ATI RN Maternal Newborn Proctored
Exam 2026 | Level 3 Practice Questions
and Answers with Rationales |
Complete Review
Section 1: Antepartum Care & Prenatal Assessment (Q1–Q25)
1. A nurse is assessing a client at 10 weeks' gestation who reports nausea and vomiting.
Which instruction should the nurse provide first?
A. "Drink large amounts of fluids with meals."
B. "Eat dry crackers before getting out of bed in the morning."
C. "Skip breakfast and eat only at night."
D. "Take iron supplements on an empty stomach."
Correct Answer: B
Rationale: Eating dry crackers before rising helps reduce morning nausea because it
stabilizes blood glucose before movement. Large fluid volumes with meals worsen nausea,
skipping meals is not recommended, and iron on an empty stomach increases GI upset.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period began March 10. Using Naegele's rule, what is the EDD?
A. December 10
B. December 17
C. December 3
D. January 10
Correct Answer: B
Rationale: Naegele's rule: subtract 3 months, add 7 days, add 1 year. March 10 → December
10 + 7 days = December 17.
,3. A nurse is reviewing prenatal lab results for a client at 28 weeks. Which finding requires
immediate follow-up?
A. Hemoglobin 11.5 g/dL
B. Platelet count 250,000/mm³
C. 1-hour glucose tolerance test 165 mg/dL
D. WBC 9,000/mm³
Correct Answer: C
Rationale: A 1-hour GTT ≥140 mg/dL is abnormal and requires a 3-hour glucose tolerance
test to evaluate for gestational diabetes. The other values are within normal limits for
pregnancy.
4. SATA: A nurse is teaching a client at 12 weeks about expected physiologic changes of
pregnancy. Which statements indicate understanding?
A. "My blood pressure may decrease slightly."
B. "I may have more frequent urination."
C. "My heart rate will decrease."
D. "I may feel constipated."
E. "My blood volume will decrease."
Correct Answers: A, B, D
Rationale: BP often decreases slightly due to vasodilation; urinary frequency increases from
pressure and increased GFR; constipation results from progesterone slowing GI motility. Heart
rate increases and blood volume increases, so C and E are incorrect.
5. A nurse is assessing a client at 34 weeks who reports a sudden gush of fluid. Which action
should the nurse take first?
A. Perform a sterile speculum exam
B. Check the fetal heart rate
C. Test the fluid with nitrazine paper
D. Obtain a urine specimen
Correct Answer: B
Rationale: When rupture of membranes is suspected, the priority is assessing fetal well-
,being (FHR) because cord prolapse or compression may occur. Nitrazine and speculum exam
follow once fetal status is confirmed stable.
6. A nurse is providing teaching about folic acid. Which statement by the client indicates a
need for further teaching?
A. "I should take 400 mcg daily before pregnancy."
B. "Folic acid helps prevent neural tube defects."
C. "I only need folic acid after I find out I'm pregnant."
D. "Fortified cereals are a good source."
Correct Answer: C
Rationale: Folic acid is most critical in the first 4–6 weeks of gestation, often before
pregnancy is confirmed. Supplementation should begin before conception, so this statement
shows misunderstanding.
7. A nurse is assessing a client at 20 weeks who reports a "fluttering" sensation in her
abdomen. The nurse should document this as:
A. Ballottement
B. Quickening
C. Lightening
D. Braxton Hicks
Correct Answer: B
Rationale: Quickening is the first perception of fetal movement, typically felt at 16–20
weeks. Ballottement is a passive fetal palpation; lightening is fetal descent; Braxton Hicks are
irregular contractions.
8. A nurse is reviewing the prenatal record of a client who is Rh-negative. Which test
determines if the client needs Rho(D) immune globulin?
A. Indirect Coombs test
B. Direct Coombs test
C. Kleihauer-Betke test
D. Amniocentesis
, Correct Answer: A
Rationale: The indirect Coombs test detects Rh antibodies in maternal serum. If negative
(unsensitized), RhoGAM is given at 28 weeks and within 72 hours postpartum.
9. A nurse is teaching a client about kick counts. Which instruction is correct?
A. "Count kicks for 1 hour after breakfast."
B. "You should feel at least 10 movements in 2 hours."
C. "Count only strong kicks, not flutters."
D. "Do kick counts once a week."
Correct Answer: B
Rationale: The standard is 10 fetal movements in 2 hours (or 10 in 1 hour if counting
differently). Daily counting after meals when the fetus is most active is recommended. All
movements count.
10. A nurse is assessing a client at 36 weeks. Which finding should the nurse report
immediately?
A. Hemoglobin 10.8 g/dL
B. Blood pressure 148/96 mmHg
C. Fetal heart rate 140 bpm
D. Mild ankle edema
Correct Answer: B
Rationale: BP ≥140/90 after 20 weeks may indicate gestational hypertension or
preeclampsia, requiring immediate evaluation. Mild anemia, FHR 140, and dependent edema
are common in pregnancy.
11. SATA: A nurse is providing nutritional teaching. Which foods should be avoided during
pregnancy?
