Maternal Newborn Nursing Complete Exam Study Guide
with NGN Questions – ATI and NCLEX-RN® Preparation
SECTION I: ANTEPARTUM CARE & PRENATAL ASSESSMENT
1. A nurse in a prenatal clinic is caring for a client who suspects she may be
pregnant. Which of the following findings should the nurse identify as
a positive sign of pregnancy?
A) Amenorrhea
B) Chadwick's sign
C) Positive urine pregnancy test
D) Palpable fetal movement
Correct Answer: D
Rationale: Positive signs of pregnancy are those that can be confirmed
objectively and are diagnostic of pregnancy. Palpable fetal movement by an
examiner, visualization of the fetus via ultrasound, and auscultation of fetal heart
tones are positive signs. Amenorrhea (A) and Chadwick's sign (B)
are presumptive signs—they suggest pregnancy but can be caused by other
conditions. A positive urine pregnancy test (C) is a probable sign, as it detects hCG
but false positives can occur.
2. A nurse is caring for a client at 32 weeks of gestation who is experiencing
preterm labor. Which medication should the nurse plan to administer to
promote fetal lung maturity?
A) Misoprostol
B) Betamethasone
C) Poractant alfa
D) Methylergonovine
Correct Answer: B
,Rationale: Betamethasone is a corticosteroid administered to pregnant clients
between 24 and 34 weeks of gestation who are at risk for preterm delivery. It
accelerates fetal lung maturation by stimulating surfactant production.
Misoprostol (A) is a prostaglandin used for cervical ripening and induction.
Poractant alfa (C) is a surfactant replacement given to the newborn, not the
mother. Methylergonovine (D) is used to treat postpartum hemorrhage.
3. A nurse is providing teaching to a client at 28 weeks of gestation about fetal
movement counting. Which statement by the client indicates an understanding
of the teaching?
A) "I should feel at least 10 movements within 2 hours."
B) "Fetal movement normally decreases after 28 weeks."
C) "I only need to count movements if I have risk factors."
D) "I should count movements for 30 minutes after each meal."
Correct Answer: A
Rationale: Fetal movement counting (kick counts) is a method for assessing fetal
well-being. The client should feel at least 10 movements within 2 hours. If fewer
than 10 movements are felt in 2 hours, the client should notify the provider. Fetal
movement does not normally decrease after 28 weeks; a decrease may indicate
fetal compromise. All pregnant clients should perform kick counts, not just those
with risk factors.
4. A client at 34 weeks of gestation has a prescription for terbutaline for
preterm labor. Which of the following statements by the client is the priority for
the nurse to address?
A) "I have a headache that won't go away."
B) "My heart feels like it is racing."
C) "I am feeling nauseous."
D) "I am having some mild contractions."
Correct Answer: B
,Rationale: Terbutaline is a beta-adrenergic agonist used as a tocolytic to suppress
preterm labor. Tachycardia and palpitations are significant adverse effects that
can indicate cardiovascular strain. The priority is to assess the client's heart rate
and notify the provider if significant tachycardia occurs. While headache (A) and
nausea (C) can occur, they are not as immediately concerning as cardiac effects.
Mild contractions (D) are the expected reason for the medication.
5. A nurse is reviewing laboratory results for a client at 10 weeks of gestation.
Which of the following findings should the nurse report to the provider?
A) Hemoglobin 12.0 g/dL
B) Hematocrit 36%
C) White blood cell count 14,000/mm³
D) Platelet count 90,000/mm³
Correct Answer: D
Rationale: A platelet count of 90,000/mm³ is thrombocytopenia and is below the
normal range of 150,000–400,000/mm³. This finding should be reported to the
provider as it may indicate conditions such as gestational thrombocytopenia,
preeclampsia, or HELLP syndrome. Mild leukocytosis (WBC 14,000/mm³) is normal
in pregnancy (C). Hemoglobin of 12.0 g/dL (A) and hematocrit of 36% (B) are
within normal limits for pregnancy.
