1|Page
ATI RN Maternal Newborn Proctored
Exam 2026 | Practice Questions with Ra
tionales & Visuals | Guaranteed Pass
Section 1: Antepartum Care (Questions 1-60)
Question 1
A 26-year-old primigravida at 8 weeks of gestation tells the nurse she is concerned
about the over-the-counter medications she can take for a cold. Which response by
the nurse is most appropriate?
A) "You should avoid all medications during the first trimester."
B) "You can take any medication labeled as 'natural' or 'herbal'."
C) "You should check with your provider before taking any medication,
including over-the-counter drugs."
D) "It is safe to take ibuprofen for fever during pregnancy."
*Rationale: The safest approach is to consult the provider before taking any
medication. Ibuprofen (NSAIDs) are generally avoided, especially in the third
trimester due to risks of premature closure of the ductus arteriosus. 'Natural'
does not mean safe, and some medications are acceptable with provider
guidance.
Question 2
A nurse is teaching a client at 16 weeks of gestation about the signs of preterm
labor. Which statement by the client indicates a need for further teaching?
A) "I should report any vaginal bleeding to my provider."
B) "I will call my provider if I feel more than 4 contractions in one hour."
C) "I should report a sudden gush of fluid from my vagina."
D) "I need to go to the hospital if I feel any abdominal tightening."
*Rationale: Abdominal tightening (Braxton-Hicks contractions) is normal and
does not necessarily indicate preterm labor. However, regular, painful
contractions, bleeding, or fluid leakage should be reported.
,2|Page
Table 1: Physiologic Changes in Pregnancy
System Change Clinical Significance
Increased blood volume (40-
Physiologic anemia of pregnancy;
Cardiovascular 50%), increased cardiac
supine hypotensive syndrome
output
Increased tidal volume, Dyspnea of pregnancy; respiratory
Respiratory
decreased residual volume alkalosis
Increased glomerular filtration Glycosuria; decreased BUN and
Renal
rate (GFR) creatinine
Delayed gastric emptying, Nausea/vomiting; constipation;
Gastrointestinal
decreased GI motility heartburn
Increased melanocyte- Linea nigra; melasma (chloasma);
Integumentary
stimulating hormone striae gravidarum
Question 3
A nurse is assessing a client at 32 weeks of gestation who reports heartburn. Which
instruction should the nurse provide?
A) "Lie down immediately after eating to prevent reflux."
B) "Drink fluids with meals to dilute stomach acid."
C) "Eat small, frequent meals throughout the day."
D) "Avoid all spicy foods completely."
*Rationale: Small, frequent meals prevent the stomach from becoming overly
full, reducing reflux. Lying down worsens heartburn. Fluid with meals can
distend the stomach. Spicy foods can be avoided if they trigger symptoms, but
complete avoidance is not required for everyone.
Question 4
A nurse is calculating the estimated date of birth (EDB) for a client whose last
menstrual period began on March 25th. Using Naegele's rule, which date should the
nurse document?
,3|Page
A) December 25th
B) January 1st
C) January 1st
D) January 8th
*Rationale: Naegele's rule: LMP - 3 months + 7 days. March 25th minus 3
months = December 25th. Adding 7 days = January 1st.
Question 5
A nurse is reviewing laboratory results for a client at 12 weeks of gestation. The
hemoglobin is 10.8 g/dL and hematocrit is 32%. Which action should the nurse take?
A) Notify the provider immediately as this indicates hemorrhage.
B) Document the findings as expected in pregnancy.
C) Prepare the client for a blood transfusion.
D) Instruct the client to increase her fluid intake.
*Rationale: Physiologic anemia of pregnancy occurs due to plasma volume
expansion exceeding red blood cell production. Normal Hgb is >11 g/dL in the
first trimester and >10.5 g/dL in the second and third trimesters. This finding is
within expected parameters.
Question 6
A nurse is providing teaching about folic acid supplementation to a client who is
planning to become pregnant. Which statement indicates understanding?
A) "I should start taking folic acid after I confirm I am pregnant."
B) "I need to take 400 to 800 mcg of folic acid daily to prevent neural tube
defects."
C) "Folic acid is only necessary if I have a family history of birth defects."
D) "I can get all the folic acid I need from a balanced diet."
*Rationale: Folic acid (400-800 mcg) is recommended before conception and
during early pregnancy to prevent neural tube defects. Neural tube defects
occur before many women know they are pregnant, so supplementation should
begin preconception. While diet contributes, supplementation is necessary to
meet requirements.
Question 7
A nurse is assessing a client at 20 weeks of gestation. The client reports feeling dizzy
when lying flat on her back. What is the most likely cause?
