ATI CAPSTONE MATERNAL NEWBORN ASSESSMENT
Questions and Answers () (Verified
Answers)
SECTION 1: ANTEPARTUM CARE & PRENATAL ASSESSMENT
1. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period (LMP) began on March 10, 2026. Using Naegele's rule, which of the following is the
EDD?
A. November 17, 2026
B. December 17, 2026
C. January 17, 2027
D. October 17, 2026
Correct Answer: B. December 17, 2026
Rationale: Naegele's rule calculates EDD by subtracting 3 months from the LMP and adding
7 days. March 10 minus 3 months = December 10; plus 7 days = December 17, 2026. This
calculation assumes a 28-day menstrual cycle and is the standard method for EDD estimation
per ACOG guidelines .
2. A client is pregnant for the fourth time. She delivered one child at 39 weeks, one at 34
weeks, and had one spontaneous abortion at 8 weeks. She has two living children. What is
her GTPAL?
A. G4 T1 P1 A1 L2
B. G4 T2 P0 A1 L2
C. G3 T1 P1 A1 L2
D. G4 T1 P2 A0 L2
Correct Answer: A. G4 T1 P1 A1 L2
Rationale: G = 4 (total pregnancies including current). T = 1 (term ≥37 weeks). P = 1
(preterm 20-36.6 weeks). A = 1 (abortion <20 weeks). L = 2 (living children). The current
pregnancy counts in gravida but has not yet contributed to T, P, or L .
3. At a prenatal visit at 24 weeks gestation, the nurse measures the client's fundal height.
Which measurement is consistent with normal fetal growth?
,A. 18 cm
B. 22 cm
C. 24 cm
D. 30 cm
Correct Answer: C. 24 cm
Rationale: After 20 weeks, fundal height in centimeters should approximate gestational age
in weeks ±2 cm. At 24 weeks, 24 cm is expected. A measurement of 18 cm suggests growth
restriction or incorrect dates, while 30 cm suggests macrosomia, polyhydramnios, or multifetal
gestation .
4. A nurse auscultates the fetal heart rate using a Doppler device at a routine prenatal visit. At
what gestational age is FHR typically first detectable with a handheld Doppler, and what is the
normal range?
A. 6-8 weeks; 100-140 bpm
B. 10-12 weeks; 110-160 bpm
C. 14-16 weeks; 120-170 bpm
D. 18-20 weeks; 110-150 bpm
Correct Answer: B. 10-12 weeks; 110-160 bpm
Rationale: FHR is typically first audible via handheld Doppler at 10-12 weeks gestation. The
normal baseline FHR is 110-160 bpm. Before 10 weeks, transvaginal ultrasound is required, and
rates <110 or >160 require further evaluation .
5. A client at 16 weeks gestation asks about maternal serum alpha-fetoprotein (MSAFP)
screening. The nurse explains that this test screens for which condition, and when is it
performed?
A. Gestational diabetes; 24-28 weeks
B. Neural tube defects; 15-20 weeks
C. Chromosomal abnormalities; 10-14 weeks
D. Group B streptococcus; 35-37 weeks
Correct Answer: B. Neural tube defects; 15-20 weeks
Rationale: MSAFP screening is performed at 15-20 weeks to detect open neural tube
defects (open spina bifida, anencephaly). Elevated levels suggest neural tube defects; low levels
may indicate chromosomal abnormalities such as Down syndrome .
,6. A nurse is reviewing the health record of a client who is pregnant. The provider
documented that the client exhibits probable signs of pregnancy. Which of the following
findings should the nurse expect?
A. Montgomery's glands
B. Goodell's sign
C. Quickening
D. Breast tenderness
Correct Answer: B. Goodell's sign
Rationale: Goodell's sign (softening of the cervical tip) is classified as a probable sign of
pregnancy because it is detected on physical examination but can have other causes.
Montgomery's glands, quickening, and breast tenderness are presumptive signs based on
subjective client reports .
7. A nurse is teaching a client who is at 8 weeks of gestation about nutrition during pregnancy.
Which of the following statements should the nurse include in the teaching?
A. "You should consume 2 cups of milk daily."
B. "You should consume 6 ounces of protein foods daily."
C. "You should consume 2 cups of vegetables each day."
D. "You should consume 4 ounces of grains each day."
Correct Answer: B. "You should consume 6 ounces of protein foods daily."
Rationale: Pregnant clients should consume approximately 5.5 to 6.5 ounces of protein
foods daily, selecting high-protein sources such as legumes, nuts, eggs, and lean meats. Dairy
intake should be 3 cups daily, vegetables 2.5 to 3 cups, and grains 6 to 8 ounces .
