HESI Maternity OB Exam Bundle - Versions 1, 2, 3 + A/B/C Review 2026/2027 | Page 1 | Passing Score: Pass/Fail
HESI / ELSEVIER
HESI Maternity OB Exam Bundle - Versions 1, 2, 3
+ A/B/C Review
2026/2027 Edition - Official Exam 2026/2027
85 P/F N/A
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Antepartum Care Q1-15
Section 2 Intrapartum Care Q16-30
Section 3 Postpartum Care Q31-45
Section 4 Newborn Care Q46-60
Section 5 High-Risk Pregnancy Q61-75
Section 6 Complications and Emergencies Q76-85
Instructions: Select the single best answer for each question. This exam is designed for HESI Maternity OB Exam
certification preparation. Passing score determined by HESI standard.
, SECTION 1 | Antepartum Care | Q1-Q15 | HESI Maternity OB Exam 2026/2027
Q1 Question 1 of 85
A 26-year-old primigravida at 12 weeks gestation presents to the prenatal clinic for her initial visit.
The nurse calculates the estimated date of delivery using Nagele's rule. The first day of the patient's
last menstrual period was August 10. What is the estimated date of delivery?
A. May 10
B. August 17
C. May 17
D. November 17
Correct Answer: C
Rationale:
Nagele's rule subtracts 3 months from the first day of the last menstrual period and adds 7 days. August 10 minus 3
months is May 10, plus 7 days equals May 17. This is the standard method for estimating the due date in a regular
28-day cycle.
Q2 Question 2 of 85
A pregnant client at 16 weeks gestation asks the nurse why she needs to take a folic acid
supplement throughout her pregnancy. The nurse explains that folic acid supplementation primarily
reduces the risk of which condition in the developing fetus?
A. Cardiac defects
B. Cleft lip and palate
C. Neural tube defects
D. Limb reduction defects
Correct Answer: C
Rationale:
Folic acid supplementation before conception and during early pregnancy significantly reduces the risk of neural tube
defects such as spina bifida and anencephaly. While folic acid has other benefits, its most well-established protective
effect is against neural tube defects during the critical period of neural tube closure in the first 4 weeks of gestation.
, SECTION 1 | Antepartum Care | Q1-Q15 | HESI Maternity OB Exam 2026/2027
Q4 Question 4 of 85
A 32-year-old client at 20 weeks gestation has a maternal serum alpha-fetoprotein (MSAFP) level
that is elevated above normal for gestational age. The nurse understands that an elevated MSAFP
may indicate which condition?
A. Down syndrome
B. Gestational diabetes
C. Open neural tube defect
D. Intrauterine growth restriction
Correct Answer: C
Rationale:
An elevated maternal serum alpha-fetoprotein level is associated with open neural tube defects such as anencephaly
and spina bifida, as AFP leaks from the fetal circulation into the maternal bloodstream through the open defect. Down
syndrome is associated with decreased MSAFP, and gestational diabetes and IUGR are not detected by MSAFP
screening.
Q5 Question 5 of 85
A pregnant client at 10 weeks gestation calls the clinic reporting severe nausea and vomiting that has
caused a 3-pound weight loss since her last visit. The nurse suspects hyperemesis gravidarum and
knows that which finding differentiates this condition from normal morning sickness?
A. Nausea that occurs primarily in the morning
B. Weight loss exceeding 5% of pre-pregnancy weight with ketonuria
C. Intermittent vomiting that improves with small meals
D. Mild dehydration that resolves with oral fluid intake
Correct Answer: B
Rationale:
Hyperemesis gravidarum is distinguished from normal nausea and vomiting of pregnancy by weight loss exceeding 5%
of pre-pregnancy weight, persistent vomiting, ketonuria, and significant dehydration. Normal morning sickness involves
intermittent nausea and vomiting without substantial weight loss or metabolic disturbance.
, SECTION 1 | Antepartum Care | Q1-Q15 | HESI Maternity OB Exam 2026/2027
Q7 Question 7 of 85
A client at 18 weeks gestation undergoes a quadruple screen test. The results show decreased
alpha-fetoprotein, decreased estriol, and elevated human chorionic gonadotropin. These findings are
most consistent with which condition?
A. Neural tube defect
B. Trisomy 18 (Edwards syndrome)
C. Trisomy 21 (Down syndrome)
D. Turner syndrome
Correct Answer: C
Rationale:
The classic triple marker pattern for Down syndrome includes decreased alpha-fetoprotein, decreased estriol, and
elevated hCG. This pattern is the basis of the quad screen used to assess the risk of chromosomal abnormalities.
Neural tube defects show elevated AFP, and Trisomy 18 typically shows decreased levels of all markers.
Q8 Question 8 of 85
A pregnant client at 24 weeks gestation has a 1-hour glucose challenge test result of 155 mg/dL. The
nurse understands that the next step in the diagnostic process is which of these actions?
A. Initiate insulin therapy immediately
B. Refer the client for nutritional counseling only
C. Repeat the 1-hour glucose challenge test in 2 weeks
D. Perform a 3-hour oral glucose tolerance test
Correct Answer: D
Rationale:
A 1-hour glucose challenge test result of 140 mg/dL or higher requires follow-up with a 3-hour oral glucose tolerance
test to confirm or rule out gestational diabetes. The 3-hour OGTT is the diagnostic standard, as the 1-hour test is a
screening tool only. Insulin therapy and dietary modifications are initiated only after a confirmed diagnosis.
