ATI RN Maternal Newborn Proctored
Exam(10 Versions)(NEW-2020/2021,
Answers)
Section 1: Antepartum Care & Prenatal Assessment
1. A client at 10 weeks' gestation asks when she should expect to feel fetal movement. The
nurse should respond that quickening is typically first felt at which time?
A. 8 to 10 weeks
B. 12 to 14 weeks
C. 18 to 20 weeks
D. 24 to 26 weeks
Quickening (first perception of fetal movement) is typically felt between 18 and 20 weeks in
a primigravida, and possibly 2 weeks earlier in a multigravida. Earlier dates are too soon for
perception; later dates are beyond the expected range.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period began on March 10. Using Naegele's rule, what is the EDD?
A. December 3
B. December 17
C. December 24
D. January 7
Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days and 1 year.
March 10 → December 10 + 7 days = December 17.
3. A pregnant client reports nausea and vomiting in the first trimester. Which instruction
should the nurse include?
A. "Drink a large glass of water with each meal."
B. "Eat dry crackers before getting out of bed in the morning."
C. "Skip breakfast to avoid triggering nausea."
D. "Increase intake of spicy foods to stimulate appetite."
, Eating dry, bland carbohydrates before rising helps reduce morning nausea related to an
empty stomach and postural changes. Large fluid volumes with meals worsen nausea; skipping
meals worsens it; spicy foods are common triggers.
4. Which findings are expected physiologic changes of pregnancy? (Select all that apply.)
A. Blood pressure slightly lower in second trimester
B. Physiologic anemia due to increased plasma volume
C. Decreased heart rate
D. Lordosis with shifting center of gravity
E. Increased renal filtration rate
Plasma volume increases more than RBC mass (physiologic anemia), BP often dips in the
second trimester, lordosis compensates for the gravid uterus, and GFR rises. Heart rate typically
increases in pregnancy, so C is incorrect.
5. A nurse is reviewing prenatal labs. Which result should be reported immediately?
A. Hemoglobin 11.5 g/dL
B. Platelets 220,000/mm³
C. Rubella titer nonimmune with a client who is 8 weeks pregnant
D. Urine culture negative
A nonimmune rubella status is important but not an emergency—the client must avoid
infection and receive vaccination postpartum. The other values are normal. (Note: if the
question asks for the priority action, it would be teaching avoidance; if asking for abnormally
concerning result requiring follow-up, nonimmune status is the key finding among these
options.)
6. A client at 36 weeks' gestation reports a sudden gush of fluid from the vagina. Which action
should the nurse take first?
A. Perform a sterile vaginal exam
B. Assess fetal heart rate and check the fluid for pooling
C. Obtain a urine specimen
D. Instruct the client to ambulate
, After suspected rupture of membranes, the priority is assessing fetal well-being (FHR) and
confirming rupture (pooling, nitrazine, ferning) while avoiding infection risk. Digital vaginal exam
is avoided until rupture is confirmed and is not the first action due to infection risk.
7. Which instruction should the nurse give a client scheduled for a 1-hour glucose tolerance
test?
A. "Fast for 12 hours before the test."
B. "You do not need to fast; drink the glucose solution and remain seated."
C. "Eat a high-carbohydrate meal 1 hour before."
D. "Void immediately before drinking the solution."
The 1-hour GTT is a non-fasting screening test. The client drinks the solution, stays seated
(activity can affect results), and has blood drawn at 1 hour.
8. A nurse is teaching a client about folic acid. Which statement indicates correct
understanding?
A. "I only need folic acid after I find out I'm pregnant."
B. "I should take 400 mcg daily before and during early pregnancy."
C. "Folic acid prevents all birth defects."
D. "I should take 10 mg daily if I have no risk factors."
400 mcg daily is recommended for all women of childbearing age to reduce neural tube
defects. It is most critical in the first 4–6 weeks, often before pregnancy is confirmed. High-dose
(4 mg) is for prior NTD-affected pregnancy.
9. Which client is at highest risk for gestational diabetes?
A. 22-year-old with BMI 22
B. 26-year-old with one prior uncomplicated term birth
C. 34-year-old with BMI 32 and a prior infant weighing 9 lb 8 oz
D. 28-year-old with chronic hypertension
Risk factors include age >25, obesity, and prior macrosomic infant. The combination in C is
highest risk.
, 10. A client at 28 weeks reports leg cramps at night. Which instruction is appropriate?
A. "Point your toes downward when the cramp occurs."
B. "Dorsiflex your foot and massage the muscle."
C. "Decrease your calcium intake."
D. "Limit fluids in the evening."
Dorsiflexion (toes toward the knee) stretches the gastrocnemius and relieves cramps.
Pointing toes worsens cramping. Calcium intake should be adequate, not decreased.
11. A nurse is assessing a client at 32 weeks. Which finding requires further evaluation?
A. Fetal heart rate 140/min
B. Blood pressure 148/96 mm Hg
C. Mild ankle edema
D. Weight gain of 1 lb in 1 week
BP ≥140/90 on two occasions after 20 weeks suggests gestational
hypertension/preeclampsia. The other findings are expected.
12. Which screening test assesses for neural tube defects?
A. Chorionic villus sampling
B. Maternal serum alpha-fetoprotein (MSAFP)
C. Nonstress test
D. Contraction stress test
MSAFP screens for open neural tube defects and abdominal wall defects. CVS is diagnostic
but not a screening blood test; NST/CST assess fetal oxygenation.
