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Quizzes > Health & Medicine > Human Anatomy & Medicine

Challenge Yourself with the Maternity HESI Practice Quiz

Challenge Yourself with OB HESI Practice Questions

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art mother cradles newborn surrounded by nursing symbols on sky blue background promoting maternity HESI quiz

This Maternity HESI practice quiz helps you review OB topics and spot gaps before the exam. You'll work through prenatal, labor, postpartum, and newborn care items that feel like the real test, then use your results to plan study time. When you're done, try extra practice questions or another OB quiz .

What is the recommended total weight gain for a woman with a normal pre-pregnancy BMI?
11-20 lbs
35-45 lbs
25-35 lbs
15-25 lbs
For women with a normal BMI (18.5 - 24.9), guidelines recommend 25 - 35 pounds of weight gain to support fetal growth and minimize maternal complications. Staying within this range reduces risks of gestational diabetes and hypertension. Close monitoring and dietary counseling help ensure appropriate gain.
What is the expected fundal height in centimeters at 24 weeks gestation?
22 cm
24 cm
26 cm
20 cm
After about 20 weeks, fundal height in centimeters generally corresponds to the number of weeks of gestation. At 24 weeks, you would expect approximately 24 cm measured from the symphysis pubis to the uterine fundus. Small deviations of 1 - 2 cm are considered normal.
Which laboratory test is routinely ordered at the first prenatal visit?
Oral Glucose Tolerance Test
Amniocentesis
CBC (Complete Blood Count)
Nonstress Test
A CBC is standard at the initial prenatal visit to assess hemoglobin, hematocrit, and platelet levels. This screening identifies anemia, infection, and clotting risks early in pregnancy. Glucose tolerance and nonstress tests are done later in gestation.
What is the recommended daily folic acid intake for women of childbearing age to prevent neural tube defects?
0.4 mg
1 mg
4 mg
2 mg
The CDC and ACOG recommend 0.4 mg (400 mcg) of folic acid daily for all women of childbearing age to reduce neural tube defect risk. Women with a prior NTD - affected pregnancy may require a higher dose. Adequate intake is crucial before conception and during early pregnancy.
At what gestational age does the American College of Obstetricians and Gynecologists define full term?
38 weeks
41 weeks
37 weeks
39 weeks
ACOG defines full-term pregnancy as 39?0/7 to 40?6/7 weeks of gestation. Earlier than 39 weeks is considered early term, and after 41 weeks is late or post-term. This categorization helps guide decisions on labor induction and neonatal care.
Leopold's maneuvers are used during prenatal assessment to determine:
Fetal heart tones
Uterine contraction strength
Amniotic fluid volume
Fetal position and presentation
Leopold's maneuvers are a series of abdominal palpations to identify fetal lie, presentation, and engagement. This hands-on technique helps the clinician estimate fetal head position and orientation. It does not directly assess heart tones or fluid volume.
Which event marks the end of the first stage of labor?
Full cervical effacement
Complete cervical dilation
Birth of the infant
Passage of the placenta
The first stage of labor is from the onset of regular contractions until full cervical dilation (10 cm). Effacement often precedes dilation, and birth of the infant marks the second stage. Placental delivery defines the third stage.
What is the normal baseline fetal heart rate range?
110-160 bpm
90-130 bpm
100-140 bpm
120-180 bpm
A normal fetal heart rate baseline ranges from 110 to 160 beats per minute. Rates below or above this range may indicate fetal distress and require further evaluation. Continuous monitoring helps ensure timely intervention.
Which of the following is a probable sign of pregnancy?
Visualization of fetus on ultrasound
Hearing fetal heart tones
Quickening (fetal movement felt by mother)
Ballottement (rebounding of fetus on palpation)
Ballottement is an objective finding where the examiner feels the fetal body rebound when the cervix is tapped. Quickening is a presumptive sign, and visualization or auscultation are positive signs. Probable signs include changes like uterine enlargement and Braxton Hicks.
Which best describes Braxton Hicks contractions?
Painless, irregular uterine contractions
Contractions associated with placental abruption