6. A nurse is assessing a client at 16 weeks of gestation. Which of the following
findings should the nurse expect?
A) Fetal heart tones audible by Doppler
B) Quickening reported by the client
C) Fundus palpable at the umbilicus
D) Positive Ortolani sign
Correct Answer: A
Rationale: Fetal heart tones can typically be detected by Doppler ultrasound at
10–12 weeks of gestation. Quickening (B) is usually felt by the client between 16–
, 20 weeks but is not an expected finding for all clients at exactly 16 weeks. The
fundus reaches the umbilicus at approximately 20 weeks (C). Ortolani sign (D) is a
newborn assessment for developmental dysplasia of the hip.
7. A nurse is providing education about nutrition to a client who is 12 weeks
pregnant. Which of the following statements indicates the client understands
the teaching?
A) "I need to double my calorie intake now that I am pregnant."
B) "I should take 400 mcg of folic acid daily."
C) "I need to increase my calcium intake to 1,000 mg daily."
D) "I should avoid all fish during pregnancy."
Correct Answer: C
Rationale: The recommended daily calcium intake during pregnancy is 1,000–
1,300 mg. Calorie needs increase by approximately 300–350 calories/day in the
second and third trimesters, not double (A). Folic acid recommendation is 600
mcg/day during pregnancy, not 400 mcg (B). Clients should avoid high-
mercury fish (shark, swordfish, king mackerel, tilefish) but can safely eat low-
mercury fish (B) (salmon, shrimp, canned light tuna).
8. A nurse is assessing a client at 38 weeks of gestation during a routine prenatal
visit. The client's blood pressure is 148/94 mmHg and urine dipstick shows 2+
protein. The client denies headache or visual changes. Which diagnosis is most
likely?
A) Gestational hypertension
B) Preeclampsia without severe features
C) Chronic hypertension
D) Eclampsia
Correct Answer: B
Rationale: New-onset hypertension (≥140/90 mmHg) after 20 weeks of gestation
with proteinuria (≥1+ on dipstick or ≥300 mg in 24 hours) defines preeclampsia
with NGN Questions – ATI and NCLEX-RN® Preparation
SECTION I: ANTEPARTUM CARE & PRENATAL ASSESSMENT
1. A nurse in a prenatal clinic is caring for a client who suspects she may be
pregnant. Which of the following findings should the nurse identify as
a positive sign of pregnancy?
A) Amenorrhea
B) Chadwick's sign
C) Positive urine pregnancy test
D) Palpable fetal movement
Correct Answer: D
Rationale: Positive signs of pregnancy are those that can be confirmed
objectively and are diagnostic of pregnancy. Palpable fetal movement by an
examiner, visualization of the fetus via ultrasound, and auscultation of fetal heart
tones are positive signs. Amenorrhea (A) and Chadwick's sign (B)
are presumptive signs—they suggest pregnancy but can be caused by other
conditions. A positive urine pregnancy test (C) is a probable sign, as it detects hCG
but false positives can occur.
2. A nurse is caring for a client at 32 weeks of gestation who is experiencing
preterm labor. Which medication should the nurse plan to administer to
promote fetal lung maturity?
A) Misoprostol
B) Betamethasone
C) Poractant alfa
D) Methylergonovine
Correct Answer: B
,Rationale: Betamethasone is a corticosteroid administered to pregnant clients
between 24 and 34 weeks of gestation who are at risk for preterm delivery. It
accelerates fetal lung maturation by stimulating surfactant production.
Misoprostol (A) is a prostaglandin used for cervical ripening and induction.
Poractant alfa (C) is a surfactant replacement given to the newborn, not the
mother. Methylergonovine (D) is used to treat postpartum hemorrhage.
3. A nurse is providing teaching to a client at 28 weeks of gestation about fetal
movement counting. Which statement by the client indicates an understanding
of the teaching?
A) "I should feel at least 10 movements within 2 hours."
B) "Fetal movement normally decreases after 28 weeks."
C) "I only need to count movements if I have risk factors."
D) "I should count movements for 30 minutes after each meal."
