ATI Capstone Maternal Newborn
Assessment Questions And Answers With
Rationales /Graded A +/2026
Update/100% Correct
Section 1: Antepartum Assessment & Complications
1. A nurse is assessing a client at 12 weeks gestation. The client reports
frequent urination and breast tenderness. Which of the following responses
should the nurse make?
• A. "These are signs of a urinary tract infection; we should test your urine."
• B. "These are presumptive signs of pregnancy, likely related to hormonal
changes."
• C. "These are expected findings due to hormonal changes and uterine
pressure."
• D. "These findings indicate you may be carrying twins."
Rationale: Frequent urination (due to uterine pressure on the bladder) and breast
tenderness (due to increased estrogen and progesterone) are common discomforts
in the first trimester.
2. A nurse is reviewing prenatal laboratory results for a client at 24 weeks
gestation. Which of the following results requires immediate intervention?
• A. Hematocrit 34%
• B. White blood cell count 11,000/mm³
• C. Platelet count 100,000/mm³
• D. Rubella titer 1:8
Rationale: A platelet count of 100,000/mm³ is indicative of thrombocytopenia,
which poses a risk for hemorrhage. Normal platelet count is 150,000–
400,000/mm³. Rubella titer of 1:8 indicates immunity.
,3. A nurse is providing education to a client about the 1-hour glucose tolerance
test (GTT) at 26 weeks. Which of the following instructions is correct?
• A. "You do not need to fast for this test, but avoid high-sugar foods
beforehand."
• B. "You must fast for 8 hours prior to the test."
• C. "You will drink the solution and then rest for 3 hours before the blood
draw."
• D. "If this test is positive, you will need to repeat the same test in 4 weeks."
Rationale: The 1-hour GTT is a screening test that does not require fasting. A
result ≥130-140 mg/dL indicates the need for a 3-hour fasting GTT for diagnosis.
4. A nurse is assessing a client with preeclampsia who is receiving magnesium
sulfate. Which of the following findings indicates magnesium toxicity?
• A. Blood pressure 150/90 mm Hg
• B. Urinary output 40 mL/hr
• C. Respiratory rate 10/min
• D. Deep tendon reflexes 2+
Rationale: Magnesium sulfate toxicity affects the central nervous system and
respiratory muscles. Key signs include respiratory depression (<12/min), absent
deep tendon reflexes, and decreased urine output (<30 mL/hr).
5. A nurse is caring for a client with gestational diabetes mellitus (GDM). The
nurse should monitor the client for which of the following complications?
• A. Placenta previa
• B. Macrosomia
• C. Oligohydramnios
• D. Rh incompatibility
Rationale: Maternal hyperglycemia leads to fetal hyperglycemia and fetal
hyperinsulinemia, which acts as a growth hormone, resulting in macrosomia (large
body size).
, 6. A nurse is performing a nonstress test (NST) on a client at 34 weeks
gestation. The nurse notes two accelerations of the fetal heart rate of 20 bpm
above baseline lasting 20 seconds in 20 minutes. How should the nurse
interpret this result?
• A. Reactive
• B. Nonreactive
• C. Positive
• D. Negative
Rationale: A reactive NST is defined as two or more accelerations of at least 15
bpm (for ≥32 weeks) lasting at least 15 seconds within a 20-minute window.
7. A nurse is providing teaching to a client with hyperemesis gravidarum.
Which of the following statements indicates an understanding of the teaching?
• A. "I will eat dry crackers before getting out of bed in the morning."
• B. "I will drink a large glass of water with each meal."
• C. "I will lie flat for 30 minutes after eating."
• D. "I will increase my intake of fried foods for calories."
Rationale: Dry crackers are bland, easily digestible carbohydrates that help
combat morning sickness by preventing an empty stomach. Clients should avoid
large amounts of liquids with meals and avoid fatty/greasy foods.
8. A nurse is caring for a client with suspected placenta previa. The nurse
should prepare for which of the following diagnostic tests?
• A. Transvaginal ultrasound
• B. Abdominal ultrasound
• C. Amniocentesis
• D. Biophysical profile
Rationale: Abdominal ultrasound is the standard for diagnosing placenta previa.
Transvaginal ultrasound is avoided due to the risk of stimulating bleeding. A digital
cervical exam is contraindicated.