A) Hyperglycemia
B) Dehydration
C) Supine hypotensive syndrome
D) Anemia
*Rationale: Supine hypotensive syndrome occurs when the gravid uterus
compresses the inferior vena cava, reducing venous return and causing
hypotension, dizziness, and pallor. This is relieved by positioning the client on
her left side.
, 4|Page
Question 8
A nurse is performing a prenatal assessment on a client at 28 weeks. The fundal
height is 26 cm. Which action should the nurse take?
A) Document this as a normal finding.
B) Schedule a fetal ultrasound.
C) Reassure the client that the fetus is small.
D) Increase the client's caloric intake.
*Rationale: Fundal height in cm should correlate with gestational age in weeks
(±2 cm). 28 weeks should be 26-30 cm. A measurement of 26 cm is at the lower
limit of normal. While it could be normal, a small-for-gestational-age fetus
requires evaluation (ultrasound).
Question 9
A nurse is teaching a client with gestational diabetes about nutrition. Which meal
plan is most appropriate?
A) High protein, low carbohydrate, high fat
B) Consistent carbohydrates, moderate protein, healthy fats
C) No carbohydrates, high protein, unlimited fats
D) Low fat, high carbohydrate, high fiber
*Rationale: Consistent carbohydrate intake throughout the day helps maintain
stable blood glucose levels. Carbohydrates should not be eliminated entirely;
they are essential for fetal brain development.
Question 10
A nurse is assessing a client for Chadwick's sign. What finding does the nurse expect?
A) Bluish discoloration of the cervix and vagina
B) Softening of the cervix
C) Palpable fetal movement
D) Uterine contractions
*Rationale: Chadwick's sign is a bluish-purple discoloration of the cervix and
vaginal mucosa due to increased vascularity. This is a probable sign of
pregnancy. Goodell's sign is softening of the cervix.
Question 11
A client at 34 weeks of gestation reports shortness of breath. Which instruction
should the nurse provide?
A) "You should lie flat on your back to help with breathing."
B) "This is a sign of preeclampsia; you need to go to the hospital."
C) "Try to maintain good posture and sleep with extra pillows."
D) "You should limit your fluid intake to reduce pressure on the diaphragm."
*Rationale: Shortness of breath is common in the third trimester due to the
uterus pushing up against the diaphragm. Good posture and elevating the head
with pillows can help. Lying flat worsens the problem.
ATI RN Maternal Newborn Proctored
Exam 2026 | Practice Questions with Ra
tionales & Visuals | Guaranteed Pass
Section 1: Antepartum Care (Questions 1-60)
Question 1
A 26-year-old primigravida at 8 weeks of gestation tells the nurse she is concerned
about the over-the-counter medications she can take for a cold. Which response by
the nurse is most appropriate?
A) "You should avoid all medications during the first trimester."
B) "You can take any medication labeled as 'natural' or 'herbal'."
C) "You should check with your provider before taking any medication,
including over-the-counter drugs."
D) "It is safe to take ibuprofen for fever during pregnancy."
*Rationale: The safest approach is to consult the provider before taking any
medication. Ibuprofen (NSAIDs) are generally avoided, especially in the third
trimester due to risks of premature closure of the ductus arteriosus. 'Natural'
does not mean safe, and some medications are acceptable with provider
guidance.
Question 2
A nurse is teaching a client at 16 weeks of gestation about the signs of preterm
labor. Which statement by the client indicates a need for further teaching?
A) "I should report any vaginal bleeding to my provider."
B) "I will call my provider if I feel more than 4 contractions in one hour."
C) "I should report a sudden gush of fluid from my vagina."
D) "I need to go to the hospital if I feel any abdominal tightening."
*Rationale: Abdominal tightening (Braxton-Hicks contractions) is normal and
does not necessarily indicate preterm labor. However, regular, painful
contractions, bleeding, or fluid leakage should be reported.
,2|Page
Table 1: Physiologic Changes in Pregnancy
System Change Clinical Significance
Increased blood volume (40-
Physiologic anemia of pregnancy;
Cardiovascular 50%), increased cardiac
supine hypotensive syndrome
output
Increased tidal volume, Dyspnea of pregnancy; respiratory
Respiratory
decreased residual volume alkalosis
Increased glomerular filtration Glycosuria; decreased BUN and
Renal
rate (GFR) creatinine
Delayed gastric emptying, Nausea/vomiting; constipation;
Gastrointestinal
decreased GI motility heartburn
Increased melanocyte- Linea nigra; melasma (chloasma);
Integumentary
stimulating hormone striae gravidarum
Question 3
A nurse is assessing a client at 32 weeks of gestation who reports heartburn. Which
instruction should the nurse provide?
