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Quizzes > Health & Medicine

Maternity HESI Practice Questions: Sharpen Your Nursing Skills

Quick, free quiz for the HESI maternity practice exam. Instant results.

Editorial: Review CompletedCreated By: Joypreet AnandUpdated Aug 24, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for HESI maternity quiz on a teal background

This HESI maternity practice quiz helps you review key maternity nursing topics and spot weak areas before the exam. For more focused practice, check out ob hesi practice questions, build labor knowledge with an intrapartum nclex quiz, or round out study with a maternal newborn final exam.

At 24 weeks of gestation, what should the fundal height measurement in centimeters approximately be?
20 cm
30 cm
28 cm
24 cm
After 20 weeks, fundal height in centimeters generally corresponds to gestational age in weeks. At 24 weeks, the fundus should be at the level of the umbilicus, approximately 24 cm. Variations greater than 2 cm may require further assessment for fetal growth or amniotic fluid issues.
Which vitamin is recommended in early pregnancy to reduce the risk of neural tube defects?
Vitamin C
Vitamin D
Folic acid
Vitamin B12
Folic acid supplementation before conception and in early pregnancy reduces neural tube defects significantly. The recommended dose is 400 - 800 mcg daily. It supports rapid cell division and neural tube closure in the first trimester.
A presumptive sign of pregnancy is:
Fetal heartbeat on Doppler
Positive home pregnancy test
Braxton Hicks contractions
Quickening
Presumptive signs are subjective changes reported by the woman. Quickening, the first perception of fetal movement, usually occurs around 16 - 20 weeks. It can, however, be mistaken for gas or muscle twitching.
At what gestational age is a transvaginal ultrasound most accurate for confirming pregnancy dating?
16 - 18 weeks
12 - 14 weeks
8 - 10 weeks
4 - 6 weeks
A transvaginal ultrasound between 4 - 6 weeks provides the most accurate crown - rump length measurement for dating. Earlier scans ensure minimal variation in fetal size. Accuracy decreases as gestation advances due to individual growth differences.
What is the normal weight gain for a woman with a normal BMI during pregnancy?
5 - 10 pounds
25 - 35 pounds
40 - 50 pounds
11 - 20 pounds
Women with a normal BMI (18.5 - 24.9) are recommended to gain 25 - 35 pounds during pregnancy. This supports fetal growth and maternal energy stores. Gains below or above recommendations can lead to growth restriction or macrosomia.
Which is a positive sign of pregnancy?
Fetal heartbeat auscultated by Doppler
Amenorrhea
Hegar's sign
Chadwick's sign
Positive signs are objective and confirm pregnancy. Hearing fetal heartbeat with a Doppler is definitive. Other objective signs include fetal visualization on ultrasound and palpation of fetal movements by examiner.
Which food item should pregnant women avoid to reduce risk of listeriosis?
Pasteurized milk
Soft cheeses like Brie
Cooked poultry
Well-washed fruits
Soft cheeses made from unpasteurized milk can harbor Listeria monocytogenes. Listeriosis can cause miscarriage or neonatal infection. Pasteurized products and thoroughly cooked foods are safe choices.
When is Group B Streptococcus screening typically performed in pregnancy?
After labor onset
10 - 12 weeks
20 - 24 weeks
35 - 37 weeks
Universal GBS screening is done at 35 - 37 weeks to identify colonization. Positive cultures guide intrapartum antibiotic prophylaxis to prevent neonatal sepsis. Earlier screening may miss late colonization.
Which of the following is a probable sign of pregnancy?
Visualization of fetus on ultrasound
Positive urinary hCG test
Amenorrhea
Fetal movement felt by examiner
Probable signs are objective but not definitive. A positive urine hCG test indicates hormone presence but can have false positives. True positive signs include ultrasound and fetal movement by examiner.
Quickening typically occurs at which gestational age in primigravidas?
20 - 24 weeks
8 - 12 weeks
16 - 20 weeks
12 - 14 weeks
Primigravidas usually detect fetal movement between 16 - 20 weeks. Multiparas may sense it earlier around 14 - 16 weeks. Variation depends on maternal habitus and placenta placement.
What does G4P2A1L2 indicate in obstetric history?
4 pregnancies, 3 births, 1 abortion, 2 living children
4 pregnancies, 2 births, 1 abortion, 2 living children
4 pregnancies, 2 births, 1 abortion, 3 living children
4 pregnancies, 2 births, 2 abortions, 1 living child
G4 = four total pregnancies. P2 = two births beyond viability. A1 = one abortion or miscarriage. L2 = two living children. This notation sums outcomes of all pregnancies.
Which test is used routinely in the first trimester to screen for chromosomal abnormalities?
Cell-free fetal DNA
Quad screen
Glucose challenge test
Amniocentesis
Cell-free fetal DNA testing analyzes fetal DNA fragments in maternal blood as early as 10 weeks. It screens for trisomies 21, 18, and 13 with high sensitivity. It is noninvasive compared to invasive diagnostic tests.
