ATI RN Maternal Newborn Exam 2024/2025 – Proctored Ques-
tions & Verified Rationales for Full Score Confidence
80 Scenario-Based Questions with Verified Answers and Rationales
Question 1 A nurse is assessing a client at 28 weeks of gestation during a prenatal visit.
The client reports occasional dizziness and palpitations. Which finding should
the nurse prioritize for further evaluation?
A. Blood pressure 110/70 mmHg
B. Heart rate 110 bpm
C. Hemoglobin 12 g/dL
D. Fundal height 26 cm
Answer: B. Heart rate 110 bpm
Rationale: A heart rate of 110 bpm at rest is elevated and may indicate
cardiovascular stress or anemia, requiring further evaluation. Blood pressure
of 110/70 mmHg and hemoglobin of 12 g/dL are within normal limits for
pregnancy. A fundal height of 26 cm is slightly below expected (should be
approximately 28 cm at 28 weeks), but tachycardia is a priority for immediate
assessment.
Question 2 A nurse is teaching a client at 12 weeks of gestation about nutrition. Which
statement by the client indicates a need for further teaching?
A. ”I will increase my intake of iron-rich foods like spinach.”
B. ”I should avoid drinking unpasteurized milk.”
C. ”I can have two cups of coffee daily to stay alert.”
D. ”I will include folate-rich foods like lentils in my diet.”
Answer: C. I can have two cups of coffee daily to stay alert.
Rationale: Caffeine intake should be limited to 200 mg/day (about one 12-
ounce cup of coffee) during pregnancy to avoid risks to the fetus. The other
statements reflect safe and appropriate nutritional choices.
Question 3 A nurse is caring for a client at 36 weeks of gestation with gestational diabetes.
Which laboratory result should the nurse report to the provider immediately?
A. Fasting blood glucose 95 mg/dL
B. Hemoglobin A1c 7.5%
C. Urine glucose negative
D. Platelet count 150,000/mm³
Answer: B. Hemoglobin A1c 7.5%
Rationale: A Hemoglobin A1c of 7.5% indicates poor long-term glucose con-
trol, increasing risks for fetal macrosomia and other complications. The other
values are within expected ranges for pregnancy.
Question 4 A nurse is providing education to a client at 16 weeks of gestation about pre-
natal screenings. Which test should the nurse explain is typically performed
at this time?
A. Amniocentesis
B. Quad screen
C. Nonstress test
D. Chorionic villus sampling
1
, Answer: B. Quad screen
Rationale: The quad screen, assessing for neural tube defects and chromoso-
mal abnormalities, is typically performed between 15–20 weeks of gestation.
Amniocentesis and chorionic villus sampling are diagnostic tests, and non-
stress tests are used later in pregnancy.
Question 5 A nurse is assessing a client at 20 weeks of gestation who reports abdominal
pain. Which finding requires immediate action?
A. Mild, intermittent cramping
B. Fundal height at the umbilicus
C. Continuous pain with vaginal bleeding
D. Positive fetal movement
Answer: C. Continuous pain with vaginal bleeding
Rationale: Continuous abdominal pain with vaginal bleeding may indicate
placental abruption or other serious complications, requiring urgent evalu-
ation. Mild cramping and positive fetal movement are normal, and fundal
height at the umbilicus is expected at 20 weeks.
Question 6 A nurse is teaching a client at 24 weeks of gestation about signs of preterm
labor. Which client statement indicates understanding?
A. ”I should call my provider if I have irregular contractions.”
B. ”Persistent pelvic pressure could be a warning sign.”
C. ”Mild back pain is always a sign of labor.”
D. ”I don’t need to worry unless I have heavy bleeding.”
Answer: B. Persistent pelvic pressure could be a warning sign.
Rationale: Persistent pelvic pressure is a sign of preterm labor and should
prompt immediate reporting. Irregular contractions and mild back pain are
common in pregnancy, and heavy bleeding is a separate emergency.
Question 7 A nurse is caring for a client at 32 weeks of gestation with preeclampsia.
Which intervention is the priority?
A. Administer magnesium sulfate IV
B. Encourage ambulation every 2 hours
C. Provide a high-sodium diet
D. Monitor blood glucose levels
Answer: A. Administer magnesium sulfate IV
Rationale: Magnesium sulfate is the priority to prevent seizures in preeclamp-
sia. Ambulation and a high-sodium diet are contraindicated, and blood glu-
cose monitoring is not directly related to preeclampsia management.
Question 8 A nurse is assessing a client at 14 weeks of gestation. Which finding is ex-
pected during this stage of pregnancy?
A. Increased heart rate by 10–20 bpm
B. Fundal height at the symphysis pubis
C. Presence of lanugo on ultrasound
D. Quickening felt by the client
Answer: A. Increased heart rate by 10–20 bpm
Rationale: Increased maternal heart rate by 10–20 bpm is a normal phys-
iological change in pregnancy. Fundal height reaches the symphysis pubis
at 12 weeks, lanugo is present but not visible on ultrasound, and quickening
2
, typically occurs at 16–20 weeks.
