ATI Maternal Newborn Proctored Exam Bank 2026
2027 | Complete Q&A
Section 1: Questions 1–100
1. A nurse is caring for a client at 32 weeks of gestation who is experiencing
preterm labor. Which medication should the nurse anticipate administering?
A. Misoprostol
B. Betamethasone
C. Poractant alfa
D. Methylergonovine
Rationale: Betamethasone is an antenatal corticosteroid administered when preterm
birth is anticipated to accelerate fetal lung maturation and reduce complications of
prematurity, including respiratory distress syndrome and intraventricular hemorrhage.
Misoprostol is used for cervical ripening, poractant alfa is a neonatal surfactant, and
methylergonovine is a uterotonic for postpartum hemorrhage .
2. A nurse at a prenatal clinic is caring for a client who suspects she may be
pregnant. Which laboratory test will confirm pregnancy?
A. Urine test for the presence of hCG
B. Urine test for the presence of hCS
C. Blood test for the presence of estrogen
D. Blood test for the amount of circulating progesterone
Rationale: Pregnancy is confirmed by detecting human chorionic gonadotropin (hCG),
a hormone produced by trophoblastic tissue after implantation. Urine pregnancy tests
detect hCG and are rapid and noninvasive .
3. A nurse is caring for a client who believes she may be pregnant. Which
finding should the nurse identify as a positive sign of pregnancy?
A. Palpable fetal movement
B. Amenorrhea
C. Chadwick's sign
D. Positive pregnancy test
Rationale: Palpable fetal movement by an examiner is a positive sign of pregnancy
because it is direct evidence of a fetus. Amenorrhea, Chadwick's sign, and a positive
pregnancy test are presumptive or probable signs rather than definitive positive signs .
,4. A nurse is caring for a client who has oligohydramnios. Which fetal anomaly
should the nurse expect?
A. Renal agenesis
B. Atrial septal defect
C. Spina bifida
D. Hydrocephalus
Rationale: Severe oligohydramnios can result from fetal renal abnormalities such as
bilateral renal agenesis because fetal urine is a major contributor to amniotic fluid
during the second half of pregnancy .
5. A nurse is assessing a client at 37 weeks of gestation who has a suspected
pelvic fracture due to blunt abdominal trauma. Which finding should the nurse
expect?
A. Uterine contractions
B. Bradycardia
C. Seizures
D. Bradypnea
Rationale: Significant abdominal trauma during pregnancy can stimulate uterine
activity and may precipitate preterm labor or placental complications. The nurse
should monitor uterine contractions and fetal heart rate .
6. A client reports her last menstrual period began on March 10, 2026. Using
Naegele's rule, what is her estimated date of delivery?
A. November 17, 2026
B. December 17, 2026
C. January 17, 2027
D. October 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 .
7. 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
,Rationale: G = 4 (total pregnancies including current), T = 1 (term ≥37 weeks), P = 1
(preterm 20–36 weeks), A = 1 (abortion <20 weeks), L = 2 (living children) .
8. At a prenatal visit at 24 weeks of gestation, which fundal height
measurement is consistent with normal fetal growth?
A. 18 cm
B. 22 cm
C. 24 cm
D. 30 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; 30 cm suggests macrosomia, polyhydramnios, or multifetal
gestation .
9. At what gestational age is fetal heart rate 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
Rationale: FHR is typically first audible via handheld Doppler at 10–12 weeks. The
normal baseline FHR is 110–160 bpm .
10. A client at 16 weeks of gestation asks about maternal serum alpha-
fetoprotein screening. The nurse explains that this test screens for which
condition and is performed when?
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
Rationale: MSAFP screening is performed at 15–20 weeks to detect open neural tube
defects. Elevated levels suggest neural tube defects .
11. A nurse is reviewing the prenatal record of a client at 28 weeks of gestation.
The fundal height measures 26 cm. Which action should the nurse take?