Which physiologic change occurs in pregnancy?
Decreased cardiac output
Decreased plasma volume
Elevated white blood cell count
Increased systemic vascular resistance
In pregnancy, cardiac output increases and systemic vascular resistance decreases. Plasma volume expands, causing dilutional anemia and leukocytosis. WBC counts can rise to 15,000/mm³.
Which immunization is recommended during each pregnancy regardless of prior history?
Tetanus-diphtheria-acellular pertussis (Tdap)
Tetanus-diphtheria
Influenza (inactivated)
TNF vaccine
Tdap vaccination between 27 - 36 weeks is recommended each pregnancy to protect newborns from pertussis. Maternal antibodies pass to the fetus and confer early protection. Prior Tdap does not replace recommendation.
What is the primary purpose of performing Leopold maneuvers?
Determine fetal position
Assess fetal heart rate
Check amniotic fluid volume
Measure fundal height
Leopold maneuvers palpate the maternal abdomen to identify fetal presentation, lie, and engagement. They help guide decisions on labor management and delivery route. Accuracy improves after 28 weeks when the fetus is larger.
Which hormone initiates labor by promoting uterine contractions?
Progesterone
Oxytocin
Estrogen
Relaxin
Oxytocin stimulates uterine smooth muscle contraction and cervical dilation. It is produced by the posterior pituitary and increases in late pregnancy. Synthetic oxytocin is used for labor induction.
Which condition is indicated by hyperemesis gravidarum?
Painless bleeding
Hypertension and edema
Mild nausea and vomiting
Excessive nausea with weight loss
Hyperemesis gravidarum involves severe vomiting leading to dehydration, electrolyte imbalance, and weight loss. It often requires hospitalization and IV fluids. It differs from common morning sickness by its severity.
During which trimester is the quad screen performed?
First trimester
Second trimester
Preconception period
Third trimester
The quad screen, measuring AFP, hCG, estriol, and inhibin-A, is done between 15 - 22 weeks, most accurate at 16 - 18 weeks. It screens for neural tube defects and chromosomal abnormalities. Early or late testing reduces predictive value.
Which oral glucose tolerance test result indicates gestational diabetes?
Fasting 90 mg/dL, 1-hour 150 mg/dL
Fasting 80 mg/dL, 1-hour 140 mg/dL
Fasting 100 mg/dL, 1-hour 140 mg/dL
Fasting 95 mg/dL, 1-hour 190 mg/dL
According to ADA, a 100-g OGTT is diagnostic when two or more values exceed thresholds: fasting ?95 mg/dL, 1-hour ?180 mg/dL, 2-hour ?155 mg/dL, 3-hour ?140 mg/dL. In this example, the 1-hour value of 190 mg/dL and fasting of 95 mg/dL meet criteria. Early diagnosis permits timely management.
A test for fetal lung maturity that measures lecithin-to-sphingomyelin ratio requires a ratio of at least:
1.5:1
1:1
2:1
3:1
An L/S ratio ?2:1 indicates adequate surfactant production and lung maturity. Values below 1.5 suggest risk for neonatal respiratory distress. The test is performed on amniotic fluid after 34 weeks if early delivery is considered.
In Rh-negative mothers, when is Rho(D) immune globulin administered if the baby is Rh-positive?
At 20 weeks only
Within 24 hours postpartum only
Not needed if mother's titers are low
At 28 weeks and within 72 hours postpartum
Rho(D) immune globulin is given at 28 weeks to prevent sensitization and within 72 hours postpartum if the newborn is Rh-positive. Additional doses may be needed after invasive procedures. This reduces hemolytic disease of the fetus/newborn.
What is the most common cause of first-trimester spontaneous abortion?
Maternal infection
Uterine fibroids
Chromosomal abnormalities
Cervical insufficiency
Approximately 50% of first-trimester losses are due to chromosomal abnormalities. These result from nondisjunction during gametogenesis. Other causes include hormonal issues and uterine anomalies but are less common.
In preeclampsia with severe features, which antihypertensive is first-line for acute blood pressure control?
Methyldopa
Labetalol
Nifedipine
Hydralazine
Hydralazine IV is recommended for acute control of severe hypertension in preeclampsia. It reduces afterload by arteriolar vasodilation. Labetalol and nifedipine are alternatives but hydralazine remains first-line in many protocols.
Which TORCH infection is most associated with congenital sensorineural hearing loss?
Cytomegalovirus
Toxoplasmosis
Other (Syphilis)
Rubella
Congenital rubella syndrome features sensorineural hearing loss, cardiac defects, and cataracts. CMV is also a cause, but rubella historically has the highest association. Rubella immunity screening is standard in prenatal care.
What amniotic fluid index (AFI) is considered oligohydramnios?
AFI <5 cm
AFI 5 - 25 cm
AFI >25 cm
AFI 15 - 20 cm
Oligohydramnios is defined by an AFI less than 5 cm on ultrasound. It indicates reduced amniotic fluid volume, which can impair fetal development. Management depends on gestational age and severity.