Question 9 A nurse is teaching a client about safe exercise during pregnancy. Which
recommendation is appropriate?
A. Avoid swimming due to infection risk
B. Perform high-intensity interval training
C. Engage in 30 minutes of moderate walking daily
D. Continue contact sports until the third trimester
Answer: C. Engage in 30 minutes of moderate walking daily
Rationale: Moderate exercise, like 30 minutes of walking daily, is safe and
beneficial during pregnancy. Swimming is also safe, but high-intensity train-
ing and contact sports pose risks to the fetus.
Question 10 A nurse is caring for a client at 18 weeks of gestation who asks about vacci-
nations. Which vaccination is contraindicated during pregnancy?
A. Tdap
B. Influenza
C. MMR
D. Hepatitis B
Answer: C. MMR
Rationale: The MMR vaccine is a live virus vaccine and is contraindicated
during pregnancy due to potential fetal harm. Tdap, influenza, and hepatitis
B vaccines are safe and recommended.
Question 11 A nurse is assessing a client at 30 weeks of gestation with oligohydramnios.
Which intervention should the nurse anticipate?
A. Prepare for immediate cesarean delivery
B. Administer betamethasone intramuscularly
C. Monitor fetal heart rate continuously
D. Encourage increased caffeine intake
Answer: C. Monitor fetal heart rate continuously
Rationale: Oligohydramnios increases the risk of fetal distress, necessitating
continuous fetal heart rate monitoring. Cesarean delivery and betamethasone
may be considered later, and caffeine is not indicated.
Question 12 A nurse is teaching a client at 22 weeks of gestation about iron supplemen-
tation. Which statement indicates understanding?
A. ”I’ll take my iron pill with orange juice.”
B. ”I should take iron with my prenatal vitamin at bedtime.”
C. ”Iron supplements are only needed in the first trimester.”
D. ”I can skip iron if I eat red meat daily.”
Answer: A. I’ll take my iron pill with orange juice.
Rationale: Vitamin C (in orange juice) enhances iron absorption. Iron should
be taken separately from prenatal vitamins to avoid absorption interference,
and it is needed throughout pregnancy.
Question 13 A nurse is caring for a client at 26 weeks of gestation with a history of epilepsy.
The client begins seizing. What is the priority action?
A. Administer lorazepam IV
B. Turn the client to her left side
3
tions & Verified Rationales for Full Score Confidence
80 Scenario-Based Questions with Verified Answers and Rationales
Question 1 A nurse is assessing a client at 28 weeks of gestation during a prenatal visit.
The client reports occasional dizziness and palpitations. Which finding should
the nurse prioritize for further evaluation?
A. Blood pressure 110/70 mmHg
B. Heart rate 110 bpm
C. Hemoglobin 12 g/dL
D. Fundal height 26 cm
Answer: B. Heart rate 110 bpm
Rationale: A heart rate of 110 bpm at rest is elevated and may indicate
cardiovascular stress or anemia, requiring further evaluation. Blood pressure
of 110/70 mmHg and hemoglobin of 12 g/dL are within normal limits for
pregnancy. A fundal height of 26 cm is slightly below expected (should be
approximately 28 cm at 28 weeks), but tachycardia is a priority for immediate
assessment.
Question 2 A nurse is teaching a client at 12 weeks of gestation about nutrition. Which
statement by the client indicates a need for further teaching?
A. ”I will increase my intake of iron-rich foods like spinach.”
B. ”I should avoid drinking unpasteurized milk.”
C. ”I can have two cups of coffee daily to stay alert.”
D. ”I will include folate-rich foods like lentils in my diet.”
Answer: C. I can have two cups of coffee daily to stay alert.
Rationale: Caffeine intake should be limited to 200 mg/day (about one 12-
ounce cup of coffee) during pregnancy to avoid risks to the fetus. The other
statements reflect safe and appropriate nutritional choices.
Question 3 A nurse is caring for a client at 36 weeks of gestation with gestational diabetes.
Which laboratory result should the nurse report to the provider immediately?
A. Fasting blood glucose 95 mg/dL
B. Hemoglobin A1c 7.5%
C. Urine glucose negative
D. Platelet count 150,000/mm³
Answer: B. Hemoglobin A1c 7.5%
Rationale: A Hemoglobin A1c of 7.5% indicates poor long-term glucose con-
trol, increasing risks for fetal macrosomia and other complications. The other
values are within expected ranges for pregnancy.
Question 4 A nurse is providing education to a client at 16 weeks of gestation about pre-
natal screenings. Which test should the nurse explain is typically performed
at this time?
A. Amniocentesis
B. Quad screen
C. Nonstress test
D. Chorionic villus sampling
1
, Answer: B. Quad screen
Rationale: The quad screen, assessing for neural tube defects and chromoso-
mal abnormalities, is typically performed between 15–20 weeks of gestation.