A. Unpasteurized milk
B. Deli meats
C. Cooked salmon
D. Raw sprouts
E. Pasteurized cheese
Exam 2026 | Level 3 Practice Questions
and Answers with Rationales |
Complete Review
Section 1: Antepartum Care & Prenatal Assessment (Q1–Q25)
1. A nurse is assessing a client at 10 weeks' gestation who reports nausea and vomiting.
Which instruction should the nurse provide first?
A. "Drink large amounts of fluids with meals."
B. "Eat dry crackers before getting out of bed in the morning."
C. "Skip breakfast and eat only at night."
D. "Take iron supplements on an empty stomach."
Correct Answer: B
Rationale: Eating dry crackers before rising helps reduce morning nausea because it
stabilizes blood glucose before movement. Large fluid volumes with meals worsen nausea,
skipping meals is not recommended, and iron on an empty stomach increases GI upset.
2. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period began March 10. Using Naegele's rule, what is the EDD?
A. December 10
B. December 17
C. December 3
D. January 10
Correct Answer: B
Rationale: Naegele's rule: subtract 3 months, add 7 days, add 1 year. March 10 → December
10 + 7 days = December 17.
,3. A nurse is reviewing prenatal lab results for a client at 28 weeks. Which finding requires
immediate follow-up?
A. Hemoglobin 11.5 g/dL
B. Platelet count 250,000/mm³
C. 1-hour glucose tolerance test 165 mg/dL
D. WBC 9,000/mm³
Correct Answer: C
Rationale: A 1-hour GTT ≥140 mg/dL is abnormal and requires a 3-hour glucose tolerance
test to evaluate for gestational diabetes. The other values are within normal limits for
pregnancy.
4. SATA: A nurse is teaching a client at 12 weeks about expected physiologic changes of
pregnancy. Which statements indicate understanding?
A. "My blood pressure may decrease slightly."
B. "I may have more frequent urination."
C. "My heart rate will decrease."
D. "I may feel constipated."
E. "My blood volume will decrease."
Correct Answers: A, B, D
Rationale: BP often decreases slightly due to vasodilation; urinary frequency increases from
pressure and increased GFR; constipation results from progesterone slowing GI motility. Heart
rate increases and blood volume increases, so C and E are incorrect.
5. A nurse is assessing a client at 34 weeks who reports a sudden gush of fluid. Which action
should the nurse take first?
A. Perform a sterile speculum exam
B. Check the fetal heart rate
C. Test the fluid with nitrazine paper
D. Obtain a urine specimen
Correct Answer: B
Rationale: When rupture of membranes is suspected, the priority is assessing fetal well-
,being (FHR) because cord prolapse or compression may occur. Nitrazine and speculum exam
follow once fetal status is confirmed stable.
6. A nurse is providing teaching about folic acid. Which statement by the client indicates a
need for further teaching?
A. "I should take 400 mcg daily before pregnancy."
B. "Folic acid helps prevent neural tube defects."
C. "I only need folic acid after I find out I'm pregnant."
D. "Fortified cereals are a good source."
Correct Answer: C
Rationale: Folic acid is most critical in the first 4–6 weeks of gestation, often before
pregnancy is confirmed. Supplementation should begin before conception, so this statement
shows misunderstanding.
7. A nurse is assessing a client at 20 weeks who reports a "fluttering" sensation in her
abdomen. The nurse should document this as:
A. Ballottement
B. Quickening
C. Lightening
D. Braxton Hicks
Correct Answer: B
Rationale: Quickening is the first perception of fetal movement, typically felt at 16–20
weeks. Ballottement is a passive fetal palpation; lightening is fetal descent; Braxton Hicks are
irregular contractions.
8. A nurse is reviewing the prenatal record of a client who is Rh-negative. Which test
determines if the client needs Rho(D) immune globulin?
A. Indirect Coombs test
B. Direct Coombs test
C. Kleihauer-Betke test
D. Amniocentesis
, Correct Answer: A
Rationale: The indirect Coombs test detects Rh antibodies in maternal serum. If negative
(unsensitized), RhoGAM is given at 28 weeks and within 72 hours postpartum.
9. A nurse is teaching a client about kick counts. Which instruction is correct?
A. "Count kicks for 1 hour after breakfast."
B. "You should feel at least 10 movements in 2 hours."
C. "Count only strong kicks, not flutters."
D. "Do kick counts once a week."
Correct Answer: B
Rationale: The standard is 10 fetal movements in 2 hours (or 10 in 1 hour if counting
differently). Daily counting after meals when the fetus is most active is recommended. All
movements count.
10. A nurse is assessing a client at 36 weeks. Which finding should the nurse report
immediately?
A. Hemoglobin 10.8 g/dL
B. Blood pressure 148/96 mmHg
C. Fetal heart rate 140 bpm
D. Mild ankle edema
Correct Answer: B
Rationale: BP ≥140/90 after 20 weeks may indicate gestational hypertension or
preeclampsia, requiring immediate evaluation. Mild anemia, FHR 140, and dependent edema
are common in pregnancy.
11. SATA: A nurse is providing nutritional teaching. Which foods should be avoided during
pregnancy?
A. Unpasteurized milk
B. Deli meats
C. Cooked salmon
D. Raw sprouts
E. Pasteurized cheese