A. Document the finding as expected
B. Report the finding to the provider immediately
C. Request an ultrasound to evaluate fetal growth
D. Assess the client for gestational diabetes
, Rationale: At 28 weeks, fundal height should approximate gestational age ±2 cm. A
measurement of 26 cm falls within the expected range (26–30 cm). Documentation is
appropriate .
12. A client at 12 weeks of gestation asks why she needs folic acid supplements.
Which response by the nurse is correct?
A. "Folic acid prevents iron-deficiency anemia during pregnancy."
B. "Folic acid reduces the risk of neural tube defects in the fetus."
C. "Folic acid promotes adequate calcium absorption for fetal bone development."
D. "Folic acid prevents gestational hypertension."
Rationale: Folic acid supplementation of at least 400 mcg daily before and during early
pregnancy reduces the risk of neural tube defects. The neural tube closes by the fourth
week of gestation .
13. A client at 16 weeks of gestation reports frequent headaches and visual
changes. Blood pressure is 148/92 mm Hg. Which action should the nurse take
first?
A. Instruct the client to lie on her left side
B. Obtain a urine specimen for protein analysis
C. Administer acetaminophen for headache relief
D. Document the findings in the client's chart
Rationale: These findings suggest possible preeclampsia. Proteinuria is a required
criterion for diagnosis. Obtaining a urine specimen gathers essential assessment data
before interventions .
14. A nurse is reviewing laboratory results for a client at 10 weeks of gestation.
Which finding should the nurse report immediately?
A. Hemoglobin 11.2 g/dL
B. Hematocrit 34%
C. Blood type O negative
D. Rubella titer less than 1:8
Rationale: A rubella titer less than 1:8 indicates susceptibility to rubella. The provider
should be notified. The vaccine is contraindicated during pregnancy and should be
administered postpartum .
15. A nurse is providing teaching to a client at 8 weeks of gestation about
manifestations to report. Which finding should the nurse include?
A. Nausea upon awakening
B. Blurred or double vision
2027 | Complete Q&A
Section 1: Questions 1–100
1. A nurse is caring for a client at 32 weeks of gestation who is experiencing
preterm labor. Which medication should the nurse anticipate administering?
A. Misoprostol
B. Betamethasone
C. Poractant alfa
D. Methylergonovine
Rationale: Betamethasone is an antenatal corticosteroid administered when preterm
birth is anticipated to accelerate fetal lung maturation and reduce complications of
prematurity, including respiratory distress syndrome and intraventricular hemorrhage.
Misoprostol is used for cervical ripening, poractant alfa is a neonatal surfactant, and
methylergonovine is a uterotonic for postpartum hemorrhage .
2. A nurse at a prenatal clinic is caring for a client who suspects she may be
pregnant. Which laboratory test will confirm pregnancy?
A. Urine test for the presence of hCG
B. Urine test for the presence of hCS
C. Blood test for the presence of estrogen
D. Blood test for the amount of circulating progesterone
Rationale: Pregnancy is confirmed by detecting human chorionic gonadotropin (hCG),
a hormone produced by trophoblastic tissue after implantation. Urine pregnancy tests
detect hCG and are rapid and noninvasive .
3. A nurse is caring for a client who believes she may be pregnant. Which
finding should the nurse identify as a positive sign of pregnancy?
A. Palpable fetal movement
B. Amenorrhea
C. Chadwick's sign
D. Positive pregnancy test
Rationale: Palpable fetal movement by an examiner is a positive sign of pregnancy
because it is direct evidence of a fetus. Amenorrhea, Chadwick's sign, and a positive
pregnancy test are presumptive or probable signs rather than definitive positive signs .
,4. A nurse is caring for a client who has oligohydramnios. Which fetal anomaly
should the nurse expect?
A. Renal agenesis
B. Atrial septal defect
C. Spina bifida
D. Hydrocephalus
Rationale: Severe oligohydramnios can result from fetal renal abnormalities such as
bilateral renal agenesis because fetal urine is a major contributor to amniotic fluid
during the second half of pregnancy .
