ATI RN MATERNAL NEWBORN PROCTORED EXAM
2026 STUDY GUIDE: COMPREHENSIVE PRACTICE
QUESTIONS WITH VERIFIED ANSWERS AND
RATIONALES
SECTION 1: ANTEPARTUM ASSESSMENT AND PRENATAL CARE
1. A nurse is assessing a client at 10 weeks of gestation who reports severe nausea and
vomiting with a 5% weight loss from pre-pregnancy weight and ketonuria. The nurse should
identify these findings as indicative of which condition?
A. Normal morning sickness
B. Hyperemesis gravidarum
C. Gastroenteritis
D. Gestational diabetes
Answer: B. Hyperemesis gravidarum
Rationale: Hyperemesis gravidarum is characterized by severe, persistent nausea and
vomiting during pregnancy that leads to fluid and electrolyte imbalances, nutritional
deficiencies, ketonuria, and significant weight loss (typically >5% of pre-pregnancy weight).
Unlike normal morning sickness, this condition requires medical intervention to prevent
complications such as Wernicke's encephalopathy, electrolyte disturbances, and
malnutrition. Management includes IV hydration, antiemetics, electrolyte monitoring, and
thiamine supplementation to prevent Wernicke's encephalopathy from prolonged
vomiting .
2. A nurse is calculating the estimated date of birth (EDB) for a client whose last menstrual
period (LMP) began on July 20. Using Naegele's rule, which date should the nurse
document as the EDB?
A. April 13
B. April 20
,C. April 27
D. May 5
Answer: C. April 27
Rationale: Naegele's rule calculates the estimated date of birth by subtracting 3 months
from the first day of the last menstrual period and adding 7 days. For LMP July 20: subtract
3 months = April 20, add 7 days = April 27. This calculation assumes a 28-day menstrual
cycle and is the standard method used in obstetric care to estimate the due date .
3. A nurse is providing education to a client at 13 weeks of gestation who is scheduled for a
cervical cerclage due to an incompetent cervix. Which statement by the client indicates an
understanding of the teaching?
A. "I should go to the hospital if I think I may be in labor"
B. "I should expect bright red bleeding while the cerclage is in place"
C. "I am sad that I won't be able to get pregnant again"
D. "I can resume having sex as soon as I feel up to it"
Answer: A. "I should go to the hospital if I think I may be in labor"
Rationale: Cervical cerclage is a surgical procedure that places a suture around the cervix
to prevent premature opening during pregnancy. The client should immediately report to a
healthcare facility if she experiences any manifestations of labor while the cerclage is in
place, as preterm uterine contractions may require tocolytic therapy. Bleeding, sexual
activity, and concerns about future fertility should be addressed, but the priority teaching is
the recognition of labor signs .
4. A nurse is assessing a client at 35 weeks of gestation who is receiving magnesium sulfate
via continuous IV infusion for severe pre-eclampsia. Which finding should the nurse report
to the provider immediately?
A. Deep tendon reflexes 2+
B. Respiratory rate 16/min
C. Blood pressure 150/92 mm Hg
D. Urinary output 20 mL/hr
Answer: D. Urinary output 20 mL/hr
,Rationale: A urinary output of 20 mL/hr is below the expected minimum of 30 mL/hr and
indicates inadequate renal perfusion, increasing the risk of magnesium sulfate toxicity.
Magnesium is excreted renally, and decreased output can lead to accumulation and
toxicity. The nurse should also monitor for signs of magnesium toxicity including respiratory
depression (<12/min), loss of deep tendon reflexes, and cardiac arrest. Calcium gluconate
is the antidote for magnesium toxicity .
5. A nurse is teaching a client at 30 weeks of gestation about warning signs of
complications to report to the provider. Which finding should the nurse include in the
teaching?
A. 10 fetal movements per hour
B. Mild constipation
C. Vaginal bleeding
D. Nasal congestion
Answer: C. Vaginal bleeding
Rationale: Vaginal bleeding during pregnancy is an abnormal finding that may indicate
serious complications such as placental abruption, placenta previa, or preterm labor.
Clients should be instructed to report any vaginal bleeding immediately. Other warning
signs include severe headache, visual disturbances, epigastric pain, sudden weight gain,
and decreased fetal movement .
