ATI RN MATERNAL NEWBORN PROCTORED EXAM WITH NGN – 200 QUESTIONS &
RATIONALES
SECTION 1: ANTEPARTUM ASSESSMENT AND PRENATAL CARE (QUESTIONS 1-40)
1. A nurse is caring for a client who is at 10 weeks of gestation and reports nausea and
vomiting. Which of the following instructions should the nurse provide?
A. Eat three large meals daily
B. Drink fluids with meals
C. Eat dry crackers before rising
D. Lie flat after eating
Answer: C
Rationale: Eating dry crackers or toast before rising helps alleviate morning sickness by
reducing gastric emptiness and stabilizing blood sugar. Large meals (A) worsen nausea;
fluids with meals (B) distend the stomach; lying flat (D) promotes reflux.
2. A nurse is calculating a client's estimated date of birth using Naegele's rule. The
client's last menstrual period began on March 12. Which of the following is the
estimated date of birth?
A. December 5
B. December 19
C. January 5
D. January 19
Answer: B
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days.
March 12 minus 3 months = December 12, plus 7 days = December 19.
,3. A nurse is providing education to a client at 8 weeks of gestation about prenatal
vitamins. Which of the following statements by the client indicates understanding?
A. "I will take 400 mcg of folic acid daily."
B. "I need 800 mcg of folic acid daily."
C. "I should avoid all iron supplements."
D. "Calcium interferes with fetal bone development."
Answer: B
Rationale: The recommended daily folic acid intake during pregnancy is 600-800 mcg to
prevent neural tube defects. 400 mcg (A) is the recommendation for non-pregnant women.
Iron (C) is essential; calcium (D) supports fetal bone development.
4. A nurse is assessing a client at 16 weeks of gestation. Which of the following
findings should the nurse report to the provider?
A. Fundal height at the umbilicus
B. Fetal heart rate of 160/min
C. Weight gain of 5 lb (2.3 kg)
D. Blood pressure of 148/92 mm Hg
Answer: D
Rationale: Blood pressure of 148/92 mm Hg is elevated and may indicate gestational
hypertension or preeclampsia. Fundal height at the umbilicus (A) is expected at 20 weeks;
FHR 160/min (B) is normal (110-160); 5 lb weight gain (C) is appropriate for first trimester.
5. A nurse is teaching a client about expected weight gain during pregnancy. The client
has a pre-pregnancy BMI of 22. Which of the following weight gain ranges is
appropriate?
A. 15-25 lb (6.8-11.3 kg)
B. 25-35 lb (11.3-15.9 kg)
C. 28-40 lb (12.7-18.1 kg)
D. 11-20 lb (5.0-9.1 kg)
Answer: B
Rationale: For a normal BMI (18.5-24.9), recommended weight gain is 25-35 lb.
Underweight (A) requires 28-40 lb; overweight (C) requires 15-25 lb; obese (D) requires 11-
20 lb.
6. A nurse is performing a prenatal assessment on a client at 20 weeks of gestation.
Which of the following findings is expected?
A. Quickening
B. Braxton Hicks contractions
,C. Colostrum production
D. All of the above
Answer: D
Rationale: Quickening (fetal movement) is typically felt at 16-20 weeks. Braxton Hicks
contractions and colostrum production are also expected findings in the second trimester.
7. A nurse is teaching a client about signs of preterm labor. Which of the following
statements by the client indicates understanding?
A. "I will call if I have contractions that are irregular."
B. "I will report any low back pain that comes and goes."
C. "I will wait until my water breaks before calling."
D. "I will monitor for decreased fetal movement only."
Answer: B
Rationale: Low back pain that is rhythmic and persistent can indicate preterm labor.
Irregular contractions (A) may be Braxton Hicks; waiting for water breaking (C) delays care;
decreased movement alone (D) is insufficient.
8. A nurse is reviewing laboratory results for a client at 28 weeks of gestation. Which of
the following results requires follow-up?
A. Hemoglobin 11.2 g/dL
B. Platelets 140,000/mm³
C. Glucose 140 mg/dL (1-hour GTT)
D. Rubella titer 1:8
Answer: C
Rationale: A 1-hour glucose tolerance test result of 140 mg/dL or higher requires a 3-hour
GTT to diagnose gestational diabetes. Hemoglobin 11.2 (A) is acceptable; platelets 140,000
(B) is low normal; rubella titer 1:8 (D) indicates immunity.
