ATI RN Maternal Newborn CMS Proctored Exam Prep |
Latest Update 2026/2027
200 Practice Questions & Detailed Answers | Nursing
Study Guide & Exam Review | A+ Graded
Section 1: Antepartum Care, Prenatal Assessment & Fetal Development (Questions 1–40)
1. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual period
(LMP) began on April 10. Using Naegele's rule, what is the client's EDD?
A. January 17
B. January 10
C. January 24
D. January 3
Correct Answer: A
Rationale: Naegele's rule calculates the EDD by subtracting 3 months from the first day of the LMP and
adding 7 days. April 10 minus 3 months = January 10; January 10 plus 7 days = January 17. This is a
fundamental antepartum calculation tested on every proctored maternalnewborn assessment.
2. A nurse is reviewing the obstetric history of a client who is pregnant for the fourth time. She has had 2
term births, 1 preterm birth, 1 abortion, and 3 living children. Which GTPAL notation is correct?
A. G4 T2 P1 A1 L3
B. G4 T2 P0 A1 L3
C. G4 T2 P1 A0 L3
D. G4 T2 P1 A1 L2
Correct Answer: A
Rationale: GTPAL stands for Gravida, Term births, Preterm births, Abortions, Living children. G = 4
(current pregnancy plus 3 prior pregnancies). T = 2 (term births). P = 1 (preterm birth at 20–36 6/7
weeks). A = 1 (abortion before 20 weeks). L = 3 (currently living children). This is a highyield antepartum
assessment concept.
,3. A nurse is teaching a client at 12 weeks of gestation about expected physiological changes during
pregnancy. Which statement by the client indicates a need for further teaching?
A. "I may notice my gums bleeding when I brush my teeth."
B. "I should expect my blood pressure to decrease slightly."
C. "I will likely have more frequent bowel movements."
D. "My heart rate may increase by 10 to 15 beats per minute."
Correct Answer: C
Rationale: Progesterone slows gastrointestinal motility, leading to constipation—not more frequent
bowel movements. Gingival bleeding (epulis) is common due to increased vascularity. Blood pressure
often decreases slightly in the second trimester. Heart rate increases by 10–15 bpm due to increased
cardiac output.
4. A nurse is performing a prenatal assessment on a client at 32 weeks of gestation. Which finding
should the nurse report to the provider immediately?
A. Fundal height of 32 cm
B. Blood pressure 142/92 mm Hg
C. Mild ankle edema
D. Fetal heart rate 148 bpm
Correct Answer: B
Rationale: A blood pressure of 142/92 mm Hg exceeds the threshold for gestational hypertension
(≥140/90 mm Hg) and requires immediate evaluation for preeclampsia. Fundal height should
approximate gestational age in weeks (32 cm at 32 weeks is expected). Mild ankle edema is common. A
fetal heart rate of 148 bpm is within the normal range of 110–160 bpm.
5. A nurse is teaching a client who is at 10 weeks of gestation about nutritional needs during pregnancy.
Which statement by the client indicates an understanding of the teaching?
A. "I should increase my iron intake by drinking milk with my iron supplement."
B. "I need to consume approximately 300 additional calories per day during pregnancy."
C. "I should limit my folic acid intake to 200 micrograms daily."
D. "I can continue my prepregnancy diet without any changes."
Correct Answer: B
,Rationale: During pregnancy, caloric needs increase by approximately 300 calories per day to support
fetal growth and maternal metabolic demands. Iron should be taken with vitamin C, not milk, because
calcium inhibits absorption. Folic acid needs increase to 600 mcg daily, not decrease.
6. A nurse is caring for a client at 32 weeks of gestation who reports a sudden gush of clear fluid from
the vagina. Which action should the nurse take first?
A. Perform a sterile vaginal examination to assess cervical dilation.
B. Check the fetal heart rate and assess for cord prolapse.
C. Obtain a urine specimen for culture and sensitivity.
D. Instruct the client to ambulate to promote fluid drainage.
Correct Answer: B
Rationale: When a client reports spontaneous rupture of membranes (ROM), the priority nursing action
is to assess fetal wellbeing and check for cord prolapse, which is an obstetric emergency. Vaginal
examination should be avoided until cord prolapse is ruled out. Ambulation is contraindicated until fetal
status is confirmed stable.
