Ati Rn Maternal Newborn Proctored Exam 2026 |
Study Guide, Practice Q&A & Detailed Rationales
Section 1: Antepartum Care & Fetal Development
Question 1
A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period (LMP) began on June 10. Using Naegele's rule, which of the following is the EDD?
A. March 3
B. March 17
C. April 3
D. April 17
Correct Answer: B. March 17
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days
plus 1 year. June 10 minus 3 months = March 10; adding 7 days = March 17 of the following
year. This calculation assumes a 28-day cycle.
Question 2
A nurse is teaching a client at 10 weeks of 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. "I may experience nasal stuffiness due to increased blood flow."
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.
Question 3
,A nurse is assessing a client who is at 12 weeks of gestation. Which of the following findings
should the nurse identify as a presumptive sign of pregnancy?
A. Positive urine hCG test
B. Fetal heart tones detected by Doppler
C. Amenorrhea
D. Goodell's sign
Correct Answer: C. Amenorrhea
Rationale: Presumptive signs are subjective changes reported by the client, including
amenorrhea, nausea, breast tenderness, and fatigue. A positive hCG test and Goodell's sign are
probable signs (objective but not definitive). Fetal heart tones are a positive sign (definitive
confirmation of pregnancy).
Question 4
A nurse is caring for a client at 16 weeks of gestation who asks when she should expect to feel
fetal movement. The nurse should respond that quickening typically occurs at which of the
following gestational ages?
A. 8 to 10 weeks
B. 12 to 14 weeks
C. 16 to 20 weeks
D. 24 to 28 weeks
Correct Answer: C. 16 to 20 weeks
Rationale: Quickening, the first perception of fetal movement, is commonly felt between 16
and 20 weeks of gestation, particularly in a first pregnancy. Earlier or later perception can occur
depending on individual factors.
Question 5
A nurse is reviewing laboratory results for a client at 28 weeks of gestation. Which of the
following findings should the nurse report to the provider?
A. Hemoglobin 11.5 g/dL
B. Platelet count 150,000/mm³
,C. 1-hour glucose challenge result of 180 mg/dL
D. Fasting blood glucose 85 mg/dL
Correct Answer: C. 1-hour glucose challenge result of 180 mg/dL
Rationale: A 1-hour glucose challenge result above 140 mg/dL is abnormal and requires
further evaluation with a 3-hour glucose tolerance test. Hemoglobin 11.5 g/dL and platelets
150,000/mm³ are within acceptable ranges for pregnancy. Fasting glucose 85 mg/dL is normal.
Question 6
A nurse is teaching a prenatal client about nutrition during pregnancy. Which of the following
statements should the nurse include?
A. "You should consume 2 cups of milk daily."
B. "You should consume 6 ounces of protein foods daily."
C. "You should consume 1 cup of vegetables each day."
D. "You should consume 3 ounces of grains each day."
Correct Answer: B. "You should consume 6 ounces of protein foods daily."
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.
Question 7
A nurse is performing Leopold maneuvers prior to applying an external fetal monitor. Which of
the following is the purpose of this assessment?
A. To determine cervical dilation
B. To assess the position and presentation of the fetus
C. To evaluate amniotic fluid volume
D. To measure uterine contraction intensity
Correct Answer: B. To assess the position and presentation of the fetus
Rationale: Leopold maneuvers are performed to palpate the maternal abdomen and
determine fetal position and presentation. This information guides the nurse in placing the
external fetal monitoring transducer over the optimal location to obtain the fetal heart rate.
, Question 8
A nurse is caring for a client at 8 weeks of gestation who reports nausea and vomiting. Which of
the following recommendations should the nurse include in the teaching?
A. Drink large amounts of fluids with meals
B. Eat dry crackers before rising in the morning
C. Lie down immediately after eating
D. Skip breakfast to reduce stomach irritation
Correct Answer: B. Eat dry crackers before rising in the morning
Rationale: Eating dry crackers before getting out of bed helps reduce morning nausea by
stabilizing blood glucose and reducing gastric irritation. Drinking large volumes with meals, lying
down immediately after eating, and skipping meals can worsen nausea and vomiting.
Question 9
A nurse is teaching a client at 30 weeks of gestation about warning signs that require immediate
evaluation. Which of the following should the nurse include?
A. Urinary frequency
B. Vaginal bleeding
C. Mild ankle edema
D. Occasional heartburn
Correct Answer: B. Vaginal bleeding
Rationale: Vaginal bleeding during pregnancy requires prompt evaluation because it can
indicate placental abruption, placenta previa, or other serious complications. Urinary frequency,
mild ankle edema, and occasional heartburn are common discomforts of pregnancy.
Question 10
A nurse is assessing a client at 36 weeks of gestation. Which of the following findings should the
nurse identify as a probable sign of pregnancy?
