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ATI CAPSTONE — MATERNAL NEWBORN
ASSESSMENT
150 NCLEX-STYLE MULTIPLE-CHOICE QUESTIONS
WITH ANSWER KEY AND RATIONALES
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SECTION 1: ANTEPARTUM CARE (Questions 1–25)
1. A nurse is assessing a client at 8 weeks gestation who reports nausea and vomiting. Which dietary
recommendation should the nurse provide?
A. Eat three large meals per day.
B. Consume dry crackers or toast before getting out of bed.
C. Drink large amounts of fluids with each meal.
D. Avoid all carbohydrates until symptoms resolve.
Answer: B
Rationale: Dry crackers or toast before rising help absorb gastric acid and reduce morning nausea. Small, frequent
meals are preferred. Fluids should be taken between meals, not with them. Carbohydrates are well tolerated and
should not be avoided.
2. A client at 28 weeks gestation asks about the purpose of the glucose challenge test. Which response by the
nurse is most accurate?
A. It screens for gestational diabetes by evaluating how the body processes glucose.
B. It detects chromosomal abnormalities in the fetus.
C. It measures the amount of amniotic fluid surrounding the fetus.
D. It assesses fetal lung maturity in preparation for delivery.
Answer: A
Rationale: The glucose challenge test screens for gestational diabetes, typically performed between 24 and 28
weeks gestation. It does not detect chromosomal abnormalities, measure amniotic fluid, or assess fetal lung
maturity.
3. A nurse is caring for a client who is Rh-negative and delivered an Rh-positive newborn. Which
intervention should the nurse anticipate?
A. Administer Rh immune globulin to the newborn within 72 hours.
B. Administer Rh immune globulin to the mother within 72 hours of birth.
C. Perform an immediate exchange transfusion on the newborn.
D. Administer RhoGAM to the father of the newborn.
,Answer: B
Rationale: Rh immune globulin (RhoGAM) is given to Rh-negative mothers within 72 hours of delivering an
Rh-positive infant to prevent sensitization in future pregnancies. It is given to the mother, not the newborn or
father. Exchange transfusion is not prophylactic.
4. A pregnant client at 32 weeks gestation reports sudden severe headache, visual disturbances, and epigastric
pain. Her blood pressure is 162/104 mmHg. Which condition should the nurse suspect?
A. Gestational diabetes mellitus
B. Preeclampsia with severe features
C. Placenta previa
D. Preterm labor
Answer: B
Rationale: Severe headache, visual disturbances, and epigastric pain with elevated blood pressure indicate
preeclampsia with severe features. Gestational diabetes does not cause these neurologic symptoms. Placenta
previa presents with painless vaginal bleeding. Preterm labor presents with regular uterine contractions.
5. A nurse is providing education about recommended weight gain during pregnancy. The client has a pre-
pregnancy BMI of 22. Which statement indicates understanding?
A. "I should gain about 15 to 25 pounds."
B. "I should gain about 25 to 35 pounds."
C. "I should gain about 28 to 40 pounds."
D. "I should gain about 11 to 20 pounds."
Answer: B
Rationale: For a normal pre-pregnancy BMI (18.5–24.9), recommended total weight gain is 25–35 pounds.
Underweight clients should gain 28–40 pounds. Overweight clients 15–25 pounds. Obese clients 11–20
pounds.
6. A client at 10 weeks gestation asks when she should expect to feel fetal movement. Which response is
correct?
A. "Most clients feel movement between 16 and 20 weeks gestation."
B. "Fetal movement is typically felt at 24 weeks gestation."
C. "Quickening usually occurs at 12 weeks gestation."
D. "You should feel movement by 8 weeks gestation."
Answer: A
Rationale: Quickening, the first perception of fetal movement, is typically felt between 16 and 20 weeks in
primigravida clients. It may be felt slightly earlier in multigravida clients.
7. A nurse is teaching a client about using an intrauterine device (IUD) for contraception. Which statement
indicates understanding?
