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ATI CAPSTONE MATERNAL NEWBORN ACTUAL EXAM
2026/2027 | Verified Q&A | Pass Guaranteed - A+ Graded
Section 1: Antepartum Assessment & Complications (Questions 1-15)
Question 1 A pregnant client at 28 weeks' gestation has a blood pressure of 152/96
mmHg on two occasions 4 hours apart, proteinuria of 2+ on dipstick, and reports a
severe headache and visual disturbances. Which nursing action is the priority?
A. Encourage the client to rest in the left lateral recumbent position and reassess in 2
hours B. Administer a diuretic to reduce fluid retention C. Notify the provider
immediately and prepare for magnesium sulfate administration [CORRECT] D.
Instruct the client to increase sodium intake to improve vascular tone
Rationale: This client meets criteria for severe preeclampsia (BP ≥140/90, proteinuria,
headache, visual changes) and is at risk for eclampsia. Magnesium sulfate is the
anticonvulsant of choice for seizure prophylaxis. Diuretics are contraindicated;
sodium restriction, not increase, is indicated; and delaying notification risks
progression to eclampsia.
Correct Answer: C
Question 2 A client receiving magnesium sulfate for severe preeclampsia has the
following vital signs: respiratory rate 10/min, absent deep tendon reflexes, and urine
output 15 mL/hr. Which action should the nurse take first?
A. Increase the magnesium sulfate infusion rate to achieve therapeutic levels B.
Administer calcium gluconate and discontinue the magnesium sulfate immediately
[CORRECT] C. Encourage oral fluids to increase urine output D. Administer a loop
diuretic to increase magnesium excretion
Rationale: Respiratory rate <12, absent DTRs, and urine output <25-30 mL/hr are
signs of magnesium sulfate toxicity. Calcium gluconate is the antidote that
antagonizes magnesium at the neuromuscular junction. Continuing or increasing the
infusion risks respiratory arrest. Diuretics worsen hypovolemia in preeclampsia.
,2
Correct Answer: B
Question 3 A client with gestational diabetes mellitus (GDM) at 36 weeks' gestation
has a fasting blood glucose of 98 mg/dL and 2-hour postprandial glucose of 168
mg/dL. The provider prescins NPH insulin 12 units subcutaneously at bedtime and
regular insulin with meals. The nurse should monitor for which complication in the
newborn after delivery?
A. Hyperglycemia from maternal insulin crossing the placenta B. Hypoglycemia from
fetal hyperinsulinemia after abrupt glucose withdrawal [CORRECT] C. Polycythemia
from decreased erythropoietin production D. Macrosomia exclusively from genetic
factors
Rationale: Maternal hyperglycemia causes fetal pancreatic β-cell hyperplasia and
hyperinsulinemia, which promotes growth. After delivery, the abrupt withdrawal of
maternal glucose leaves the newborn with excessive insulin, causing rebound
hypoglycemia within the first 1-4 hours. Hyperglycemia is incorrect; polycythemia
results from chronic fetal hypoxia, not decreased erythropoietin.
Correct Answer: B
Question 4 A pregnant client at 24 weeks' gestation is diagnosed with preterm labor.
The provider orders betamethasone 12 mg IM. The nurse understands that the
primary purpose of this medication is to:
A. Stop uterine contractions and prolong pregnancy B. Accelerate fetal lung
maturation and reduce the incidence of respiratory distress syndrome [CORRECT] C.
Prevent maternal infection from prolonged rupture of membranes D. Induce fetal
diuresis and reduce polyhydramnios
Rationale: Betamethasone is a corticosteroid given to pregnant clients between 24
and 34 weeks' gestation (up to 36 weeks in some protocols) to accelerate fetal lung
maturation by stimulating surfactant production, reducing RDS, IVH, and NEC.
Tocolytics (not betamethasone) stop contractions; antibiotics prevent infection;
betamethasone does not induce diuresis.
Correct Answer: B
Question 5 A client at 32 weeks' gestation with a history of preterm birth presents
with painless vaginal bleeding. Ultrasound reveals a placenta partially covering the
internal cervical os. Which nursing intervention is the priority?
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A. Perform a vaginal examination to assess cervical dilation B. Place the client on bed
rest in the left lateral position and prepare for possible delivery [CORRECT] C.
