ATI MATERNAL NEWBORN PROCTORED
EXAM (A, B and C) 2019 -70 QUESTIONS
WITH ANSWERS
SECTION I: ANTEPARTUM CARE & COMPLICATIONS (Questions 1–25)
1. A nurse is caring for a client at 32 weeks gestation who reports a sudden gush
of clear fluid from the vagina. Which action should the nurse take first?
A. Obtain a urine specimen
B. Perform a sterile speculum examination
C. Assess the fetal heart rate
D. Ask the client to ambulate
Correct Answer: C
Rationale: The priority nursing action when rupture of membranes is
suspected is to assess fetal well-being by auscultating the fetal heart rate. This
detects cord prolapse or fetal distress, which are immediate threats. Urine
specimen and ambulation are not priorities. Speculum examination may be
performed later but is not first.
2. A nurse is teaching a client at 10 weeks gestation about nutrition. Which
statement indicates understanding?
A. "I need 600 extra calories per day."
B. "I should increase my folic acid intake to 600 mcg daily."
C. "I should limit my fluid intake to 1 liter per day."
D. "I can continue my weight-loss diet."
Correct Answer: B
, Rationale: Folic acid 600 mcg daily is recommended during pregnancy to
prevent neural tube defects. Only 340 extra calories are needed in the second
trimester and 452 in the third—not 600. Fluid restriction and weight-loss diets are
inappropriate.
3. A nurse is assessing a client at 36 weeks gestation who has preeclampsia. Which
finding should the nurse report immediately?
A. 1+ pitting edema of the ankles
B. Blood pressure 148/92 mm Hg
C. Epigastric pain
D. Weight gain of 1 kg in one week
Correct Answer: C
Rationale: Epigastric pain indicates liver capsule distension and is a sign of
severe preeclampsia/impending HELLP syndrome. This requires immediate
provider notification. Mild edema, mild BP elevation, and gradual weight gain are
expected in preeclampsia.
4. A nurse is caring for a client at 34 weeks gestation who has placenta previa.
Which instruction should the nurse include?
A. "You may have intercourse if bleeding stops."
B. "Perform vaginal examinations daily."
C. "Avoid vaginal intercourse and report any bleeding."
D. "Douche with warm water to prevent infection."
Correct Answer: C
Rationale: Placenta previa is a contraindication to vaginal intercourse and
vaginal examinations because they can trigger life-threatening hemorrhage.
Douching is never recommended. Clients should report any bleeding immediately.
,5. SATA: A nurse is teaching a client about signs of preterm labor. Which findings
should the client report? (Select all that apply.)
A. Uterine contractions every 10 minutes
B. Low backache
C. Increased vaginal discharge
D. Decreased fetal movement
E. Visual disturbances
Correct Answers: A, B, C, D
Rationale: Signs of preterm labor include regular contractions, low backache,
change in vaginal discharge, pelvic pressure, and decreased fetal movement.
Visual disturbances are associated with preeclampsia, not preterm labor.
6. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule
for a client whose last menstrual period began March 10. What 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 and add 7 days. March 10 →
December 10 + 7 days = December 17.
7. A nurse is assessing a client at 28 weeks gestation. Which finding indicates a
need for further evaluation?
A. Hemoglobin 11.5 g/dL
B. Fetal heart rate 140/min
, C. Blood pressure 150/95 mm Hg
D. Fundal height 28 cm
Correct Answer: C
Rationale: A BP of 150/95 mm Hg after 20 weeks gestation suggests
gestational hypertension or preeclampsia and requires further evaluation. The
other findings are within normal limits.
8. A nurse is caring for a client who is Rh-negative and has a negative indirect
Coombs test at 28 weeks. Which action should the nurse anticipate?
A. Administer RhoGAM
B. Administer betamethasone
C. Prepare for immediate delivery
D. Administer magnesium sulfate
Correct Answer: A
Rationale: Rh-negative clients with a negative indirect Coombs test receive
RhoGAM at 28 weeks and within 72 hours postpartum to prevent Rh sensitization.
9. A nurse is assessing a client with hyperemesis gravidarum. Which laboratory
value should the nurse monitor?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum phosphorus
Correct Answer: A
Rationale: Persistent vomiting in hyperemesis gravidarum causes
hypokalemia, hyponatremia, and metabolic alkalosis. Potassium is the most
critical electrolyte to monitor due to risk of cardiac dysrhythmias.
