ATI Maternal Newborn Proctored Exam 2026/2027 | ATI RN
Maternal Newborn Nursing Edition 13.0 Study Guide,
Proctored Assessment Exam Prep, Practice Questions &
Answers, Content Mastery Series, Maternal-Newborn Nursing
Review, Normal & High-Risk Pregnancy, Antepartum Care,
Intrapartum Nursing, Labor & Delivery, Fetal Monitoring,
Postpartum Care, Newborn Assessment, Newborn
Complications, Hypertensive Disorders, Gestational Diabetes,
Contraception, Infertility, Breastfeeding, Pharmacology,
Clinical Judgment, Prioritization & Detailed Rationales
Question 1: A nurse is caring for a client at 32 weeks of gestation who is
experiencing preterm labor. Which medication should the nurse
anticipate administering to promote fetal lung maturity?
A. Misoprostol
B. Betamethasone
C. Poractant alfa
D. Methylergonovine
CORRECT ANSWER: B. Betamethasone
Rationale: Betamethasone is an antenatal corticosteroid administered
when preterm birth is anticipated between 24 and 34 weeks of gestation to
accelerate fetal lung maturation and reduce the incidence of respiratory
distress syndrome, intraventricular hemorrhage, and neonatal mortality.
Misoprostol is a prostaglandin used for cervical ripening, poractant alfa is a
surfactant given after birth, and methylergonovine is a uterotonic for
postpartum hemorrhage .
Question 2: A nurse at a prenatal clinic is caring for a client who
suspects she may be pregnant. Which laboratory test should the nurse
inform the client will be used to confirm pregnancy?
A. Urine test for human chorionic somatomammotropin
B. Blood test for estrogen levels
C. Urine test for human chorionic gonadotropin
D. Blood test for progesterone levels
CORRECT ANSWER: C. Urine test for human chorionic gonadotropin
Rationale: Pregnancy is confirmed by detecting human chorionic
gonadotropin (hCG), a hormone produced by trophoblastic tissue after
implantation. Urine pregnancy tests are commonly used because they are
,rapid, noninvasive, and highly sensitive. Estrogen and progesterone levels
fluctuate during the menstrual cycle and are not diagnostic of pregnancy .
Question 3: A nurse is assessing a client who believes she may be
pregnant. Which finding should the nurse identify as a positive sign of
pregnancy?
A. Amenorrhea
B. Chadwick's sign
C. Palpable fetal movement by the examiner
D. Positive urine pregnancy test
CORRECT ANSWER: C. Palpable fetal movement by the examiner
Rationale: A positive sign of pregnancy is objective evidence of a fetus that
cannot be caused by any other condition. Palpable fetal movement
detected by an examiner is a definitive sign. Amenorrhea is presumptive,
Chadwick's sign is probable, and a positive pregnancy test is a probable
sign because hCG can be elevated in conditions other than pregnancy .
Question 4: A nurse is caring for a client who has oligohydramnios.
Which fetal anomaly should the nurse anticipate as a potential cause?
A. Renal agenesis
B. Atrial septal defect
C. Spina bifida
D. Hydrocephalus
CORRECT ANSWER: A. Renal agenesis
Rationale: Fetal urine is the primary source of amniotic fluid during the
second half of pregnancy. Bilateral renal agenesis results in absent urine
production, leading to severe oligohydramnios. Cardiac defects, neural
tube defects, and hydrocephalus are not typically associated with
decreased amniotic fluid volume .
Question 5: A nurse is assessing a client at 37 weeks of gestation who
has a suspected pelvic fracture due to blunt abdominal trauma. Which
finding should the nurse expect?
A. Uterine contractions
B. Bradycardia
,C. Seizures
D. Bradypnea
CORRECT ANSWER: A. Uterine contractions
Rationale: Significant abdominal trauma during pregnancy can stimulate
uterine activity and precipitate preterm labor or placental complications
such as abruption. The nurse should closely monitor for uterine
contractions, fetal heart rate changes, and signs of maternal hypovolemia.
Bradycardia, seizures, and bradypnea are not expected findings in this
scenario .
Question 6: A nurse is teaching a client at 8 weeks of gestation about
manifestations to report to the provider. Which finding should the
nurse include as a priority concern?
A. Nausea upon awakening
B. Blurred or double vision
C. Increase in white vaginal discharge
D. Leg cramps when sleeping
CORRECT ANSWER: B. Blurred or double vision
Rationale: Blurred or double vision can indicate preeclampsia or
gestational hypertension and requires immediate provider notification.
