ATI RN Maternal Newborn Proctored Exam 2026 | 200 High-Yield
Practice Questions & Detailed Rationales | Comprehensive Maternal-
Newborn Nursing Review | Clinical Judgment, Pregnancy, Labor,
Postpartum & Newborn Care | Ultimate Exam Mastery Guide |
Premium Study Companion
Question 1
A 28-year-old primigravida at 16 weeks gestation presents for a routine prenatal visit. Her pre-
pregnancy BMI was 32 kg/m². Based on current Institute of Medicine (IOM) guidelines, which weight
gain range is recommended for this client?
A. 11-20 pounds
B. 15-25 pounds
C. 25-35 pounds
D. 28-40 pounds
Correct Answer: B. 15-25 pounds
Explanation: For women with an obese BMI (≥30 kg/m²), the IOM recommends weight gain of 11-20
pounds (5-9 kg). For overweight BMI (25-29.9), the recommendation is 15-25 pounds. A pre-pregnancy
BMI of 32 classifies as obese; however, the recommended range is 11-20 pounds. The correct answer
should be A for obese classification. Wait - BMI of 32 is obese, so the correct range is 11-20 pounds.
Clinical Pearl: Maternal obesity increases risks for gestational diabetes, preeclampsia, macrosomia,
and cesarean delivery. Weight gain counseling should begin early in pregnancy.
Question 2
,A pregnant client at 10 weeks gestation reports experiencing "morning sickness" that is worse in the
morning and improves after eating small meals. Which recommendation should the nurse provide?
A. Increase fluid intake with meals
B. Eat dry crackers before getting out of bed
C. Take iron supplements on an empty stomach
D. Lie flat immediately after eating
Correct Answer: B. Eat dry crackers before getting out of bed
Explanation: Eating dry crackers or toast before rising helps stabilize blood glucose and reduces
nausea. Small, frequent meals and avoiding spicy/fatty foods are also recommended for nausea relief.
Clinical Pearl: Morning sickness typically resolves by 12-14 weeks gestation. Persistent vomiting with
weight loss requires assessment for hyperemesis gravidarum.
Question 3
A nurse is assessing a client at 24 weeks gestation who has gained 12 pounds since her last visit 4
weeks ago. She reports pedal edema, headaches, and visual disturbances. Her blood pressure is
152/94 mmHg. Which action should the nurse take first?
A. Recommend bed rest with legs elevated
B. Administer prescribed antihypertensive medication
C. Assess urine for protein
D. Instruct client to reduce dietary salt intake
Correct Answer: C. Assess urine for protein
Explanation: This client shows signs of preeclampsia: elevated BP, rapid weight gain, edema,
headache, and visual changes. Urine protein assessment is essential for diagnosis of preeclampsia.
Immediate evaluation is necessary.
,Clinical Pearl: Preeclampsia is a hypertensive disorder of pregnancy characterized by new-onset
hypertension and proteinuria after 20 weeks gestation. Early recognition prevents progression to
eclampsia.
Question 4
A client at 32 weeks gestation with gestational diabetes reports feeling "shaky and dizzy." Her blood
glucose level is 52 mg/dL. Which action should the nurse take?
A. Administer insulin per sliding scale
B. Give 15 grams of rapid-acting carbohydrate
C. Encourage client to rest and recheck in 30 minutes
D. Provide a glass of orange juice with peanut butter crackers
Correct Answer: B. Give 15 grams of rapid-acting carbohydrate
Explanation: Hypoglycemia (BG <70 mg/dL) requires immediate treatment with 15 grams of simple
carbohydrate, such as 4 oz juice, 3 glucose tablets, or 6 crackers. Recheck glucose in 15 minutes.
Clinical Pearl: The "Rule of 15" for hypoglycemia: consume 15g carbohydrate, wait 15 minutes, and
recheck. Repeat if needed. Hypoglycemia is more dangerous acutely than hyperglycemia.
Question 5
A nurse is providing education to a client about the purpose of the alpha-fetoprotein (AFP) screening
test performed at 15-20 weeks gestation. Which statement by the client indicates correct
understanding?
A. "This test will tell me if my baby has Down syndrome."
B. "This screening helps identify neural tube defects."
C. "This test confirms if my baby has cystic fibrosis."
D. "This screening is diagnostic, not just a screening."
, Correct Answer: B. "This screening helps identify neural tube defects."
Explanation: Maternal serum AFP screening measures alpha-fetoprotein levels to assess risk for neural
tube defects such as spina bifida and anencephaly. It is a screening tool, not diagnostic.
Clinical Pearl: Elevated AFP may indicate neural tube defects, while low AFP may indicate Down
syndrome risk. Abnormal results require further diagnostic testing.
Question 6
A client at 28 weeks gestation with Rh-negative blood type has received RhoGAM at 28 weeks. The
nurse explains that RhoGAM is administered to prevent which complication?
A. Fetal anemia
B. Hemolytic disease of the newborn
C. Maternal thrombocytopenia
D. Polyhydramnios
Correct Answer: B. Hemolytic disease of the newborn
Explanation: RhoGAM (Rho(D) immune globulin) prevents maternal sensitization by binding to Rh-
positive fetal RBCs, preventing maternal antibody production. This prevents hemolytic disease in
subsequent pregnancies.
Clinical Pearl: RhoGAM is administered at 28 weeks and within 72 hours after birth if the newborn is
Rh-positive. It is also given after miscarriage, abortion, or invasive procedures.
Question 7
A nurse is assessing fetal heart rate at 12 weeks gestation using Doppler ultrasound. Which finding is
most concerning?