6. A nurse is assessing a client at 34 weeks of gestation who has a prescription for
magnesium sulfate to treat pre-eclampsia. Which of the following findings is the priority to
report to the provider?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 10/min
C. Urinary output of 40 mL/hr
D. Increased lethargy
Answer: B. Respiratory rate of 10/min
Rationale: Magnesium sulfate toxicity causes central nervous system depression, and a
respiratory rate below 12/min is a primary sign of toxicity requiring immediate intervention.
The nurse should stop the infusion and prepare to administer calcium gluconate, the
, antidote. Other signs of toxicity include decreased deep tendon reflexes, oliguria (<30
mL/hr), and cardiac arrest .
7. A nurse is performing Leopold's maneuvers on a client at 38 weeks of gestation. After
completing the first maneuver, the nurse palpates a firm, round mass in the fundal region.
The nurse should identify this finding as which fetal part?
A. Fetal head
B. Fetal buttocks
C. Fetal back
D. Fetal extremities
Answer: B. Fetal buttocks
Rationale: Leopold's maneuvers are a systematic method of abdominal palpation to
determine fetal presentation, position, and lie. The first maneuver (fundal palpation)
identifies the fetal part occupying the fundus. A firm, round, and mobile mass typically
indicates the fetal head, while a soft, irregular mass suggests the buttocks. The fetal back
is identified during the third maneuver as a smooth, hard surface on one side of the uterus .
8. A nurse is providing teaching to a client at 12 weeks of gestation about expected prenatal
screenings. Which screening test should the nurse explain as being performed between 15
and 20 weeks of gestation?
A. Chorionic villus sampling (CVS)
B. Maternal serum alpha-fetoprotein (MSAFP)
C. Nonstress test (NST)
D. Amniocentesis for fetal lung maturity
Answer: B. Maternal serum alpha-fetoprotein (MSAFP)
Rationale: MSAFP screening is typically performed between 15 and 20 weeks of gestation
to assess the risk of neural tube defects, abdominal wall defects, and chromosomal
abnormalities. Elevated levels may indicate neural tube defects, while low levels may be
associated with Down syndrome. CVS is performed at 10-13 weeks, NST is performed in the
third trimester, and amniocentesis for fetal lung maturity is performed in the late third
trimester .
2026 STUDY GUIDE: COMPREHENSIVE PRACTICE
QUESTIONS WITH VERIFIED ANSWERS AND
RATIONALES
SECTION 1: ANTEPARTUM ASSESSMENT AND PRENATAL CARE
1. A nurse is assessing a client at 10 weeks of gestation who reports severe nausea and
vomiting with a 5% weight loss from pre-pregnancy weight and ketonuria. The nurse should
identify these findings as indicative of which condition?
A. Normal morning sickness
B. Hyperemesis gravidarum
C. Gastroenteritis
D. Gestational diabetes
Answer: B. Hyperemesis gravidarum
Rationale: Hyperemesis gravidarum is characterized by severe, persistent nausea and
vomiting during pregnancy that leads to fluid and electrolyte imbalances, nutritional
deficiencies, ketonuria, and significant weight loss (typically >5% of pre-pregnancy weight).
Unlike normal morning sickness, this condition requires medical intervention to prevent
complications such as Wernicke's encephalopathy, electrolyte disturbances, and
malnutrition. Management includes IV hydration, antiemetics, electrolyte monitoring, and
thiamine supplementation to prevent Wernicke's encephalopathy from prolonged
vomiting .
2. A nurse is calculating the estimated date of birth (EDB) for a client whose last menstrual
period (LMP) began on July 20. Using Naegele's rule, which date should the nurse
document as the EDB?
A. April 13
B. April 20
,C. April 27
D. May 5
Answer: C. April 27
Rationale: Naegele's rule calculates the estimated date of birth by subtracting 3 months
from the first day of the last menstrual period and adding 7 days. For LMP July 20: subtract
3 months = April 20, add 7 days = April 27. This calculation assumes a 28-day menstrual
cycle and is the standard method used in obstetric care to estimate the due date .
3. A nurse is providing education to a client at 13 weeks of gestation who is scheduled for a
cervical cerclage due to an incompetent cervix. Which statement by the client indicates an
understanding of the teaching?