9. A nurse is assessing a client at 32 weeks of gestation who reports ankle edema and
mild headache. Which of the following actions should the nurse take first?
A. Check blood pressure
B. Assess deep tendon reflexes
C. Obtain urine for protein
D. Review weight gain pattern
Answer: A
Rationale: Headache and edema may indicate preeclampsia. The nurse should first obtain
blood pressure, as hypertension is a key diagnostic criterion. DTRs (B) and urine protein (C)
follow after BP assessment.
, 10. A nurse is providing education about Rh incompatibility to a client who is Rh-
negative. Which of the following statements indicates understanding?
A. "I need Rho(D) immune globulin at 28 weeks."
B. "My baby will need a blood transfusion at birth."
C. "Rh incompatibility only affects future pregnancies."
D. "I only need RhoGAM if my baby is Rh-negative."
Answer: A
Rationale: Rh-negative clients receive Rho(D) immune globulin at 28 weeks and within 72
hours after birth if the newborn is Rh-positive. Rh incompatibility can affect the current
pregnancy (B, C incorrect); RhoGAM is given regardless of newborn Rh status at 28 weeks
(D incorrect).
11. A nurse is caring for a client at 12 weeks of gestation who has hyperemesis
gravidarum. Which of the following findings indicates the client is improving?
A. Weight gain of 1 lb (0.45 kg) in 1 week
B. Ketones present in urine
C. Hematocrit 45%
D. Potassium 3.2 mEq/L
Answer: A
Rationale: Weight gain indicates improvement in hyperemesis gravidarum. Ketones in
urine (B) and elevated hematocrit (C) indicate dehydration; low potassium (D) indicates
electrolyte imbalance.
12. A nurse is assessing fetal heart rate at 12 weeks of gestation. Which of the
following methods should the nurse use?
A. Doppler ultrasound
B. Fetoscope
C. Electronic fetal monitor
D. Transvaginal ultrasound
Answer: A
Rationale: Fetal heart tones can be detected by Doppler ultrasound at 10-12 weeks. A
fetoscope (B) detects at 18-20 weeks; electronic fetal monitor (C) is used during labor;
transvaginal ultrasound (D) is used earlier but not for routine FHR assessment.
13. A nurse is providing education about nutrition during pregnancy. Which of the
following foods should the nurse recommend as a source of folic acid?
A. Spinach
B. Milk
RATIONALES
SECTION 1: ANTEPARTUM ASSESSMENT AND PRENATAL CARE (QUESTIONS 1-40)
1. A nurse is caring for a client who is at 10 weeks of gestation and reports nausea and
vomiting. Which of the following instructions should the nurse provide?
A. Eat three large meals daily
B. Drink fluids with meals
C. Eat dry crackers before rising
D. Lie flat after eating
Answer: C
Rationale: Eating dry crackers or toast before rising helps alleviate morning sickness by
reducing gastric emptiness and stabilizing blood sugar. Large meals (A) worsen nausea;
fluids with meals (B) distend the stomach; lying flat (D) promotes reflux.
2. A nurse is calculating a client's estimated date of birth using Naegele's rule. The
client's last menstrual period began on March 12. Which of the following is the
estimated date of birth?
A. December 5
B. December 19
C. January 5
D. January 19
Answer: B
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7 days.
March 12 minus 3 months = December 12, plus 7 days = December 19.
,3. A nurse is providing education to a client at 8 weeks of gestation about prenatal
vitamins. Which of the following statements by the client indicates understanding?
A. "I will take 400 mcg of folic acid daily."
B. "I need 800 mcg of folic acid daily."
C. "I should avoid all iron supplements."
D. "Calcium interferes with fetal bone development."
Answer: B
Rationale: The recommended daily folic acid intake during pregnancy is 600-800 mcg to
prevent neural tube defects. 400 mcg (A) is the recommendation for non-pregnant women.
Iron (C) is essential; calcium (D) supports fetal bone development.
4. A nurse is assessing a client at 16 weeks of gestation. Which of the following
findings should the nurse report to the provider?
A. Fundal height at the umbilicus
B. Fetal heart rate of 160/min
C. Weight gain of 5 lb (2.3 kg)
D. Blood pressure of 148/92 mm Hg
Answer: D
Rationale: Blood pressure of 148/92 mm Hg is elevated and may indicate gestational
hypertension or preeclampsia. Fundal height at the umbilicus (A) is expected at 20 weeks;
FHR 160/min (B) is normal (110-160); 5 lb weight gain (C) is appropriate for first trimester.
