ALL [2026/2027] ATI Maternal Newborn & Pediatric
Proctored Exam Review | Comprehensive Study Guide,
Practice Questions & 2026 Updated Answers
Unit 1: Antepartum Care & Prenatal Assessment (Questions 1-25)
1. A nurse is caring for a client at 38 weeks' gestation who reports a sudden gush of fluid from
the vagina. Which of the following actions should the nurse take first?
A. Prepare the client for an immediate cesarean birth
B. Assess the fetal heart rate and characteristics of the fluid
C. Obtain a urine specimen for culture
D. Administer oxytocin intravenously
Correct Answer: B
Rationale: When a client reports spontaneous rupture of membranes, the priority nursing
action is to assess fetal well-being by monitoring the fetal heart rate and evaluating the fluid for
color, amount, and odor. This helps detect complications such as cord prolapse or meconium
staining. Immediate cesarean birth and oxytocin administration are not first-line actions without
further assessment .
2. A nurse is teaching a client at 10 weeks' gestation about expected physiological changes
during pregnancy. Which of the following statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
Correct Answer: C
Rationale: During pregnancy, increased estrogen levels and vascular congestion cause nasal
mucosa swelling, leading to nasal stuffiness and epistaxis. Blood pressure typically remains
stable or slightly decreases, heart rate increases, and hemoglobin levels decrease due to
hemodilution .
,3. A nurse is calculating the estimated date of delivery for a client whose last menstrual
period began on April 1st. Using Naegele's rule, which of the following is the estimated date
of delivery?
A. January 8
B. January 15
C. February 8
D. February 15
Correct Answer: A
Rationale: Naegele's rule calculates the estimated date of delivery by subtracting 3 months
from the first day of the last menstrual period and adding 7 days plus 1 year. April 1st minus 3
months equals January 1st; adding 7 days equals January 8th of the following year .
4. A nurse is reviewing the health record of a client who is pregnant. The provider
documented that the client exhibits probable signs of pregnancy. Which of the following
findings should the nurse expect?
A. Montgomery's glands
B. Goodell's sign
C. Quickening
D. Breast tenderness
Correct Answer: B
Rationale: Goodell's sign (softening of the cervical tip) is classified as a probable sign of
pregnancy because it is detected on physical examination but can have other causes.
Montgomery's glands, quickening, and breast tenderness are presumptive signs based on
subjective client reports .
5. A nurse is teaching a client who is at 8 weeks of gestation about nutrition during pregnancy.
Which of the following statements should the nurse include in the teaching?
A. "You should consume 2 cups of milk daily."
B. "You should consume 6 ounces of protein foods daily."
C. "You should consume 2 cups of vegetables each day."
D. "You should consume 4 ounces of grains each day."
Correct Answer: B
, Rationale: Pregnant clients should consume approximately 5.5 to 6.5 ounces of protein
foods daily, selecting high-protein sources such as legumes, nuts, eggs, and lean meats. Dairy
intake should be 3 cups daily, vegetables 2.5 to 3 cups, and grains 6 to 8 ounces .
6. A nurse is caring for a client who is at 11 weeks of gestation and reports abdominal
cramping. Which of the following actions should the nurse take first?
A. Administer acetaminophen as prescribed
B. Request that the provider see the client immediately
C. Document the finding as a normal discomfort of pregnancy
D. Instruct the client to lie on her left side
Correct Answer: B
Rationale: Abdominal cramping at 11 weeks of gestation can indicate ectopic pregnancy or
spontaneous abortion. Using the urgent versus nonurgent approach, the nurse should prioritize
this client and request that the provider evaluate her immediately .
7. A nurse is caring for a client at 12 weeks of gestation who reports nausea and vomiting.
Which intervention should the nurse recommend?
A. Eat small, frequent meals throughout the day
B. Increase intake of spicy foods
C. Consume large meals at bedtime
D. Avoid all fluids until symptoms subside
Correct Answer: A
Rationale: Nausea and vomiting in early pregnancy is best managed by eating small,
frequent meals to prevent the stomach from becoming empty, which exacerbates symptoms.