5. A nurse is assessing a client at 37 weeks of gestation who has a suspected
pelvic fracture due to blunt abdominal trauma. Which finding should the nurse
expect?
A. Uterine contractions
B. Bradycardia
C. Seizures
D. Bradypnea
Rationale: Significant abdominal trauma during pregnancy can stimulate uterine
activity and may precipitate preterm labor or placental complications. The nurse
should monitor uterine contractions and fetal heart rate .
6. A client reports her last menstrual period began on March 10, 2026. Using
Naegele's rule, what is her estimated date of delivery?
A. November 17, 2026
B. December 17, 2026
C. January 17, 2027
D. October 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 .
7. 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
,Rationale: G = 4 (total pregnancies including current), T = 1 (term ≥37 weeks), P = 1
(preterm 20–36 weeks), A = 1 (abortion <20 weeks), L = 2 (living children) .
8. At a prenatal visit at 24 weeks of gestation, which fundal height
measurement is consistent with normal fetal growth?
A. 18 cm
B. 22 cm
C. 24 cm
D. 30 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; 30 cm suggests macrosomia, polyhydramnios, or multifetal
gestation .
9. At what gestational age is fetal heart rate 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
Rationale: FHR is typically first audible via handheld Doppler at 10–12 weeks. The
normal baseline FHR is 110–160 bpm .
10. A client at 16 weeks of gestation asks about maternal serum alpha-
fetoprotein screening. The nurse explains that this test screens for which
condition and is performed when?
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
Rationale: MSAFP screening is performed at 15–20 weeks to detect open neural tube
defects. Elevated levels suggest neural tube defects .
11. A nurse is reviewing the prenatal record of a client at 28 weeks of gestation.
The fundal height measures 26 cm. Which action should the nurse take?
A. Document the finding as expected
B. Report the finding to the provider immediately
C. Request an ultrasound to evaluate fetal growth
D. Assess the client for gestational diabetes
, Rationale: At 28 weeks, fundal height should approximate gestational age ±2 cm. A
measurement of 26 cm falls within the expected range (26–30 cm). Documentation is
appropriate .
12. A client at 12 weeks of gestation asks why she needs folic acid supplements.
Which response by the nurse is correct?
A. "Folic acid prevents iron-deficiency anemia during pregnancy."
B. "Folic acid reduces the risk of neural tube defects in the fetus."
C. "Folic acid promotes adequate calcium absorption for fetal bone development."
D. "Folic acid prevents gestational hypertension."
Rationale: Folic acid supplementation of at least 400 mcg daily before and during early
pregnancy reduces the risk of neural tube defects. The neural tube closes by the fourth
week of gestation .
13. A client at 16 weeks of gestation reports frequent headaches and visual
changes. Blood pressure is 148/92 mm Hg. Which action should the nurse take
first?
A. Instruct the client to lie on her left side
B. Obtain a urine specimen for protein analysis
C. Administer acetaminophen for headache relief
D. Document the findings in the client's chart
Rationale: These findings suggest possible preeclampsia. Proteinuria is a required
criterion for diagnosis. Obtaining a urine specimen gathers essential assessment data
before interventions .
14. A nurse is reviewing laboratory results for a client at 10 weeks of gestation.
Which finding should the nurse report immediately?
A. Hemoglobin 11.2 g/dL
B. Hematocrit 34%
C. Blood type O negative
D. Rubella titer less than 1:8
Rationale: A rubella titer less than 1:8 indicates susceptibility to rubella. The provider
should be notified. The vaccine is contraindicated during pregnancy and should be
administered postpartum .
15. A nurse is providing teaching to a client at 8 weeks of gestation about
manifestations to report. Which finding should the nurse include?
A. Nausea upon awakening
B. Blurred or double vision