Which condition is characterized by painless bright red vaginal bleeding in the second trimester?
Vasa previa
Placenta previa
Cervical ectropion
Abruptio placentae
Placenta previa presents with painless, bright red bleeding in the second or third trimester due to placental implantation covering the cervical os. Diagnosis is confirmed by ultrasound. Management includes pelvic rest and possible C-section if bleeding is significant.
Which medication is used to enhance fetal lung maturation when preterm delivery is anticipated?
Magnesium sulfate
Oxytocin
Betamethasone
Indomethacin
Betamethasone, a corticosteroid, is given to women at risk of preterm birth between 24 - 34 weeks to accelerate fetal lung surfactant production. It reduces neonatal respiratory distress syndrome. Two doses are typically administered 24 hours apart.
Which lab value indicates Rh isoimmunization in a pregnant woman?
Direct Coombs test positive
Indirect Coombs test positive
Positive RPR
Elevated AFP
An indirect Coombs test detects maternal antibodies against fetal RBC antigens, indicating sensitization. A positive result suggests risk for hemolytic disease of the fetus/newborn. Direct Coombs tests infant RBCs for bound antibodies.
Which measure is appropriate for managing preterm premature rupture of membranes (PPROM) at 32 weeks?
Magnesium infusion only
Immediate cesarean delivery
Tocolytics and wait to 37 weeks
Administer corticosteroids and antibiotics
In PPROM at 32 weeks, antibiotics reduce infection risk and corticosteroids enhance fetal lung maturity. Tocolytics are generally avoided to prevent infection. Delivery timing depends on maternal/fetal status.
A nonstress test (NST) is considered reactive when:
Variable decelerations present
No accelerations in 20 minutes
Fetal heart rate remains constant
Two accelerations 15 bpm above baseline for 15 seconds
A reactive NST shows at least two accelerations of ?15 bpm above baseline lasting ?15 seconds within 20 minutes. This indicates adequate fetal oxygenation and autonomic function. Nonreactive NST may require further assessment like a biophysical profile.
Which condition is most likely when the mother's blood type is O and the fetus's is A or B?
Erythroblastosis fetalis
Rh incompatibility
Kleihauer - Betke discrepancies
ABO incompatibility
ABO incompatibility occurs when type O mothers produce anti-A or anti-B antibodies that cross the placenta. It can cause mild hemolysis but is generally less severe than Rh disease. It is screened by direct Coombs on the newborn.
Which maneuver is used to relieve shoulder dystocia by flexing the maternal hips and rotating the inward posterior shoulder?
Kristeller maneuver
Episiotomy
Wood screw maneuver
McRoberts maneuver
The Wood screw maneuver rotates the fetal shoulders by pushing on the posterior shoulder, converting an anterior shoulder impaction. McRoberts involves maternal hip flexion and abduction to widen pelvic outlet. Wood screw is a secondary step if McRoberts fails.
Which finding on a biophysical profile (BPP) contributes 2 points to the score?
No fetal movement
Fetal breathing movements present
AFI >5 cm
Reactive NST
Each BPP component - NST, fetal breathing, fetal movement, fetal tone, and AFI - scores 2 if normal. Presence of one or more fetal breathing episodes lasting ?30 seconds scores 2. A normal reactive NST also scores 2.
What is the most appropriate management for a HELLP syndrome patient at 34 weeks with stable vitals?
Expectant management until 37 weeks
Outpatient observation
Immediate induction of labor
Administer tocolytics
HELLP syndrome requires prompt delivery when beyond 34 weeks regardless of stability. Expectant management increases maternal/fetal risk due to hemolysis and liver dysfunction. Induction or cesarean delivery is initiated based on obstetric readiness.
Which fetal heart rate pattern indicates early deceleration?
Onset concurrent with contraction, mirrors shape
Prolonged deceleration lasting >2 minutes
Variable timing unrelated to contraction
Delayed nadir after peak of contraction
Early decelerations are gradual decreases in FHR that mirror uterine contractions and resolve by the end of the contraction. They result from fetal head compression and are benign. Delayed and variable decelerations suggest uteroplacental insufficiency or cord compression.
In the management of postpartum hemorrhage, which drug is contraindicated in hypertensive patients?
Misoprostol
Carboprost tromethamine
Methylergonovine
Oxytocin
Methylergonovine causes vasoconstriction and can significantly raise blood pressure. It is contraindicated in hypertension. Oxytocin, carboprost, and misoprostol are safer in these patients.
Which electrolyte imbalance is most commonly seen with magnesium sulfate toxicity?
Hyperkalemia
Hypernatremia
Hypocalcemia
Hypomagnesemia
Excess magnesium can precipitate calcium out of cells, leading to hypocalcemia signs like muscle weakness and ECG changes. Monitoring reflexes and serum levels is critical. Calcium gluconate is the antidote for toxicity.