Assessment Questions And Answers With
Rationales /Graded A +/2026
Update/100% Correct
Section 1: Antepartum Assessment & Complications
1. A nurse is assessing a client at 12 weeks gestation. The client reports
frequent urination and breast tenderness. Which of the following responses
should the nurse make?
• A. "These are signs of a urinary tract infection; we should test your urine."
• B. "These are presumptive signs of pregnancy, likely related to hormonal
changes."
• C. "These are expected findings due to hormonal changes and uterine
pressure."
• D. "These findings indicate you may be carrying twins."
Rationale: Frequent urination (due to uterine pressure on the bladder) and breast
tenderness (due to increased estrogen and progesterone) are common discomforts
in the first trimester.
2. A nurse is reviewing prenatal laboratory results for a client at 24 weeks
gestation. Which of the following results requires immediate intervention?
• A. Hematocrit 34%
• B. White blood cell count 11,000/mm³
• C. Platelet count 100,000/mm³
• D. Rubella titer 1:8
Rationale: A platelet count of 100,000/mm³ is indicative of thrombocytopenia,
which poses a risk for hemorrhage. Normal platelet count is 150,000–
400,000/mm³. Rubella titer of 1:8 indicates immunity.
,3. A nurse is providing education to a client about the 1-hour glucose tolerance
test (GTT) at 26 weeks. Which of the following instructions is correct?
• A. "You do not need to fast for this test, but avoid high-sugar foods
beforehand."
• B. "You must fast for 8 hours prior to the test."
• C. "You will drink the solution and then rest for 3 hours before the blood
draw."
• D. "If this test is positive, you will need to repeat the same test in 4 weeks."
Rationale: The 1-hour GTT is a screening test that does not require fasting. A
result ≥130-140 mg/dL indicates the need for a 3-hour fasting GTT for diagnosis.
4. A nurse is assessing a client with preeclampsia who is receiving magnesium
sulfate. Which of the following findings indicates magnesium toxicity?
• A. Blood pressure 150/90 mm Hg
• B. Urinary output 40 mL/hr
• C. Respiratory rate 10/min
• D. Deep tendon reflexes 2+
Rationale: Magnesium sulfate toxicity affects the central nervous system and
respiratory muscles. Key signs include respiratory depression (<12/min), absent
deep tendon reflexes, and decreased urine output (<30 mL/hr).
5. A nurse is caring for a client with gestational diabetes mellitus (GDM). The
nurse should monitor the client for which of the following complications?
• A. Placenta previa
• B. Macrosomia
• C. Oligohydramnios
• D. Rh incompatibility
Rationale: Maternal hyperglycemia leads to fetal hyperglycemia and fetal
hyperinsulinemia, which acts as a growth hormone, resulting in macrosomia (large
body size).
, 6. A nurse is performing a nonstress test (NST) on a client at 34 weeks
gestation. The nurse notes two accelerations of the fetal heart rate of 20 bpm
above baseline lasting 20 seconds in 20 minutes. How should the nurse
interpret this result?
• A. Reactive
• B. Nonreactive
• C. Positive
• D. Negative
Rationale: A reactive NST is defined as two or more accelerations of at least 15
bpm (for ≥32 weeks) lasting at least 15 seconds within a 20-minute window.
7. A nurse is providing teaching to a client with hyperemesis gravidarum.
Which of the following statements indicates an understanding of the teaching?
• A. "I will eat dry crackers before getting out of bed in the morning."
• B. "I will drink a large glass of water with each meal."
• C. "I will lie flat for 30 minutes after eating."
• D. "I will increase my intake of fried foods for calories."
Rationale: Dry crackers are bland, easily digestible carbohydrates that help
combat morning sickness by preventing an empty stomach. Clients should avoid
large amounts of liquids with meals and avoid fatty/greasy foods.
8. A nurse is caring for a client with suspected placenta previa. The nurse
should prepare for which of the following diagnostic tests?
• A. Transvaginal ultrasound
• B. Abdominal ultrasound
• C. Amniocentesis
• D. Biophysical profile
Rationale: Abdominal ultrasound is the standard for diagnosing placenta previa.
Transvaginal ultrasound is avoided due to the risk of stimulating bleeding. A digital
cervical exam is contraindicated.
