ATI RN Maternal Newborn (OB) 2024
and 2026 Proctored Exam with
Questions And Answers
1. A nurse is teaching a client at 8 weeks of gestation about expected
physiological changes. Which statement indicates understanding?
• A) "My blood pressure will likely decrease during the second trimester."
• B) "I should expect my heart rate to slow down by 10 beats per minute."
• C) "My thyroid gland will shrink during pregnancy."
• D) "My blood volume will decrease by 20% by the third trimester."
Answer: A. Blood pressure typically decreases in the second trimester due to
peripheral vasodilation from progesterone. Heart rate increases by 10-15 BPM,
thyroid enlarges, and blood volume increases by 40-50%.
2. A client at 12 weeks gestation asks about over-the-counter meds. Which
response is correct?
• A) "Avoid all OTC medications until after the first trimester."
• B) "NSAIDs like ibuprofen are safe throughout pregnancy."
• C) "Acetaminophen is the preferred analgesic for mild pain."
• D) "Decongestants are completely safe at any stage."
Answer: C. Acetaminophen is the safest OTC analgesic. NSAIDs are avoided
(risk of premature ductus arteriosus closure), and decongestants are often
avoided in the first trimester.
3. A nurse is calculating a client's EDD using Naegele's rule. LMP was May 10.
What is the EDD?
• A) February 3
• B) February 17
• C) March 3
• D) March 17
Answer: B. May 10 – 3 months = February 10; + 7 days = February 17.
4. A client is Rh-negative and her partner is Rh-positive. At which gestational
age should the nurse administer Rhogam?
• A) 24 weeks
• B) 28 weeks
• C) 32 weeks
, • D) 36 weeks
Answer: B. RhoGAM is routinely given at 28 weeks gestation and again within
72 hours after birth if the newborn is Rh-positive.
5. A nurse is assessing a client for positive signs of pregnancy. Which finding
confirms pregnancy?
• A) Chadwick's sign
• B) Positive home pregnancy test
• C) Fetal heartbeat on Doppler
• D) Goodell's sign
Answer: C. Fetal heartbeat, fetal movement palpated by the examiner, and
visualization of the fetus on ultrasound are positive signs. All others
are probable signs.
6. A client at 16 weeks with gestational diabetes is scheduled for a screening.
Which test is used?
• A) 1-hour glucose tolerance test (GTT)
• B) 3-hour glucose tolerance test
• C) Hemoglobin A1C
• D) Fasting blood glucose
Answer: A. The 1-hour 50g GTT is the initial screening (done 24-28 weeks, but
earlier if risk factors). A result ≥130-140 mg/dL triggers the 3-hour diagnostic
test.
7. A nurse is providing education on folic acid. What is the primary purpose?
• A) Prevent iron-deficiency anemia
• B) Prevent neural tube defects
• C) Increase calcium absorption
• D) Regulate blood glucose
Answer: B. Folic acid (400-800 mcg/day) prevents neural tube defects like
spina bifida. Iron prevents anemia, and Vitamin D aids calcium.
8. A client reports "quickening." What does this indicate?
• A) Braxton-Hicks contractions
• B) First fetal movements felt by the mother
• C) Lightening of the fetus into the pelvis
• D) A positive pregnancy test
Answer: B. Quickening is the mother's perception of fetal movement, typically
occurring between 16-20 weeks in primigravidas.
,9. A nurse is assessing a client with hyperemesis gravidarum. Which lab value is
a priority to monitor?
• A) Serum sodium
• B) Serum potassium
• C) Urine ketones
• D) BUN
Answer: C. Urine ketones indicate dehydration and starvation, which are
hallmark complications of hyperemesis. Electrolytes are important, but
ketones are the most direct indicator of the severity.
10. A client asks about the purpose of alpha-fetoprotein (AFP) screening. What
is it used for?
• A) Detect Down syndrome
• B) Detect neural tube defects
• C) Detect gestational diabetes
• D) Detect Rh incompatibility
Answer: B. Elevated AFP indicates neural tube defects (spina
bifida/anencephaly). Low AFP, along with other markers, can indicate Down
syndrome, but the primary screen is for neural tube defects.
Intrapartum / Labor & Delivery (Questions 11–20)
11. A nurse is assessing a client in active labor. Contractions are every 3
minutes, lasting 60 seconds. Which finding indicates uterine hyperstimulation?