A) "Lie down immediately after eating to prevent reflux."
B) "Drink fluids with meals to dilute stomach acid."
C) "Eat small, frequent meals throughout the day."
D) "Avoid all spicy foods completely."
*Rationale: Small, frequent meals prevent the stomach from becoming overly
full, reducing reflux. Lying down worsens heartburn. Fluid with meals can
distend the stomach. Spicy foods can be avoided if they trigger symptoms, but
complete avoidance is not required for everyone.
Question 4
A nurse is calculating the estimated date of birth (EDB) for a client whose last
menstrual period began on March 25th. Using Naegele's rule, which date should the
nurse document?
,3|Page
A) December 25th
B) January 1st
C) January 1st
D) January 8th
*Rationale: Naegele's rule: LMP - 3 months + 7 days. March 25th minus 3
months = December 25th. Adding 7 days = January 1st.
Question 5
A nurse is reviewing laboratory results for a client at 12 weeks of gestation. The
hemoglobin is 10.8 g/dL and hematocrit is 32%. Which action should the nurse take?
A) Notify the provider immediately as this indicates hemorrhage.
B) Document the findings as expected in pregnancy.
C) Prepare the client for a blood transfusion.
D) Instruct the client to increase her fluid intake.
*Rationale: Physiologic anemia of pregnancy occurs due to plasma volume
expansion exceeding red blood cell production. Normal Hgb is >11 g/dL in the
first trimester and >10.5 g/dL in the second and third trimesters. This finding is
within expected parameters.
Question 6
A nurse is providing teaching about folic acid supplementation to a client who is
planning to become pregnant. Which statement indicates understanding?
A) "I should start taking folic acid after I confirm I am pregnant."
B) "I need to take 400 to 800 mcg of folic acid daily to prevent neural tube
defects."
C) "Folic acid is only necessary if I have a family history of birth defects."
D) "I can get all the folic acid I need from a balanced diet."
*Rationale: Folic acid (400-800 mcg) is recommended before conception and
during early pregnancy to prevent neural tube defects. Neural tube defects
occur before many women know they are pregnant, so supplementation should
begin preconception. While diet contributes, supplementation is necessary to
meet requirements.
Question 7
A nurse is assessing a client at 20 weeks of gestation. The client reports feeling dizzy
when lying flat on her back. What is the most likely cause?
A) Hyperglycemia
B) Dehydration
C) Supine hypotensive syndrome
D) Anemia
*Rationale: Supine hypotensive syndrome occurs when the gravid uterus
compresses the inferior vena cava, reducing venous return and causing
hypotension, dizziness, and pallor. This is relieved by positioning the client on
her left side.
, 4|Page
Question 8
A nurse is performing a prenatal assessment on a client at 28 weeks. The fundal
height is 26 cm. Which action should the nurse take?
A) Document this as a normal finding.
B) Schedule a fetal ultrasound.
C) Reassure the client that the fetus is small.
D) Increase the client's caloric intake.
*Rationale: Fundal height in cm should correlate with gestational age in weeks
(±2 cm). 28 weeks should be 26-30 cm. A measurement of 26 cm is at the lower
limit of normal. While it could be normal, a small-for-gestational-age fetus
requires evaluation (ultrasound).
Question 9
A nurse is teaching a client with gestational diabetes about nutrition. Which meal
plan is most appropriate?
A) High protein, low carbohydrate, high fat
B) Consistent carbohydrates, moderate protein, healthy fats
C) No carbohydrates, high protein, unlimited fats
D) Low fat, high carbohydrate, high fiber
*Rationale: Consistent carbohydrate intake throughout the day helps maintain
stable blood glucose levels. Carbohydrates should not be eliminated entirely;
they are essential for fetal brain development.
Question 10
A nurse is assessing a client for Chadwick's sign. What finding does the nurse expect?
A) Bluish discoloration of the cervix and vagina
B) Softening of the cervix
C) Palpable fetal movement
D) Uterine contractions
*Rationale: Chadwick's sign is a bluish-purple discoloration of the cervix and
vaginal mucosa due to increased vascularity. This is a probable sign of
pregnancy. Goodell's sign is softening of the cervix.
Question 11
A client at 34 weeks of gestation reports shortness of breath. Which instruction
should the nurse provide?
A) "You should lie flat on your back to help with breathing."
B) "This is a sign of preeclampsia; you need to go to the hospital."
C) "Try to maintain good posture and sleep with extra pillows."
D) "You should limit your fluid intake to reduce pressure on the diaphragm."
*Rationale: Shortness of breath is common in the third trimester due to the
uterus pushing up against the diaphragm. Good posture and elevating the head
with pillows can help. Lying flat worsens the problem.