Painful, regular contractions causing cervical dilation
Intense contractions during active labor
Braxton Hicks contractions are intermittent, irregular, and usually painless uterine tightenings that occur throughout pregnancy. They do not cause cervical dilation and are considered a false labor sign. True labor contractions are regular and progressive.
Which blood pressure reading is indicative of mild preeclampsia?
120/70 mm Hg
160/110 mm Hg
150/100 mm Hg
130/80 mm Hg
Mild preeclampsia is diagnosed when systolic BP is ?140 mm Hg but <160 mm Hg or diastolic BP is ?90 mm Hg but <110 mm Hg on two occasions at least four hours apart, along with proteinuria. Severe preeclampsia has higher thresholds. Early detection prevents complications.
What is the normal cutoff value for a 1-hour glucose challenge test in pregnancy?
< 120 mg/dL
< 130 mg/dL
< 100 mg/dL
< 150 mg/dL
A 1-hour 50g glucose challenge test is considered normal if the plasma glucose is below 130 - 140 mg/dL, with many centers using 130 mg/dL as the cutoff. Values at or above this warrant a diagnostic 3-hour glucose tolerance test. Early screening helps manage gestational diabetes.
When should Rho(D) immune globulin be administered to an Rh-negative, unsensitized mother?
Immediately postpartum only
At 20 weeks gestation
At 36 weeks gestation
At 28 weeks gestation
Rho(D) immune globulin is routinely given at 28 weeks of gestation to unsensitized Rh-negative mothers and again within 72 hours postpartum if the newborn is Rh-positive. This prevents maternal alloimmunization. Additional doses may be required after trauma or invasive procedures.
During the active phase of labor, what is the typical contraction frequency?
Every 5 - 10 minutes
Every 1 - 2 minutes
Every 4 - 5 minutes
Every 2 - 3 minutes
In active labor, contractions usually occur every 2 - 3 minutes, lasting 60 - 90 seconds with strong intensity. This pattern promotes progressive cervical dilation. Monitoring frequency helps evaluate labor progress.
Lochia rubra typically persists for how many days postpartum?
10 - 14 days
1 - 3 days
3 - 4 days
4 - 10 days
Lochia rubra, comprised mainly of blood and decidual tissue, usually lasts 3 - 4 days after delivery. It then transitions to lochia serosa and eventually lochia alba over the next weeks. Tracking lochia helps identify abnormal postpartum bleeding.
By approximately which day postpartum should the uterus return to the level of the symphysis pubis or below?
Day 14
Day 10
Day 7
Day 2
Uterine involution proceeds at about 1 cm per day. By day 10 postpartum, the uterus typically has descended back into the pelvis below the symphysis pubis. Delayed involution may suggest infection or retained products.
Which supplement is considered first-line pharmacotherapy for hyperemesis gravidarum?
Pyridoxine (Vitamin B6)
Metoclopramide
Methylprednisolone
Ondansetron
Vitamin B6 (pyridoxine) is the first-line treatment for nausea and vomiting in pregnancy, often combined with doxylamine. It has a favorable safety profile. More potent antiemetics are reserved for refractory cases.
A hallmark sign of placenta previa is:
Uterine hypertonicity
Painless bright red vaginal bleeding
Severe abdominal pain with dark bleeding
Fetal distress with decreased movement
Placenta previa typically presents with painless, bright red vaginal bleeding in the second or third trimester. The placenta overlies the cervical os, preventing pain receptors from activation. Diagnosis is confirmed by ultrasound.
What is the first-line medication for seizure prophylaxis in eclampsia?
Magnesium sulfate
Labetalol
Diazepam
Hydralazine
Magnesium sulfate is the preferred agent for seizure prophylaxis and treatment in preeclampsia/eclampsia. It reduces neuromuscular irritability and prevents recurrent seizures. Antihypertensives manage blood pressure but do not prevent seizures.
Umbilical cord blood gas analysis primarily assesses:
Fetal blood cell count
Fetal blood sugar level
Fetal acid-base status
Fetal infection markers
Umbilical cord blood gases provide information on fetal oxygenation and acid-base balance at birth, reflecting intrapartum stress or hypoxia. Parameters like pH and base excess help assess neonatal acidosis. Other labs evaluate cell counts or infection separately.
A classic facial feature of fetal alcohol syndrome is:
Smooth philtrum
Hypertelorism
Downward slanting palpebral fissures
Macroglossia