Nausea upon awakening is a common first-trimester discomfort. Increased
white vaginal discharge (leukorrhea) is a normal physiologic change. Leg
cramps are common in later pregnancy due to altered calcium metabolism
and circulation .
Question 7: A nurse is teaching a client at 12 weeks of gestation who
has HIV. Which statement should the nurse include in the teaching?
A. You will be in isolation after delivery.
B. You should abstain from sexual intercourse throughout pregnancy.
C. You should breastfeed your newborn to provide passive immunity.
D. You should continue to take zidovudine throughout the pregnancy.
CORRECT ANSWER: D. You should continue to take zidovudine
throughout the pregnancy.
Rationale: Taking antiretroviral medication daily throughout pregnancy
significantly decreases the risk of perinatal HIV transmission. Isolation is
, not required for HIV-positive clients. Sexual activity can continue with
precautions. Breastfeeding is contraindicated because HIV can be
transmitted through breast milk .
Question 8: A nurse is reviewing the health record of a client who is
pregnant. The client's GTPAL is documented as G3 T1 P0 A1 L1. Which
interpretation should the nurse make?
A. The client has delivered one newborn at term.
B. The client has experienced no preterm births.
C. The client has had two pregnancies total.
D. The client has one living child.
CORRECT ANSWER: A. The client has delivered one newborn at term.
Rationale: In GTPAL, T indicates term births (37 weeks or greater). T1
indicates one term delivery. P0 indicates no preterm births. G3 indicates
three total pregnancies, not two. L1 indicates one living child, which is
correct but is not the only accurate interpretation. The correct
interpretation of T1 specifically is that the client has delivered one newborn
at term .
Question 9: A nurse is calculating the estimated date of delivery for a
client whose last menstrual period began on April 1. Using Naegele's
rule, which date should the nurse identify?
A. January 8
B. January 15
C. February 8
D. February 15
CORRECT ANSWER: A. January 8
Rationale: Naegele's rule involves subtracting 3 months from the first day
of the last menstrual period and adding 7 days. April 1 minus 3 months
equals January 1. Adding 7 days results in January 8 of the following year.
This calculation assumes a 28-day menstrual cycle with ovulation
occurring on day 14 .
Question 10: A client at 28 weeks of gestation reports painless vaginal
bleeding. Which action should the nurse take first?
Maternal Newborn Nursing Edition 13.0 Study Guide,
Proctored Assessment Exam Prep, Practice Questions &
Answers, Content Mastery Series, Maternal-Newborn Nursing
Review, Normal & High-Risk Pregnancy, Antepartum Care,
Intrapartum Nursing, Labor & Delivery, Fetal Monitoring,
Postpartum Care, Newborn Assessment, Newborn
Complications, Hypertensive Disorders, Gestational Diabetes,
Contraception, Infertility, Breastfeeding, Pharmacology,
Clinical Judgment, Prioritization & Detailed Rationales
Question 1: A nurse is caring for a client at 32 weeks of gestation who is
experiencing preterm labor. Which medication should the nurse
anticipate administering to promote fetal lung maturity?
A. Misoprostol
B. Betamethasone
C. Poractant alfa
D. Methylergonovine
CORRECT ANSWER: B. Betamethasone
Rationale: Betamethasone is an antenatal corticosteroid administered
when preterm birth is anticipated between 24 and 34 weeks of gestation to
accelerate fetal lung maturation and reduce the incidence of respiratory
distress syndrome, intraventricular hemorrhage, and neonatal mortality.
Misoprostol is a prostaglandin used for cervical ripening, poractant alfa is a
surfactant given after birth, and methylergonovine is a uterotonic for
postpartum hemorrhage .
Question 2: A nurse at a prenatal clinic is caring for a client who
suspects she may be pregnant. Which laboratory test should the nurse
inform the client will be used to confirm pregnancy?
A. Urine test for human chorionic somatomammotropin
B. Blood test for estrogen levels
C. Urine test for human chorionic gonadotropin
D. Blood test for progesterone levels
CORRECT ANSWER: C. Urine test for human chorionic gonadotropin
Rationale: Pregnancy is confirmed by detecting human chorionic
gonadotropin (hCG), a hormone produced by trophoblastic tissue after
implantation. Urine pregnancy tests are commonly used because they are
,rapid, noninvasive, and highly sensitive. Estrogen and progesterone levels
fluctuate during the menstrual cycle and are not diagnostic of pregnancy .
Question 3: A nurse is assessing a client who believes she may be
pregnant. Which finding should the nurse identify as a positive sign of
pregnancy?
