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RN ATI Maternal Newborn Proctored Exam Retake
EXAM LATEST ALL 300 RANDOMIZED PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES
1. A nurse is assessing a client at 12 weeks of gestation. Which of the following findings is a positive sign
of pregnancy?
A) Positive pregnancy test
B) Hegar's sign
C) Fetal heart tones heard by Doppler
D) Quickening
Answer: C
Positive signs of pregnancy are those that can only be caused by pregnancy. Fetal heart tones heard by
Doppler (or ultrasound visualization of the fetus) are positive signs. Hegar's sign and a positive pregnancy
test are probable signs. Quickening is a presumptive sign.
2. The nurse is calculating the estimated date of birth (EDB) using Naegele's rule for a client whose last
menstrual period (LMP) was May 10. What is the EDB?
A) February 3
B) February 17
C) March 3
D) March 17
Answer: B
Naegele's rule: Add 7 days to the first day of the LMP (May 10 + 7 = May 17), then subtract 3 months
(May → February). EDB = February 17.
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3. A client at 36 weeks of gestation presents with painless, bright red vaginal bleeding. Which condition
should the nurse suspect?
A) Placenta previa
B) Abruptio placentae
C) Preterm labor
D) Cervical insufficiency
Answer: A
Painless, bright red vaginal bleeding in the third trimester is the hallmark sign of placenta previa.
Abruptio placentae typically presents with painful, dark red bleeding and uterine rigidity. Preterm labor is
associated with uterine contractions. Cervical insufficiency presents with painless cervical dilation in the
second trimester.
4. A client with preeclampsia is receiving magnesium sulfate. Which finding indicates magnesium
toxicity?
A) Urine output 30 mL/hr
B) Deep tendon reflexes 2+
C) Respiratory rate 10 breaths/min
D) Serum magnesium level 5 mEq/L
Answer: C
Magnesium toxicity is indicated by a respiratory rate <12 breaths/min, absent deep tendon reflexes, and
urine output <30 mL/hr. A respiratory rate of 10 is a sign of toxicity. The normal therapeutic range for
magnesium is 4-7 mEq/L; a level of 5 is within therapeutic range. DTRs of 2+ are normal.
5. The nurse is teaching a client about the signs of preterm labor. Which of the following should the client
report immediately?
A) Backache that comes and goes
B) Menstrual-like cramps
C) Rupture of membranes
D) Increased vaginal discharge
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Answer: C
Rupture of membranes (ROM) at any gestational age before term is a medical emergency requiring
immediate evaluation. While backache, menstrual-like cramps, and increased discharge can be signs of
preterm labor, ROM indicates that labor is imminent or that infection risk is significant.
6. A client with gestational diabetes asks about dietary changes. Which of the following is an appropriate
teaching point?
A) Eliminate all carbohydrates from the diet
B) Distribute carbohydrates evenly throughout the day
C) Eat three large meals per day
D) Avoid protein with meals
Answer: B
In gestational diabetes, carbohydrates should be distributed evenly throughout the day to maintain stable
blood glucose levels. Small, frequent meals (3 meals and 2-3 snacks) help prevent hyperglycemia and
hypoglycemia. Carbohydrates should not be eliminated, as they are essential for fetal growth.
7. A nurse is assessing a client at 28 weeks of gestation. Which of the following findings should be
reported to the provider?
A) Fundal height 26 cm
B) Blood pressure 110/70 mmHg
C) Weight gain 1 lb in 1 week
D) Fetal heart rate 140/min
Answer: A
After 20 weeks, fundal height in centimeters should correlate with gestational age in weeks (±2 cm). A
fundal height of 26 cm at 28 weeks (2 cm below expected) may indicate intrauterine growth restriction
(IUGR), oligohydramnios, or incorrect dating and should be reported.
8. A client at 8 weeks of gestation reports nausea and vomiting. Which intervention should the nurse
recommend?
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A) Eat three large meals daily
B) Drink fluids with meals
C) Eat dry crackers before rising in the morning
D) Lie flat after eating
Answer: C
Eating dry crackers or toast before rising in the morning helps relieve nausea by stabilizing blood glucose
and settling the stomach. Small, frequent meals are recommended; fluids should be taken between meals,
not with meals, to reduce nausea. Lying flat can worsen reflux and nausea.
9. A client at 32 weeks of gestation with preeclampsia is being monitored. Which laboratory finding
indicates worsening of the condition?
A) Platelet count 150,000/mm³
B) Hemoglobin 12 g/dL
C) Aspartate aminotransferase (AST) 80 units/L
D) Serum creatinine 0.8 mg/dL
Answer: C
In preeclampsia, elevated liver enzymes (AST, ALT) indicate HELLP syndrome (Hemolysis, Elevated Liver
enzymes, Low Platelets), a severe complication. Platelet count <100,000/mm³, AST >70 units/L, and
elevated creatinine (>1.0 mg/dL) are concerning. A platelet count of 150,000 is normal. Hemoglobin of 12
is normal. Creatinine of 0.8 is normal.
10. A client at 16 weeks of gestation is scheduled for a maternal serum alpha-fetoprotein (MSAFP)
screening. The nurse should explain that this test screens for which condition?
A) Gestational diabetes
B) Neural tube defects
C) Preeclampsia
D) Rh incompatibility
Answer: B
Maternal serum alpha-fetoprotein (MSAFP) screening is used to screen for neural tube defects (e.g., spina
RN ATI Maternal Newborn Proctored Exam Retake
EXAM LATEST ALL 300 RANDOMIZED PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES
1. A nurse is assessing a client at 12 weeks of gestation. Which of the following findings is a positive sign
of pregnancy?
