2025 VATI Maternal Newborn Exam with NGN (Next Generation NCLEX) –
Practice Test (120 Questions | Latest Edition | Professor Verified)
Domain I: Antepartum Care (Questions 1–35)
A pregnant client at 28 weeks gestation asks why she is feeling lightheaded and
dizzy when lying on her back. What is the nurse's best response?
A. "This is caused by increased blood volume during pregnancy."
B. "This is likely due to the uterus compressing the vena cava, reducing blood return
to the heart."
C. "You are dehydrated and need to increase your fluid intake immediately."
1. D. "This is a normal sign of preterm labor and we need to monitor
contractions."
B. "This is likely due to the uterus compressing the vena cava, reducing blood
return to the heart."
Supine hypotensive syndrome occurs when the gravid uterus compresses the
inferior vena cava and aorta, decreasing cardiac output and causing
hypotension. Increased blood volume (A) is a physiological change but not the
cause of dizziness in this position. While dehydration (C) can cause dizziness,
the specific timing when lying supine points to aortocaval compression. It is
not a sign of preterm labor (D).
The nurse is calculating a client's estimated date of delivery (EDD) using Naegele's
rule. The client reports her last menstrual period (LMP) started on January 3. What is
the EDD?
A. September 10
B. October 10
C. October 17
2. D. September 24
B. October 10
Naegele's rule: Subtract 3 months from the first day of the LMP (January 3
becomes October 3), add 7 days (October 3 + 7 days = October 10), and add
1 year. The calculation is: Jan 3 - 3 months = Oct 3; Oct 3 + 7 days = Oct 10.
,A client who is Rh-negative is concerned about the need for Rho(D) immune globulin
(RhoGAM). The nurse explains that it is indicated for which of the following
situations? Select all that apply.
A. At 28 weeks of gestation.
B. Within 72 hours after the delivery of an Rh-positive infant.
C. If the client experiences abdominal trauma during the pregnancy.
3. D. If the father of the baby is Rh-negative.
A, B, C
RhoGAM is given at 28 weeks gestation (routine prophylaxis) and within 72
hours postpartum if the infant is Rh-positive. It is also given after events that
could cause fetomaternal hemorrhage, such as trauma, amniocentesis, or
miscarriage. If the father is Rh-negative (D), the baby is also Rh-negative, and
RhoGAM is not needed.
A primigravida client at 12 weeks gestation reports nausea and vomiting. She asks
for ways to manage her symptoms without medication. Which non-pharmacologic
intervention should the nurse recommend?
A. Drinking a full glass of water immediately upon waking.
B. Eating dry crackers or toast before getting out of bed in the morning.
C. Taking a hot bath to relax the abdominal muscles.
4. D. Sleeping in the supine position to reduce reflux.
B. Eating dry crackers or toast before getting out of bed in the morning.
Morning sickness is caused by rising hCG levels and metabolic changes.
Eating dry, bland carbohydrates before rising in the morning helps absorb
stomach acid and settle the stomach. Drinking water immediately (A) might
trigger vomiting. Hot baths (C) are generally discouraged in pregnancy due to
risks of overheating/hypotension. Supine position (D) worsens nausea.
The nurse is reviewing the results of a client's quad screen. The test indicates
decreased levels of Alpha-fetoprotein (AFP). The nurse understands that this finding
is associated with an increased risk for which condition?
A. Neural tube defects (e.g., Spina Bifida)
B. Down syndrome (Trisomy 21)
C. Edwards syndrome (Trisomy 18)
5. D. Open abdominal wall defect (Gastroschisis)
B. Down syndrome (Trisomy 21)
Decreased levels of AFP are associated with chromosomal abnormalities
such as Down syndrome and Edwards syndrome. Increased levels of AFP are
associated with neural tube defects (A) and abdominal wall defects (D).
A pregnant client at 24 weeks gestation has a blood pressure of 148/92 mmHg. The
nurse knows that this blood pressure classification is:
,A. Normal for gestational age.