A. Amenorrhea
B. Chadwick's sign
C. Palpable fetal movement by the examiner
D. Positive urine pregnancy test
CORRECT ANSWER: C. Palpable fetal movement by the examiner
Rationale: A positive sign of pregnancy is objective evidence of a fetus that
cannot be caused by any other condition. Palpable fetal movement
detected by an examiner is a definitive sign. Amenorrhea is presumptive,
Chadwick's sign is probable, and a positive pregnancy test is a probable
sign because hCG can be elevated in conditions other than pregnancy .
Question 4: A nurse is caring for a client who has oligohydramnios.
Which fetal anomaly should the nurse anticipate as a potential cause?
A. Renal agenesis
B. Atrial septal defect
C. Spina bifida
D. Hydrocephalus
CORRECT ANSWER: A. Renal agenesis
Rationale: Fetal urine is the primary source of amniotic fluid during the
second half of pregnancy. Bilateral renal agenesis results in absent urine
production, leading to severe oligohydramnios. Cardiac defects, neural
tube defects, and hydrocephalus are not typically associated with
decreased amniotic fluid volume .
Question 5: A nurse is assessing a client at 37 weeks of gestation who
has a suspected pelvic fracture due to blunt abdominal trauma. Which
finding should the nurse expect?
A. Uterine contractions
B. Bradycardia
,C. Seizures
D. Bradypnea
CORRECT ANSWER: A. Uterine contractions
Rationale: Significant abdominal trauma during pregnancy can stimulate
uterine activity and precipitate preterm labor or placental complications
such as abruption. The nurse should closely monitor for uterine
contractions, fetal heart rate changes, and signs of maternal hypovolemia.
Bradycardia, seizures, and bradypnea are not expected findings in this
scenario .
Question 6: A nurse is teaching a client at 8 weeks of gestation about
manifestations to report to the provider. Which finding should the
nurse include as a priority concern?
A. Nausea upon awakening
B. Blurred or double vision
C. Increase in white vaginal discharge
D. Leg cramps when sleeping
CORRECT ANSWER: B. Blurred or double vision
Rationale: Blurred or double vision can indicate preeclampsia or
gestational hypertension and requires immediate provider notification.
Nausea upon awakening is a common first-trimester discomfort. Increased
white vaginal discharge (leukorrhea) is a normal physiologic change. Leg
cramps are common in later pregnancy due to altered calcium metabolism
and circulation .
Question 7: A nurse is teaching a client at 12 weeks of gestation who
has HIV. Which statement should the nurse include in the teaching?
A. You will be in isolation after delivery.
B. You should abstain from sexual intercourse throughout pregnancy.
C. You should breastfeed your newborn to provide passive immunity.
D. You should continue to take zidovudine throughout the pregnancy.
CORRECT ANSWER: D. You should continue to take zidovudine
throughout the pregnancy.
Rationale: Taking antiretroviral medication daily throughout pregnancy
significantly decreases the risk of perinatal HIV transmission. Isolation is
, not required for HIV-positive clients. Sexual activity can continue with
precautions. Breastfeeding is contraindicated because HIV can be
transmitted through breast milk .
Question 8: A nurse is reviewing the health record of a client who is
pregnant. The client's GTPAL is documented as G3 T1 P0 A1 L1. Which
interpretation should the nurse make?
A. The client has delivered one newborn at term.
B. The client has experienced no preterm births.
C. The client has had two pregnancies total.
D. The client has one living child.
CORRECT ANSWER: A. The client has delivered one newborn at term.
Rationale: In GTPAL, T indicates term births (37 weeks or greater). T1
indicates one term delivery. P0 indicates no preterm births. G3 indicates
three total pregnancies, not two. L1 indicates one living child, which is
correct but is not the only accurate interpretation. The correct
interpretation of T1 specifically is that the client has delivered one newborn
at term .
Question 9: A nurse is calculating the estimated date of delivery for a
client whose last menstrual period began on April 1. Using Naegele's
rule, which date should the nurse identify?
A. January 8
B. January 15
C. February 8
D. February 15
CORRECT ANSWER: A. January 8
Rationale: Naegele's rule involves subtracting 3 months from the first day
of the last menstrual period and adding 7 days. April 1 minus 3 months
equals January 1. Adding 7 days results in January 8 of the following year.
This calculation assumes a 28-day menstrual cycle with ovulation
occurring on day 14 .
Question 10: A client at 28 weeks of gestation reports painless vaginal
bleeding. Which action should the nurse take first?