EXAM (A, B and C) 2019 -70 QUESTIONS
WITH ANSWERS
SECTION I: ANTEPARTUM CARE & COMPLICATIONS (Questions 1–25)
1. A nurse is caring for a client at 32 weeks gestation who reports a sudden gush
of clear fluid from the vagina. Which action should the nurse take first?
A. Obtain a urine specimen
B. Perform a sterile speculum examination
C. Assess the fetal heart rate
D. Ask the client to ambulate
Correct Answer: C
Rationale: The priority nursing action when rupture of membranes is
suspected is to assess fetal well-being by auscultating the fetal heart rate. This
detects cord prolapse or fetal distress, which are immediate threats. Urine
specimen and ambulation are not priorities. Speculum examination may be
performed later but is not first.
2. A nurse is teaching a client at 10 weeks gestation about nutrition. Which
statement indicates understanding?
A. "I need 600 extra calories per day."
B. "I should increase my folic acid intake to 600 mcg daily."
C. "I should limit my fluid intake to 1 liter per day."
D. "I can continue my weight-loss diet."
Correct Answer: B
, Rationale: Folic acid 600 mcg daily is recommended during pregnancy to
prevent neural tube defects. Only 340 extra calories are needed in the second
trimester and 452 in the third—not 600. Fluid restriction and weight-loss diets are
inappropriate.
3. A nurse is assessing a client at 36 weeks gestation who has preeclampsia. Which
finding should the nurse report immediately?
A. 1+ pitting edema of the ankles
B. Blood pressure 148/92 mm Hg
C. Epigastric pain
D. Weight gain of 1 kg in one week
Correct Answer: C
Rationale: Epigastric pain indicates liver capsule distension and is a sign of
severe preeclampsia/impending HELLP syndrome. This requires immediate
provider notification. Mild edema, mild BP elevation, and gradual weight gain are
expected in preeclampsia.
4. A nurse is caring for a client at 34 weeks gestation who has placenta previa.
Which instruction should the nurse include?
A. "You may have intercourse if bleeding stops."
B. "Perform vaginal examinations daily."
C. "Avoid vaginal intercourse and report any bleeding."
D. "Douche with warm water to prevent infection."
Correct Answer: C
Rationale: Placenta previa is a contraindication to vaginal intercourse and
vaginal examinations because they can trigger life-threatening hemorrhage.
Douching is never recommended. Clients should report any bleeding immediately.
,5. SATA: A nurse is teaching a client about signs of preterm labor. Which findings
should the client report? (Select all that apply.)
A. Uterine contractions every 10 minutes
B. Low backache
C. Increased vaginal discharge
D. Decreased fetal movement
E. Visual disturbances
Correct Answers: A, B, C, D
Rationale: Signs of preterm labor include regular contractions, low backache,
change in vaginal discharge, pelvic pressure, and decreased fetal movement.
Visual disturbances are associated with preeclampsia, not preterm labor.
6. A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule
for a client whose last menstrual period began March 10. What 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 and add 7 days. March 10 →
December 10 + 7 days = December 17.
7. A nurse is assessing a client at 28 weeks gestation. Which finding indicates a
need for further evaluation?
A. Hemoglobin 11.5 g/dL
B. Fetal heart rate 140/min
, C. Blood pressure 150/95 mm Hg
D. Fundal height 28 cm
Correct Answer: C
Rationale: A BP of 150/95 mm Hg after 20 weeks gestation suggests
gestational hypertension or preeclampsia and requires further evaluation. The
other findings are within normal limits.
8. A nurse is caring for a client who is Rh-negative and has a negative indirect
Coombs test at 28 weeks. Which action should the nurse anticipate?
A. Administer RhoGAM
B. Administer betamethasone
C. Prepare for immediate delivery
D. Administer magnesium sulfate
Correct Answer: A
Rationale: Rh-negative clients with a negative indirect Coombs test receive
RhoGAM at 28 weeks and within 72 hours postpartum to prevent Rh sensitization.
9. A nurse is assessing a client with hyperemesis gravidarum. Which laboratory
value should the nurse monitor?
A. Serum potassium
B. Serum calcium
C. Serum magnesium
D. Serum phosphorus
Correct Answer: A
Rationale: Persistent vomiting in hyperemesis gravidarum causes
hypokalemia, hyponatremia, and metabolic alkalosis. Potassium is the most
critical electrolyte to monitor due to risk of cardiac dysrhythmias.