Which Doppler finding suggests fetal anemia in Rh alloimmunization?
Absent end-diastolic flow
Decreased umbilical artery resistance
Increased peak systolic velocity in middle cerebral artery
Elevated ductus venosus pulsatility index
An increased peak systolic velocity in the fetal middle cerebral artery indicates hyperdynamic circulation from anemia. It is a noninvasive marker guiding intrauterine transfusion decisions. Other Doppler signs may reflect different pathologies.
In a biophysical profile, which score indicates normal oxygenation and CNS integrity?
Score 1 for two fetal movements
Score 2 for reactive NST
Score 0 for absent breathing
Score 0 for AFI 6 cm
A reactive NST scores 2 points and reflects adequate fetal oxygenation and central nervous system function. Each component of the BPP - NST, breathing, movement, tone, and AFI - scores 2 when normal. Scores <6 typically require intervention.
Which sign on ultrasound is indicative of placenta accreta?
Low-lying placenta
Placental lakes with turbulent flow
Polyhydramnios
Single umbilical artery
Placental lacunae with turbulent blood flow on Doppler suggest deep villous invasion seen in placenta accreta. Other ultrasound findings include loss of the clear zone and myometrial thinning. Accurate prenatal diagnosis prevents catastrophic hemorrhage at delivery.
What is the most appropriate initial step for a patient in preterm labor at 32 weeks?
Induce labor with oxytocin
Perform amniotomy
Administer betamethasone and tocolytics
Immediate cesarean delivery
At 32 weeks, delaying delivery for 48 hours with tocolytics allows corticosteroids time to enhance fetal lung maturity. Betamethasone reduces neonatal respiratory complications. Tocolysis is safe if no contraindications exist.
Which pattern on cardiotocography indicates uteroplacental insufficiency?
Recurrent accelerations
Variable decelerations
Early decelerations
Late decelerations
Late decelerations are gradual decreases in FHR that begin after the peak of a contraction and recover after it ends. They signal uteroplacental insufficiency and fetal hypoxia. Persistent late decelerations require intervention.
Which drug combination is appropriate for prevention of preeclampsia in high-risk women?
Progesterone and betamethasone
Labetalol and nifedipine
Heparin and magnesium sulfate
Low-dose aspirin and calcium supplementation
Low-dose aspirin (81 mg) started after 12 weeks and calcium supplementation in low-intake populations reduce preeclampsia risk. Heparin is used for thrombophilias. Antihypertensives treat established hypertension but do not prevent preeclampsia.
Which receptor-mediated mechanism drives increased maternal insulin resistance in late pregnancy?
Progesterone upregulates insulin receptors
Estrogen enhances glucose uptake
Human placental lactogen antagonizes insulin
Relaxin increases insulin secretion
Human placental lactogen (hPL) has anti-insulin effects that promote lipolysis and raise maternal blood glucose for fetal nutrition. hPL levels rise as placental mass increases. This physiologic insulin resistance can unmask gestational diabetes.
In a patient with amniotic fluid embolism, which lab abnormality is most characteristic?
Thrombocytopenia and DIC
Metabolic alkalosis
Hyperglycemia
Elevated fibrinogen
Amniotic fluid embolism triggers disseminated intravascular coagulation, consuming platelets and clotting factors. Sudden cardiovascular collapse, respiratory distress, and DIC define the syndrome. Early recognition and supportive management are critical.
Which component of the uterine contraction pressure tracing defines tachysystole?
Each contraction lasting over 90 seconds
Fewer than 3 contractions in 10 minutes
One contraction every 2 minutes
More than 5 contractions in 10 minutes averaged over 30 minutes
Uterine tachysystole is defined as more than 5 contractions in a 10-minute window averaged across 30 minutes. It can cause fetal hypoxia due to reduced uteroplacental perfusion. Management includes reducing or stopping oxytocin infusion.
Which genetic mutation is linked to preeclampsia in some women?
MTHFR mutation
BRCA1 mutation
Factor V Leiden
ACE gene insertion/deletion
The ACE gene insertion/deletion polymorphism has been associated with altered angiotensin II levels and preeclampsia risk. Studies suggest women with the D allele have increased vasoconstriction and hypertension. Other thrombophilias also contribute but less consistently.
Which placental pathology is characterized by abnormal villous maturation with infarcts and accelerated villous maturation?
Maternal vascular malperfusion
Villitis of unknown etiology
Chorioamnionitis
Chronic intervillositis
Maternal vascular malperfusion features infarcts, accelerated villous maturation, and distal villous hypoplasia due to inadequate spiral artery remodeling. It is seen in preeclampsia and fetal growth restriction. Histology guides clinical correlation and recurrence risk.
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Study Outcomes

