1
ATI CMS RN Maternal newborn with NGN
, 2
1. A nurse is teaching a client at 8 weeks gestation about expected changes. Which
statement indicates understanding?
A) "I should expect my pulse rate to decrease by 20 beats per minute."
B) "It is normal to have nasal stuffiness and nosebleeds."
C) "My blood pressure will decrease significantly in the first trimester."
D) "I will stop urinating so often after the first trimester."
Answer: B – Increased estrogen causes nasal mucosa hyperemia, leading to congestion and
epistaxis. Pulse increases 10-15 bpm. BP decreases slightly in second trimester. Urinary
frequency persists until the third trimester when the uterus rises out of the pelvis briefly, then
returns.
2. A nurse reviews a prenatal record. Which finding requires further assessment?
A) Fundal height 24 cm at 24 weeks
B) Quickening reported at 18 weeks
C) 2+ proteinuria at 32 weeks
D) Chadwick sign at 10 weeks
Answer: C – Proteinuria (≥1+) after 20 weeks may indicate preeclampsia. Fundal height +2 cm
is normal. Quickening by 20 weeks is expected. Chadwick sign (bluish cervix) is normal at 8-12
weeks.
3. A client at 36 weeks with gestational diabetes has an ultrasound showing
polyhydramnios. The nurse associates this with which fetal risk?
A) Intrauterine growth restriction
B) Esophageal atresia
C) Renal agenesis
D) Microcephaly
Answer: B – Polyhydramnios is linked to fetal swallowing issues (e.g., esophageal atresia,
anencephaly). Oligohydramnios is linked to renal issues.
4. A primigravida at 39 weeks reports a "gush of fluid" but no contractions. What is the
priority action?
A) Assess cervical dilation
B) Check fetal heart rate
C) Test fluid with nitrazine paper
D) Have client ambulate to stimulate labor
Answer: C – Confirm rupture of membranes (nitrazine turns blue if amniotic fluid) to assess
infection risk. FHR check is important but after confirmation.
5. A client at 28 weeks with Rh-negative blood and an Rh-positive fetus has an indirect
Coombs test positive. The nurse anticipates:
A) RhoGAM at 28 weeks only
B) RhoGAM within 72 hours postpartum
C) Increased surveillance for fetal anemia
D) Immediate delivery
, 3
Answer: C – Positive indirect Coombs indicates maternal sensitization (existing anti-Rh
antibodies). RhoGAM is ineffective now. Monitor for fetal hemolytic disease.
6. A nurse teaches a client with hyperemesis gravidarum. Which statement by the client
indicates understanding?
A) "I should drink a glass of water with every meal."
B) "Eating dry crackers before getting out of bed may help."
C) "I will eat three large meals to settle my stomach."
D) "I should avoid brushing my teeth after vomiting."
Answer: B – Dry, bland carbohydrates before rising help reduce nausea. Small, frequent meals
are better. Fluids should be between meals. Rinse mouth after vomiting to protect teeth.
7. A client at 34 weeks with preeclampsia has a platelet count of 80,000/mm³. The nurse
prioritizes assessment for:
A) Deep tendon reflexes 3+
B) Epigastric pain
C) Petechiae or bleeding gums
D) Clonus
Answer: C – Low platelets increase bleeding risk. This may indicate HELLP syndrome.
Epigastric pain and hyperreflexia are also concerns but bleeding risk is the immediate safety
priority.
8. A nurse reviews a biophysical profile (BPP) score of 6/10. The components included:
breathing (2), movement (2), tone (2), fluid (0), NST (0). What action is indicated?
A) Repeat BPP in 24 hours
B) Prepare for immediate delivery
C) Continue weekly surveillance
D) Perform a contraction stress test
Answer: D – BPP 6/10 is equivocal. CST can further assess placental reserve. Immediate
delivery if ≤4/10.
9. A client at 12 weeks wants to know when she can feel the baby move. The nurse
responds:
A) "You may feel fluttering between 16-22 weeks."
B) "Most women feel movement by 12 weeks."
C) "You will not feel movement until 28 weeks."
D) "Movement is not felt until after 30 weeks."
Answer: A – Quickening is typically felt 16-22 weeks in primigravidas; earlier in multigravidas.
10. A nurse assesses a pregnant client with iron deficiency anemia. Which finding is
expected?
