ATI MATERNAL NEWBORN
PROCTORED 2019
Section 1: Antepartum Care (Questions 1-30)
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. "Drink a glass of water with each meal."
B. "Eat small, frequent meals throughout the day."
C. "Increase your intake of high-fat foods."
D. "Skip breakfast to avoid morning sickness."
Correct Answer: B
Rationale: Eating small, frequent meals helps maintain blood sugar levels and prevents an
empty stomach, which can exacerbate nausea. Drinking water with meals can increase feelings
of fullness and nausea. High-fat foods are harder to digest and can worsen nausea. Skipping
meals is not recommended.
2. A nurse is teaching a client who is at 12 weeks of gestation about expected physiological
changes. Which of the following statements by the client indicates an understanding of the
teaching?
A. "I should expect my blood pressure to increase."
B. "I might experience nasal stuffiness."
C. "My heart rate will decrease."
D. "I will have less vaginal discharge."
Correct Answer: B
Rationale: Nasal stuffiness (rhinitis of pregnancy) is a common physiological change due to
increased estrogen and blood volume. Blood pressure typically remains the same or decreases
slightly. Heart rate increases by 10-15 bpm. Vaginal discharge (leukorrhea) increases.
3. A nurse is calculating the estimated date of delivery (EDD) for a client who reports that her
last menstrual period (LMP) began on March 10. Using Naegele's rule, which of the following
is the EDD?
A. December 3
B. December 17
,C. December 10
D. December 24
Correct Answer: B
Rationale: Naegele's rule: Subtract 3 months from the first day of the LMP and add 7 days
and 1 year. March 10 - 3 months = December 10. December 10 + 7 days = December 17.
4. A nurse is assessing a client who is at 20 weeks of gestation. Which of the following findings
should the nurse report to the provider?
A. Fetal heart rate of 140/min
B. Fundal height of 20 cm
C. Blood pressure of 140/90 mm Hg
D. Hemoglobin of 11.5 g/dL
Correct Answer: C
Rationale: A blood pressure of 140/90 mm Hg is considered hypertensive and can be a sign
of gestational hypertension or preeclampsia, requiring further evaluation. The other findings are
expected at 20 weeks.
5. A nurse is providing teaching to a client who is at 8 weeks of gestation and has a history of
a neural tube defect in a previous pregnancy. The nurse should instruct the client to increase
her intake of which of the following?
A. Vitamin C
B. Folic acid
C. Iron
D. Calcium
Correct Answer: B
Rationale: Folic acid is crucial for the prevention of neural tube defects. Clients with a
history of NTD should take a higher dose (4 mg/day) as prescribed.
6. SATA: A nurse is reviewing the medical record of a client who is at 36 weeks of gestation.
Which of the following findings are expected physiological changes of pregnancy? (Select all
that apply.)
A. Lordosis
B. Decreased gastric emptying
C. Hyperventilation
D. Increased tidal volume
E. Decreased glomerular filtration rate
, Correct Answer: A, B, D
Rationale: Lordosis (A) is a compensatory curvature of the spine due to the growing uterus.
Progesterone decreases gastric motility and emptying (B). Tidal volume (D) increases to meet
oxygen demands. Hyperventilation is not a normal finding; the client may have increased
respiratory rate but not hyperventilation. GFR increases, not decreases.
7. A nurse is caring for a client who is in the first trimester of pregnancy. The client asks,
"When will I feel the baby move?" The nurse should respond that quickening is typically felt
at which of the following times?
A. 8 to 10 weeks
B. 16 to 20 weeks
C. 24 to 28 weeks
D. 30 to 32 weeks
Correct Answer: B
Rationale: Quickening, the first perception of fetal movement, is typically felt between 16
and 20 weeks of gestation in a primigravida client.
8. A nurse is performing a pelvic examination on a client who is at 38 weeks of gestation. The
nurse notes that the client's cervix is soft and has begun to dilate. The nurse should document
this finding as which of the following?
A. Goodell's sign
B. Chadwick's sign
C. Hegar's sign
D. Ballottement
Correct Answer: A
Rationale: Goodell's sign is the softening of the cervix. Chadwick's sign is a bluish
discoloration of the cervix and vagina. Hegar's sign is the softening of the lower uterine
segment. Ballottement is the rebound of the fetus when pushed.