  1. Understand Maternal Physiological Changes -

    Identify and explain the key adaptations in cardiovascular, respiratory, and endocrine systems during pregnancy to answer HESI maternity questions accurately.

  2. Apply Labor Management Interventions -

    Select appropriate nursing actions for different stages of labor and delivery based on evidence-based guidelines and best practices in maternity care.

  3. Analyze Fetal Assessment Data -

    Interpret findings from fetal heart rate monitoring, ultrasound, and biophysical profiles to determine fetal well-being and guide clinical decisions.

  4. Differentiate Common Pregnancy Complications -

    Recognize signs and symptoms of preeclampsia, gestational diabetes, and other high-risk conditions to prioritize nursing interventions and patient safety.

  5. Recall HESI Maternity Quiz Strategies -

    Employ targeted test-taking techniques and time management tips specifically for HESI maternity practice questions to boost exam confidence.

  6. Evaluate Personal Performance Gaps -

    Use instant feedback from the maternity nursing quiz to identify areas for further study and create a focused review plan before test day.

Cheat Sheet

  1. GTPAL Mnemonic for Obstetric History -

    Mnemonic stands for Gravida, Term, Preterm, Abortion, and Living to help recall key maternal history details quickly. Many HESI maternity questions use patient charts, so practicing GTPAL ensures accurate interpretation. For example, G2T1P0A1L1 describes a second pregnancy with one term birth, zero preterm births, one abortion, and one living child.

  2. Physiological Cardiovascular Changes -

    During pregnancy, blood volume increases by 30 - 50% and cardiac output rises by about 30%, which can cause mild tachycardia and decreased systemic vascular resistance (ACOG, 2021). HESI maternity practice questions often focus on recognizing normal adaptations vs. signs of decompensation, like sudden edema or hypertension. Remember "BUMP" - Blood volume Up, Murmurs possible, Pulse up, Pressure down.

  3. Fetal Heart Rate Monitoring: VEAL-CHOP -

    Use the VEAL-CHOP mnemonic to match decelerations (Variable, Early, Accelerations, Late) with causes (Cord compression, Head compression, Oxygenation, Placental insufficiency). Many HESI maternity questions will ask you to interpret a strip, so practice identifying patterns and appropriate interventions. For instance, late decels paired with placental insufficiency often require maternal repositioning and oxygen.

  4. Preeclampsia Management and Magnesium Sulfate -

    Preeclampsia is defined by new-onset hypertension after 20 weeks with proteinuria or end-organ dysfunction (NIH, 2022). HESI maternity questions target magnesium sulfate dosing (usually a 4 - 6 g IV bolus followed by 1 - 2 g/hr) and toxicity signs such as loss of deep tendon reflexes. Always monitor reflexes, respiratory rate, and urine output to ensure safe therapeutic levels.

  5. Stages of Labor and Bishop Score -

    Knowing the four stages - latent, active, transition, and delivery - is vital for answering HESI maternity quiz scenarios on labor progress. The Bishop score (0 - 13) helps predict induction success by evaluating cervical dilation, effacement, consistency, position, and fetal station. A score ≥8 in nulliparas suggests favorable cervical conditions for induction.

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