2023 ATI RN Maternal Newborn Proctored
2019 NGN (REVISED FULL EXAM)
Section I: Antepartum Care & Complications (Questions 1–35)
1. A nurse is teaching a client who is at 10 weeks of gestation about expected
physiological changes. Which statement by the client indicates understanding?
A) "I should expect my vaginal discharge to become thick and yellow."
B) "My breasts may feel tender and fuller than usual."
C) "I will likely have less frequent urination during the first trimester."
D) "My blood pressure will normally increase significantly."
B) "My breasts may feel tender and fuller than usual."
Rationale: Breast tenderness and enlargement are common early signs of
pregnancy due to hormonal changes (estrogen and progesterone). Vaginal
discharge (leukorrhea) is typically white or clear, not thick and yellow (which
suggests infection). Urinary frequency increases in the first trimester due to
pressure on the bladder and increased renal blood flow. Blood pressure typically
remains stable or slightly decreases during the first two trimesters.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose
last menstrual period began on September 15. Using Nägele's rule, what is the
EDD?
A) June 22
B) June 8
C) July 22
D) July 15
A) June 22
, Rationale: Nägele's rule: Subtract 3 months from the first day of the LMP, add
7 days, and add 1 year. September 15 − 3 months = June 15. June 15 + 7 days =
June 22.
3. A nurse is reviewing the obstetric history of a client: G4 T2 P1 A1 L3. Which
interpretation is correct? (Select all that apply.)
A) The client has been pregnant 4 times.
B) The client has delivered 2 infants at term.
C) The client has had 1 preterm delivery.
D) The client has experienced 2 abortions.
E) The client has 3 living children.
A, B, C, E
Rationale: GTPAL: G = 4 total pregnancies; T = 2 term births; P = 1 preterm
birth; A = 1 abortion/miscarriage; L = 3 living children. Option D is incorrect
because the abortion count is 1, not 2.
4. A nurse is assessing a client at 36 weeks of gestation who has preeclampsia.
Which finding should the nurse report to the provider immediately?
A) Blood pressure 142/90 mm Hg
B) 1+ proteinuria
C) Epigastric pain
D) Mild ankle edema
C) Epigastric pain
Rationale: Epigastric pain is a sign of severe preeclampsia and impending
HELLP syndrome, indicating liver capsule distension. This requires immediate
provider notification. Blood pressure of 142/90 is elevated but not yet in severe
range. 1+ proteinuria is expected with preeclampsia. Mild ankle edema is a
common finding in pregnancy.
,5. A nurse is providing teaching to a client at 12 weeks of gestation who has HIV.
Which statement should the nurse include?
A) "You will be in isolation after delivery."
B) "Breastfeeding is safe if you take your medications."
C) "You should continue taking antiretroviral therapy throughout pregnancy."
D) "You should abstain from sexual intercourse throughout pregnancy."
C) "You should continue taking antiretroviral therapy throughout
pregnancy."
Rationale: Antiretroviral therapy reduces the risk of vertical transmission of
HIV to the newborn. Isolation is not required. Breastfeeding is contraindicated
because HIV can be transmitted through breast milk. Sexual activity can continue
with precautions (condom use).
6. A nurse is teaching a client at 8 weeks of gestation about manifestations that
should be reported to the provider. Which symptom should the nurse include?
A) Nausea upon awakening
B) Blurred or double vision
C) Increased white vaginal discharge
D) Leg cramps at night
B) Blurred or double vision
Rationale: Blurred or double vision can indicate preeclampsia or gestational
hypertension and requires immediate evaluation. Nausea upon awakening,
leukorrhea, and leg cramps are common discomforts of pregnancy.
7. A nurse is performing a non-stress test (NST) on a client at 34 weeks of
gestation. Which finding indicates a reactive NST?
, A) Two FHR accelerations of at least 15 bpm lasting 15 seconds within 20 minutes
B) No accelerations after 40 minutes
C) Late decelerations following contractions
D) Baseline FHR of 110 bpm with minimal variability
A) Two FHR accelerations of at least 15 bpm lasting 15 seconds within 20
minutes
Rationale: A reactive NST demonstrates fetal well-being. Late decelerations
indicate uteroplacental insufficiency and are concerning. Baseline of 110 with
minimal variability is non-reassuring.
8. A client at 38 weeks of gestation with gestational diabetes has a reactive NST.
What does this indicate?
A) Fetal distress requiring immediate delivery
B) Fetal well-being and adequate oxygenation
C) Maternal hyperglycemia
D) Placental insufficiency
B) Fetal well-being and adequate oxygenation
Rationale: A reactive NST indicates the fetus is not in distress and has
adequate oxygenation. It does not indicate maternal glucose status or placental
insufficiency.
9. A nurse is assessing a client at 32 weeks of gestation with placenta previa.
Which finding is most concerning?