B. Chronic hypertension.
C. Gestational hypertension.
6. D. Preeclampsia.
C. Gestational hypertension.
Gestational hypertension is defined as a blood pressure of ≥140/90 mmHg on
two occasions at least 4 hours apart, after 20 weeks of gestation, without
proteinuria or signs of end-organ damage. Preeclampsia (D) requires the
addition of proteinuria or severe features. Chronic hypertension (B) is
diagnosed prior to 20 weeks.
Which laboratory finding is a critical diagnostic indicator for severe preeclampsia with
HELLP syndrome?
A. Elevated serum glucose.
B. Decreased platelet count (<100,000/mm³).
C. Elevated hemoglobin and hematocrit.
7. D. Decreased white blood cell count.
B. Decreased platelet count (<100,000/mm³).
HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets. Thrombocytopenia (low platelets) is a hallmark of this severe variant
of preeclampsia. Elevated glucose (A) is associated with diabetes. Elevated
hemoglobin (C) might indicate dehydration but is not diagnostic for HELLP.
Low WBC (D) is not characteristic.
A client is scheduled for a glucose challenge test (GCT) to screen for gestational
diabetes mellitus (GDM). The nurse explains that this test involves:
A. Fasting for 12 hours followed by a 100g oral glucose load.
B. Drinking a 50g glucose solution regardless of fasting status, with blood glucose
measured 1 hour later.
C. Drinking a 75g glucose solution after fasting, with blood glucose measured at 1, 2,
and 3 hours.
8. D. Monitoring blood glucose levels at home for 7 days.
B. Drinking a 50g glucose solution regardless of fasting status, with blood
glucose measured 1 hour later.
The GCT is a screening test performed between 24-28 weeks. It does not
require fasting. The patient drinks a 50g glucose load, and blood is drawn 1
hour later. A value >130-140 mg/dL is considered abnormal and requires the
diagnostic 3-hour OGTT (100g glucose load).
A client at 32 weeks gestation reports painless, bright red vaginal bleeding. The
nurse immediately suspects:
A. Placental abruption.
, B. Placenta previa.
C. Uterine rupture.
9. D. Normal bloody show.
B. Placenta previa.
Placenta previa is characterized by painless, bright red bleeding that often
occurs spontaneously as the lower uterine segment thins and the placenta
detaches slightly. Abruption (A) typically involves painful, dark red bleeding
and a "board-like" abdomen. Normal bloody show (D) occurs with labor and is
mixed with mucus.
When performing Leopold's maneuvers, the nurse palpates a hard, round, movable
object in the fundal region. What does this indicate?
A. The fetal head.
B. The fetal back.
C. The fetal buttocks (breech).
10.D. Extremities.
C. The fetal buttocks (breech).
The first maneuver determines what is in the fundus. A hard, round, movable
object in the fundus indicates the breech (buttocks). The head (A) is hard and
round but usually engaged in the pelvis later in pregnancy. The back (B) feels
smooth and firm.
The nurse is conducting prenatal education. Which statement by the client indicates
a need for further teaching regarding danger signs in pregnancy?
A. "I should call the doctor if I have blurred vision or a severe headache."
B. "If I leak fluid, I should note the color and call my provider."
C. "I will expect some swelling in my ankles at the end of the day, so I won't worry
about it."
11.D. "If the baby stops moving, I should drink juice and wait an hour to see if he
wakes up."
D. "If the baby stops moving, I should drink juice and wait an hour to see if he
wakes up."
Decreased fetal movement is an urgent sign of possible fetal compromise.
The client should contact the provider immediately or go to the hospital for
monitoring, not wait at home. Headache/blurred vision (A) are signs of
preeclampsia requiring reporting. Fluid leakage (B) requires evaluation. Ankle
swelling (C) is physiological, but facial swelling is not.