A) Bounding pulse and hypertension
B) Pallor of conjunctivae and nail beds
C) Jaundice and dark urine
D) Petechiae and ecchymosis
ATI CMS RN Maternal newborn with NGN
, 2
1. A nurse is teaching a client at 8 weeks gestation about expected changes. Which
statement indicates understanding?
A) "I should expect my pulse rate to decrease by 20 beats per minute."
B) "It is normal to have nasal stuffiness and nosebleeds."
C) "My blood pressure will decrease significantly in the first trimester."
D) "I will stop urinating so often after the first trimester."
Answer: B – Increased estrogen causes nasal mucosa hyperemia, leading to congestion and
epistaxis. Pulse increases 10-15 bpm. BP decreases slightly in second trimester. Urinary
frequency persists until the third trimester when the uterus rises out of the pelvis briefly, then
returns.
2. A nurse reviews a prenatal record. Which finding requires further assessment?
A) Fundal height 24 cm at 24 weeks
B) Quickening reported at 18 weeks
C) 2+ proteinuria at 32 weeks
D) Chadwick sign at 10 weeks
Answer: C – Proteinuria (≥1+) after 20 weeks may indicate preeclampsia. Fundal height +2 cm
is normal. Quickening by 20 weeks is expected. Chadwick sign (bluish cervix) is normal at 8-12
weeks.
3. A client at 36 weeks with gestational diabetes has an ultrasound showing
polyhydramnios. The nurse associates this with which fetal risk?
A) Intrauterine growth restriction
B) Esophageal atresia
C) Renal agenesis
D) Microcephaly
Answer: B – Polyhydramnios is linked to fetal swallowing issues (e.g., esophageal atresia,
anencephaly). Oligohydramnios is linked to renal issues.
4. A primigravida at 39 weeks reports a "gush of fluid" but no contractions. What is the
priority action?
A) Assess cervical dilation
B) Check fetal heart rate
C) Test fluid with nitrazine paper
D) Have client ambulate to stimulate labor
Answer: C – Confirm rupture of membranes (nitrazine turns blue if amniotic fluid) to assess
infection risk. FHR check is important but after confirmation.
5. A client at 28 weeks with Rh-negative blood and an Rh-positive fetus has an indirect
Coombs test positive. The nurse anticipates:
A) RhoGAM at 28 weeks only
B) RhoGAM within 72 hours postpartum
C) Increased surveillance for fetal anemia
D) Immediate delivery
, 3
Answer: C – Positive indirect Coombs indicates maternal sensitization (existing anti-Rh
antibodies). RhoGAM is ineffective now. Monitor for fetal hemolytic disease.
6. A nurse teaches a client with hyperemesis gravidarum. Which statement by the client
indicates understanding?
A) "I should drink a glass of water with every meal."
B) "Eating dry crackers before getting out of bed may help."
C) "I will eat three large meals to settle my stomach."
D) "I should avoid brushing my teeth after vomiting."
Answer: B – Dry, bland carbohydrates before rising help reduce nausea. Small, frequent meals
are better. Fluids should be between meals. Rinse mouth after vomiting to protect teeth.
7. A client at 34 weeks with preeclampsia has a platelet count of 80,000/mm³. The nurse
prioritizes assessment for:
A) Deep tendon reflexes 3+
B) Epigastric pain
C) Petechiae or bleeding gums
D) Clonus
Answer: C – Low platelets increase bleeding risk. This may indicate HELLP syndrome.
Epigastric pain and hyperreflexia are also concerns but bleeding risk is the immediate safety
priority.
8. A nurse reviews a biophysical profile (BPP) score of 6/10. The components included:
breathing (2), movement (2), tone (2), fluid (0), NST (0). What action is indicated?
A) Repeat BPP in 24 hours
B) Prepare for immediate delivery
C) Continue weekly surveillance
D) Perform a contraction stress test
Answer: D – BPP 6/10 is equivocal. CST can further assess placental reserve. Immediate
delivery if ≤4/10.
9. A client at 12 weeks wants to know when she can feel the baby move. The nurse
responds:
A) "You may feel fluttering between 16-22 weeks."
B) "Most women feel movement by 12 weeks."
C) "You will not feel movement until 28 weeks."
D) "Movement is not felt until after 30 weeks."
Answer: A – Quickening is typically felt 16-22 weeks in primigravidas; earlier in multigravidas.
10. A nurse assesses a pregnant client with iron deficiency anemia. Which finding is
expected?
A) Bounding pulse and hypertension
B) Pallor of conjunctivae and nail beds
C) Jaundice and dark urine
D) Petechiae and ecchymosis