Smooth philtrum and a thin upper lip are hallmark dysmorphic features of fetal alcohol syndrome. Other signs include microcephaly and growth restriction. Early identification allows for supportive interventions.
Exclusive breastfeeding for the first 6 months reduces maternal risk of:
Hypertension in later life
Postpartum depression
Osteoporosis
Ovarian and breast cancer
Longer durations of breastfeeding are associated with reduced risks of breast and ovarian cancers in mothers. Lactation delays ovarian function and promotes hormonal modulation. Encouraging exclusive breastfeeding supports both maternal and infant health.
When should intrapartum prophylaxis for Group B Streptococcus be administered?
At 37 weeks gestation
When labor begins or membranes rupture
At the first prenatal visit
After delivery
Intrapartum antibiotic prophylaxis (usually penicillin) is given when labor begins or membranes rupture to prevent neonatal GBS sepsis. Screening occurs at 35 - 37 weeks, but treatment is timed with labor onset. Postpartum administration does not prevent neonatal disease.
Amniocentesis for genetic testing is typically performed after which gestational age?
After 24 weeks
15 - 20 weeks
Before 12 weeks
During the first prenatal visit
Amniocentesis is usually performed between 15 and 20 weeks gestation to obtain fetal cells for genetic and chromosomal analysis. Performing it earlier increases risks of limb defects. Results guide management for chromosomal anomalies.
What fasting glucose level constitutes a positive screen on the 3-hour oral glucose tolerance test in pregnancy?
? 95 mg/dL
? 105 mg/dL
? 115 mg/dL
? 85 mg/dL
Diagnostic criteria for gestational diabetes on the 3-hour OGTT include a fasting plasma glucose of 95 mg/dL or higher. Other timepoints have their own cutoffs. Meeting or exceeding two values confirms the diagnosis.
Which infection is included in the TORCH screening panel?
Cytomegalovirus (CMV)
HIV
RSV
Parvovirus B19
TORCH stands for Toxoplasma, Other (like syphilis), Rubella, CMV, and Herpes simplex virus. These infections can cross the placenta and harm the fetus. CMV is the most common congenital viral infection.
Which of the following is a tocolytic agent used to inhibit preterm labor?
Labetalol
Methylergonovine
Nifedipine
Oxytocin
Nifedipine, a calcium channel blocker, relaxes uterine smooth muscle and is frequently used as a tocolytic. It delays delivery to allow for steroid administration. Oxytocin and methylergonovine have the opposite effect, and labetalol treats hypertension.
The term fetal 'lie' refers to:
The presenting part of the fetus
The side of the maternal pelvis where the occiput is located
The relation of the fetal spinal axis to the maternal spinal axis
The angle of fetal head flexion
Fetal lie describes the orientation of the fetal spine relative to the mother's spine (longitudinal, transverse, or oblique). Presentation refers to the fetal part entering the pelvis, and attitude refers to flexion or extension of the fetal head.
Which patient is the best candidate for a trial of labor after cesarean (TOLAC)?
Placenta previa in current pregnancy
Suspected macrosomic fetus at 42 weeks
Previous low-transverse cesarean incision with no other uterine surgery
History of classical cesarean incision
A woman with one prior low-transverse cesarean and no contraindications is a good candidate for TOLAC and VBAC. Classical incisions or other scars carry high rupture risk. Placenta previa and suspected macrosomia are also contraindications.
What is the therapeutic serum magnesium level for seizure prophylaxis in preeclampsia?
2 - 4 mEq/L
10 - 12 mEq/L
8 - 10 mEq/L
4 - 7 mEq/L
For seizure prophylaxis, magnesium sulfate is titrated to a serum concentration of 4 - 7 mEq/L. Levels below this may be ineffective, and levels above can cause toxicity. Clinical assessment for reflexes and respiratory rate is also critical.
A reactive nonstress test requires fetal heart accelerations of at least 15 bpm above baseline lasting 15 seconds, occurring:
2 times within 20 minutes
3 times within 10 minutes
2 times within 10 minutes
1 time within 15 minutes
A reactive NST is defined by at least two accelerations ?15 bpm above baseline, lasting ?15 seconds, within a 20-minute period. This indicates adequate fetal oxygenation and autonomic function. Nonreactive tests require further evaluation.
A Bishop score of 9 suggests that:
The cervix is unfavorable for induction
