
B. Obtain a prescription for an antihypertensive medication and schedule a follow-up in one
week.
C. Prepare the client for immediate hospital admission and initiation of magnesium sulfate.
D. Instruct the client to perform daily fetal kick counts and restrict her fluid intake.
C. Prepare the client for immediate hospital admission and initiation of magnesium sulfate.
[CORRECT]
Correct Answer: C
Rationale: The client's blood pressure and new-onset headache with proteinuria indicate
gestational hypertension with severe features (preeclampsia), requiring immediate hospitalization
for magnesium sulfate to prevent eclampsia. Sending the client home or just treating the
headache is dangerous, as preeclampsia can rapidly progress to seizures or stroke.
Q2: A pregnant client at 24 weeks' gestation is scheduled for a 1-hour glucose tolerance test
(GCT). Which of the following instructions should the nurse provide to the client regarding this
screening?
A. "Fast for at least 12 hours before the test and only drink water."
B. "Eat a high-protein breakfast before arriving and avoid carbohydrates."
C. "Drink the glucose solution within a 5-minute window and remain seated during the test."
,2
D. "You do not need to restrict your diet beforehand, but avoid taking your prenatal vitamin that
morning."
C. "Drink the glucose solution within a 5-minute window and remain seated during the test."
[CORRECT]
Correct Answer: C
Rationale: The 1-hour GCT does not require fasting; the client should maintain a normal diet but
avoid high-sugar meals immediately prior. The glucose solution must be consumed quickly
(usually within 5 minutes), and the client should remain sedentary to prevent falsely elevated
blood glucose results from muscular activity.
Q3: [IMAGE DESCRIPTION: A transvaginal ultrasound image showing the placenta completely
covering the internal cervical os, with the fetus located in the fundal area.] A 32-year-old G3P2 at
30 weeks' gestation undergoes a routine ultrasound. Based on the findings in the image, which of
the following nursing interventions is most appropriate?
A. Prepare the client for an immediate cesarean section delivery.
B. Instruct the client to avoid sexual intercourse and vaginal examinations.
C. Perform a digital cervical exam to assess for cervical dilation.
D. Educate the client on the use of misoprostol for cervical ripening.
B. Instruct the client to avoid sexual intercourse and vaginal examinations. [CORRECT]
Correct Answer: B
Rationale: The image depicts placenta previa, where the placenta covers the cervical os. Digital
vaginal exams or any activity that disrupts the cervix (intercourse) are strictly contraindicated
due to the high risk of massive hemorrhage. Immediate delivery is not indicated at 30 weeks
without active bleeding, and misoprostol is contraindicated as it can trigger bleeding.
Q4: A nurse is assessing a client at 10 weeks' gestation who reports severe nausea and vomiting
three to four times a day. The client's weight is 3 lbs less than her pre-pregnancy weight, and her
urine dipstick shows ketones. Which condition does this presentation most likely indicate?
A. Pyelonephritis
B. Hyperemesis gravidarum
C. Gestational hypertension
,3
D. Placental abruption
B. Hyperemesis gravidarum [CORRECT]
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by severe, intractable nausea and vomiting
leading to dehydration, weight loss (greater than 5% of pre-pregnancy weight), and metabolic
imbalances such as ketonuria. It differs from typical pregnancy nausea by its severity and
associated metabolic derangements.
Q5: A 34-year-old G2P1 at 18 weeks' gestation has an ultrasound that reveals a shortened
cervical length of 18 mm. The client has no contractions or bleeding. Which of the following
medical interventions should the nurse anticipate preparing the client for?
A. Administration of betamethasone
B. Placement of a cervical cerclage
C. Emergency cesarean delivery
D. Initiation of oxytocin induction
B. Placement of a cervical cerclage [CORRECT]
Correct Answer: B
Rationale: A short cervix (<25 mm) in the second trimester without active labor is a primary
indication for a cervical cerclage, a procedure where the cervix is stitched closed to prevent
premature cervical dilation and preterm birth. Betamethasone is given later (24-34 weeks) if
preterm labor is imminent, and delivery is not indicated.
Q6: A client at 8 weeks' gestation presents to the emergency department with vaginal bleeding
and mild cramping. Her cervix is closed. An ultrasound confirms a fetal heart rate of 140 bpm.
Which type of miscarriage is the client experiencing?
A. Inevitable abortion
B. Threatened abortion
C. Incomplete abortion
D. Missed abortion
B. Threatened abortion [CORRECT]
, 4
Correct Answer: B
Rationale: A threatened abortion is characterized by vaginal bleeding and cramping in the first
trimester with a closed cervix and a viable fetus (confirmed by fetal heart tones). An inevitable
abortion involves an open cervix, while an incomplete abortion involves partial expulsion of
products of conception.
Q7: A 26-year-old client at 12 weeks' gestation presents with sudden, severe right lower quadrant
abdominal pain, vaginal spotting, and signs of hypovolemic shock. Which of the following is the
priority nursing action?
A. Administer a PRN dose of ondansetron for nausea.
B. Prepare the client for an immediate pelvic ultrasound.
C. Initiate a large-bore IV and prepare for emergency surgery.
D. Draw blood for a type and screen and wait for results.
C. Initiate a large-bore IV and prepare for emergency surgery. [CORRECT]
Correct Answer: C
Rationale: The client's presentation is classic for a ruptured ectopic pregnancy with hypovolemic
shock. The absolute priority is volume resuscitation via large-bore IVs and immediate surgical
intervention (laparotomy or laparoscopy) to stop the life-threatening intra-abdominal
hemorrhage. Delaying for imaging or labs is fatal.
Q8: A nurse is providing genetic counseling to a 38-year-old G1P0 at 12 weeks' gestation. The
client asks about the purpose of chorionic villus sampling (CVS). Which response by the nurse is
accurate?
A. "It detects neural tube defects such as spina bifida."
B. "It can diagnose chromosomal abnormalities like Down syndrome early in the first trimester."
C. "It measures the level of alpha-fetoprotein in your blood."
D. "It evaluates the amniotic fluid for fetal lung maturity."
B. "It can diagnose chromosomal abnormalities like Down syndrome early in the first trimester."
[CORRECT]
Correct Answer: B