A. "The IUD protects against sexually transmitted infections."
B. "I need to have the IUD replaced every 3 months."
C. "The IUD can be inserted during my menstrual period."
,D. "The IUD is 100% effective at preventing pregnancy."
Answer: C
Rationale: IUDs can be inserted during menstruation when the cervix is slightly dilated. IUDs do not protect
against STIs. Depending on type, IUDs last 3–10 years. No contraceptive is 100% effective.
8. A nurse is reviewing laboratory results for a client at 29 weeks gestation. Which result should the nurse
report to the provider?
A. WBC count 11,000/mm³
B. Hgb 11.2 g/dL
C. Hct 34%
D. Platelets 140,000/mm³
Answer: D
Rationale: A platelet count of 140,000/mm³ is below normal (150,000–400,000/mm³) and may indicate
thrombocytopenia associated with preeclampsia or HELLP syndrome. The other values are within expected
ranges for pregnancy.
9. A client is pregnant for the fourth time. She delivered two full-term newborns and had one spontaneous
abortion at 10 weeks. How should the nurse document her obstetrical history?
A. Gravida 3, Para 2
B. Gravida 3, Para 3
C. Gravida 4, Para 2
D. Gravida 4, Para 3
Answer: C
Rationale: Gravida = number of pregnancies including current (4). Para = births after 20 weeks (2). The 10-
week abortion does not count toward para. Therefore Gravida 4, Para 2.
10. A nurse is caring for a client at 32 weeks gestation experiencing preterm labor. Which medication should
the nurse plan to administer?
A. Misoprostol
B. Betamethasone
C. Poractant alfa
D. Methylergonovine
Answer: B
Rationale: Betamethasone is an antenatal corticosteroid given when preterm birth is anticipated to accelerate
fetal lung maturation. Misoprostol is for cervical ripening. Poractant alfa is surfactant for newborns.
Methylergonovine is a uterotonic for postpartum hemorrhage.
11. A nurse is assessing a client who has oligohydramnios. Which fetal anomaly should the nurse expect?
A. Renal agenesis
B. Atrial septal defect
C. Spina bifida
, D. Hydrocephalus
Answer: A
Rationale: Severe oligohydramnios can result from fetal renal abnormalities such as bilateral renal agenesis
because fetal urine is a major contributor to amniotic fluid in the second half of pregnancy.
12. A nurse is caring for a client at 37 weeks gestation with a suspected pelvic fracture due to blunt
abdominal trauma. Which finding should the nurse expect?
A. Uterine contractions
B. Bradycardia
C. Seizures
D. Bradypnea
Answer: A
Rationale: Significant abdominal trauma during pregnancy can stimulate uterine activity and precipitate
preterm labor or placental complications. Monitor for uterine contractions and fetal status.
13. A nurse is teaching a pregnant client who is Rh-negative about Rh(D) immune globulin. Which statement
indicates understanding?
A. "If my partner is Rh-negative, I will not receive the shot."
B. "I will receive the shot after delivery if my baby is Rh-negative."
C. "I should not receive any immunizations for 3 months after the shot."
D. "This shot may be given after birth to protect future pregnancies."
Answer: D
Rationale: Rh immune globulin is given to Rh-negative mothers after delivery of an Rh-positive infant to
prevent sensitization affecting future pregnancies. It is given if the baby is Rh-positive, not Rh-negative.
14. A nurse is discussing daily nutrient intake during pregnancy. Which nutrient should the nurse instruct the
client to increase?
A. Vitamin E
B. Vitamin D
C. Fiber
D. Calcium
Answer: D
Rationale: Calcium requirements increase during pregnancy to support fetal skeletal development.
Recommended intake is 1,000 mg/day. Vitamin D is important but calcium has a more direct increased
demand.
