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ATI CAPSTONE MATERNAL NEWBORN
ASSESSMENT 2026/2027 | ATI NURSING | EXPERT
VERIFIED | 150 QUESTIONS & COMPLETE
RATIONALES | PASS GUARANTEED - A+ GRADED
SECTION 1: ANTEPARTUM NURSING CARE (25 Questions)
Q1: A nurse is performing Leopold maneuvers on a client at 38 weeks gestation. The nurse palpates a firm,
round mass in the fundus and a smooth, hard mass above the symphysis pubis. The fetal heart tones are heard
loudest in the right lower quadrant. Which of the following fetal presentations should the nurse document?
A. Breech presentation
B. Transverse lie
C. Cephalic presentation
D. Shoulder presentation
Correct Answer: C
Rationale: In cephalic presentation (vertex), the fetal head is the presenting part and is palpated as a firm,
round mass above the symphysis pubis. The fetal back is located laterally, with fetal heart tones heard loudest
below the maternal umbilicus on the side of the fetal back. In breech presentation (A), the firm, round mass
(the head) is palpated in the fundus, not above the symphysis. Transverse lie (B) and shoulder presentation
(D) would have the fetal long axis perpendicular to the maternal spine, with no presenting part engaged in the
pelvis. Key teaching point: Leopold maneuvers help identify fetal presentation, position, and engagement to
guide labor management.
Q2: A client at 34 weeks gestation with preeclampsia has a new prescription for betamethasone 12 mg IM. The
client asks the nurse, "Why am I receiving this medication?" Which of the following responses should the
nurse provide?
A. "This medication will help lower your blood pressure and prevent seizures."
B. "This medication will speed up your baby's lung development in case of early delivery."
C. "This medication will stop your contractions and prevent preterm labor."
D. "This medication will help your baby gain weight before delivery."
Correct Answer: B
Rationale: Betamethasone is a corticosteroid administered to pregnant clients between 24-34 weeks gestation
who are at risk for preterm delivery. It accelerates fetal lung maturity by stimulating surfactant production,
,2
reducing the risk of respiratory distress syndrome (RDS) in the newborn . Option A describes magnesium
sulfate (seizure prevention) and antihypertensives (blood pressure control). Option C describes tocolytics
such as terbutaline or nifedipine. Option D is incorrect; betamethasone does not promote fetal weight
gain. Key teaching point: Betamethasone is given to enhance fetal lung maturity when preterm delivery is
anticipated, with maximum effect 24-48 hours after administration.
Q3: A nurse is assessing a client at 16 weeks gestation who reports feeling "fluttering" movements in her lower
abdomen. The nurse should document this finding as which of the following?
A. Ballottement
B. Quickening
C. Braxton Hicks contractions
D. Lightening
Correct Answer: B
Rationale: Quickening is the maternal perception of fetal movement, typically felt between 16-20 weeks
gestation. Primigravidas often feel it later (18-20 weeks), while multigravidas may feel it as early as 14-16
weeks. Ballottement (A) is a physical examination technique where the examiner taps the cervix to feel the
fetus rebound in the amniotic fluid. Braxton Hicks contractions (C) are irregular, painless uterine
contractions that occur throughout pregnancy. Lightening (D) is the descent of the fetal head into the pelvis,
typically occurring 2-4 weeks before term in primigravidas. Key teaching point: Quickening is an important
fetal well-being milestone; clients should be instructed to report decreased fetal movement after 28 weeks.
Q4: A client at 12 weeks gestation is diagnosed with hyperemesis gravidarum and is admitted for IV fluid
therapy. Which of the following laboratory findings should the nurse anticipate?
A. Elevated serum potassium
B. Decreased hematocrit
C. Elevated urine specific gravity
D. Decreased blood urea nitrogen (BUN)
Correct Answer: C
Rationale: Hyperemesis gravidarum causes severe dehydration and metabolic derangements due to persistent
vomiting. Elevated urine specific gravity (C) indicates concentrated urine from dehydration. Serum potassium
would be decreased (hypokalemia), not elevated (A), due to potassium loss in vomitus and inadequate intake.
Hematocrit would be elevated (hemoconcentration), not decreased (B), due to fluid volume depletion. BUN
would be elevated (prerenal azotemia), not decreased (D), due to decreased renal perfusion. Key teaching
point: Hyperemesis gravidarum requires hospitalization for IV hydration, electrolyte replacement, and
antiemetic therapy; monitor for ketonuria, weight loss, and electrolyte imbalances.
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Q5: A nurse is providing teaching to a client who is at 28 weeks gestation and has gestational diabetes. Which
of the following statements by the client indicates an understanding of the dietary management?
