) ATI MATERNAL PROCTORED EXAM (3 DIFFERENT VERSION EXAM) – QUESTIONS
AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED
PASS | LATEST EXAM UPDATE]
Core Domains
Antepartum Nursing Care
Intrapartum Nursing Care
Postpartum Nursing Care
Newborn Nursing Care
Maternal-Newborn Pharmacology
High-Risk Pregnancy and Complications
Maternal and Newborn Health Promotion and Maintenance
Psychosocial Adaptation and Family Dynamics
Legal, Ethical, and Professional Standards in Maternal-Newborn Nursing
Introduction
This comprehensive assessment is designed to evaluate the essential competencies required for safe
and effective maternal-newborn nursing practice. It tests your foundational knowledge of
physiological and psychological adaptations during the childbearing cycle, as well as your ability to
apply complex clinical reasoning in a variety of scenarios. The examination includes multiple-choice
questions that challenge your understanding of antepartum, intrapartum, postpartum, and newborn
care, along with critical decision-making skills in high-risk situations. Each question is crafted to
mimic real-world clinical challenges, emphasizing evidence-based practice and the professional
standards integral to nursing. This guide provides detailed rationales to reinforce learning and ensure
readiness for the proctored exam.
SECTION ONE: QUESTIONS 1-100
Question 1
A nurse is assessing a client at 12 weeks of gestation who reports frequent episodes of nausea and
vomiting. Which of the following findings should the nurse identify as an indication of hyperemesis
gravidarum?
A. Weight loss of 2 kg (4.4 lbs) since the last visit
B. Ketones present in the urine
C. Blood pressure of 110/70 mm Hg
D. Heart rate of 88/min
🟢 B. Ketones present in the urine
🔴 Explanation: The presence of ketones in the urine indicates dehydration and a starvation state,
which are hallmark signs of hyperemesis gravidarum. While weight loss can be a symptom, the
presence of ketones is a more specific and objective indicator of the severity of the condition.
Normal vital signs do not rule out hyperemesis.
,Question 2
A nurse is providing education to a client at 28 weeks of gestation about fetal movement counting.
Which of the following instructions should the nurse include?
A. "Count movements for 1 hour after each meal."
B. "Count movements for 30 minutes at the same time each day."
C. "Count movements for 2 hours and expect at least 10 movements."
D. "Count movements for 1 hour and expect at least 4 movements."
🟢 A. "Count movements for 1 hour after each meal."
🔴 Explanation: The standard recommendation for fetal movement counting is to count for one
hour after each meal, as fetal activity often increases following maternal eating. This helps establish
a baseline for normal activity. Less than 4 movements in one hour should prompt further
evaluation.
Question 3
A nurse is reviewing the laboratory results of a client who is at 36 weeks of gestation. Which of the
following findings should the nurse report to the provider?
A. Hemoglobin 11.0 g/dL
B. Platelet count 140,000/mm³
C. White blood cell count 12,000/mm³
D. Fasting blood glucose 95 mg/dL
🟢 B. Platelet count 140,000/mm³
🔴 Explanation: A platelet count of 140,000/mm³ is below the normal range for pregnancy
(150,000-400,000/mm³) and should be reported. A hemoglobin of 11.0 g/dL is within normal limits
for the third trimester. An elevated WBC count and a fasting blood glucose of 95 mg/dL are also
expected variations in pregnancy.
Question 4
A nurse is performing a vaginal examination on a client who is in active labor. The nurse identifies
the presenting part as the fetal occiput at the right side of the maternal pelvis. Which of the
following fetal positions should the nurse document?
A. LOA
B. ROP
C. ROA
D. LOP
🟢 C. ROA
🔴 Explanation: ROA stands for Right Occiput Anterior. This describes the position where the fetal
occiput is located on the right side of the maternal pelvis and is directed anteriorly. The other
options denote different positions (Left Occiput Anterior, Right Occiput Posterior, Left Occiput
Posterior).
,Question 5
A nurse is providing education about breastfeeding to a client who is 24 hours postpartum. Which
of the following client statements indicates an understanding of the teaching?