9. A nurse is providing nutritional counseling to a client who is pregnant. Which of the
following foods should the nurse recommend as a good source of iron?
A. Milk
B. Oranges
C. Lean red meat
D. Whole wheat bread
Correct Answer: C
Rationale: Lean red meat is an excellent source of heme iron, which is more readily
, absorbed than non-heme iron. Milk is a good source of calcium. Oranges are a source of vitamin
C and folate. Whole wheat bread provides fiber and some non-heme iron, but red meat is a
richer source.
10. A nurse is assessing a client who is at 32 weeks of gestation. The client reports a sudden
gush of fluid from her vagina. Which of the following actions should the nurse take first?
A. Perform a sterile speculum exam.
B. Check the fetal heart rate.
C. Test the fluid with nitrazine paper.
D. Place the client in a supine position.
Correct Answer: B
Rationale: The priority action is to assess the fetal heart rate to ensure fetal well-being. This
should be done before other assessments like a speculum exam, which could introduce
infection, or a nitrazine test.
11. A nurse is teaching a client who is at 10 weeks of gestation about prenatal nutrition.
Which of the following statements indicates a need for further teaching?
A. "I will increase my intake of calcium-rich foods."
B. "I will take a daily iron supplement."
C. "I will double my calorie intake."
D. "I will avoid raw fish."
Correct Answer: C
Rationale: Calorie needs do not double. The client needs an additional 340 calories/day in
the second trimester and 450 calories/day in the third. The other statements are correct.
12. A nurse is caring for a client who is at 16 weeks of gestation and is scheduled for a
maternal serum alpha-fetoprotein (MSAFP) test. The client asks what the test is for. The nurse
should explain that this test is used to screen for which of the following?
A. Gestational diabetes
B. Neural tube defects
C. Down syndrome
D. Preeclampsia
Correct Answer: B
Rationale: MSAFP is a screening test for neural tube defects (e.g., spina bifida, anencephaly)
and chromosomal abnormalities like Down syndrome.
13. A nurse is assessing a client who is at 24 weeks of gestation. Which of the following
findings should the nurse identify as a potential sign of a urinary tract infection (UTI)?
PROCTORED 2019
Section 1: Antepartum Care (Questions 1-30)
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. "Drink a glass of water with each meal."
B. "Eat small, frequent meals throughout the day."
C. "Increase your intake of high-fat foods."
D. "Skip breakfast to avoid morning sickness."
Correct Answer: B
Rationale: Eating small, frequent meals helps maintain blood sugar levels and prevents an
empty stomach, which can exacerbate nausea. Drinking water with meals can increase feelings
of fullness and nausea. High-fat foods are harder to digest and can worsen nausea. Skipping
meals is not recommended.
2. A nurse is teaching a client who is at 12 weeks of gestation about expected physiological
changes. Which of the following statements by the client indicates an understanding of the
teaching?
A. "I should expect my blood pressure to increase."
B. "I might experience nasal stuffiness."
C. "My heart rate will decrease."
D. "I will have less vaginal discharge."
Correct Answer: B
Rationale: Nasal stuffiness (rhinitis of pregnancy) is a common physiological change due to
increased estrogen and blood volume. Blood pressure typically remains the same or decreases
slightly. Heart rate increases by 10-15 bpm. Vaginal discharge (leukorrhea) increases.
3. A nurse is calculating the estimated date of delivery (EDD) for a client who reports that her
last menstrual period (LMP) began on March 10. Using Naegele's rule, which of the following
is the EDD?
A. December 3
B. December 17
,C. December 10
D. December 24
Correct Answer: B
Rationale: Naegele's rule: Subtract 3 months from the first day of the LMP and add 7 days
and 1 year. March 10 - 3 months = December 10. December 10 + 7 days = December 17.
4. A nurse is assessing a client who is at 20 weeks of gestation. Which of the following findings
should the nurse report to the provider?
A. Fetal heart rate of 140/min
B. Fundal height of 20 cm
C. Blood pressure of 140/90 mm Hg
D. Hemoglobin of 11.5 g/dL
Correct Answer: C
Rationale: A blood pressure of 140/90 mm Hg is considered hypertensive and can be a sign
of gestational hypertension or preeclampsia, requiring further evaluation. The other findings are
expected at 20 weeks.