8. A nurse is caring for a client at 38 weeks' gestation who reports a sudden gush of fluid from
the vagina. Which of the following actions should the nurse take first?
A. Prepare the client for an immediate cesarean birth
B. Assess the fetal heart rate and characteristics of the fluid
C. Obtain a urine specimen for culture
D. Administer oxytocin intravenously
Correct Answer: B. Assess the fetal heart rate and characteristics of the fluid
Rationale: When a client reports spontaneous rupture of membranes, the priority nursing
action is to assess fetal well-being by monitoring the fetal heart rate and evaluating the fluid for
color, amount, and odor. This helps detect complications such as cord prolapse or meconium
, staining. Immediate cesarean birth and oxytocin administration are not first-line actions without
further assessment .
9. A nurse is teaching a client at 10 weeks' gestation about expected physiological changes
during pregnancy. Which of the following statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
Correct Answer: C. "I may experience nasal stuffiness due to increased blood flow."
Rationale: During pregnancy, increased estrogen levels and vascular congestion cause nasal
mucosa swelling, leading to nasal stuffiness and epistaxis. Blood pressure typically remains
stable or slightly decreases, heart rate increases, and hemoglobin levels decrease due to
hemodilution .
10. A nurse is reviewing the medical record of a client at 36 weeks' gestation. Which of the
following findings should the nurse identify as a risk factor for postpartum hemorrhage?
A. Previous vaginal delivery
B. History of placenta previa
C. Maternal age of 25 years
D. Singleton pregnancy
Correct Answer: B. History of placenta previa
Rationale: Placenta previa increases the risk of postpartum hemorrhage due to abnormal
placental implantation and potential uterine atony. Previous vaginal delivery, maternal age of
25, and singleton pregnancy are not significant risk factors for postpartum hemorrhage .
11. A nurse is teaching a pregnant client about folic acid supplementation. Which statement
by the client indicates understanding?
A. "I should take 400 mcg daily before and during early pregnancy."
B. "I only need folic acid after the first trimester."
C. "Folic acid prevents all birth defects."
D. "I should take 4,000 mcg daily throughout pregnancy."
Correct Answer: A. "I should take 400 mcg daily before and during early pregnancy."
Rationale: Folic acid supplementation of 400 mcg daily is recommended before conception
and during early pregnancy to reduce the risk of neural tube defects. It does not prevent all
Questions and Answers () (Verified
Answers)
SECTION 1: ANTEPARTUM CARE & PRENATAL ASSESSMENT
1. A nurse is calculating the estimated date of delivery (EDD) for a client whose last menstrual
period (LMP) began on March 10, 2026. Using Naegele's rule, which of the following is the
EDD?
A. November 17, 2026
B. December 17, 2026
C. January 17, 2027
D. October 17, 2026
Correct Answer: B. December 17, 2026
Rationale: Naegele's rule calculates EDD by subtracting 3 months from the LMP and adding
7 days. March 10 minus 3 months = December 10; plus 7 days = December 17, 2026. This
calculation assumes a 28-day menstrual cycle and is the standard method for EDD estimation
per ACOG guidelines .
2. A client is pregnant for the fourth time. She delivered one child at 39 weeks, one at 34
weeks, and had one spontaneous abortion at 8 weeks. She has two living children. What is
her GTPAL?
A. G4 T1 P1 A1 L2
B. G4 T2 P0 A1 L2
C. G3 T1 P1 A1 L2
D. G4 T1 P2 A0 L2
Correct Answer: A. G4 T1 P1 A1 L2
Rationale: G = 4 (total pregnancies including current). T = 1 (term ≥37 weeks). P = 1
(preterm 20-36.6 weeks). A = 1 (abortion <20 weeks). L = 2 (living children). The current
pregnancy counts in gravida but has not yet contributed to T, P, or L .
3. At a prenatal visit at 24 weeks gestation, the nurse measures the client's fundal height.
Which measurement is consistent with normal fetal growth?
,A. 18 cm
B. 22 cm
C. 24 cm
D. 30 cm
Correct Answer: C. 24 cm
Rationale: After 20 weeks, fundal height in centimeters should approximate gestational age
in weeks ±2 cm. At 24 weeks, 24 cm is expected. A measurement of 18 cm suggests growth
restriction or incorrect dates, while 30 cm suggests macrosomia, polyhydramnios, or multifetal
gestation .
4. A nurse auscultates the fetal heart rate using a Doppler device at a routine prenatal visit. At
what gestational age is FHR typically first detectable with a handheld Doppler, and what is the
normal range?