A. "My nipples should be moist and pliable to prevent cracking."
B. "I should clean my nipples with alcohol before each feeding."
C. "I can use a lanolin-based cream to keep my nipples soft."
D. "If my baby is latched correctly, I will hear clicking sounds."
🟢 C. "I can use a lanolin-based cream to keep my nipples soft."
🔴 Explanation: Lanolin-based creams are safe and effective for keeping nipples soft and
preventing cracking. Nipples should be dry and not excessively moist to prevent maceration.
Alcohol is drying and should be avoided. Clicking sounds indicate a poor latch.
Question 6
A nurse is caring for a client who is receiving magnesium sulfate for severe preeclampsia. Which of
the following findings indicates magnesium toxicity?
A. Urine output of 40 mL/hr
B. Deep tendon reflexes 2+
C. Respiratory rate of 16/min
D. Absent patellar reflexes
🟢 D. Absent patellar reflexes
🔴 Explanation: Absence of deep tendon reflexes (DTRs) is a late sign of magnesium toxicity. Urine
output should be at least 30 mL/hr. A respiratory rate of less than 12/min is also a sign of toxicity. A
DTR of 2+ is within normal limits.
Question 7
A nurse is assessing a newborn at 1 minute of life. The infant has a heart rate of 120/min, a strong
cry, active motion, and acrocyanosis. What is the Apgar score?
A. 7
B. 8
C. 9
D. 10
🟢 B. 8
🔴 Explanation: The Apgar score is calculated as follows: Heart rate (2), Respiratory effort (2),
Muscle tone (2), Reflex irritability (2), and Color (1 for acrocyanosis). 2+2+2+2+1 = 9. Wait, an error.
Re-calculate: Heart rate >100 (2), Strong cry (2), Active motion (2), Reflex irritability (2), Color =
acrocyanosis (1) = 9. The answer should be C. 9. Let's correct.
🟢 C. 9
🔴 Explanation: The Apgar score is calculated using five categories. The infant receives a score of 2
for heart rate >100/min, 2 for a strong cry, 2 for active motion, 2 for reflex irritability, and 1 for
, acrocyanosis (pink body, blue extremities). A perfect score is 10. The total is 9.
Question 8
A nurse is administering Rh(D) immunoglobulin (RhoGAM) to a client who is Rh-negative. Which of
the following clients is a candidate for this medication?
A. A client at 28 weeks of gestation who is Rh-negative and has a negative antibody screen
B. A client at 10 weeks of gestation who is Rh-negative and has a negative antibody screen after a
spontaneous abortion
C. A client who is Rh-negative and just gave birth to an Rh-negative newborn
D. A client who is Rh-positive and has a negative antibody screen
🟢 B. A client at 10 weeks of gestation who is Rh-negative and has a negative antibody screen after
a spontaneous abortion
🔴 Explanation: RhoGAM is administered to Rh-negative clients who have been sensitized by Rh-
positive fetal blood. This includes after spontaneous or induced abortion, ectopic pregnancy, or at
28 weeks of gestation and within 72 hours of birth of an Rh-positive infant. Option B is correct as
it's a sensitizing event. Option A is also a candidate for RhoGAM, but B is a more specific example
of a sensitizing event requiring administration.
Question 9
A nurse is assessing a client who is 6 hours postpartum and has a boggy uterus and heavy lochia.
Which of the following actions should the nurse take first?
A. Administer oxytocin IV
B. Massage the fundus
C. Assess vital signs
D. Notify the provider
🟢 B. Massage the fundus
🔴 Explanation: The first action for a boggy uterus and heavy lochia is to massage the fundus to
stimulate uterine contractions and reduce bleeding. This is a priority nursing intervention. After
massage, the nurse can assess vital signs, administer oxytocin if needed, and notify the provider if
the uterus does not firm up.
Question 10
A nurse is providing discharge teaching to a client following a cesarean section. Which of the
following findings should the client report to the provider?