• A) Contractions every 2 minutes, lasting 90 seconds
• B) Contractions every 4 minutes, lasting 45 seconds
• C) Resting tone of 10 mmHg
• D) Contractions causing mild discomfort
Answer: A. Hyperstimulation is defined as >5 contractions in 10 minutes,
lasting >90 seconds, or a resting tone >20 mmHg.
12. A client's fetal heart rate tracing shows a baseline of 140, moderate
variability, with accelerations. This is classified as:
• A) Category I (Normal)
• B) Category II (Indeterminate)
• C) Category III (Abnormal)
, • D) Non-reassuring
Answer: A. Category I requires: Baseline 110-160, moderate variability, no
late/variable decels, and accelerations present. This is a normal tracing.
13. A nurse notes late decelerations on the fetal monitor. The priority action is:
• A) Turn the client to her left side
• B) Increase the IV fluid rate
• C) Administer oxygen via face mask
• D) All of the above
Answer: D. Late decels indicate uteroplacental insufficiency. The classic
interventions are: Position change (left side), IV bolus, and oxygen 8-10L via
non-rebreather.
14. A client is 6 cm dilated and receives an epidural. Which side effect should
the nurse monitor for first?
• A) Urinary retention
• B) Respiratory depression
• C) Hypotension
• D) Pruritus
Answer: C. Hypotension from sympathetic blockade is the most common and
immediate side effect. The nurse should have IV fluid bolus ready.
15. A nurse is assessing cervical dilation using a sterile glove. The cervix is
completely dilated. What is the measurement?
• A) 8 cm
• B) 9 cm
• C) 10 cm
• D) 12 cm
Answer: C. Complete dilation is 10 cm.
16. A client's membranes rupture spontaneously. The nurse sees a loop of
umbilical cord protruding from the vagina. What is the immediate action?
• A) Push the cord back into the vagina
• B) Place the client in Trendelenburg position and apply pressure to the
presenting part
• C) Prepare for immediate vaginal delivery
• D) Administer terbutaline
Answer: B. This is a cord prolapse. The nurse should elevate the presenting
part off the cord (using a gloved hand inside the vagina), place the client in
knee-chest or Trendelenburg, and prepare for emergency C-section.
and 2026 Proctored Exam with
Questions And Answers
1. A nurse is teaching a client at 8 weeks of gestation about expected
physiological changes. Which statement indicates understanding?
• A) "My blood pressure will likely decrease during the second trimester."
• B) "I should expect my heart rate to slow down by 10 beats per minute."
• C) "My thyroid gland will shrink during pregnancy."
• D) "My blood volume will decrease by 20% by the third trimester."
Answer: A. Blood pressure typically decreases in the second trimester due to
peripheral vasodilation from progesterone. Heart rate increases by 10-15 BPM,
thyroid enlarges, and blood volume increases by 40-50%.
2. A client at 12 weeks gestation asks about over-the-counter meds. Which
response is correct?
• A) "Avoid all OTC medications until after the first trimester."
• B) "NSAIDs like ibuprofen are safe throughout pregnancy."
• C) "Acetaminophen is the preferred analgesic for mild pain."
• D) "Decongestants are completely safe at any stage."
Answer: C. Acetaminophen is the safest OTC analgesic. NSAIDs are avoided
(risk of premature ductus arteriosus closure), and decongestants are often
avoided in the first trimester.
3. A nurse is calculating a client's EDD using Naegele's rule. LMP was May 10.
What is the EDD?
• A) February 3
• B) February 17
• C) March 3
• D) March 17
Answer: B. May 10 – 3 months = February 10; + 7 days = February 17.
4. A client is Rh-negative and her partner is Rh-positive. At which gestational
age should the nurse administer Rhogam?
• A) 24 weeks
• B) 28 weeks
• C) 32 weeks
, • D) 36 weeks
Answer: B. RhoGAM is routinely given at 28 weeks gestation and again within
72 hours after birth if the newborn is Rh-positive.
5. A nurse is assessing a client for positive signs of pregnancy. Which finding
confirms pregnancy?
• A) Chadwick's sign
• B) Positive home pregnancy test
• C) Fetal heartbeat on Doppler
• D) Goodell's sign
Answer: C. Fetal heartbeat, fetal movement palpated by the examiner, and
visualization of the fetus on ultrasound are positive signs. All others
are probable signs.