A. "I should eat three large meals per day with no snacks."
B. "I should consume 45% to 60% of my daily calories from carbohydrates."
C. "I should avoid all carbohydrates in my diet."
D. "I should eat small, frequent meals and include protein with each meal."
Correct Answer: D
Rationale: Clients with gestational diabetes should eat small, frequent meals (3 meals and 2-3 snacks daily) to
maintain stable blood glucose levels. Including protein with each meal (D) helps slow carbohydrate
absorption and prevents postprandial glucose spikes. Option A is incorrect; large meals cause glucose surges.
Option B is too high; the recommended carbohydrate intake is typically 40-45% of total calories. Option C is
incorrect; carbohydrates are essential for fetal brain development and should be distributed evenly throughout
the day. Key teaching point: Consistent carbohydrate intake with adequate protein helps maintain glycemic
control in gestational diabetes.
Q6: A client at 30 weeks gestation with placenta previa is admitted with vaginal bleeding. Which of the
following nursing interventions is the priority?
A. Perform a vaginal examination to assess bleeding source
B. Administer oxytocin to stimulate contractions
C. Prepare for immediate cesarean delivery
D. Monitor maternal and fetal status while maintaining bed rest
Correct Answer: D
Rationale: The priority for placenta previa is to maintain bed rest and monitor maternal and fetal status (D)
while avoiding any cervical stimulation. Vaginal examinations (A) are strictly contraindicated in suspected
placenta previa because they can disrupt the placental attachment and cause catastrophic hemorrhage.
Oxytocin (B) would be contraindicated as it increases uterine contractions and bleeding risk. Immediate
cesarean (C) is only indicated for severe, uncontrolled hemorrhage or fetal distress; initial management is
expectant. Key teaching point: In placenta previa, "no vaginal exams" is the cardinal rule; maintain bed rest
and monitor for bleeding and fetal well-being.
Q7: A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule for a client whose last
menstrual period (LMP) was May 10. Which of the following dates should the nurse document as the EDD?
A. February 3
B. February 10
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C. February 17
D. March 3
Correct Answer: C
Rationale: Naegele's rule calculates EDD by subtracting 3 months from the first day of the LMP and adding 7
days. May 10 - 3 months = February 10; February 10 + 7 days = February 17. Option A (February 3) subtracts
14 days incorrectly. Option B (February 10) fails to add 7 days. Option D (March 3) adds too many days. Key
teaching point: Naegele's rule is: LMP - 3 months + 7 days + 1 year; it assumes a 28-day menstrual cycle.
Q8: A client at 36 weeks gestation with preeclampsia is receiving magnesium sulfate IV. Which of the
following assessment findings should the nurse report to the provider immediately?
A. Respiratory rate of 14 breaths/min
B. Urinary output of 20 mL in the last 2 hours
C. Deep tendon reflexes (DTRs) of 2+
D. Blood pressure of 142/90 mmHg
Correct Answer: B
Rationale: Magnesium sulfate is excreted renally, and adequate urinary output of at least 30 mL/hr is required
to prevent toxicity. A urinary output of 20 mL in 2 hours (10 mL/hr) indicates oliguria and risk for
magnesium accumulation and toxicity, requiring immediate provider notification . Respiratory rate of 14 (A)
is acceptable (>12). DTRs of 2+ (C) are normal; decreased or absent DTRs would indicate toxicity. BP of
142/90 (D) is elevated but expected in preeclampsia and is not the priority over renal function. Key teaching
point: The earliest sign of magnesium toxicity is loss of deep tendon reflexes, followed by respiratory
depression and oliguria; calcium gluconate is the antidote.
Q9: A nurse is caring for a client at 10 weeks gestation who has Rh-negative blood. The client's partner is Rh-
positive. Which of the following instructions should the nurse provide regarding Rho(D) immune globulin
(RhoGAM)?
A. "You will receive RhoGAM at 28 weeks and again within 72 hours after delivery if the baby is Rh-positive."
B. "You will receive RhoGAM only after delivery if the baby is Rh-negative."
C. "You will receive RhoGAM only if you have a miscarriage."
D. "You will receive RhoGAM if your antibody screen becomes positive."
Correct Answer: A
Rationale: RhoGAM is administered at 28 weeks gestation AND within 72 hours after delivery if the newborn
is Rh-positive . This prevents maternal antibody formation against Rh-positive fetal blood cells, protecting
subsequent pregnancies. Option B is incorrect; RhoGAM is given prophylactically at 28 weeks regardless of
fetal Rh status. Option C is incorrect; RhoGAM is also indicated after miscarriage, abortion, or any event that
ATI CAPSTONE MATERNAL NEWBORN
ASSESSMENT 2026/2027 | ATI NURSING | EXPERT
VERIFIED | 150 QUESTIONS & COMPLETE
RATIONALES | PASS GUARANTEED - A+ GRADED
SECTION 1: ANTEPARTUM NURSING CARE (25 Questions)
Q1: A nurse is performing Leopold maneuvers on a client at 38 weeks gestation. The nurse palpates a firm,
round mass in the fundus and a smooth, hard mass above the symphysis pubis. The fetal heart tones are heard
loudest in the right lower quadrant. Which of the following fetal presentations should the nurse document?