Spicy foods may worsen nausea, large bedtime meals increase discomfort due to slowed
digestion, and fluid avoidance risks dehydration .
8. A nurse is assessing a client at 32 weeks of gestation who reports experiencing occasional
mild contractions. Which of the following findings should the nurse identify as a sign of
preterm labor?
, A. Irregular contractions that subside with rest
B. Cervical dilation of 2 cm with 50% effacement
C. Fetal heart rate baseline of 140/min with moderate variability
D. Urinary frequency without dysuria
Correct Answer: B
Rationale: Cervical changes, including dilation and effacement, prior to 37 weeks of
gestation are key indicators of preterm labor. Irregular contractions that resolve with rest are
typically Braxton Hicks contractions. A fetal heart rate of 140/min with moderate variability is
reassuring. Urinary frequency is a common discomfort of pregnancy and not indicative of
preterm labor .
9. A nurse is teaching a client at 10 weeks of gestation about nutritional needs during
pregnancy. Which of the following statements by the client indicates understanding?
A. "I should increase my daily caloric intake by 500 calories during the first trimester."
B. "I need to take a folic acid supplement to reduce the risk of neural tube defects."
C. "I can continue to drink one cup of coffee per day without any concerns."
D. "I should avoid all fish during pregnancy to prevent mercury exposure."
Correct Answer: B
Rationale: Folic acid supplementation (400-800 mcg daily) before conception and during
early pregnancy significantly reduces the risk of neural tube defects. Caloric needs do not
increase substantially in the first trimester. Caffeine should be limited to less than 200 mg/day.
Low-mercury fish can be consumed in moderation (2-3 servings/week) for beneficial omega-3
fatty acids .
10. A nurse is reviewing the medical record of a client at 36 weeks' gestation. Which of the
following findings should the nurse identify as a risk factor for postpartum hemorrhage?
A. Previous vaginal delivery
B. History of placenta previa
C. Maternal age of 25 years
D. Singleton pregnancy
Correct Answer: B
Proctored Exam Review | Comprehensive Study Guide,
Practice Questions & 2026 Updated Answers
Unit 1: Antepartum Care & Prenatal Assessment (Questions 1-25)
1. A nurse is caring for a client at 38 weeks' gestation who reports a sudden gush of fluid from
the vagina. Which of the following actions should the nurse take first?
A. Prepare the client for an immediate cesarean birth
B. Assess the fetal heart rate and characteristics of the fluid
C. Obtain a urine specimen for culture
D. Administer oxytocin intravenously
Correct Answer: B
Rationale: When a client reports spontaneous rupture of membranes, the priority nursing
action is to assess fetal well-being by monitoring the fetal heart rate and evaluating the fluid for
color, amount, and odor. This helps detect complications such as cord prolapse or meconium
staining. Immediate cesarean birth and oxytocin administration are not first-line actions without
further assessment .
2. A nurse is teaching a client at 10 weeks' gestation about expected physiological changes
during pregnancy. Which of the following statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
Correct Answer: C
Rationale: During pregnancy, increased estrogen levels and vascular congestion cause nasal
mucosa swelling, leading to nasal stuffiness and epistaxis. Blood pressure typically remains
stable or slightly decreases, heart rate increases, and hemoglobin levels decrease due to
hemodilution .
,3. A nurse is calculating the estimated date of delivery for a client whose last menstrual
period began on April 1st. Using Naegele's rule, which of the following is the estimated date
of delivery?
A. January 8
B. January 15
C. February 8
D. February 15
Correct Answer: A
Rationale: Naegele's rule calculates the estimated date of delivery by subtracting 3 months
from the first day of the last menstrual period and adding 7 days plus 1 year. April 1st minus 3
months equals January 1st; adding 7 days equals January 8th of the following year .
4. A nurse is reviewing the health record of a client who is pregnant. The provider
documented that the client exhibits probable signs of pregnancy. Which of the following
findings should the nurse expect?