6. A client at 16 weeks with gestational diabetes is scheduled for a screening.
Which test is used?
• A) 1-hour glucose tolerance test (GTT)
• B) 3-hour glucose tolerance test
• C) Hemoglobin A1C
• D) Fasting blood glucose
Answer: A. The 1-hour 50g GTT is the initial screening (done 24-28 weeks, but
earlier if risk factors). A result ≥130-140 mg/dL triggers the 3-hour diagnostic
test.
7. A nurse is providing education on folic acid. What is the primary purpose?
• A) Prevent iron-deficiency anemia
• B) Prevent neural tube defects
• C) Increase calcium absorption
• D) Regulate blood glucose
Answer: B. Folic acid (400-800 mcg/day) prevents neural tube defects like
spina bifida. Iron prevents anemia, and Vitamin D aids calcium.
8. A client reports "quickening." What does this indicate?
• A) Braxton-Hicks contractions
• B) First fetal movements felt by the mother
• C) Lightening of the fetus into the pelvis
• D) A positive pregnancy test
Answer: B. Quickening is the mother's perception of fetal movement, typically
occurring between 16-20 weeks in primigravidas.
,9. A nurse is assessing a client with hyperemesis gravidarum. Which lab value is
a priority to monitor?
• A) Serum sodium
• B) Serum potassium
• C) Urine ketones
• D) BUN
Answer: C. Urine ketones indicate dehydration and starvation, which are
hallmark complications of hyperemesis. Electrolytes are important, but
ketones are the most direct indicator of the severity.
10. A client asks about the purpose of alpha-fetoprotein (AFP) screening. What
is it used for?
• A) Detect Down syndrome
• B) Detect neural tube defects
• C) Detect gestational diabetes
• D) Detect Rh incompatibility
Answer: B. Elevated AFP indicates neural tube defects (spina
bifida/anencephaly). Low AFP, along with other markers, can indicate Down
syndrome, but the primary screen is for neural tube defects.
Intrapartum / Labor & Delivery (Questions 11–20)
11. A nurse is assessing a client in active labor. Contractions are every 3
minutes, lasting 60 seconds. Which finding indicates uterine hyperstimulation?
• A) Contractions every 2 minutes, lasting 90 seconds
• B) Contractions every 4 minutes, lasting 45 seconds
• C) Resting tone of 10 mmHg
• D) Contractions causing mild discomfort
Answer: A. Hyperstimulation is defined as >5 contractions in 10 minutes,
lasting >90 seconds, or a resting tone >20 mmHg.
12. A client's fetal heart rate tracing shows a baseline of 140, moderate
variability, with accelerations. This is classified as:
• A) Category I (Normal)
• B) Category II (Indeterminate)
• C) Category III (Abnormal)
, • D) Non-reassuring
Answer: A. Category I requires: Baseline 110-160, moderate variability, no
late/variable decels, and accelerations present. This is a normal tracing.
13. A nurse notes late decelerations on the fetal monitor. The priority action is:
• A) Turn the client to her left side
• B) Increase the IV fluid rate
• C) Administer oxygen via face mask
• D) All of the above
Answer: D. Late decels indicate uteroplacental insufficiency. The classic
interventions are: Position change (left side), IV bolus, and oxygen 8-10L via
non-rebreather.
14. A client is 6 cm dilated and receives an epidural. Which side effect should
the nurse monitor for first?
• A) Urinary retention
• B) Respiratory depression
• C) Hypotension
• D) Pruritus
Answer: C. Hypotension from sympathetic blockade is the most common and
immediate side effect. The nurse should have IV fluid bolus ready.
15. A nurse is assessing cervical dilation using a sterile glove. The cervix is
completely dilated. What is the measurement?
• A) 8 cm
• B) 9 cm
• C) 10 cm
• D) 12 cm
Answer: C. Complete dilation is 10 cm.
16. A client's membranes rupture spontaneously. The nurse sees a loop of
umbilical cord protruding from the vagina. What is the immediate action?
• A) Push the cord back into the vagina
• B) Place the client in Trendelenburg position and apply pressure to the
presenting part
• C) Prepare for immediate vaginal delivery
• D) Administer terbutaline
Answer: B. This is a cord prolapse. The nurse should elevate the presenting
part off the cord (using a gloved hand inside the vagina), place the client in
knee-chest or Trendelenburg, and prepare for emergency C-section.