Induction of labor is likely to succeed
Cervical ripening is contraindicated
Oxytocin augmentation should be delayed
A Bishop score ?8 indicates favorable cervical conditions for induction and a high likelihood of vaginal delivery. Lower scores (<6) suggest the need for cervical ripening agents. Scoring assesses dilation, effacement, consistency, position, and station.
In disseminated intravascular coagulation (DIC), which laboratory finding is expected?
Decreased prothrombin time
Prolonged prothrombin time
Elevated fibrinogen level
Thrombocytosis
DIC features consumption of clotting factors leading to prolonged PT and aPTT, thrombocytopenia, and low fibrinogen. The body simultaneously forms and degrades clots, causing bleeding and microthrombi. Early recognition and management of underlying cause are vital.
Which maneuver is first recommended to relieve shoulder dystocia during delivery?
Fundal pressure
Knee - chest position
McRoberts maneuver
Episiotomy
The McRoberts maneuver involves hyperflexing the maternal hips to straighten the sacrum and rotate the symphysis, often freeing the impacted anterior shoulder. Fundal pressure is contraindicated. Additional maneuvers follow if McRoberts fails.
HELLP syndrome is characterized by all of the following EXCEPT:
Elevated liver enzymes
Low platelet count
Hemolysis
Hyperfibrinogenemia
HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelets. Fibrinogen is typically low or normal; high fibrinogen would not be expected. HELLP is a variant of severe preeclampsia requiring prompt management.
Oligohydramnios is most commonly associated with which fetal condition?
Excessive fetal urination
Maternal diabetes
Renal agenesis
Fetal polycystic kidney disease
Fetal urine is the main source of amniotic fluid in the second half of pregnancy. Renal agenesis leads to minimal or absent urine output, causing oligohydramnios. Early detection helps anticipate pulmonary hypoplasia.
Polyhydramnios may indicate which fetal anomaly?
Renal agenesis
Placental insufficiency
Cord prolapse
Esophageal atresia
Polyhydramnios can result from impaired fetal swallowing, as seen in esophageal atresia. Excessive amniotic fluid accumulates when the fetus cannot swallow and recycle fluid. Ultrasound evaluation helps identify the underlying cause.
The indirect Coombs test in pregnancy detects:
Fetal red blood cell antigens
Maternal procoagulant antibodies
Maternal antibodies against RBC antigens
Direct binding of antibodies to fetal cells
The indirect Coombs test screens maternal serum for antibodies to foreign RBC antigens, such as Rh. A positive result indicates sensitization risk to the fetus. The direct Coombs test detects antibodies attached to RBCs.
What is the first action when uterine tachysystole occurs with oxytocin infusion?
Administer methylergonovine
Increase the oxytocin dose
Decrease or stop the oxytocin infusion
Perform fundal pressure
When uterine hyperstimulation (tachysystole) occurs, reducing or discontinuing oxytocin is the primary step to restore uterine resting tone and fetal oxygenation. Tocolytics may follow if contractions remain excessive. Fundal pressure is never used.
A negative fetal fibronectin test suggests:
Presence of infection
High likelihood of delivery within 1 week
Unlikely to deliver within the next 2 weeks
Need for immediate tocolytics
A negative fetal fibronectin test has a high negative predictive value for preterm birth within 14 days. This helps avoid unnecessary interventions in women with threatened preterm labor. A positive result has lower predictive accuracy.
Which maneuver is used to elevate the fetal anterior shoulder in shoulder dystocia after McRoberts?
Rubin's maneuver
Episiotomy
Wood's screw maneuver
Fundal pressure
Rubin's maneuver involves rotating the fetal shoulders into an oblique plane by applying pressure on the posterior aspect of the anterior shoulder. It often follows the McRoberts maneuver if dystocia persists. Forced fundal pressure is contraindicated.
Cephalopelvic disproportion is most likely indicated by:
Arrest of descent despite adequate contractions
Spontaneous rupture of membranes
Progressive cervical dilation
Frequent moderate contractions
Cephalopelvic disproportion occurs when the fetal head cannot pass through the maternal pelvis despite strong, regular contractions and adequate engagement. Labor stalls in the active phase. Diagnosis often leads to cesarean delivery.