Amniocentesis and chorionic villus sampling are diagnostic tests, and non-
stress tests are used later in pregnancy.
Question 5 A nurse is assessing a client at 20 weeks of gestation who reports abdominal
pain. Which finding requires immediate action?
A. Mild, intermittent cramping
B. Fundal height at the umbilicus
C. Continuous pain with vaginal bleeding
D. Positive fetal movement
Answer: C. Continuous pain with vaginal bleeding
Rationale: Continuous abdominal pain with vaginal bleeding may indicate
placental abruption or other serious complications, requiring urgent evalu-
ation. Mild cramping and positive fetal movement are normal, and fundal
height at the umbilicus is expected at 20 weeks.
Question 6 A nurse is teaching a client at 24 weeks of gestation about signs of preterm
labor. Which client statement indicates understanding?
A. ”I should call my provider if I have irregular contractions.”
B. ”Persistent pelvic pressure could be a warning sign.”
C. ”Mild back pain is always a sign of labor.”
D. ”I don’t need to worry unless I have heavy bleeding.”
Answer: B. Persistent pelvic pressure could be a warning sign.
Rationale: Persistent pelvic pressure is a sign of preterm labor and should
prompt immediate reporting. Irregular contractions and mild back pain are
common in pregnancy, and heavy bleeding is a separate emergency.
Question 7 A nurse is caring for a client at 32 weeks of gestation with preeclampsia.
Which intervention is the priority?
A. Administer magnesium sulfate IV
B. Encourage ambulation every 2 hours
C. Provide a high-sodium diet
D. Monitor blood glucose levels
Answer: A. Administer magnesium sulfate IV
Rationale: Magnesium sulfate is the priority to prevent seizures in preeclamp-
sia. Ambulation and a high-sodium diet are contraindicated, and blood glu-
cose monitoring is not directly related to preeclampsia management.
Question 8 A nurse is assessing a client at 14 weeks of gestation. Which finding is ex-
pected during this stage of pregnancy?
A. Increased heart rate by 10–20 bpm
B. Fundal height at the symphysis pubis
C. Presence of lanugo on ultrasound
D. Quickening felt by the client
Answer: A. Increased heart rate by 10–20 bpm
Rationale: Increased maternal heart rate by 10–20 bpm is a normal phys-
iological change in pregnancy. Fundal height reaches the symphysis pubis
at 12 weeks, lanugo is present but not visible on ultrasound, and quickening
2
, typically occurs at 16–20 weeks.
Question 9 A nurse is teaching a client about safe exercise during pregnancy. Which
recommendation is appropriate?
A. Avoid swimming due to infection risk
B. Perform high-intensity interval training
C. Engage in 30 minutes of moderate walking daily
D. Continue contact sports until the third trimester
Answer: C. Engage in 30 minutes of moderate walking daily
Rationale: Moderate exercise, like 30 minutes of walking daily, is safe and
beneficial during pregnancy. Swimming is also safe, but high-intensity train-
ing and contact sports pose risks to the fetus.
Question 10 A nurse is caring for a client at 18 weeks of gestation who asks about vacci-
nations. Which vaccination is contraindicated during pregnancy?
A. Tdap
B. Influenza
C. MMR
D. Hepatitis B
Answer: C. MMR
Rationale: The MMR vaccine is a live virus vaccine and is contraindicated
during pregnancy due to potential fetal harm. Tdap, influenza, and hepatitis
B vaccines are safe and recommended.
Question 11 A nurse is assessing a client at 30 weeks of gestation with oligohydramnios.
Which intervention should the nurse anticipate?
A. Prepare for immediate cesarean delivery
B. Administer betamethasone intramuscularly
C. Monitor fetal heart rate continuously
D. Encourage increased caffeine intake
Answer: C. Monitor fetal heart rate continuously
Rationale: Oligohydramnios increases the risk of fetal distress, necessitating
continuous fetal heart rate monitoring. Cesarean delivery and betamethasone
may be considered later, and caffeine is not indicated.
Question 12 A nurse is teaching a client at 22 weeks of gestation about iron supplemen-
tation. Which statement indicates understanding?
A. ”I’ll take my iron pill with orange juice.”
B. ”I should take iron with my prenatal vitamin at bedtime.”
C. ”Iron supplements are only needed in the first trimester.”
D. ”I can skip iron if I eat red meat daily.”
Answer: A. I’ll take my iron pill with orange juice.
Rationale: Vitamin C (in orange juice) enhances iron absorption. Iron should
be taken separately from prenatal vitamins to avoid absorption interference,
and it is needed throughout pregnancy.
Question 13 A nurse is caring for a client at 26 weeks of gestation with a history of epilepsy.
The client begins seizing. What is the priority action?
A. Administer lorazepam IV
B. Turn the client to her left side
3