A) Painless vaginal bleeding
B) Uterine contractions
C) Fetal heart rate of 140 bpm
D) Blood pressure 120/80 mm Hg
2019 NGN (REVISED FULL EXAM)
Section I: Antepartum Care & Complications (Questions 1–35)
1. A nurse is teaching a client who is at 10 weeks of gestation about expected
physiological changes. Which statement by the client indicates understanding?
A) "I should expect my vaginal discharge to become thick and yellow."
B) "My breasts may feel tender and fuller than usual."
C) "I will likely have less frequent urination during the first trimester."
D) "My blood pressure will normally increase significantly."
B) "My breasts may feel tender and fuller than usual."
Rationale: Breast tenderness and enlargement are common early signs of
pregnancy due to hormonal changes (estrogen and progesterone). Vaginal
discharge (leukorrhea) is typically white or clear, not thick and yellow (which
suggests infection). Urinary frequency increases in the first trimester due to
pressure on the bladder and increased renal blood flow. Blood pressure typically
remains stable or slightly decreases during the first two trimesters.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose
last menstrual period began on September 15. Using Nägele's rule, what is the
EDD?
A) June 22
B) June 8
C) July 22
D) July 15
A) June 22
, Rationale: Nägele's rule: Subtract 3 months from the first day of the LMP, add
7 days, and add 1 year. September 15 − 3 months = June 15. June 15 + 7 days =
June 22.
3. A nurse is reviewing the obstetric history of a client: G4 T2 P1 A1 L3. Which
interpretation is correct? (Select all that apply.)
A) The client has been pregnant 4 times.
B) The client has delivered 2 infants at term.
C) The client has had 1 preterm delivery.
D) The client has experienced 2 abortions.
E) The client has 3 living children.
A, B, C, E
Rationale: GTPAL: G = 4 total pregnancies; T = 2 term births; P = 1 preterm
birth; A = 1 abortion/miscarriage; L = 3 living children. Option D is incorrect
because the abortion count is 1, not 2.
4. A nurse is assessing a client at 36 weeks of gestation who has preeclampsia.
Which finding should the nurse report to the provider immediately?
A) Blood pressure 142/90 mm Hg
B) 1+ proteinuria
C) Epigastric pain
D) Mild ankle edema
C) Epigastric pain
Rationale: Epigastric pain is a sign of severe preeclampsia and impending
HELLP syndrome, indicating liver capsule distension. This requires immediate
provider notification. Blood pressure of 142/90 is elevated but not yet in severe
range. 1+ proteinuria is expected with preeclampsia. Mild ankle edema is a
common finding in pregnancy.
,5. A nurse is providing teaching to a client at 12 weeks of gestation who has HIV.
Which statement should the nurse include?
A) "You will be in isolation after delivery."
B) "Breastfeeding is safe if you take your medications."
C) "You should continue taking antiretroviral therapy throughout pregnancy."
D) "You should abstain from sexual intercourse throughout pregnancy."
C) "You should continue taking antiretroviral therapy throughout
pregnancy."
Rationale: Antiretroviral therapy reduces the risk of vertical transmission of
HIV to the newborn. Isolation is not required. Breastfeeding is contraindicated
because HIV can be transmitted through breast milk. Sexual activity can continue
with precautions (condom use).
6. A nurse is teaching a client at 8 weeks of gestation about manifestations that
should be reported to the provider. Which symptom should the nurse include?
A) Nausea upon awakening
B) Blurred or double vision
C) Increased white vaginal discharge
D) Leg cramps at night
B) Blurred or double vision
Rationale: Blurred or double vision can indicate preeclampsia or gestational
hypertension and requires immediate evaluation. Nausea upon awakening,
leukorrhea, and leg cramps are common discomforts of pregnancy.
7. A nurse is performing a non-stress test (NST) on a client at 34 weeks of
gestation. Which finding indicates a reactive NST?
, A) Two FHR accelerations of at least 15 bpm lasting 15 seconds within 20 minutes
B) No accelerations after 40 minutes
C) Late decelerations following contractions
D) Baseline FHR of 110 bpm with minimal variability
A) Two FHR accelerations of at least 15 bpm lasting 15 seconds within 20
minutes
Rationale: A reactive NST demonstrates fetal well-being. Late decelerations
indicate uteroplacental insufficiency and are concerning. Baseline of 110 with
minimal variability is non-reassuring.
8. A client at 38 weeks of gestation with gestational diabetes has a reactive NST.
What does this indicate?
A) Fetal distress requiring immediate delivery
B) Fetal well-being and adequate oxygenation
C) Maternal hyperglycemia
D) Placental insufficiency
B) Fetal well-being and adequate oxygenation
Rationale: A reactive NST indicates the fetus is not in distress and has
adequate oxygenation. It does not indicate maternal glucose status or placental
insufficiency.
9. A nurse is assessing a client at 32 weeks of gestation with placenta previa.
Which finding is most concerning?
A) Painless vaginal bleeding
B) Uterine contractions
C) Fetal heart rate of 140 bpm
D) Blood pressure 120/80 mm Hg