A. 6-8 weeks; 100-140 bpm
B. 10-12 weeks; 110-160 bpm
C. 14-16 weeks; 120-170 bpm
D. 18-20 weeks; 110-150 bpm
Correct Answer: B. 10-12 weeks; 110-160 bpm
Rationale: FHR is typically first audible via handheld Doppler at 10-12 weeks gestation. The
normal baseline FHR is 110-160 bpm. Before 10 weeks, transvaginal ultrasound is required, and
rates <110 or >160 require further evaluation .
5. A client at 16 weeks gestation asks about maternal serum alpha-fetoprotein (MSAFP)
screening. The nurse explains that this test screens for which condition, and when is it
performed?
A. Gestational diabetes; 24-28 weeks
B. Neural tube defects; 15-20 weeks
C. Chromosomal abnormalities; 10-14 weeks
D. Group B streptococcus; 35-37 weeks
Correct Answer: B. Neural tube defects; 15-20 weeks
Rationale: MSAFP screening is performed at 15-20 weeks to detect open neural tube
defects (open spina bifida, anencephaly). Elevated levels suggest neural tube defects; low levels
may indicate chromosomal abnormalities such as Down syndrome .
,6. A nurse is reviewing the health record of a client who is pregnant. The provider
documented that the client exhibits probable signs of pregnancy. Which of the following
findings should the nurse expect?
A. Montgomery's glands
B. Goodell's sign
C. Quickening
D. Breast tenderness
Correct Answer: B. Goodell's sign
Rationale: Goodell's sign (softening of the cervical tip) is classified as a probable sign of
pregnancy because it is detected on physical examination but can have other causes.
Montgomery's glands, quickening, and breast tenderness are presumptive signs based on
subjective client reports .
7. A nurse is teaching a client who is at 8 weeks of gestation about nutrition during pregnancy.
Which of the following statements should the nurse include in the teaching?
A. "You should consume 2 cups of milk daily."
B. "You should consume 6 ounces of protein foods daily."
C. "You should consume 2 cups of vegetables each day."
D. "You should consume 4 ounces of grains each day."
Correct Answer: B. "You should consume 6 ounces of protein foods daily."
Rationale: Pregnant clients should consume approximately 5.5 to 6.5 ounces of protein
foods daily, selecting high-protein sources such as legumes, nuts, eggs, and lean meats. Dairy
intake should be 3 cups daily, vegetables 2.5 to 3 cups, and grains 6 to 8 ounces .
8. A nurse is caring for a client at 38 weeks' gestation who reports a sudden gush of fluid from
the vagina. Which of the following actions should the nurse take first?
A. Prepare the client for an immediate cesarean birth
B. Assess the fetal heart rate and characteristics of the fluid
C. Obtain a urine specimen for culture
D. Administer oxytocin intravenously
Correct Answer: B. Assess the fetal heart rate and characteristics of the fluid
Rationale: When a client reports spontaneous rupture of membranes, the priority nursing
action is to assess fetal well-being by monitoring the fetal heart rate and evaluating the fluid for
color, amount, and odor. This helps detect complications such as cord prolapse or meconium
, staining. Immediate cesarean birth and oxytocin administration are not first-line actions without
further assessment .
9. A nurse is teaching a client at 10 weeks' gestation about expected physiological changes
during pregnancy. Which of the following statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
Correct Answer: C. "I may experience nasal stuffiness due to increased blood flow."
Rationale: During pregnancy, increased estrogen levels and vascular congestion cause nasal
mucosa swelling, leading to nasal stuffiness and epistaxis. Blood pressure typically remains
stable or slightly decreases, heart rate increases, and hemoglobin levels decrease due to
hemodilution .
10. A nurse is reviewing the medical record of a client at 36 weeks' gestation. Which of the
following findings should the nurse identify as a risk factor for postpartum hemorrhage?
A. Previous vaginal delivery
B. History of placenta previa
C. Maternal age of 25 years
D. Singleton pregnancy
Correct Answer: B. History of placenta previa
Rationale: Placenta previa increases the risk of postpartum hemorrhage due to abnormal
placental implantation and potential uterine atony. Previous vaginal delivery, maternal age of
25, and singleton pregnancy are not significant risk factors for postpartum hemorrhage .
11. A nurse is teaching a pregnant client about folic acid supplementation. Which statement
by the client indicates understanding?
A. "I should take 400 mcg daily before and during early pregnancy."
B. "I only need folic acid after the first trimester."
C. "Folic acid prevents all birth defects."
D. "I should take 4,000 mcg daily throughout pregnancy."
Correct Answer: A. "I should take 400 mcg daily before and during early pregnancy."
Rationale: Folic acid supplementation of 400 mcg daily is recommended before conception
and during early pregnancy to reduce the risk of neural tube defects. It does not prevent all