15. A nurse is teaching a client about the Papanicolaou (Pap) test. Which statement should the nurse include?
A. "A yearly Pap test is recommended until 70 years of age."
B. "Pap tests are discontinued following removal of the ovaries."
C. "Avoid having sexual intercourse for 24 hours prior to the Pap test."
D. "Viral infections can be detected by a Pap test."
═══════════════════════════
ATI CAPSTONE — MATERNAL NEWBORN
ASSESSMENT
150 NCLEX-STYLE MULTIPLE-CHOICE QUESTIONS
WITH ANSWER KEY AND RATIONALES
══════════════════════════════════════════════════════════════
═
SECTION 1: ANTEPARTUM CARE (Questions 1–25)
1. A nurse is assessing a client at 8 weeks gestation who reports nausea and vomiting. Which dietary
recommendation should the nurse provide?
A. Eat three large meals per day.
B. Consume dry crackers or toast before getting out of bed.
C. Drink large amounts of fluids with each meal.
D. Avoid all carbohydrates until symptoms resolve.
Answer: B
Rationale: Dry crackers or toast before rising help absorb gastric acid and reduce morning nausea. Small, frequent
meals are preferred. Fluids should be taken between meals, not with them. Carbohydrates are well tolerated and
should not be avoided.
2. A client at 28 weeks gestation asks about the purpose of the glucose challenge test. Which response by the
nurse is most accurate?
A. It screens for gestational diabetes by evaluating how the body processes glucose.
B. It detects chromosomal abnormalities in the fetus.
C. It measures the amount of amniotic fluid surrounding the fetus.
D. It assesses fetal lung maturity in preparation for delivery.
Answer: A
Rationale: The glucose challenge test screens for gestational diabetes, typically performed between 24 and 28
weeks gestation. It does not detect chromosomal abnormalities, measure amniotic fluid, or assess fetal lung
maturity.
3. A nurse is caring for a client who is Rh-negative and delivered an Rh-positive newborn. Which
intervention should the nurse anticipate?
A. Administer Rh immune globulin to the newborn within 72 hours.
B. Administer Rh immune globulin to the mother within 72 hours of birth.
C. Perform an immediate exchange transfusion on the newborn.
D. Administer RhoGAM to the father of the newborn.
,Answer: B
Rationale: Rh immune globulin (RhoGAM) is given to Rh-negative mothers within 72 hours of delivering an
Rh-positive infant to prevent sensitization in future pregnancies. It is given to the mother, not the newborn or
father. Exchange transfusion is not prophylactic.
4. A pregnant client at 32 weeks gestation reports sudden severe headache, visual disturbances, and epigastric
pain. Her blood pressure is 162/104 mmHg. Which condition should the nurse suspect?
A. Gestational diabetes mellitus
B. Preeclampsia with severe features
C. Placenta previa
D. Preterm labor
Answer: B
Rationale: Severe headache, visual disturbances, and epigastric pain with elevated blood pressure indicate
preeclampsia with severe features. Gestational diabetes does not cause these neurologic symptoms. Placenta
previa presents with painless vaginal bleeding. Preterm labor presents with regular uterine contractions.
5. A nurse is providing education about recommended weight gain during pregnancy. The client has a pre-
pregnancy BMI of 22. Which statement indicates understanding?
A. "I should gain about 15 to 25 pounds."
B. "I should gain about 25 to 35 pounds."
C. "I should gain about 28 to 40 pounds."
D. "I should gain about 11 to 20 pounds."
Answer: B
Rationale: For a normal pre-pregnancy BMI (18.5–24.9), recommended total weight gain is 25–35 pounds.
Underweight clients should gain 28–40 pounds. Overweight clients 15–25 pounds. Obese clients 11–20
pounds.
6. A client at 10 weeks gestation asks when she should expect to feel fetal movement. Which response is
correct?
A. "Most clients feel movement between 16 and 20 weeks gestation."
B. "Fetal movement is typically felt at 24 weeks gestation."
C. "Quickening usually occurs at 12 weeks gestation."
D. "You should feel movement by 8 weeks gestation."
Answer: A
Rationale: Quickening, the first perception of fetal movement, is typically felt between 16 and 20 weeks in
primigravida clients. It may be felt slightly earlier in multigravida clients.
7. A nurse is teaching a client about using an intrauterine device (IUD) for contraception. Which statement
indicates understanding?