Administer oxytocin to augment labor D. Prepare the client for immediate vaginal
delivery
Rationale: Placenta previa (painless bleeding in the third trimester with placental
tissue over the cervical os) is managed expectantly with bed rest, fetal monitoring,
and preparation for delivery if bleeding is severe or fetal compromise occurs. Vaginal
examination is contraindicated as it can precipitate catastrophic hemorrhage.
Oxytocin and vaginal delivery are contraindicated.
Correct Answer: B
Question 6 A client at 18 weeks' gestation has a fundal height measurement of 24
cm. Ultrasound confirms polyhydramnios. Which condition should the nurse suspect
as a potential fetal cause?
A. Renal agenesis B. Esophageal atresia or other gastrointestinal obstruction
preventing fetal swallowing [CORRECT] C. Placental abruption D. Intrauterine growth
restriction
Rationale: Polyhydramnios (excessive amniotic fluid, AFI >24 cm) can result from
decreased fetal swallowing or absorption, as seen with esophageal atresia, duodenal
atresia, or anencephaly. Renal agenesis causes oligohydramnios (no fetal urine
production). Placental abruption and IUGR are not direct causes of polyhydramnios.
Correct Answer: B
Question 7 A pregnant client at 30 weeks' gestation is Rh-negative and has a
negative antibody screen. She experienced abdominal trauma from a motor vehicle
accident. Which intervention is indicated?
A. No intervention is needed because she is not yet at 36 weeks B. Administer Rho(D)
immune globulin (RhoGAM) 300 mcg IM within 72 hours [CORRECT] C. Administer
RhoGAM 50 mcg IM because she is in the second trimester D. Wait for the Kleihauer-
Betke test results before administering any RhoGAM
Rationale: RhoGAM 300 mcg is indicated for Rh-negative clients after any event
risking fetomaternal hemorrhage (trauma, amniocentesis, vaginal bleeding) at any
gestational age to prevent alloimmunization. The standard dose is 300 mcg; 50 mcg
is for first-trimester events. Waiting for KB test delays protection.
ATI CAPSTONE MATERNAL NEWBORN ACTUAL EXAM
2026/2027 | Verified Q&A | Pass Guaranteed - A+ Graded
Section 1: Antepartum Assessment & Complications (Questions 1-15)
Question 1 A pregnant client at 28 weeks' gestation has a blood pressure of 152/96
mmHg on two occasions 4 hours apart, proteinuria of 2+ on dipstick, and reports a
severe headache and visual disturbances. Which nursing action is the priority?
A. Encourage the client to rest in the left lateral recumbent position and reassess in 2
hours B. Administer a diuretic to reduce fluid retention C. Notify the provider
immediately and prepare for magnesium sulfate administration [CORRECT] D.
Instruct the client to increase sodium intake to improve vascular tone
Rationale: This client meets criteria for severe preeclampsia (BP ≥140/90, proteinuria,
headache, visual changes) and is at risk for eclampsia. Magnesium sulfate is the
anticonvulsant of choice for seizure prophylaxis. Diuretics are contraindicated;
sodium restriction, not increase, is indicated; and delaying notification risks
progression to eclampsia.
Correct Answer: C
Question 2 A client receiving magnesium sulfate for severe preeclampsia has the
following vital signs: respiratory rate 10/min, absent deep tendon reflexes, and urine
output 15 mL/hr. Which action should the nurse take first?
A. Increase the magnesium sulfate infusion rate to achieve therapeutic levels B.
Administer calcium gluconate and discontinue the magnesium sulfate immediately
[CORRECT] C. Encourage oral fluids to increase urine output D. Administer a loop
diuretic to increase magnesium excretion
Rationale: Respiratory rate <12, absent DTRs, and urine output <25-30 mL/hr are
signs of magnesium sulfate toxicity. Calcium gluconate is the antidote that
antagonizes magnesium at the neuromuscular junction. Continuing or increasing the
infusion risks respiratory arrest. Diuretics worsen hypovolemia in preeclampsia.