A. Montgomery's glands
B. Goodell's sign
C. Quickening
D. Breast tenderness
Correct Answer: B
Rationale: Goodell's sign (softening of the cervical tip) is classified as a probable sign of
pregnancy because it is detected on physical examination but can have other causes.
Montgomery's glands, quickening, and breast tenderness are presumptive signs based on
subjective client reports .
5. A nurse is teaching a client who is at 8 weeks of gestation about nutrition during pregnancy.
Which of the following statements should the nurse include in the teaching?
A. "You should consume 2 cups of milk daily."
B. "You should consume 6 ounces of protein foods daily."
C. "You should consume 2 cups of vegetables each day."
D. "You should consume 4 ounces of grains each day."
Correct Answer: B
, Rationale: Pregnant clients should consume approximately 5.5 to 6.5 ounces of protein
foods daily, selecting high-protein sources such as legumes, nuts, eggs, and lean meats. Dairy
intake should be 3 cups daily, vegetables 2.5 to 3 cups, and grains 6 to 8 ounces .
6. A nurse is caring for a client who is at 11 weeks of gestation and reports abdominal
cramping. Which of the following actions should the nurse take first?
A. Administer acetaminophen as prescribed
B. Request that the provider see the client immediately
C. Document the finding as a normal discomfort of pregnancy
D. Instruct the client to lie on her left side
Correct Answer: B
Rationale: Abdominal cramping at 11 weeks of gestation can indicate ectopic pregnancy or
spontaneous abortion. Using the urgent versus nonurgent approach, the nurse should prioritize
this client and request that the provider evaluate her immediately .
7. A nurse is caring for a client at 12 weeks of gestation who reports nausea and vomiting.
Which intervention should the nurse recommend?
A. Eat small, frequent meals throughout the day
B. Increase intake of spicy foods
C. Consume large meals at bedtime
D. Avoid all fluids until symptoms subside
Correct Answer: A
Rationale: Nausea and vomiting in early pregnancy is best managed by eating small,
frequent meals to prevent the stomach from becoming empty, which exacerbates symptoms.
Spicy foods may worsen nausea, large bedtime meals increase discomfort due to slowed
digestion, and fluid avoidance risks dehydration .
8. A nurse is assessing a client at 32 weeks of gestation who reports experiencing occasional
mild contractions. Which of the following findings should the nurse identify as a sign of
preterm labor?
, A. Irregular contractions that subside with rest
B. Cervical dilation of 2 cm with 50% effacement
C. Fetal heart rate baseline of 140/min with moderate variability
D. Urinary frequency without dysuria
Correct Answer: B
Rationale: Cervical changes, including dilation and effacement, prior to 37 weeks of
gestation are key indicators of preterm labor. Irregular contractions that resolve with rest are
typically Braxton Hicks contractions. A fetal heart rate of 140/min with moderate variability is
reassuring. Urinary frequency is a common discomfort of pregnancy and not indicative of
preterm labor .
9. A nurse is teaching a client at 10 weeks of gestation about nutritional needs during
pregnancy. Which of the following statements by the client indicates understanding?
A. "I should increase my daily caloric intake by 500 calories during the first trimester."
B. "I need to take a folic acid supplement to reduce the risk of neural tube defects."
C. "I can continue to drink one cup of coffee per day without any concerns."
D. "I should avoid all fish during pregnancy to prevent mercury exposure."
Correct Answer: B
Rationale: Folic acid supplementation (400-800 mcg daily) before conception and during
early pregnancy significantly reduces the risk of neural tube defects. Caloric needs do not
increase substantially in the first trimester. Caffeine should be limited to less than 200 mg/day.
Low-mercury fish can be consumed in moderation (2-3 servings/week) for beneficial omega-3
fatty acids .
10. A nurse is reviewing the medical record of a client at 36 weeks' gestation. Which of the
following findings should the nurse identify as a risk factor for postpartum hemorrhage?
A. Previous vaginal delivery
B. History of placenta previa
C. Maternal age of 25 years
D. Singleton pregnancy
Correct Answer: B