5. A nurse is providing teaching to a client who is at 8 weeks of gestation and has a history of
a neural tube defect in a previous pregnancy. The nurse should instruct the client to increase
her intake of which of the following?
A. Vitamin C
B. Folic acid
C. Iron
D. Calcium
Correct Answer: B
Rationale: Folic acid is crucial for the prevention of neural tube defects. Clients with a
history of NTD should take a higher dose (4 mg/day) as prescribed.
6. SATA: A nurse is reviewing the medical record of a client who is at 36 weeks of gestation.
Which of the following findings are expected physiological changes of pregnancy? (Select all
that apply.)
A. Lordosis
B. Decreased gastric emptying
C. Hyperventilation
D. Increased tidal volume
E. Decreased glomerular filtration rate
, Correct Answer: A, B, D
Rationale: Lordosis (A) is a compensatory curvature of the spine due to the growing uterus.
Progesterone decreases gastric motility and emptying (B). Tidal volume (D) increases to meet
oxygen demands. Hyperventilation is not a normal finding; the client may have increased
respiratory rate but not hyperventilation. GFR increases, not decreases.
7. A nurse is caring for a client who is in the first trimester of pregnancy. The client asks,
"When will I feel the baby move?" The nurse should respond that quickening is typically felt
at which of the following times?
A. 8 to 10 weeks
B. 16 to 20 weeks
C. 24 to 28 weeks
D. 30 to 32 weeks
Correct Answer: B
Rationale: Quickening, the first perception of fetal movement, is typically felt between 16
and 20 weeks of gestation in a primigravida client.
8. A nurse is performing a pelvic examination on a client who is at 38 weeks of gestation. The
nurse notes that the client's cervix is soft and has begun to dilate. The nurse should document
this finding as which of the following?
A. Goodell's sign
B. Chadwick's sign
C. Hegar's sign
D. Ballottement
Correct Answer: A
Rationale: Goodell's sign is the softening of the cervix. Chadwick's sign is a bluish
discoloration of the cervix and vagina. Hegar's sign is the softening of the lower uterine
segment. Ballottement is the rebound of the fetus when pushed.
9. A nurse is providing nutritional counseling to a client who is pregnant. Which of the
following foods should the nurse recommend as a good source of iron?
A. Milk
B. Oranges
C. Lean red meat
D. Whole wheat bread
Correct Answer: C
Rationale: Lean red meat is an excellent source of heme iron, which is more readily
, absorbed than non-heme iron. Milk is a good source of calcium. Oranges are a source of vitamin
C and folate. Whole wheat bread provides fiber and some non-heme iron, but red meat is a
richer source.
10. A nurse is assessing a client who is at 32 weeks of gestation. The client reports a sudden
gush of fluid from her vagina. Which of the following actions should the nurse take first?
A. Perform a sterile speculum exam.
B. Check the fetal heart rate.
C. Test the fluid with nitrazine paper.
D. Place the client in a supine position.
Correct Answer: B
Rationale: The priority action is to assess the fetal heart rate to ensure fetal well-being. This
should be done before other assessments like a speculum exam, which could introduce
infection, or a nitrazine test.
11. A nurse is teaching a client who is at 10 weeks of gestation about prenatal nutrition.
Which of the following statements indicates a need for further teaching?
A. "I will increase my intake of calcium-rich foods."
B. "I will take a daily iron supplement."
C. "I will double my calorie intake."
D. "I will avoid raw fish."
Correct Answer: C
Rationale: Calorie needs do not double. The client needs an additional 340 calories/day in
the second trimester and 450 calories/day in the third. The other statements are correct.
12. A nurse is caring for a client who is at 16 weeks of gestation and is scheduled for a
maternal serum alpha-fetoprotein (MSAFP) test. The client asks what the test is for. The nurse
should explain that this test is used to screen for which of the following?
A. Gestational diabetes
B. Neural tube defects
C. Down syndrome
D. Preeclampsia
Correct Answer: B
Rationale: MSAFP is a screening test for neural tube defects (e.g., spina bifida, anencephaly)
and chromosomal abnormalities like Down syndrome.
13. A nurse is assessing a client who is at 24 weeks of gestation. Which of the following
findings should the nurse identify as a potential sign of a urinary tract infection (UTI)?