A. Breast tenderness
B. Nausea
Study Guide, Practice Q&A & Detailed Rationales
Section 1: Antepartum Care & Fetal Development
Question 1
A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period (LMP) began on June 10. Using Naegele's rule, which of the following is the EDD?
A. March 3
B. March 17
C. April 3
D. April 17
Correct Answer: B. March 17
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days
plus 1 year. June 10 minus 3 months = March 10; adding 7 days = March 17 of the following
year. This calculation assumes a 28-day cycle.
Question 2
A nurse is teaching a client at 10 weeks of 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. "I may experience nasal stuffiness due to increased blood flow."
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.
Question 3
,A nurse is assessing a client who is at 12 weeks of gestation. Which of the following findings
should the nurse identify as a presumptive sign of pregnancy?
A. Positive urine hCG test
B. Fetal heart tones detected by Doppler
C. Amenorrhea
D. Goodell's sign
Correct Answer: C. Amenorrhea
Rationale: Presumptive signs are subjective changes reported by the client, including
amenorrhea, nausea, breast tenderness, and fatigue. A positive hCG test and Goodell's sign are
probable signs (objective but not definitive). Fetal heart tones are a positive sign (definitive
confirmation of pregnancy).
Question 4
A nurse is caring for a client at 16 weeks of gestation who asks when she should expect to feel
fetal movement. The nurse should respond that quickening typically occurs at which of the
following gestational ages?
A. 8 to 10 weeks
B. 12 to 14 weeks
C. 16 to 20 weeks
D. 24 to 28 weeks
Correct Answer: C. 16 to 20 weeks
Rationale: Quickening, the first perception of fetal movement, is commonly felt between 16
and 20 weeks of gestation, particularly in a first pregnancy. Earlier or later perception can occur
depending on individual factors.
Question 5
A nurse is reviewing laboratory results for a client at 28 weeks of gestation. Which of the
following findings should the nurse report to the provider?
A. Hemoglobin 11.5 g/dL
B. Platelet count 150,000/mm³
,C. 1-hour glucose challenge result of 180 mg/dL
D. Fasting blood glucose 85 mg/dL
Correct Answer: C. 1-hour glucose challenge result of 180 mg/dL
Rationale: A 1-hour glucose challenge result above 140 mg/dL is abnormal and requires
further evaluation with a 3-hour glucose tolerance test. Hemoglobin 11.5 g/dL and platelets
150,000/mm³ are within acceptable ranges for pregnancy. Fasting glucose 85 mg/dL is normal.
Question 6
A nurse is teaching a prenatal client about nutrition during pregnancy. Which of the following
statements should the nurse include?
A. "You should consume 2 cups of milk daily."
B. "You should consume 6 ounces of protein foods daily."
C. "You should consume 1 cup of vegetables each day."
D. "You should consume 3 ounces of grains each day."
Correct Answer: B. "You should consume 6 ounces of protein foods daily."
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.
Question 7
A nurse is performing Leopold maneuvers prior to applying an external fetal monitor. Which of
the following is the purpose of this assessment?
A. To determine cervical dilation
B. To assess the position and presentation of the fetus
C. To evaluate amniotic fluid volume
D. To measure uterine contraction intensity
Correct Answer: B. To assess the position and presentation of the fetus
Rationale: Leopold maneuvers are performed to palpate the maternal abdomen and
determine fetal position and presentation. This information guides the nurse in placing the
external fetal monitoring transducer over the optimal location to obtain the fetal heart rate.
, Question 8
A nurse is caring for a client at 8 weeks of gestation who reports nausea and vomiting. Which of
the following recommendations should the nurse include in the teaching?
A. Drink large amounts of fluids with meals
B. Eat dry crackers before rising in the morning
C. Lie down immediately after eating
D. Skip breakfast to reduce stomach irritation
Correct Answer: B. Eat dry crackers before rising in the morning
Rationale: Eating dry crackers before getting out of bed helps reduce morning nausea by
stabilizing blood glucose and reducing gastric irritation. Drinking large volumes with meals, lying
down immediately after eating, and skipping meals can worsen nausea and vomiting.
Question 9
A nurse is teaching a client at 30 weeks of gestation about warning signs that require immediate
evaluation. Which of the following should the nurse include?
A. Urinary frequency
B. Vaginal bleeding
C. Mild ankle edema
D. Occasional heartburn
Correct Answer: B. Vaginal bleeding
Rationale: Vaginal bleeding during pregnancy requires prompt evaluation because it can
indicate placental abruption, placenta previa, or other serious complications. Urinary frequency,
mild ankle edema, and occasional heartburn are common discomforts of pregnancy.
Question 10
A nurse is assessing a client at 36 weeks of gestation. Which of the following findings should the
nurse identify as a probable sign of pregnancy?
A. Breast tenderness
B. Nausea