A. Breech presentation
B. Transverse lie
C. Cephalic presentation
D. Shoulder presentation
Correct Answer: C
Rationale: In cephalic presentation (vertex), the fetal head is the presenting part and is palpated as a firm,
round mass above the symphysis pubis. The fetal back is located laterally, with fetal heart tones heard loudest
below the maternal umbilicus on the side of the fetal back. In breech presentation (A), the firm, round mass
(the head) is palpated in the fundus, not above the symphysis. Transverse lie (B) and shoulder presentation
(D) would have the fetal long axis perpendicular to the maternal spine, with no presenting part engaged in the
pelvis. Key teaching point: Leopold maneuvers help identify fetal presentation, position, and engagement to
guide labor management.
Q2: A client at 34 weeks gestation with preeclampsia has a new prescription for betamethasone 12 mg IM. The
client asks the nurse, "Why am I receiving this medication?" Which of the following responses should the
nurse provide?
A. "This medication will help lower your blood pressure and prevent seizures."
B. "This medication will speed up your baby's lung development in case of early delivery."
C. "This medication will stop your contractions and prevent preterm labor."
D. "This medication will help your baby gain weight before delivery."
Correct Answer: B
Rationale: Betamethasone is a corticosteroid administered to pregnant clients between 24-34 weeks gestation
who are at risk for preterm delivery. It accelerates fetal lung maturity by stimulating surfactant production,
,2
reducing the risk of respiratory distress syndrome (RDS) in the newborn . Option A describes magnesium
sulfate (seizure prevention) and antihypertensives (blood pressure control). Option C describes tocolytics
such as terbutaline or nifedipine. Option D is incorrect; betamethasone does not promote fetal weight
gain. Key teaching point: Betamethasone is given to enhance fetal lung maturity when preterm delivery is
anticipated, with maximum effect 24-48 hours after administration.
Q3: A nurse is assessing a client at 16 weeks gestation who reports feeling "fluttering" movements in her lower
abdomen. The nurse should document this finding as which of the following?
A. Ballottement
B. Quickening
C. Braxton Hicks contractions
D. Lightening
Correct Answer: B
Rationale: Quickening is the maternal perception of fetal movement, typically felt between 16-20 weeks
gestation. Primigravidas often feel it later (18-20 weeks), while multigravidas may feel it as early as 14-16
weeks. Ballottement (A) is a physical examination technique where the examiner taps the cervix to feel the
fetus rebound in the amniotic fluid. Braxton Hicks contractions (C) are irregular, painless uterine
contractions that occur throughout pregnancy. Lightening (D) is the descent of the fetal head into the pelvis,
typically occurring 2-4 weeks before term in primigravidas. Key teaching point: Quickening is an important
fetal well-being milestone; clients should be instructed to report decreased fetal movement after 28 weeks.
Q4: A client at 12 weeks gestation is diagnosed with hyperemesis gravidarum and is admitted for IV fluid
therapy. Which of the following laboratory findings should the nurse anticipate?
A. Elevated serum potassium
B. Decreased hematocrit
C. Elevated urine specific gravity
D. Decreased blood urea nitrogen (BUN)
Correct Answer: C
Rationale: Hyperemesis gravidarum causes severe dehydration and metabolic derangements due to persistent
vomiting. Elevated urine specific gravity (C) indicates concentrated urine from dehydration. Serum potassium
would be decreased (hypokalemia), not elevated (A), due to potassium loss in vomitus and inadequate intake.
Hematocrit would be elevated (hemoconcentration), not decreased (B), due to fluid volume depletion. BUN
would be elevated (prerenal azotemia), not decreased (D), due to decreased renal perfusion. Key teaching
point: Hyperemesis gravidarum requires hospitalization for IV hydration, electrolyte replacement, and
antiemetic therapy; monitor for ketonuria, weight loss, and electrolyte imbalances.
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Q5: A nurse is providing teaching to a client who is at 28 weeks gestation and has gestational diabetes. Which
of the following statements by the client indicates an understanding of the dietary management?