Which is a key component of intrauterine resuscitation in a nonreassuring fetal heart rate pattern?
Maternal Valsalva maneuvers
Left lateral maternal position
Trendelenburg position
Immediate oxytocin infusion
Turning the mother to the left lateral position improves uteroplacental perfusion by relieving aortocaval compression. Additional steps include IV fluids and oxygen. Trendelenburg and Valsalva maneuvers are not recommended.
How does nifedipine act as a tocolytic agent?
Beta-adrenergic blockade
Oxytocin receptor antagonism
Calcium channel blockade
Prostaglandin synthesis inhibition
Nifedipine blocks L-type calcium channels in uterine smooth muscle, reducing intracellular calcium and inhibiting contractions. It effectively delays preterm labor and is widely used due to a good safety profile.
What is the recommended dosing regimen for betamethasone to promote fetal lung maturity?
24 mg IM once
12 mg IM every 24 hours for 2 doses
12 mg IM every 12 hours for 4 doses
6 mg IM every 6 hours for 4 doses
The standard regimen for antenatal corticosteroids is betamethasone 12 mg IM, repeated once after 24 hours. This two-dose course enhances fetal lung surfactant production and reduces neonatal respiratory distress.
What is the first-line uterotonic agent for postpartum hemorrhage management?
Oxytocin
Misoprostol
Methylergonovine
Carboprost tromethamine
Oxytocin is the first-line uterotonic for preventing and treating postpartum hemorrhage due to its efficacy and safety profile. It stimulates uterine contractions to compress spiral arteries. Other agents are used if bleeding persists.
Which postpartum sign is most suggestive of endometritis?
Elevated blood pressure
Breast engorgement
Persistent itching
Fever with foul-smelling lochia and uterine tenderness
Endometritis typically presents with fever, uterine tenderness, and malodorous lochia in the postpartum period. Early antibiotic therapy and supportive care are essential. Other symptoms like itching or hypertension are unrelated.
In mastitis during breastfeeding, the recommended approach is to:
Perform breast massage only
Discontinue breastfeeding until antibiotics finish
Continue breastfeeding or milk expression
Switch to formula feeding
Continuing breastfeeding or regular milk expression helps relieve ductal blockage and infection in mastitis. Antibiotics safe in lactation should be prescribed. Stopping breastfeeding can worsen engorgement.
After treatment for choriocarcinoma, how should serial hCG levels be monitored?
Daily for one week, then weekly for one month
Weekly for two weeks only
Monthly for one year
Weekly until normal for three consecutive weeks, then monthly for six months
hCG levels should be measured weekly until normalization for three consecutive weeks, then monthly for six months to monitor for recurrence. Choriocarcinoma can recur rapidly, and hCG is a sensitive tumor marker. Long-term follow-up improves outcomes.
The optimal window for antenatal corticosteroid administration in preterm labor is between:
28 and 36 weeks
24 and 34 weeks
30 and 37 weeks
20 and 24 weeks
Antenatal corticosteroids (e.g., betamethasone) given between 24 and 34 weeks gestation reduce neonatal respiratory distress syndrome, intraventricular hemorrhage, and mortality. Use is considered up to 37 weeks in some cases. Outside this window, benefits decline.
What is the recommended management for vasa previa diagnosed at 32 weeks gestation?
Scheduled cesarean delivery before labor onset (around 34 - 37 weeks)
Immediate induction of labor
Trial of vaginal delivery with continuous monitoring
Expectant management until 40 weeks
Vasa previa carries high risk of fetal hemorrhage with membrane rupture. Cesarean delivery between 34 and 37 weeks before labor or rupture of membranes is recommended. Vaginal delivery is contraindicated.
In the event of umbilical cord prolapse, the immediate action should be to:
Increase oxytocin infusion
Perform an artificial rupture of membranes
Administer magnesium sulfate
Place the mother in a knee - chest or Trendelenburg position and prepare for emergency cesarean
Cord prolapse is an obstetric emergency requiring immediate relief of cord compression by positioning the mother in knee - chest or Trendelenburg and urgent cesarean delivery. Rupturing membranes or increasing contractions worsens outcomes.
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Study Outcomes