A. Mild incisional pain that is relieved by medication
B. Slight redness along the incision
C. A temperature of 100.4°F (38°C)
D. Light pink lochia on the peripad
🟢 C. A temperature of 100.4°F (38°C)
AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED
PASS | LATEST EXAM UPDATE]
Core Domains
Antepartum Nursing Care
Intrapartum Nursing Care
Postpartum Nursing Care
Newborn Nursing Care
Maternal-Newborn Pharmacology
High-Risk Pregnancy and Complications
Maternal and Newborn Health Promotion and Maintenance
Psychosocial Adaptation and Family Dynamics
Legal, Ethical, and Professional Standards in Maternal-Newborn Nursing
Introduction
This comprehensive assessment is designed to evaluate the essential competencies required for safe
and effective maternal-newborn nursing practice. It tests your foundational knowledge of
physiological and psychological adaptations during the childbearing cycle, as well as your ability to
apply complex clinical reasoning in a variety of scenarios. The examination includes multiple-choice
questions that challenge your understanding of antepartum, intrapartum, postpartum, and newborn
care, along with critical decision-making skills in high-risk situations. Each question is crafted to
mimic real-world clinical challenges, emphasizing evidence-based practice and the professional
standards integral to nursing. This guide provides detailed rationales to reinforce learning and ensure
readiness for the proctored exam.
SECTION ONE: QUESTIONS 1-100
Question 1
A nurse is assessing a client at 12 weeks of gestation who reports frequent episodes of nausea and
vomiting. Which of the following findings should the nurse identify as an indication of hyperemesis
gravidarum?
A. Weight loss of 2 kg (4.4 lbs) since the last visit
B. Ketones present in the urine
C. Blood pressure of 110/70 mm Hg
D. Heart rate of 88/min
🟢 B. Ketones present in the urine
🔴 Explanation: The presence of ketones in the urine indicates dehydration and a starvation state,
which are hallmark signs of hyperemesis gravidarum. While weight loss can be a symptom, the
presence of ketones is a more specific and objective indicator of the severity of the condition.
Normal vital signs do not rule out hyperemesis.
,Question 2
A nurse is providing education to a client at 28 weeks of gestation about fetal movement counting.
Which of the following instructions should the nurse include?
A. "Count movements for 1 hour after each meal."
B. "Count movements for 30 minutes at the same time each day."
C. "Count movements for 2 hours and expect at least 10 movements."
D. "Count movements for 1 hour and expect at least 4 movements."
🟢 A. "Count movements for 1 hour after each meal."
🔴 Explanation: The standard recommendation for fetal movement counting is to count for one
hour after each meal, as fetal activity often increases following maternal eating. This helps establish
a baseline for normal activity. Less than 4 movements in one hour should prompt further
evaluation.
Question 3
A nurse is reviewing the laboratory results of a client who is at 36 weeks of gestation. Which of the
following findings should the nurse report to the provider?
A. Hemoglobin 11.0 g/dL
B. Platelet count 140,000/mm³
C. White blood cell count 12,000/mm³
D. Fasting blood glucose 95 mg/dL
🟢 B. Platelet count 140,000/mm³
🔴 Explanation: A platelet count of 140,000/mm³ is below the normal range for pregnancy
(150,000-400,000/mm³) and should be reported. A hemoglobin of 11.0 g/dL is within normal limits
for the third trimester. An elevated WBC count and a fasting blood glucose of 95 mg/dL are also
expected variations in pregnancy.
Question 4
A nurse is performing a vaginal examination on a client who is in active labor. The nurse identifies
the presenting part as the fetal occiput at the right side of the maternal pelvis. Which of the
following fetal positions should the nurse document?
A. LOA
B. ROP
C. ROA
D. LOP
🟢 C. ROA
🔴 Explanation: ROA stands for Right Occiput Anterior. This describes the position where the fetal
occiput is located on the right side of the maternal pelvis and is directed anteriorly. The other
options denote different positions (Left Occiput Anterior, Right Occiput Posterior, Left Occiput
Posterior).
,Question 5
A nurse is providing education about breastfeeding to a client who is 24 hours postpartum. Which
of the following client statements indicates an understanding of the teaching?