A. "I should eat three large meals per day with no snacks."
B. "I should consume 45% to 60% of my daily calories from carbohydrates."
C. "I should avoid all carbohydrates in my diet."
D. "I should eat small, frequent meals and include protein with each meal."
Correct Answer: D
Rationale: Clients with gestational diabetes should eat small, frequent meals (3 meals and 2-3 snacks daily) to
maintain stable blood glucose levels. Including protein with each meal (D) helps slow carbohydrate
absorption and prevents postprandial glucose spikes. Option A is incorrect; large meals cause glucose surges.
Option B is too high; the recommended carbohydrate intake is typically 40-45% of total calories. Option C is
incorrect; carbohydrates are essential for fetal brain development and should be distributed evenly throughout
the day. Key teaching point: Consistent carbohydrate intake with adequate protein helps maintain glycemic
control in gestational diabetes.
Q6: A client at 30 weeks gestation with placenta previa is admitted with vaginal bleeding. Which of the
following nursing interventions is the priority?
A. Perform a vaginal examination to assess bleeding source
B. Administer oxytocin to stimulate contractions
C. Prepare for immediate cesarean delivery
D. Monitor maternal and fetal status while maintaining bed rest
Correct Answer: D
Rationale: The priority for placenta previa is to maintain bed rest and monitor maternal and fetal status (D)
while avoiding any cervical stimulation. Vaginal examinations (A) are strictly contraindicated in suspected
placenta previa because they can disrupt the placental attachment and cause catastrophic hemorrhage.
Oxytocin (B) would be contraindicated as it increases uterine contractions and bleeding risk. Immediate
cesarean (C) is only indicated for severe, uncontrolled hemorrhage or fetal distress; initial management is
expectant. Key teaching point: In placenta previa, "no vaginal exams" is the cardinal rule; maintain bed rest
and monitor for bleeding and fetal well-being.
Q7: A nurse is calculating the estimated date of delivery (EDD) using Naegele's rule for a client whose last
menstrual period (LMP) was May 10. Which of the following dates should the nurse document as the EDD?
A. February 3
B. February 10
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C. February 17
D. March 3
Correct Answer: C
Rationale: Naegele's rule calculates EDD by subtracting 3 months from the first day of the LMP and adding 7
days. May 10 - 3 months = February 10; February 10 + 7 days = February 17. Option A (February 3) subtracts
14 days incorrectly. Option B (February 10) fails to add 7 days. Option D (March 3) adds too many days. Key
teaching point: Naegele's rule is: LMP - 3 months + 7 days + 1 year; it assumes a 28-day menstrual cycle.
Q8: A client at 36 weeks gestation with preeclampsia is receiving magnesium sulfate IV. Which of the
following assessment findings should the nurse report to the provider immediately?
A. Respiratory rate of 14 breaths/min
B. Urinary output of 20 mL in the last 2 hours
C. Deep tendon reflexes (DTRs) of 2+
D. Blood pressure of 142/90 mmHg
Correct Answer: B
Rationale: Magnesium sulfate is excreted renally, and adequate urinary output of at least 30 mL/hr is required
to prevent toxicity. A urinary output of 20 mL in 2 hours (10 mL/hr) indicates oliguria and risk for
magnesium accumulation and toxicity, requiring immediate provider notification . Respiratory rate of 14 (A)
is acceptable (>12). DTRs of 2+ (C) are normal; decreased or absent DTRs would indicate toxicity. BP of
142/90 (D) is elevated but expected in preeclampsia and is not the priority over renal function. Key teaching
point: The earliest sign of magnesium toxicity is loss of deep tendon reflexes, followed by respiratory
depression and oliguria; calcium gluconate is the antidote.
Q9: A nurse is caring for a client at 10 weeks gestation who has Rh-negative blood. The client's partner is Rh-
positive. Which of the following instructions should the nurse provide regarding Rho(D) immune globulin
(RhoGAM)?
A. "You will receive RhoGAM at 28 weeks and again within 72 hours after delivery if the baby is Rh-positive."
B. "You will receive RhoGAM only after delivery if the baby is Rh-negative."
C. "You will receive RhoGAM only if you have a miscarriage."
D. "You will receive RhoGAM if your antibody screen becomes positive."
Correct Answer: A
Rationale: RhoGAM is administered at 28 weeks gestation AND within 72 hours after delivery if the newborn
is Rh-positive . This prevents maternal antibody formation against Rh-positive fetal blood cells, protecting
subsequent pregnancies. Option B is incorrect; RhoGAM is given prophylactically at 28 weeks regardless of
fetal Rh status. Option C is incorrect; RhoGAM is also indicated after miscarriage, abortion, or any event that