7. A nurse is teaching a pregnant client about folic acid supplementation. Which birth defect is folic acid
most effective in preventing?
A. Neural tube defects
B. Cleft palate
C. Congenital cataracts
D. Clubfoot
Correct Answer: A
Rationale: Adequate folic acid intake before conception and during early pregnancy reduces the risk of
neural tube defects such as spina bifida. Folic acid is one of the highestyield prenatal nutrition topics.
8. A nurse is caring for a client at 10 weeks of gestation. Which finding is considered an expected
physiological change during pregnancy?
A. Increased urinary frequency
B. Severe hypertension
C. Vaginal bleeding
D. Persistent fever
, Correct Answer: A
Rationale: Increased urinary frequency commonly occurs during early pregnancy due to hormonal
changes and pressure on the bladder. Severe hypertension, vaginal bleeding, and persistent fever are
signs of complications, not expected changes.
9. A nurse is assessing a pregnant client at 28 weeks of gestation. Which laboratory test is commonly
performed during this period?
A. Glucose screening test
B. Newborn metabolic screening
C. Apgar scoring
D. Heelstick blood sampling
Correct Answer: A
Rationale: Gestational diabetes screening is commonly performed between 24 and 28 weeks of
gestation. Newborn metabolic screening and Apgar scoring are performed after birth, not during
pregnancy.
10. A nurse is caring for a client at 32 weeks of gestation who reports a severe headache, blurred vision,
and epigastric pain. Which complication should the nurse suspect?
A. Preeclampsia
B. Hyperemesis gravidarum
C. Placenta previa
D. Physiological pregnancy changes
Correct Answer: A
Rationale: Severe headache, visual disturbances, and epigastric pain are classic manifestations of severe
preeclampsia. These are warning signs of hypertensive disorders of pregnancy requiring immediate
evaluation.
11. A nurse is reinforcing teaching about the rhythm method of contraception. Which instruction is
correct?
A. "You should abstain from intercourse on days 10 to 17 of your cycle."
B. "This method is highly effective with perfect use."
C. "You should take your temperature at night before bed."
Latest Update 2026/2027
200 Practice Questions & Detailed Answers | Nursing
Study Guide & Exam Review | A+ Graded
Section 1: Antepartum Care, Prenatal Assessment & Fetal Development (Questions 1–40)
1. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual period
(LMP) began on April 10. Using Naegele's rule, what is the client's EDD?
A. January 17
B. January 10
C. January 24
D. January 3
Correct Answer: A
Rationale: Naegele's rule calculates the EDD by subtracting 3 months from the first day of the LMP and
adding 7 days. April 10 minus 3 months = January 10; January 10 plus 7 days = January 17. This is a
fundamental antepartum calculation tested on every proctored maternalnewborn assessment.
2. A nurse is reviewing the obstetric history of a client who is pregnant for the fourth time. She has had 2
term births, 1 preterm birth, 1 abortion, and 3 living children. Which GTPAL notation is correct?
A. G4 T2 P1 A1 L3
B. G4 T2 P0 A1 L3
C. G4 T2 P1 A0 L3
D. G4 T2 P1 A1 L2
Correct Answer: A
Rationale: GTPAL stands for Gravida, Term births, Preterm births, Abortions, Living children. G = 4
(current pregnancy plus 3 prior pregnancies). T = 2 (term births). P = 1 (preterm birth at 20–36 6/7
weeks). A = 1 (abortion before 20 weeks). L = 3 (currently living children). This is a highyield antepartum
assessment concept.
,3. A nurse is teaching a client at 12 weeks of gestation about expected physiological changes during
pregnancy. Which statement by the client indicates a need for further teaching?
A. "I may notice my gums bleeding when I brush my teeth."
B. "I should expect my blood pressure to decrease slightly."
C. "I will likely have more frequent bowel movements."
D. "My heart rate may increase by 10 to 15 beats per minute."
Correct Answer: C
Rationale: Progesterone slows gastrointestinal motility, leading to constipation—not more frequent
bowel movements. Gingival bleeding (epulis) is common due to increased vascularity. Blood pressure
often decreases slightly in the second trimester. Heart rate increases by 10–15 bpm due to increased
cardiac output.