,2
Correct Answer: B
Question 3 A client with gestational diabetes mellitus (GDM) at 36 weeks' gestation
has a fasting blood glucose of 98 mg/dL and 2-hour postprandial glucose of 168
mg/dL. The provider prescins NPH insulin 12 units subcutaneously at bedtime and
regular insulin with meals. The nurse should monitor for which complication in the
newborn after delivery?
A. Hyperglycemia from maternal insulin crossing the placenta B. Hypoglycemia from
fetal hyperinsulinemia after abrupt glucose withdrawal [CORRECT] C. Polycythemia
from decreased erythropoietin production D. Macrosomia exclusively from genetic
factors
Rationale: Maternal hyperglycemia causes fetal pancreatic β-cell hyperplasia and
hyperinsulinemia, which promotes growth. After delivery, the abrupt withdrawal of
maternal glucose leaves the newborn with excessive insulin, causing rebound
hypoglycemia within the first 1-4 hours. Hyperglycemia is incorrect; polycythemia
results from chronic fetal hypoxia, not decreased erythropoietin.
Correct Answer: B
Question 4 A pregnant client at 24 weeks' gestation is diagnosed with preterm labor.
The provider orders betamethasone 12 mg IM. The nurse understands that the
primary purpose of this medication is to:
A. Stop uterine contractions and prolong pregnancy B. Accelerate fetal lung
maturation and reduce the incidence of respiratory distress syndrome [CORRECT] C.
Prevent maternal infection from prolonged rupture of membranes D. Induce fetal
diuresis and reduce polyhydramnios
Rationale: Betamethasone is a corticosteroid given to pregnant clients between 24
and 34 weeks' gestation (up to 36 weeks in some protocols) to accelerate fetal lung
maturation by stimulating surfactant production, reducing RDS, IVH, and NEC.
Tocolytics (not betamethasone) stop contractions; antibiotics prevent infection;
betamethasone does not induce diuresis.
Correct Answer: B
Question 5 A client at 32 weeks' gestation with a history of preterm birth presents
with painless vaginal bleeding. Ultrasound reveals a placenta partially covering the
internal cervical os. Which nursing intervention is the priority?
, 3
A. Perform a vaginal examination to assess cervical dilation B. Place the client on bed
rest in the left lateral position and prepare for possible delivery [CORRECT] C.
Administer oxytocin to augment labor D. Prepare the client for immediate vaginal
delivery
Rationale: Placenta previa (painless bleeding in the third trimester with placental
tissue over the cervical os) is managed expectantly with bed rest, fetal monitoring,
and preparation for delivery if bleeding is severe or fetal compromise occurs. Vaginal
examination is contraindicated as it can precipitate catastrophic hemorrhage.
Oxytocin and vaginal delivery are contraindicated.
Correct Answer: B
Question 6 A client at 18 weeks' gestation has a fundal height measurement of 24
cm. Ultrasound confirms polyhydramnios. Which condition should the nurse suspect
as a potential fetal cause?
A. Renal agenesis B. Esophageal atresia or other gastrointestinal obstruction
preventing fetal swallowing [CORRECT] C. Placental abruption D. Intrauterine growth
restriction
Rationale: Polyhydramnios (excessive amniotic fluid, AFI >24 cm) can result from
decreased fetal swallowing or absorption, as seen with esophageal atresia, duodenal
atresia, or anencephaly. Renal agenesis causes oligohydramnios (no fetal urine
production). Placental abruption and IUGR are not direct causes of polyhydramnios.
Correct Answer: B
Question 7 A pregnant client at 30 weeks' gestation is Rh-negative and has a
negative antibody screen. She experienced abdominal trauma from a motor vehicle
accident. Which intervention is indicated?
A. No intervention is needed because she is not yet at 36 weeks B. Administer Rho(D)
immune globulin (RhoGAM) 300 mcg IM within 72 hours [CORRECT] C. Administer
RhoGAM 50 mcg IM because she is in the second trimester D. Wait for the Kleihauer-
Betke test results before administering any RhoGAM
Rationale: RhoGAM 300 mcg is indicated for Rh-negative clients after any event
risking fetomaternal hemorrhage (trauma, amniocentesis, vaginal bleeding) at any
gestational age to prevent alloimmunization. The standard dose is 300 mcg; 50 mcg
is for first-trimester events. Waiting for KB test delays protection.