13. A client asks about the purpose of a nonstress test. The nurse explains it evaluates:
A. Uterine contraction strength
B. Fetal heart rate response to fetal movement
C. Placental grade
D. Amniotic fluid volume
Exam(10 Versions)(NEW-2020/2021,
Answers)
Section 1: Antepartum Care & Prenatal Assessment
1. A client at 10 weeks' gestation asks when she should expect to feel fetal movement. The
nurse should respond that quickening is typically first felt at which time?
A. 8 to 10 weeks
B. 12 to 14 weeks
C. 18 to 20 weeks
D. 24 to 26 weeks
Quickening (first perception of fetal movement) is typically felt between 18 and 20 weeks in
a primigravida, and possibly 2 weeks earlier in a multigravida. Earlier dates are too soon for
perception; later dates are beyond the expected range.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period began on March 10. Using Naegele's rule, what is the EDD?
A. December 3
B. December 17
C. December 24
D. January 7
Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days and 1 year.
March 10 → December 10 + 7 days = December 17.
3. A pregnant client reports nausea and vomiting in the first trimester. Which instruction
should the nurse include?
A. "Drink a large glass of water with each meal."
B. "Eat dry crackers before getting out of bed in the morning."
C. "Skip breakfast to avoid triggering nausea."
D. "Increase intake of spicy foods to stimulate appetite."
, Eating dry, bland carbohydrates before rising helps reduce morning nausea related to an
empty stomach and postural changes. Large fluid volumes with meals worsen nausea; skipping
meals worsens it; spicy foods are common triggers.
4. Which findings are expected physiologic changes of pregnancy? (Select all that apply.)
A. Blood pressure slightly lower in second trimester
B. Physiologic anemia due to increased plasma volume
C. Decreased heart rate
D. Lordosis with shifting center of gravity
E. Increased renal filtration rate
Plasma volume increases more than RBC mass (physiologic anemia), BP often dips in the
second trimester, lordosis compensates for the gravid uterus, and GFR rises. Heart rate typically
increases in pregnancy, so C is incorrect.
5. A nurse is reviewing prenatal labs. Which result should be reported immediately?
A. Hemoglobin 11.5 g/dL
B. Platelets 220,000/mm³
C. Rubella titer nonimmune with a client who is 8 weeks pregnant
D. Urine culture negative
A nonimmune rubella status is important but not an emergency—the client must avoid
infection and receive vaccination postpartum. The other values are normal. (Note: if the
question asks for the priority action, it would be teaching avoidance; if asking for abnormally
concerning result requiring follow-up, nonimmune status is the key finding among these
options.)
6. A client at 36 weeks' gestation reports a sudden gush of fluid from the vagina. Which action
should the nurse take first?
A. Perform a sterile vaginal exam
B. Assess fetal heart rate and check the fluid for pooling
C. Obtain a urine specimen
D. Instruct the client to ambulate
, After suspected rupture of membranes, the priority is assessing fetal well-being (FHR) and
confirming rupture (pooling, nitrazine, ferning) while avoiding infection risk. Digital vaginal exam
is avoided until rupture is confirmed and is not the first action due to infection risk.
7. Which instruction should the nurse give a client scheduled for a 1-hour glucose tolerance
test?
A. "Fast for 12 hours before the test."
B. "You do not need to fast; drink the glucose solution and remain seated."
C. "Eat a high-carbohydrate meal 1 hour before."
D. "Void immediately before drinking the solution."
The 1-hour GTT is a non-fasting screening test. The client drinks the solution, stays seated
(activity can affect results), and has blood drawn at 1 hour.
8. A nurse is teaching a client about folic acid. Which statement indicates correct
understanding?
A. "I only need folic acid after I find out I'm pregnant."
B. "I should take 400 mcg daily before and during early pregnancy."
C. "Folic acid prevents all birth defects."
D. "I should take 10 mg daily if I have no risk factors."
400 mcg daily is recommended for all women of childbearing age to reduce neural tube
defects. It is most critical in the first 4–6 weeks, often before pregnancy is confirmed. High-dose
(4 mg) is for prior NTD-affected pregnancy.
9. Which client is at highest risk for gestational diabetes?
A. 22-year-old with BMI 22
B. 26-year-old with one prior uncomplicated term birth
C. 34-year-old with BMI 32 and a prior infant weighing 9 lb 8 oz
D. 28-year-old with chronic hypertension
Risk factors include age >25, obesity, and prior macrosomic infant. The combination in C is
highest risk.
, 10. A client at 28 weeks reports leg cramps at night. Which instruction is appropriate?
A. "Point your toes downward when the cramp occurs."
B. "Dorsiflex your foot and massage the muscle."
C. "Decrease your calcium intake."
D. "Limit fluids in the evening."
Dorsiflexion (toes toward the knee) stretches the gastrocnemius and relieves cramps.
Pointing toes worsens cramping. Calcium intake should be adequate, not decreased.
11. A nurse is assessing a client at 32 weeks. Which finding requires further evaluation?
A. Fetal heart rate 140/min
B. Blood pressure 148/96 mm Hg
C. Mild ankle edema
D. Weight gain of 1 lb in 1 week
BP ≥140/90 on two occasions after 20 weeks suggests gestational
hypertension/preeclampsia. The other findings are expected.
12. Which screening test assesses for neural tube defects?
A. Chorionic villus sampling
B. Maternal serum alpha-fetoprotein (MSAFP)
C. Nonstress test
D. Contraction stress test
MSAFP screens for open neural tube defects and abdominal wall defects. CVS is diagnostic
but not a screening blood test; NST/CST assess fetal oxygenation.
13. A client asks about the purpose of a nonstress test. The nurse explains it evaluates:
A. Uterine contraction strength
B. Fetal heart rate response to fetal movement
C. Placental grade
D. Amniotic fluid volume