4. A nurse is performing a prenatal assessment on a client at 32 weeks of gestation. Which finding
should the nurse report to the provider immediately?
A. Fundal height of 32 cm
B. Blood pressure 142/92 mm Hg
C. Mild ankle edema
D. Fetal heart rate 148 bpm
Correct Answer: B
Rationale: A blood pressure of 142/92 mm Hg exceeds the threshold for gestational hypertension
(≥140/90 mm Hg) and requires immediate evaluation for preeclampsia. Fundal height should
approximate gestational age in weeks (32 cm at 32 weeks is expected). Mild ankle edema is common. A
fetal heart rate of 148 bpm is within the normal range of 110–160 bpm.
5. A nurse is teaching a client who is at 10 weeks of gestation about nutritional needs during pregnancy.
Which statement by the client indicates an understanding of the teaching?
A. "I should increase my iron intake by drinking milk with my iron supplement."
B. "I need to consume approximately 300 additional calories per day during pregnancy."
C. "I should limit my folic acid intake to 200 micrograms daily."
D. "I can continue my prepregnancy diet without any changes."
Correct Answer: B
,Rationale: During pregnancy, caloric needs increase by approximately 300 calories per day to support
fetal growth and maternal metabolic demands. Iron should be taken with vitamin C, not milk, because
calcium inhibits absorption. Folic acid needs increase to 600 mcg daily, not decrease.
6. A nurse is caring for a client at 32 weeks of gestation who reports a sudden gush of clear fluid from
the vagina. Which action should the nurse take first?
A. Perform a sterile vaginal examination to assess cervical dilation.
B. Check the fetal heart rate and assess for cord prolapse.
C. Obtain a urine specimen for culture and sensitivity.
D. Instruct the client to ambulate to promote fluid drainage.
Correct Answer: B
Rationale: When a client reports spontaneous rupture of membranes (ROM), the priority nursing action
is to assess fetal wellbeing and check for cord prolapse, which is an obstetric emergency. Vaginal
examination should be avoided until cord prolapse is ruled out. Ambulation is contraindicated until fetal
status is confirmed stable.
7. A nurse is teaching a pregnant client about folic acid supplementation. Which birth defect is folic acid
most effective in preventing?
A. Neural tube defects
B. Cleft palate
C. Congenital cataracts
D. Clubfoot
Correct Answer: A
Rationale: Adequate folic acid intake before conception and during early pregnancy reduces the risk of
neural tube defects such as spina bifida. Folic acid is one of the highestyield prenatal nutrition topics.
8. A nurse is caring for a client at 10 weeks of gestation. Which finding is considered an expected
physiological change during pregnancy?
A. Increased urinary frequency
B. Severe hypertension
C. Vaginal bleeding
D. Persistent fever
, Correct Answer: A
Rationale: Increased urinary frequency commonly occurs during early pregnancy due to hormonal
changes and pressure on the bladder. Severe hypertension, vaginal bleeding, and persistent fever are
signs of complications, not expected changes.
9. A nurse is assessing a pregnant client at 28 weeks of gestation. Which laboratory test is commonly
performed during this period?
A. Glucose screening test
B. Newborn metabolic screening
C. Apgar scoring
D. Heelstick blood sampling
Correct Answer: A
Rationale: Gestational diabetes screening is commonly performed between 24 and 28 weeks of
gestation. Newborn metabolic screening and Apgar scoring are performed after birth, not during
pregnancy.
10. A nurse is caring for a client at 32 weeks of gestation who reports a severe headache, blurred vision,
and epigastric pain. Which complication should the nurse suspect?
A. Preeclampsia
B. Hyperemesis gravidarum
C. Placenta previa
D. Physiological pregnancy changes
Correct Answer: A
Rationale: Severe headache, visual disturbances, and epigastric pain are classic manifestations of severe
preeclampsia. These are warning signs of hypertensive disorders of pregnancy requiring immediate
evaluation.
11. A nurse is reinforcing teaching about the rhythm method of contraception. Which instruction is
correct?
A. "You should abstain from intercourse on days 10 to 17 of your cycle."
B. "This method is highly effective with perfect use."
C. "You should take your temperature at night before bed."