Correct Answer: A
Rationale: Fetal movement counting (kick counts) is a method for assessing fetal
well-being. The client should feel at least 10 movements within 2 hours. If fewer
than 10 movements are felt in 2 hours, the client should notify the provider. Fetal
movement does not normally decrease after 28 weeks; a decrease may indicate
fetal compromise. All pregnant clients should perform kick counts, not just those
with risk factors.
4. A client at 34 weeks of gestation has a prescription for terbutaline for
preterm labor. Which of the following statements by the client is the priority for
the nurse to address?
A) "I have a headache that won't go away."
B) "My heart feels like it is racing."
C) "I am feeling nauseous."
D) "I am having some mild contractions."
Correct Answer: B
,Rationale: Terbutaline is a beta-adrenergic agonist used as a tocolytic to suppress
preterm labor. Tachycardia and palpitations are significant adverse effects that
can indicate cardiovascular strain. The priority is to assess the client's heart rate
and notify the provider if significant tachycardia occurs. While headache (A) and
nausea (C) can occur, they are not as immediately concerning as cardiac effects.
Mild contractions (D) are the expected reason for the medication.
5. A nurse is reviewing laboratory results for a client at 10 weeks of gestation.
Which of the following findings should the nurse report to the provider?
A) Hemoglobin 12.0 g/dL
B) Hematocrit 36%
C) White blood cell count 14,000/mm³
D) Platelet count 90,000/mm³
Correct Answer: D
Rationale: A platelet count of 90,000/mm³ is thrombocytopenia and is below the
normal range of 150,000–400,000/mm³. This finding should be reported to the
provider as it may indicate conditions such as gestational thrombocytopenia,
preeclampsia, or HELLP syndrome. Mild leukocytosis (WBC 14,000/mm³) is normal
in pregnancy (C). Hemoglobin of 12.0 g/dL (A) and hematocrit of 36% (B) are
within normal limits for pregnancy.
6. A nurse is assessing a client at 16 weeks of gestation. Which of the following
findings should the nurse expect?
A) Fetal heart tones audible by Doppler
B) Quickening reported by the client
C) Fundus palpable at the umbilicus
D) Positive Ortolani sign
Correct Answer: A
Rationale: Fetal heart tones can typically be detected by Doppler ultrasound at
10–12 weeks of gestation. Quickening (B) is usually felt by the client between 16–
, 20 weeks but is not an expected finding for all clients at exactly 16 weeks. The
fundus reaches the umbilicus at approximately 20 weeks (C). Ortolani sign (D) is a
newborn assessment for developmental dysplasia of the hip.
7. A nurse is providing education about nutrition to a client who is 12 weeks
pregnant. Which of the following statements indicates the client understands
the teaching?
A) "I need to double my calorie intake now that I am pregnant."
B) "I should take 400 mcg of folic acid daily."
C) "I need to increase my calcium intake to 1,000 mg daily."
D) "I should avoid all fish during pregnancy."
Correct Answer: C
Rationale: The recommended daily calcium intake during pregnancy is 1,000–
1,300 mg. Calorie needs increase by approximately 300–350 calories/day in the
second and third trimesters, not double (A). Folic acid recommendation is 600
mcg/day during pregnancy, not 400 mcg (B). Clients should avoid high-
mercury fish (shark, swordfish, king mackerel, tilefish) but can safely eat low-
mercury fish (B) (salmon, shrimp, canned light tuna).
8. A nurse is assessing a client at 38 weeks of gestation during a routine prenatal
visit. The client's blood pressure is 148/94 mmHg and urine dipstick shows 2+
protein. The client denies headache or visual changes. Which diagnosis is most
likely?
A) Gestational hypertension
B) Preeclampsia without severe features
C) Chronic hypertension
D) Eclampsia
Correct Answer: B
Rationale: New-onset hypertension (≥140/90 mmHg) after 20 weeks of gestation
with proteinuria (≥1+ on dipstick or ≥300 mg in 24 hours) defines preeclampsia