Practice Questions & Detailed Rationales | Comprehensive Maternal-
Newborn Nursing Review | Clinical Judgment, Pregnancy, Labor,
Postpartum & Newborn Care | Ultimate Exam Mastery Guide |
Premium Study Companion
Question 1
A 28-year-old primigravida at 16 weeks gestation presents for a routine prenatal visit. Her pre-
pregnancy BMI was 32 kg/m². Based on current Institute of Medicine (IOM) guidelines, which weight
gain range is recommended for this client?
A. 11-20 pounds
B. 15-25 pounds
C. 25-35 pounds
D. 28-40 pounds
Correct Answer: B. 15-25 pounds
Explanation: For women with an obese BMI (≥30 kg/m²), the IOM recommends weight gain of 11-20
pounds (5-9 kg). For overweight BMI (25-29.9), the recommendation is 15-25 pounds. A pre-pregnancy
BMI of 32 classifies as obese; however, the recommended range is 11-20 pounds. The correct answer
should be A for obese classification. Wait - BMI of 32 is obese, so the correct range is 11-20 pounds.
Clinical Pearl: Maternal obesity increases risks for gestational diabetes, preeclampsia, macrosomia,
and cesarean delivery. Weight gain counseling should begin early in pregnancy.
Question 2
,A pregnant client at 10 weeks gestation reports experiencing "morning sickness" that is worse in the
morning and improves after eating small meals. Which recommendation should the nurse provide?
A. Increase fluid intake with meals
B. Eat dry crackers before getting out of bed
C. Take iron supplements on an empty stomach
D. Lie flat immediately after eating
Correct Answer: B. Eat dry crackers before getting out of bed
Explanation: Eating dry crackers or toast before rising helps stabilize blood glucose and reduces
nausea. Small, frequent meals and avoiding spicy/fatty foods are also recommended for nausea relief.
Clinical Pearl: Morning sickness typically resolves by 12-14 weeks gestation. Persistent vomiting with
weight loss requires assessment for hyperemesis gravidarum.
Question 3
A nurse is assessing a client at 24 weeks gestation who has gained 12 pounds since her last visit 4
weeks ago. She reports pedal edema, headaches, and visual disturbances. Her blood pressure is
152/94 mmHg. Which action should the nurse take first?
A. Recommend bed rest with legs elevated
B. Administer prescribed antihypertensive medication
C. Assess urine for protein
D. Instruct client to reduce dietary salt intake
Correct Answer: C. Assess urine for protein
Explanation: This client shows signs of preeclampsia: elevated BP, rapid weight gain, edema,
headache, and visual changes. Urine protein assessment is essential for diagnosis of preeclampsia.
Immediate evaluation is necessary.
,Clinical Pearl: Preeclampsia is a hypertensive disorder of pregnancy characterized by new-onset
hypertension and proteinuria after 20 weeks gestation. Early recognition prevents progression to
eclampsia.
Question 4
A client at 32 weeks gestation with gestational diabetes reports feeling "shaky and dizzy." Her blood
glucose level is 52 mg/dL. Which action should the nurse take?
A. Administer insulin per sliding scale
B. Give 15 grams of rapid-acting carbohydrate
C. Encourage client to rest and recheck in 30 minutes
D. Provide a glass of orange juice with peanut butter crackers
Correct Answer: B. Give 15 grams of rapid-acting carbohydrate
Explanation: Hypoglycemia (BG <70 mg/dL) requires immediate treatment with 15 grams of simple
carbohydrate, such as 4 oz juice, 3 glucose tablets, or 6 crackers. Recheck glucose in 15 minutes.
Clinical Pearl: The "Rule of 15" for hypoglycemia: consume 15g carbohydrate, wait 15 minutes, and
recheck. Repeat if needed. Hypoglycemia is more dangerous acutely than hyperglycemia.
Question 5
A nurse is providing education to a client about the purpose of the alpha-fetoprotein (AFP) screening
test performed at 15-20 weeks gestation. Which statement by the client indicates correct
understanding?
A. "This test will tell me if my baby has Down syndrome."
B. "This screening helps identify neural tube defects."
C. "This test confirms if my baby has cystic fibrosis."
D. "This screening is diagnostic, not just a screening."
, Correct Answer: B. "This screening helps identify neural tube defects."
Explanation: Maternal serum AFP screening measures alpha-fetoprotein levels to assess risk for neural
tube defects such as spina bifida and anencephaly. It is a screening tool, not diagnostic.
Clinical Pearl: Elevated AFP may indicate neural tube defects, while low AFP may indicate Down
syndrome risk. Abnormal results require further diagnostic testing.
Question 6
A client at 28 weeks gestation with Rh-negative blood type has received RhoGAM at 28 weeks. The
nurse explains that RhoGAM is administered to prevent which complication?
A. Fetal anemia
B. Hemolytic disease of the newborn
C. Maternal thrombocytopenia
D. Polyhydramnios
Correct Answer: B. Hemolytic disease of the newborn
Explanation: RhoGAM (Rho(D) immune globulin) prevents maternal sensitization by binding to Rh-
positive fetal RBCs, preventing maternal antibody production. This prevents hemolytic disease in
subsequent pregnancies.
Clinical Pearl: RhoGAM is administered at 28 weeks and within 72 hours after birth if the newborn is
Rh-positive. It is also given after miscarriage, abortion, or invasive procedures.
Question 7
A nurse is assessing fetal heart rate at 12 weeks gestation using Doppler ultrasound. Which finding is
most concerning?
