ATI- RN Maternal Newborn Nursing
REVIEW MODULE. 12.0 Edition Latest
Edition (2023)
Question 1: A nurse is caring for a client at 12 weeks of gestation who reports nausea
and vomiting. Which intervention should the nurse recommend?
A) Increase intake of spicy foods
B) Eat small, frequent meals throughout the day
C) Consume large meals at bedtime
D) Avoid all fluids until symptoms subside
Rationale: Small, frequent meals prevent the stomach from becoming empty, which
exacerbates symptoms. Spicy foods may worsen nausea, large bedtime meals increase
discomfort due to slowed digestion, and fluid avoidance risks dehydration .
Question 2: A nurse is calculating the estimated date of delivery for a client whose last
menstrual period began on June 21. Using Naegele's rule, which is the estimated date of
delivery?
A) March 14
B) March 28
C) April 14
D) April 28
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7
days. June 21 minus 3 months = March 21; March 21 plus 7 days = March 28 .
, Question 3: A nurse is reviewing laboratory results for a client at 10 weeks of gestation.
Which finding should the nurse report to the provider?
A) Hemoglobin 10 g/dL
B) WBC count 15,000/mm³
C) RBC count 5.8 million/mm³
D) Hematocrit 34%
Rationale: A hemoglobin level of 10 g/dL is below the expected reference range of
greater than 11 g/dL for a client who is pregnant. The nurse should report this finding .
Question 4: A client at 36 weeks of gestation presents with painless, bright red vaginal
bleeding. The nurse should suspect:
A) Placenta previa
B) Abruptio placentae
C) Uterine rupture
D) Vasa previa
Rationale: Placenta previa classically presents with painless, bright red vaginal bleeding
in the third trimester. Abruptio placentae typically presents with painful bleeding and a
rigid abdomen .
Question 5: A nurse is teaching a prenatal client about folic acid. The nurse should
explain that folic acid helps prevent:
A) Gestational diabetes
B) Neural tube defects
C) Preeclampsia
D) Preterm labor
Rationale: Folic acid supplementation before and during early pregnancy significantly
reduces the risk of neural tube defects such as spina bifida and anencephaly .
, Question 6: A client at 32 weeks of gestation reports a sudden gush of fluid from the
vagina. The nurse should first:
A) Perform a sterile vaginal exam
B) Check the fetal heart rate
C) Test the fluid with nitrazine paper
D) Ambulate the client
Rationale: When rupture of membranes is suspected, the priority is to assess fetal well-
being by checking the fetal heart rate. A sterile vaginal exam should be avoided to
prevent infection .
Question 7: A nurse is assessing a client who is at 36 weeks of gestation and reports a
headache, blurred vision, and epigastric pain. Which condition should the nurse
suspect?
A) Gestational diabetes mellitus
B) Preeclampsia with severe features
C) Placenta previa
D) Hyperemesis gravidarum
Rationale: Headache, visual disturbances, and epigastric pain are classic signs of
preeclampsia with severe features, indicating possible HELLP syndrome or impending
eclampsia .
Question 8: A nurse is teaching a client at 12 weeks of gestation about expected
physiological changes. Which statement by the client indicates understanding?
A) "I should expect my blood pressure to increase significantly."
B) "I may notice my gums bleeding when I brush my teeth."
C) "My hemoglobin level will increase during pregnancy."
D) "I will have less vaginal discharge than before pregnancy."
, Rationale: Gingival hyperemia and bleeding are common during pregnancy due to
increased estrogen and blood flow to mucous membranes. Blood pressure typically
decreases slightly, hemoglobin levels decrease due to hemodilution, and vaginal
discharge increases .
Question 9: A nurse is providing teaching to a client at 8 weeks of gestation about
manifestations to report to the provider. Which information should the nurse include?
A) Nausea upon awakening
B) Blurred or double vision
C) Increase in white vaginal discharge
D) Leg cramps when sleeping
Rationale: Blurred or double vision can indicate preeclampsia or gestational
hypertension and should be reported immediately .
Question 10: A nurse is assessing a client at 20 weeks of gestation. Where should the
nurse expect the uterine fundus to be located?
A) At the symphysis pubis
B) Halfway between the symphysis pubis and umbilicus
C) At approximately the level of the umbilicus
D) At the xiphoid process
Rationale: At approximately 20 weeks of gestation, the uterine fundus is normally at the
level of the umbilicus .
Intrapartum Care
Question 11: A client in active labor is dilated to 7 cm. The fetal heart rate shows late
decelerations. What is the priority nursing action?