A. "My nipples should be moist and pliable to prevent cracking."
B. "I should clean my nipples with alcohol before each feeding."
C. "I can use a lanolin-based cream to keep my nipples soft."
D. "If my baby is latched correctly, I will hear clicking sounds."
🟢 C. "I can use a lanolin-based cream to keep my nipples soft."
🔴 Explanation: Lanolin-based creams are safe and effective for keeping nipples soft and
preventing cracking. Nipples should be dry and not excessively moist to prevent maceration.
Alcohol is drying and should be avoided. Clicking sounds indicate a poor latch.
Question 6
A nurse is caring for a client who is receiving magnesium sulfate for severe preeclampsia. Which of
the following findings indicates magnesium toxicity?
A. Urine output of 40 mL/hr
B. Deep tendon reflexes 2+
C. Respiratory rate of 16/min
D. Absent patellar reflexes
🟢 D. Absent patellar reflexes
🔴 Explanation: Absence of deep tendon reflexes (DTRs) is a late sign of magnesium toxicity. Urine
output should be at least 30 mL/hr. A respiratory rate of less than 12/min is also a sign of toxicity. A
DTR of 2+ is within normal limits.
Question 7
A nurse is assessing a newborn at 1 minute of life. The infant has a heart rate of 120/min, a strong
cry, active motion, and acrocyanosis. What is the Apgar score?
A. 7
B. 8
C. 9
D. 10
🟢 B. 8
🔴 Explanation: The Apgar score is calculated as follows: Heart rate (2), Respiratory effort (2),
Muscle tone (2), Reflex irritability (2), and Color (1 for acrocyanosis). 2+2+2+2+1 = 9. Wait, an error.
Re-calculate: Heart rate >100 (2), Strong cry (2), Active motion (2), Reflex irritability (2), Color =
acrocyanosis (1) = 9. The answer should be C. 9. Let's correct.
🟢 C. 9
🔴 Explanation: The Apgar score is calculated using five categories. The infant receives a score of 2
for heart rate >100/min, 2 for a strong cry, 2 for active motion, 2 for reflex irritability, and 1 for
, acrocyanosis (pink body, blue extremities). A perfect score is 10. The total is 9.
Question 8
A nurse is administering Rh(D) immunoglobulin (RhoGAM) to a client who is Rh-negative. Which of
the following clients is a candidate for this medication?
A. A client at 28 weeks of gestation who is Rh-negative and has a negative antibody screen
B. A client at 10 weeks of gestation who is Rh-negative and has a negative antibody screen after a
spontaneous abortion
C. A client who is Rh-negative and just gave birth to an Rh-negative newborn
D. A client who is Rh-positive and has a negative antibody screen
🟢 B. A client at 10 weeks of gestation who is Rh-negative and has a negative antibody screen after
a spontaneous abortion
🔴 Explanation: RhoGAM is administered to Rh-negative clients who have been sensitized by Rh-
positive fetal blood. This includes after spontaneous or induced abortion, ectopic pregnancy, or at
28 weeks of gestation and within 72 hours of birth of an Rh-positive infant. Option B is correct as
it's a sensitizing event. Option A is also a candidate for RhoGAM, but B is a more specific example
of a sensitizing event requiring administration.
Question 9
A nurse is assessing a client who is 6 hours postpartum and has a boggy uterus and heavy lochia.
Which of the following actions should the nurse take first?
A. Administer oxytocin IV
B. Massage the fundus
C. Assess vital signs
D. Notify the provider
🟢 B. Massage the fundus
🔴 Explanation: The first action for a boggy uterus and heavy lochia is to massage the fundus to
stimulate uterine contractions and reduce bleeding. This is a priority nursing intervention. After
massage, the nurse can assess vital signs, administer oxytocin if needed, and notify the provider if
the uterus does not firm up.
Question 10
A nurse is providing discharge teaching to a client following a cesarean section. Which of the
following findings should the client report to the provider?
A. Mild incisional pain that is relieved by medication
B. Slight redness along the incision
C. A temperature of 100.4°F (38°C)
D. Light pink lochia on the peripad
🟢 C. A temperature of 100.4°F (38°C)