A client at 10 weeks gestation is prescribed iron supplements. She asks why she
needs them. The nurse's best response is:
A. "To prevent neural tube defects in the fetus."
B. "To support the expanded blood volume and prevent anemia."
Practice Test (120 Questions | Latest Edition | Professor Verified)
Domain I: Antepartum Care (Questions 1–35)
A pregnant client at 28 weeks gestation asks why she is feeling lightheaded and
dizzy when lying on her back. What is the nurse's best response?
A. "This is caused by increased blood volume during pregnancy."
B. "This is likely due to the uterus compressing the vena cava, reducing blood return
to the heart."
C. "You are dehydrated and need to increase your fluid intake immediately."
1. D. "This is a normal sign of preterm labor and we need to monitor
contractions."
B. "This is likely due to the uterus compressing the vena cava, reducing blood
return to the heart."
Supine hypotensive syndrome occurs when the gravid uterus compresses the
inferior vena cava and aorta, decreasing cardiac output and causing
hypotension. Increased blood volume (A) is a physiological change but not the
cause of dizziness in this position. While dehydration (C) can cause dizziness,
the specific timing when lying supine points to aortocaval compression. It is
not a sign of preterm labor (D).
The nurse is calculating a client's estimated date of delivery (EDD) using Naegele's
rule. The client reports her last menstrual period (LMP) started on January 3. What is
the EDD?
A. September 10
B. October 10
C. October 17
2. D. September 24
B. October 10
Naegele's rule: Subtract 3 months from the first day of the LMP (January 3
becomes October 3), add 7 days (October 3 + 7 days = October 10), and add
1 year. The calculation is: Jan 3 - 3 months = Oct 3; Oct 3 + 7 days = Oct 10.
,A client who is Rh-negative is concerned about the need for Rho(D) immune globulin
(RhoGAM). The nurse explains that it is indicated for which of the following
situations? Select all that apply.
A. At 28 weeks of gestation.
B. Within 72 hours after the delivery of an Rh-positive infant.
C. If the client experiences abdominal trauma during the pregnancy.
3. D. If the father of the baby is Rh-negative.
A, B, C
RhoGAM is given at 28 weeks gestation (routine prophylaxis) and within 72
hours postpartum if the infant is Rh-positive. It is also given after events that
could cause fetomaternal hemorrhage, such as trauma, amniocentesis, or
miscarriage. If the father is Rh-negative (D), the baby is also Rh-negative, and
RhoGAM is not needed.
A primigravida client at 12 weeks gestation reports nausea and vomiting. She asks
for ways to manage her symptoms without medication. Which non-pharmacologic
intervention should the nurse recommend?
A. Drinking a full glass of water immediately upon waking.
B. Eating dry crackers or toast before getting out of bed in the morning.
C. Taking a hot bath to relax the abdominal muscles.
4. D. Sleeping in the supine position to reduce reflux.
B. Eating dry crackers or toast before getting out of bed in the morning.
Morning sickness is caused by rising hCG levels and metabolic changes.
Eating dry, bland carbohydrates before rising in the morning helps absorb
stomach acid and settle the stomach. Drinking water immediately (A) might
trigger vomiting. Hot baths (C) are generally discouraged in pregnancy due to
risks of overheating/hypotension. Supine position (D) worsens nausea.
The nurse is reviewing the results of a client's quad screen. The test indicates
decreased levels of Alpha-fetoprotein (AFP). The nurse understands that this finding
is associated with an increased risk for which condition?
A. Neural tube defects (e.g., Spina Bifida)
B. Down syndrome (Trisomy 21)
C. Edwards syndrome (Trisomy 18)
5. D. Open abdominal wall defect (Gastroschisis)
B. Down syndrome (Trisomy 21)
Decreased levels of AFP are associated with chromosomal abnormalities
such as Down syndrome and Edwards syndrome. Increased levels of AFP are
associated with neural tube defects (A) and abdominal wall defects (D).
A pregnant client at 24 weeks gestation has a blood pressure of 148/92 mmHg. The
nurse knows that this blood pressure classification is:
,A. Normal for gestational age.