  1. Understand prenatal and antenatal assessment principles -

    Master key maternal and fetal health parameters during pregnancy to ensure comprehensive prenatal care and readiness for maternity HESI questions.

  2. Apply evidence-based interventions for labor and delivery -

    Implement appropriate nursing actions for common intrapartum complications, reinforcing best practices in OB HESI scenarios.

  3. Analyze postpartum and newborn assessment findings -

    Interpret vital signs, reflexes, and physical exam data to identify normal versus abnormal postpartum and neonatal conditions.

  4. Utilize critical thinking strategies for OB HESI practice questions -

    Employ systematic approaches to dissect question stems, eliminate distractors, and select the most accurate answers.

  5. Identify knowledge gaps and plan targeted review -

    Recognize personal strengths and weaknesses through this scored quiz, guiding focused study on maternal and child health nursing topics.

Cheat Sheet

  1. Naegele's Rule for EDD Calculation -

    Use Naegele's Rule (add 7 days, subtract 3 months from the first day of the last menstrual period) to estimate the expected due date - an essential formula for any maternity hesi preparation. For example, an LMP of April 10 yields an EDD of January 17. Mnemonic "LMP + 7 - 3" keeps this calculation top of mind for OB HESI practice questions.

  2. Fetal Heart Rate Patterns & Decelerations -

    Recognizing early, variable, and late decelerations is critical for assessing fetal well-being on maternity hesi quizzes. Early decels mirror contractions and are benign, variable decels suggest cord compression, and late decels signal uteroplacental insufficiency. Remember "Early = head, Variable = cord, Late = placenta" to boost your confidence when you see these patterns in OB HESI practice questions.

  3. Leopold's Maneuvers for Fetal Position -

    Master the four Leopold's maneuvers to determine fetal lie, presentation, and engagement before labor assessment - skills often tested on the ob hesi. Practice palpating the fundus, sides, and presenting part on a mannequin or volunteer to perfect your technique. Use the sequence "Feel, Find, Face, Finish" as a mnemonic for each maneuver.

  4. Preeclampsia vs. Eclampsia Management -

    Distinguish mild from severe preeclampsia by BP ≥160/110 mm Hg, significant proteinuria, and organ dysfunction, then prepare to administer magnesium sulfate to prevent eclamptic seizures. Know the therapeutic range (4 - 7 mEq/L) and watch for loss of deep-tendon reflexes as an early toxicity sign. The "BP-PRO" checklist (Blood pressure, Proteinuria, Reflexes, Organs) is a quick recall tool for OB HESI scenarios.

  5. APGAR Scoring & Newborn Transition -

    APGAR evaluates Appearance, Pulse, Grimace, Activity, and Respiration at 1 and 5 minutes after birth, each scored 0 - 2 for a total of 10. A score below 7 indicates the need for immediate interventions like gentle stimulation or airway support. Keep the acronym "APGAR" front and center when tackling newborn assessment questions on your maternity hesi.

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