A. "The IUD protects against sexually transmitted infections."
B. "I need to have the IUD replaced every 3 months."
C. "The IUD can be inserted during my menstrual period."
,D. "The IUD is 100% effective at preventing pregnancy."
Answer: C
Rationale: IUDs can be inserted during menstruation when the cervix is slightly dilated. IUDs do not protect
against STIs. Depending on type, IUDs last 3–10 years. No contraceptive is 100% effective.
8. A nurse is reviewing laboratory results for a client at 29 weeks gestation. Which result should the nurse
report to the provider?
A. WBC count 11,000/mm³
B. Hgb 11.2 g/dL
C. Hct 34%
D. Platelets 140,000/mm³
Answer: D
Rationale: A platelet count of 140,000/mm³ is below normal (150,000–400,000/mm³) and may indicate
thrombocytopenia associated with preeclampsia or HELLP syndrome. The other values are within expected
ranges for pregnancy.
9. A client is pregnant for the fourth time. She delivered two full-term newborns and had one spontaneous
abortion at 10 weeks. How should the nurse document her obstetrical history?
A. Gravida 3, Para 2
B. Gravida 3, Para 3
C. Gravida 4, Para 2
D. Gravida 4, Para 3
Answer: C
Rationale: Gravida = number of pregnancies including current (4). Para = births after 20 weeks (2). The 10-
week abortion does not count toward para. Therefore Gravida 4, Para 2.
10. A nurse is caring for a client at 32 weeks gestation experiencing preterm labor. Which medication should
the nurse plan to administer?
A. Misoprostol
B. Betamethasone
C. Poractant alfa
D. Methylergonovine
Answer: B
Rationale: Betamethasone is an antenatal corticosteroid given when preterm birth is anticipated to accelerate
fetal lung maturation. Misoprostol is for cervical ripening. Poractant alfa is surfactant for newborns.
Methylergonovine is a uterotonic for postpartum hemorrhage.
11. A nurse is assessing a client who has oligohydramnios. Which fetal anomaly should the nurse expect?
A. Renal agenesis
B. Atrial septal defect
C. Spina bifida
, D. Hydrocephalus
Answer: A
Rationale: Severe oligohydramnios can result from fetal renal abnormalities such as bilateral renal agenesis
because fetal urine is a major contributor to amniotic fluid in the second half of pregnancy.
12. A nurse is caring for a client at 37 weeks gestation with a suspected pelvic fracture due to blunt
abdominal trauma. Which finding should the nurse expect?
A. Uterine contractions
B. Bradycardia
C. Seizures
D. Bradypnea
Answer: A
Rationale: Significant abdominal trauma during pregnancy can stimulate uterine activity and precipitate
preterm labor or placental complications. Monitor for uterine contractions and fetal status.
13. A nurse is teaching a pregnant client who is Rh-negative about Rh(D) immune globulin. Which statement
indicates understanding?
A. "If my partner is Rh-negative, I will not receive the shot."
B. "I will receive the shot after delivery if my baby is Rh-negative."
C. "I should not receive any immunizations for 3 months after the shot."
D. "This shot may be given after birth to protect future pregnancies."
Answer: D
Rationale: Rh immune globulin is given to Rh-negative mothers after delivery of an Rh-positive infant to
prevent sensitization affecting future pregnancies. It is given if the baby is Rh-positive, not Rh-negative.
14. A nurse is discussing daily nutrient intake during pregnancy. Which nutrient should the nurse instruct the
client to increase?
A. Vitamin E
B. Vitamin D
C. Fiber
D. Calcium
Answer: D
Rationale: Calcium requirements increase during pregnancy to support fetal skeletal development.
Recommended intake is 1,000 mg/day. Vitamin D is important but calcium has a more direct increased
demand.
15. A nurse is teaching a client about the Papanicolaou (Pap) test. Which statement should the nurse include?
A. "A yearly Pap test is recommended until 70 years of age."
B. "Pap tests are discontinued following removal of the ovaries."
C. "Avoid having sexual intercourse for 24 hours prior to the Pap test."
D. "Viral infections can be detected by a Pap test."