B. Chronic hypertension.
C. Gestational hypertension.
6. D. Preeclampsia.
C. Gestational hypertension.
Gestational hypertension is defined as a blood pressure of ≥140/90 mmHg on
two occasions at least 4 hours apart, after 20 weeks of gestation, without
proteinuria or signs of end-organ damage. Preeclampsia (D) requires the
addition of proteinuria or severe features. Chronic hypertension (B) is
diagnosed prior to 20 weeks.
Which laboratory finding is a critical diagnostic indicator for severe preeclampsia with
HELLP syndrome?
A. Elevated serum glucose.
B. Decreased platelet count (<100,000/mm³).
C. Elevated hemoglobin and hematocrit.
7. D. Decreased white blood cell count.
B. Decreased platelet count (<100,000/mm³).
HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low
Platelets. Thrombocytopenia (low platelets) is a hallmark of this severe variant
of preeclampsia. Elevated glucose (A) is associated with diabetes. Elevated
hemoglobin (C) might indicate dehydration but is not diagnostic for HELLP.
Low WBC (D) is not characteristic.
A client is scheduled for a glucose challenge test (GCT) to screen for gestational
diabetes mellitus (GDM). The nurse explains that this test involves:
A. Fasting for 12 hours followed by a 100g oral glucose load.
B. Drinking a 50g glucose solution regardless of fasting status, with blood glucose
measured 1 hour later.
C. Drinking a 75g glucose solution after fasting, with blood glucose measured at 1, 2,
and 3 hours.
8. D. Monitoring blood glucose levels at home for 7 days.
B. Drinking a 50g glucose solution regardless of fasting status, with blood
glucose measured 1 hour later.
The GCT is a screening test performed between 24-28 weeks. It does not
require fasting. The patient drinks a 50g glucose load, and blood is drawn 1
hour later. A value >130-140 mg/dL is considered abnormal and requires the
diagnostic 3-hour OGTT (100g glucose load).
A client at 32 weeks gestation reports painless, bright red vaginal bleeding. The
nurse immediately suspects:
A. Placental abruption.
, B. Placenta previa.
C. Uterine rupture.
9. D. Normal bloody show.
B. Placenta previa.
Placenta previa is characterized by painless, bright red bleeding that often
occurs spontaneously as the lower uterine segment thins and the placenta
detaches slightly. Abruption (A) typically involves painful, dark red bleeding
and a "board-like" abdomen. Normal bloody show (D) occurs with labor and is
mixed with mucus.
When performing Leopold's maneuvers, the nurse palpates a hard, round, movable
object in the fundal region. What does this indicate?
A. The fetal head.
B. The fetal back.
C. The fetal buttocks (breech).
10.D. Extremities.
C. The fetal buttocks (breech).
The first maneuver determines what is in the fundus. A hard, round, movable
object in the fundus indicates the breech (buttocks). The head (A) is hard and
round but usually engaged in the pelvis later in pregnancy. The back (B) feels
smooth and firm.
The nurse is conducting prenatal education. Which statement by the client indicates
a need for further teaching regarding danger signs in pregnancy?
A. "I should call the doctor if I have blurred vision or a severe headache."
B. "If I leak fluid, I should note the color and call my provider."
C. "I will expect some swelling in my ankles at the end of the day, so I won't worry
about it."
11.D. "If the baby stops moving, I should drink juice and wait an hour to see if he
wakes up."
D. "If the baby stops moving, I should drink juice and wait an hour to see if he
wakes up."
Decreased fetal movement is an urgent sign of possible fetal compromise.
The client should contact the provider immediately or go to the hospital for
monitoring, not wait at home. Headache/blurred vision (A) are signs of
preeclampsia requiring reporting. Fluid leakage (B) requires evaluation. Ankle
swelling (C) is physiological, but facial swelling is not.
A client at 10 weeks gestation is prescribed iron supplements. She asks why she
needs them. The nurse's best response is:
A. "To prevent neural tube defects in the fetus."
B. "To support the expanded blood volume and prevent anemia."