A) Positive pregnancy test
B) Hegar's sign
C) Fetal heart tones heard by Doppler
D) Quickening
Answer: C
Positive signs of pregnancy are those that can only be caused by pregnancy. Fetal heart tones heard by
Doppler (or ultrasound visualization of the fetus) are positive signs. Hegar's sign and a positive pregnancy
test are probable signs. Quickening is a presumptive sign.
2. The nurse is calculating the estimated date of birth (EDB) using Naegele's rule for a client whose last
menstrual period (LMP) was May 10. What is the EDB?
A) February 3
B) February 17
C) March 3
D) March 17
Answer: B
Naegele's rule: Add 7 days to the first day of the LMP (May 10 + 7 = May 17), then subtract 3 months
(May → February). EDB = February 17.
, Page 2 of 116
3. A client at 36 weeks of gestation presents with painless, bright red vaginal bleeding. Which condition
should the nurse suspect?
A) Placenta previa
B) Abruptio placentae
C) Preterm labor
D) Cervical insufficiency
Answer: A
Painless, bright red vaginal bleeding in the third trimester is the hallmark sign of placenta previa.
Abruptio placentae typically presents with painful, dark red bleeding and uterine rigidity. Preterm labor is
associated with uterine contractions. Cervical insufficiency presents with painless cervical dilation in the
second trimester.
4. A client with preeclampsia is receiving magnesium sulfate. Which finding indicates magnesium
toxicity?
A) Urine output 30 mL/hr
B) Deep tendon reflexes 2+
C) Respiratory rate 10 breaths/min
D) Serum magnesium level 5 mEq/L
Answer: C
Magnesium toxicity is indicated by a respiratory rate <12 breaths/min, absent deep tendon reflexes, and
urine output <30 mL/hr. A respiratory rate of 10 is a sign of toxicity. The normal therapeutic range for
magnesium is 4-7 mEq/L; a level of 5 is within therapeutic range. DTRs of 2+ are normal.
5. The nurse is teaching a client about the signs of preterm labor. Which of the following should the client
report immediately?
A) Backache that comes and goes
B) Menstrual-like cramps
C) Rupture of membranes
D) Increased vaginal discharge
, Page 3 of 116
Answer: C
Rupture of membranes (ROM) at any gestational age before term is a medical emergency requiring
immediate evaluation. While backache, menstrual-like cramps, and increased discharge can be signs of
preterm labor, ROM indicates that labor is imminent or that infection risk is significant.
6. A client with gestational diabetes asks about dietary changes. Which of the following is an appropriate
teaching point?
A) Eliminate all carbohydrates from the diet
B) Distribute carbohydrates evenly throughout the day
C) Eat three large meals per day
D) Avoid protein with meals
Answer: B
In gestational diabetes, carbohydrates should be distributed evenly throughout the day to maintain stable
blood glucose levels. Small, frequent meals (3 meals and 2-3 snacks) help prevent hyperglycemia and
hypoglycemia. Carbohydrates should not be eliminated, as they are essential for fetal growth.
7. A nurse is assessing a client at 28 weeks of gestation. Which of the following findings should be
reported to the provider?
A) Fundal height 26 cm
B) Blood pressure 110/70 mmHg
C) Weight gain 1 lb in 1 week
D) Fetal heart rate 140/min
Answer: A
After 20 weeks, fundal height in centimeters should correlate with gestational age in weeks (±2 cm). A
fundal height of 26 cm at 28 weeks (2 cm below expected) may indicate intrauterine growth restriction
(IUGR), oligohydramnios, or incorrect dating and should be reported.
8. A client at 8 weeks of gestation reports nausea and vomiting. Which intervention should the nurse
recommend?
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A) Eat three large meals daily
B) Drink fluids with meals
C) Eat dry crackers before rising in the morning
D) Lie flat after eating
Answer: C
Eating dry crackers or toast before rising in the morning helps relieve nausea by stabilizing blood glucose
and settling the stomach. Small, frequent meals are recommended; fluids should be taken between meals,
not with meals, to reduce nausea. Lying flat can worsen reflux and nausea.
9. A client at 32 weeks of gestation with preeclampsia is being monitored. Which laboratory finding
indicates worsening of the condition?
A) Platelet count 150,000/mm³
B) Hemoglobin 12 g/dL
C) Aspartate aminotransferase (AST) 80 units/L
D) Serum creatinine 0.8 mg/dL
Answer: C
In preeclampsia, elevated liver enzymes (AST, ALT) indicate HELLP syndrome (Hemolysis, Elevated Liver
enzymes, Low Platelets), a severe complication. Platelet count <100,000/mm³, AST >70 units/L, and
elevated creatinine (>1.0 mg/dL) are concerning. A platelet count of 150,000 is normal. Hemoglobin of 12
is normal. Creatinine of 0.8 is normal.
10. A client at 16 weeks of gestation is scheduled for a maternal serum alpha-fetoprotein (MSAFP)
screening. The nurse should explain that this test screens for which condition?
A) Gestational diabetes
B) Neural tube defects
C) Preeclampsia
D) Rh incompatibility
Answer: B
Maternal serum alpha-fetoprotein (MSAFP) screening is used to screen for neural tube defects (e.g., spina