REVIEW MODULE. 12.0 Edition Latest
Edition (2023)
Question 1: A nurse is caring for a client at 12 weeks of gestation who reports nausea
and vomiting. Which intervention should the nurse recommend?
A) Increase intake of spicy foods
B) Eat small, frequent meals throughout the day
C) Consume large meals at bedtime
D) Avoid all fluids until symptoms subside
Rationale: Small, frequent meals prevent the stomach from becoming empty, which
exacerbates symptoms. Spicy foods may worsen nausea, large bedtime meals increase
discomfort due to slowed digestion, and fluid avoidance risks dehydration .
Question 2: A nurse is calculating the estimated date of delivery for a client whose last
menstrual period began on June 21. Using Naegele's rule, which is the estimated date of
delivery?
A) March 14
B) March 28
C) April 14
D) April 28
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP and add 7
days. June 21 minus 3 months = March 21; March 21 plus 7 days = March 28 .
, Question 3: A nurse is reviewing laboratory results for a client at 10 weeks of gestation.
Which finding should the nurse report to the provider?
A) Hemoglobin 10 g/dL
B) WBC count 15,000/mm³
C) RBC count 5.8 million/mm³
D) Hematocrit 34%
Rationale: A hemoglobin level of 10 g/dL is below the expected reference range of
greater than 11 g/dL for a client who is pregnant. The nurse should report this finding .
Question 4: A client at 36 weeks of gestation presents with painless, bright red vaginal
bleeding. The nurse should suspect:
A) Placenta previa
B) Abruptio placentae
C) Uterine rupture
D) Vasa previa
Rationale: Placenta previa classically presents with painless, bright red vaginal bleeding
in the third trimester. Abruptio placentae typically presents with painful bleeding and a
rigid abdomen .
Question 5: A nurse is teaching a prenatal client about folic acid. The nurse should
explain that folic acid helps prevent:
A) Gestational diabetes
B) Neural tube defects
C) Preeclampsia
D) Preterm labor
Rationale: Folic acid supplementation before and during early pregnancy significantly
reduces the risk of neural tube defects such as spina bifida and anencephaly .
, Question 6: A client at 32 weeks of gestation reports a sudden gush of fluid from the
vagina. The nurse should first:
A) Perform a sterile vaginal exam
B) Check the fetal heart rate
C) Test the fluid with nitrazine paper
D) Ambulate the client
Rationale: When rupture of membranes is suspected, the priority is to assess fetal well-
being by checking the fetal heart rate. A sterile vaginal exam should be avoided to
prevent infection .
Question 7: A nurse is assessing a client who is at 36 weeks of gestation and reports a
headache, blurred vision, and epigastric pain. Which condition should the nurse
suspect?
A) Gestational diabetes mellitus
B) Preeclampsia with severe features
C) Placenta previa
D) Hyperemesis gravidarum
Rationale: Headache, visual disturbances, and epigastric pain are classic signs of
preeclampsia with severe features, indicating possible HELLP syndrome or impending
eclampsia .
Question 8: A nurse is teaching a client at 12 weeks of gestation about expected
physiological changes. Which statement by the client indicates understanding?
A) "I should expect my blood pressure to increase significantly."
B) "I may notice my gums bleeding when I brush my teeth."
C) "My hemoglobin level will increase during pregnancy."
D) "I will have less vaginal discharge than before pregnancy."
, Rationale: Gingival hyperemia and bleeding are common during pregnancy due to
increased estrogen and blood flow to mucous membranes. Blood pressure typically
decreases slightly, hemoglobin levels decrease due to hemodilution, and vaginal
discharge increases .
Question 9: A nurse is providing teaching to a client at 8 weeks of gestation about
manifestations to report to the provider. Which information should the nurse include?
A) Nausea upon awakening
B) Blurred or double vision
C) Increase in white vaginal discharge
D) Leg cramps when sleeping
Rationale: Blurred or double vision can indicate preeclampsia or gestational
hypertension and should be reported immediately .
Question 10: A nurse is assessing a client at 20 weeks of gestation. Where should the
nurse expect the uterine fundus to be located?
A) At the symphysis pubis
B) Halfway between the symphysis pubis and umbilicus
C) At approximately the level of the umbilicus
D) At the xiphoid process
Rationale: At approximately 20 weeks of gestation, the uterine fundus is normally at the
level of the umbilicus .
Intrapartum Care
Question 11: A client in active labor is dilated to 7 cm. The fetal heart rate shows late
decelerations. What is the priority nursing action?
