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2026 RN ATI MATERNAL PROCTORED EXAM WITH NGN
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CASE STUDY 1: ANTEPARTUM ASSESSMENT AND PRENATAL CARE
QUESTION 1: NAELELE'S RULE CALCULATION
• Question: A 28-year-old female at her first prenatal visit reports her last menstrual period
(LMP) was on October 15, 2025. Using Naegele's rule, which date should the nurse
calculate as the estimated date of delivery (EDD)?
• Options:
A. July 8, 2026
B. July 22, 2026
C. August 8, 2026
D. August 22, 2026
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Naegele's rule: Subtract 3 months from the first day
of the LMP and add 7 days, then adjust the year. October 15 minus 3 months =
July 15; July 15 plus 7 days = July 22, 2026.
o Distractor Pitfalls: Option A would be July 8 (incorrect calculation). Option C
would be August 8 (adding a month incorrectly). Option D would be August 22
(calculating forward incorrectly).
QUESTION 2: SATA - DANGER SIGNS IN PREGNANCY
• Question: The nurse is educating a primigravida client at 16 weeks gestation about
danger signs that should be reported to the healthcare provider immediately. Which
findings should the nurse include in this teaching? Select all that apply.
• Options:
A. Vaginal bleeding
B. Swelling of the face and fingers
C. Mild nausea in the morning
D. Decreased fetal movement after 28 weeks
E. Headache unrelieved by acetaminophen
• Zero-Flip Premium Rationale Box:
o Correct Answers: A, B, D, E
o Pathophysiology Summary: Danger signs in pregnancy include vaginal bleeding
(possible abruption, previa), facial/finger swelling (possible preeclampsia),
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decreased fetal movement (possible fetal compromise), and severe headache
unrelieved by acetaminophen (possible preeclampsia). These require immediate
evaluation.
o Distractor Pitfalls: Option C (mild morning sickness) is a normal early
pregnancy symptom and not a danger sign.
QUESTION 3: FUNDAL HEIGHT ASSESSMENT
• Question: A 32-year-old female at 24 weeks gestation is in the clinic for a routine
prenatal visit. The nurse measures the fundal height and obtains 28 cm. What is the most
appropriate nursing action?
• Options:
A. Document the measurement as expected
B. Notify the provider immediately
C. Re-measure and verify the location of the fundus
D. Schedule an ultrasound to confirm dates
• Zero-Flip Premium Rationale Box:
o Correct Answer: C
o Pathophysiology Summary: Fundal height in cm should approximately equal the
gestational age in weeks ± 2 cm. At 24 weeks, expected fundal height is 22-26
cm. A measurement of 28 cm is 4 cm above expected and may indicate multiple
gestation, polyhydramnios, or inaccurate dating. Re-measurement and verification
is the priority first step.
o Distractor Pitfalls: Option A is incorrect as 28 cm is not expected. Option B
(notify provider) may be appropriate after verification. Option D (ultrasound) is
an intervention, not the first action.
QUESTION 4: MATERNAL SERUM SCREENING - ALPHA-FETOPROTEIN (AFP)
• Question: A 35-year-old primigravida client at 16 weeks gestation has a maternal serum
alpha-fetoprotein (MSAFP) level that is 3.5 multiples of the median (MoM) above the
normal range. Which condition is most likely associated with this elevated level?
• Options:
A. Down syndrome
B. Open neural tube defects such as spina bifida
2026 RN ATI MATERNAL PROCTORED EXAM WITH NGN
,2
, 3
CASE STUDY 1: ANTEPARTUM ASSESSMENT AND PRENATAL CARE
QUESTION 1: NAELELE'S RULE CALCULATION
• Question: A 28-year-old female at her first prenatal visit reports her last menstrual period
(LMP) was on October 15, 2025. Using Naegele's rule, which date should the nurse
calculate as the estimated date of delivery (EDD)?
• Options:
A. July 8, 2026
B. July 22, 2026
C. August 8, 2026
D. August 22, 2026
• Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Naegele's rule: Subtract 3 months from the first day
of the LMP and add 7 days, then adjust the year. October 15 minus 3 months =
July 15; July 15 plus 7 days = July 22, 2026.
o Distractor Pitfalls: Option A would be July 8 (incorrect calculation). Option C
would be August 8 (adding a month incorrectly). Option D would be August 22
(calculating forward incorrectly).
QUESTION 2: SATA - DANGER SIGNS IN PREGNANCY
• Question: The nurse is educating a primigravida client at 16 weeks gestation about
danger signs that should be reported to the healthcare provider immediately. Which
findings should the nurse include in this teaching? Select all that apply.
• Options:
A. Vaginal bleeding
B. Swelling of the face and fingers
C. Mild nausea in the morning
D. Decreased fetal movement after 28 weeks
E. Headache unrelieved by acetaminophen
• Zero-Flip Premium Rationale Box:
o Correct Answers: A, B, D, E
o Pathophysiology Summary: Danger signs in pregnancy include vaginal bleeding
(possible abruption, previa), facial/finger swelling (possible preeclampsia),
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decreased fetal movement (possible fetal compromise), and severe headache
unrelieved by acetaminophen (possible preeclampsia). These require immediate
evaluation.
o Distractor Pitfalls: Option C (mild morning sickness) is a normal early
pregnancy symptom and not a danger sign.
QUESTION 3: FUNDAL HEIGHT ASSESSMENT
• Question: A 32-year-old female at 24 weeks gestation is in the clinic for a routine
prenatal visit. The nurse measures the fundal height and obtains 28 cm. What is the most
appropriate nursing action?
• Options:
A. Document the measurement as expected
B. Notify the provider immediately
C. Re-measure and verify the location of the fundus
D. Schedule an ultrasound to confirm dates
• Zero-Flip Premium Rationale Box:
o Correct Answer: C
o Pathophysiology Summary: Fundal height in cm should approximately equal the
gestational age in weeks ± 2 cm. At 24 weeks, expected fundal height is 22-26
cm. A measurement of 28 cm is 4 cm above expected and may indicate multiple
gestation, polyhydramnios, or inaccurate dating. Re-measurement and verification
is the priority first step.
o Distractor Pitfalls: Option A is incorrect as 28 cm is not expected. Option B
(notify provider) may be appropriate after verification. Option D (ultrasound) is
an intervention, not the first action.
QUESTION 4: MATERNAL SERUM SCREENING - ALPHA-FETOPROTEIN (AFP)
• Question: A 35-year-old primigravida client at 16 weeks gestation has a maternal serum
alpha-fetoprotein (MSAFP) level that is 3.5 multiples of the median (MoM) above the
normal range. Which condition is most likely associated with this elevated level?
• Options:
A. Down syndrome
B. Open neural tube defects such as spina bifida