5. A nurse is teaching a client about expected weight gain during pregnancy. The client
has a pre-pregnancy BMI of 22. Which of the following weight gain ranges is
appropriate?
A. 15-25 lb (6.8-11.3 kg)
B. 25-35 lb (11.3-15.9 kg)
C. 28-40 lb (12.7-18.1 kg)
D. 11-20 lb (5.0-9.1 kg)
Answer: B
Rationale: For a normal BMI (18.5-24.9), recommended weight gain is 25-35 lb.
Underweight (A) requires 28-40 lb; overweight (C) requires 15-25 lb; obese (D) requires 11-
20 lb.
6. A nurse is performing a prenatal assessment on a client at 20 weeks of gestation.
Which of the following findings is expected?
A. Quickening
B. Braxton Hicks contractions
,C. Colostrum production
D. All of the above
Answer: D
Rationale: Quickening (fetal movement) is typically felt at 16-20 weeks. Braxton Hicks
contractions and colostrum production are also expected findings in the second trimester.
7. A nurse is teaching a client about signs of preterm labor. Which of the following
statements by the client indicates understanding?
A. "I will call if I have contractions that are irregular."
B. "I will report any low back pain that comes and goes."
C. "I will wait until my water breaks before calling."
D. "I will monitor for decreased fetal movement only."
Answer: B
Rationale: Low back pain that is rhythmic and persistent can indicate preterm labor.
Irregular contractions (A) may be Braxton Hicks; waiting for water breaking (C) delays care;
decreased movement alone (D) is insufficient.
8. A nurse is reviewing laboratory results for a client at 28 weeks of gestation. Which of
the following results requires follow-up?
A. Hemoglobin 11.2 g/dL
B. Platelets 140,000/mm³
C. Glucose 140 mg/dL (1-hour GTT)
D. Rubella titer 1:8
Answer: C
Rationale: A 1-hour glucose tolerance test result of 140 mg/dL or higher requires a 3-hour
GTT to diagnose gestational diabetes. Hemoglobin 11.2 (A) is acceptable; platelets 140,000
(B) is low normal; rubella titer 1:8 (D) indicates immunity.
9. A nurse is assessing a client at 32 weeks of gestation who reports ankle edema and
mild headache. Which of the following actions should the nurse take first?
A. Check blood pressure
B. Assess deep tendon reflexes
C. Obtain urine for protein
D. Review weight gain pattern
Answer: A
Rationale: Headache and edema may indicate preeclampsia. The nurse should first obtain
blood pressure, as hypertension is a key diagnostic criterion. DTRs (B) and urine protein (C)
follow after BP assessment.
, 10. A nurse is providing education about Rh incompatibility to a client who is Rh-
negative. Which of the following statements indicates understanding?
A. "I need Rho(D) immune globulin at 28 weeks."
B. "My baby will need a blood transfusion at birth."
C. "Rh incompatibility only affects future pregnancies."
D. "I only need RhoGAM if my baby is Rh-negative."
Answer: A
Rationale: Rh-negative clients receive Rho(D) immune globulin at 28 weeks and within 72
hours after birth if the newborn is Rh-positive. Rh incompatibility can affect the current
pregnancy (B, C incorrect); RhoGAM is given regardless of newborn Rh status at 28 weeks
(D incorrect).
11. A nurse is caring for a client at 12 weeks of gestation who has hyperemesis
gravidarum. Which of the following findings indicates the client is improving?
A. Weight gain of 1 lb (0.45 kg) in 1 week
B. Ketones present in urine
C. Hematocrit 45%
D. Potassium 3.2 mEq/L
Answer: A
Rationale: Weight gain indicates improvement in hyperemesis gravidarum. Ketones in
urine (B) and elevated hematocrit (C) indicate dehydration; low potassium (D) indicates
electrolyte imbalance.
12. A nurse is assessing fetal heart rate at 12 weeks of gestation. Which of the
following methods should the nurse use?
A. Doppler ultrasound
B. Fetoscope
C. Electronic fetal monitor
D. Transvaginal ultrasound
Answer: A
Rationale: Fetal heart tones can be detected by Doppler ultrasound at 10-12 weeks. A
fetoscope (B) detects at 18-20 weeks; electronic fetal monitor (C) is used during labor;
transvaginal ultrasound (D) is used earlier but not for routine FHR assessment.
13. A nurse is providing education about nutrition during pregnancy. Which of the
following foods should the nurse recommend as a source of folic acid?
A. Spinach
B. Milk