A. "I should go to the hospital if I think I may be in labor"
B. "I should expect bright red bleeding while the cerclage is in place"
C. "I am sad that I won't be able to get pregnant again"
D. "I can resume having sex as soon as I feel up to it"
Answer: A. "I should go to the hospital if I think I may be in labor"
Rationale: Cervical cerclage is a surgical procedure that places a suture around the cervix
to prevent premature opening during pregnancy. The client should immediately report to a
healthcare facility if she experiences any manifestations of labor while the cerclage is in
place, as preterm uterine contractions may require tocolytic therapy. Bleeding, sexual
activity, and concerns about future fertility should be addressed, but the priority teaching is
the recognition of labor signs .
4. A nurse is assessing a client at 35 weeks of gestation who is receiving magnesium sulfate
via continuous IV infusion for severe pre-eclampsia. Which finding should the nurse report
to the provider immediately?
A. Deep tendon reflexes 2+
B. Respiratory rate 16/min
C. Blood pressure 150/92 mm Hg
D. Urinary output 20 mL/hr
Answer: D. Urinary output 20 mL/hr
,Rationale: A urinary output of 20 mL/hr is below the expected minimum of 30 mL/hr and
indicates inadequate renal perfusion, increasing the risk of magnesium sulfate toxicity.
Magnesium is excreted renally, and decreased output can lead to accumulation and
toxicity. The nurse should also monitor for signs of magnesium toxicity including respiratory
depression (<12/min), loss of deep tendon reflexes, and cardiac arrest. Calcium gluconate
is the antidote for magnesium toxicity .
5. A nurse is teaching a client at 30 weeks of gestation about warning signs of
complications to report to the provider. Which finding should the nurse include in the
teaching?
A. 10 fetal movements per hour
B. Mild constipation
C. Vaginal bleeding
D. Nasal congestion
Answer: C. Vaginal bleeding
Rationale: Vaginal bleeding during pregnancy is an abnormal finding that may indicate
serious complications such as placental abruption, placenta previa, or preterm labor.
Clients should be instructed to report any vaginal bleeding immediately. Other warning
signs include severe headache, visual disturbances, epigastric pain, sudden weight gain,
and decreased fetal movement .
6. A nurse is assessing a client at 34 weeks of gestation who has a prescription for
magnesium sulfate to treat pre-eclampsia. Which of the following findings is the priority to
report to the provider?
A. Deep tendon reflexes of 2+
B. Respiratory rate of 10/min
C. Urinary output of 40 mL/hr
D. Increased lethargy
Answer: B. Respiratory rate of 10/min
Rationale: Magnesium sulfate toxicity causes central nervous system depression, and a
respiratory rate below 12/min is a primary sign of toxicity requiring immediate intervention.
The nurse should stop the infusion and prepare to administer calcium gluconate, the
, antidote. Other signs of toxicity include decreased deep tendon reflexes, oliguria (<30
mL/hr), and cardiac arrest .
7. A nurse is performing Leopold's maneuvers on a client at 38 weeks of gestation. After
completing the first maneuver, the nurse palpates a firm, round mass in the fundal region.
The nurse should identify this finding as which fetal part?
A. Fetal head
B. Fetal buttocks
C. Fetal back
D. Fetal extremities
Answer: B. Fetal buttocks
Rationale: Leopold's maneuvers are a systematic method of abdominal palpation to
determine fetal presentation, position, and lie. The first maneuver (fundal palpation)
identifies the fetal part occupying the fundus. A firm, round, and mobile mass typically
indicates the fetal head, while a soft, irregular mass suggests the buttocks. The fetal back
is identified during the third maneuver as a smooth, hard surface on one side of the uterus .
8. A nurse is providing teaching to a client at 12 weeks of gestation about expected prenatal
screenings. Which screening test should the nurse explain as being performed between 15
and 20 weeks of gestation?
A. Chorionic villus sampling (CVS)
B. Maternal serum alpha-fetoprotein (MSAFP)
C. Nonstress test (NST)
D. Amniocentesis for fetal lung maturity
Answer: B. Maternal serum alpha-fetoprotein (MSAFP)
Rationale: MSAFP screening is typically performed between 15 and 20 weeks of gestation
to assess the risk of neural tube defects, abdominal wall defects, and chromosomal
abnormalities. Elevated levels may indicate neural tube defects, while low levels may be
associated with Down syndrome. CVS is performed at 10-13 weeks, NST is performed in the
third trimester, and amniocentesis for fetal lung maturity is performed in the late third
trimester .