HESI / ELSEVIER
HESI Maternity OB Exam Bundle - Versions 1, 2, 3
+ A/B/C Review
2026/2027 Edition - Official Exam 2026/2027
85 P/F N/A
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Antepartum Care Q1-15
Section 2 Intrapartum Care Q16-30
Section 3 Postpartum Care Q31-45
Section 4 Newborn Care Q46-60
Section 5 High-Risk Pregnancy Q61-75
Section 6 Complications and Emergencies Q76-85
Instructions: Select the single best answer for each question. This exam is designed for HESI Maternity OB Exam
certification preparation. Passing score determined by HESI standard.
, SECTION 1 | Antepartum Care | Q1-Q15 | HESI Maternity OB Exam 2026/2027
Q1 Question 1 of 85
A 26-year-old primigravida at 12 weeks gestation presents to the prenatal clinic for her initial visit.
The nurse calculates the estimated date of delivery using Nagele's rule. The first day of the patient's
last menstrual period was August 10. What is the estimated date of delivery?
A. May 10
B. August 17
C. May 17
D. November 17
Correct Answer: C
Rationale:
Nagele's rule subtracts 3 months from the first day of the last menstrual period and adds 7 days. August 10 minus 3
months is May 10, plus 7 days equals May 17. This is the standard method for estimating the due date in a regular
28-day cycle.
Q2 Question 2 of 85
A pregnant client at 16 weeks gestation asks the nurse why she needs to take a folic acid
supplement throughout her pregnancy. The nurse explains that folic acid supplementation primarily
reduces the risk of which condition in the developing fetus?
A. Cardiac defects
B. Cleft lip and palate
C. Neural tube defects
D. Limb reduction defects
Correct Answer: C
Rationale:
Folic acid supplementation before conception and during early pregnancy significantly reduces the risk of neural tube
defects such as spina bifida and anencephaly. While folic acid has other benefits, its most well-established protective
effect is against neural tube defects during the critical period of neural tube closure in the first 4 weeks of gestation.
, SECTION 1 | Antepartum Care | Q1-Q15 | HESI Maternity OB Exam 2026/2027
Q4 Question 4 of 85
A 32-year-old client at 20 weeks gestation has a maternal serum alpha-fetoprotein (MSAFP) level
that is elevated above normal for gestational age. The nurse understands that an elevated MSAFP
may indicate which condition?
A. Down syndrome
B. Gestational diabetes
C. Open neural tube defect
D. Intrauterine growth restriction
Correct Answer: C
Rationale:
An elevated maternal serum alpha-fetoprotein level is associated with open neural tube defects such as anencephaly
and spina bifida, as AFP leaks from the fetal circulation into the maternal bloodstream through the open defect. Down
syndrome is associated with decreased MSAFP, and gestational diabetes and IUGR are not detected by MSAFP
screening.
Q5 Question 5 of 85
A pregnant client at 10 weeks gestation calls the clinic reporting severe nausea and vomiting that has
caused a 3-pound weight loss since her last visit. The nurse suspects hyperemesis gravidarum and
knows that which finding differentiates this condition from normal morning sickness?
A. Nausea that occurs primarily in the morning
B. Weight loss exceeding 5% of pre-pregnancy weight with ketonuria
C. Intermittent vomiting that improves with small meals
D. Mild dehydration that resolves with oral fluid intake
Correct Answer: B
Rationale:
Hyperemesis gravidarum is distinguished from normal nausea and vomiting of pregnancy by weight loss exceeding 5%
of pre-pregnancy weight, persistent vomiting, ketonuria, and significant dehydration. Normal morning sickness involves
intermittent nausea and vomiting without substantial weight loss or metabolic disturbance.
, SECTION 1 | Antepartum Care | Q1-Q15 | HESI Maternity OB Exam 2026/2027
Q7 Question 7 of 85
A client at 18 weeks gestation undergoes a quadruple screen test. The results show decreased
alpha-fetoprotein, decreased estriol, and elevated human chorionic gonadotropin. These findings are
most consistent with which condition?
A. Neural tube defect
B. Trisomy 18 (Edwards syndrome)
C. Trisomy 21 (Down syndrome)
D. Turner syndrome
Correct Answer: C
Rationale:
The classic triple marker pattern for Down syndrome includes decreased alpha-fetoprotein, decreased estriol, and
elevated hCG. This pattern is the basis of the quad screen used to assess the risk of chromosomal abnormalities.
Neural tube defects show elevated AFP, and Trisomy 18 typically shows decreased levels of all markers.
Q8 Question 8 of 85
A pregnant client at 24 weeks gestation has a 1-hour glucose challenge test result of 155 mg/dL. The
nurse understands that the next step in the diagnostic process is which of these actions?
A. Initiate insulin therapy immediately
B. Refer the client for nutritional counseling only
C. Repeat the 1-hour glucose challenge test in 2 weeks
D. Perform a 3-hour oral glucose tolerance test
Correct Answer: D
Rationale:
A 1-hour glucose challenge test result of 140 mg/dL or higher requires follow-up with a 3-hour oral glucose tolerance
test to confirm or rule out gestational diabetes. The 3-hour OGTT is the diagnostic standard, as the 1-hour test is a
screening tool only. Insulin therapy and dietary modifications are initiated only after a confirmed diagnosis.
