ATI RN Maternal Newborn Proctored Exam 2025 Latest
Questions & Verified Answers with Rationales
1. A nurse is providing preconception counseling to a client who has type 1
diabetes mellitus. Which of the following glycosylated hemoglobin (HbA1c)
levels indicates optimal blood glucose control before conception?
A) 8.5%
B) 7.5%
C) 6.5%
D) 5.5%
Correct Answer: C
Rationale: For women with preexisting diabetes, an HbA1c of <6.5% (some
sources say <7%) is recommended before conception to reduce the risk of
congenital anomalies. Higher levels are associated with increased risk of
miscarriage and fetal malformations.
,2. A nurse is assessing a client at 10 weeks gestation. Which of the following
findings is a positive sign of pregnancy?
A) Positive pregnancy test
B) Visualization of the fetus on ultrasound
C) Chadwick's sign
D) Goodell's sign
Correct Answer: B
Rationale: Positive signs of pregnancy are those that can only be explained by
pregnancy. They include visualization of the fetus on ultrasound, auscultation of
fetal heart tones, and fetal movement palpated by the examiner. Positive
pregnancy test, Chadwick's sign, and Goodell's sign are probable signs.
,3. A nurse is caring for a client at 24 weeks gestation who has a diagnosis of
pyelonephritis. The client has a temperature of 102°F (38.9°C) and reports flank
pain. Which of the following actions should the nurse take first?
A) Administer acetaminophen for fever
B) Obtain a urine culture
C) Administer antibiotics as prescribed
D) Assess fetal heart rate
Correct Answer: D
Rationale: The priority is to assess fetal well-being because maternal fever and
infection can cause fetal tachycardia and distress. After assessing the fetal heart
rate, the nurse can administer antipyretics and antibiotics.
4. A nurse is providing teaching to a client at 16 weeks gestation about the
purpose of alpha-fetoprotein (AFP) screening. Which of the following
statements indicates understanding?
A) "The test will tell me if my baby has Down syndrome."
B) "The test screens for neural tube defects like spina bifida."
C) "The test is diagnostic for chromosomal abnormalities."
D) "The test must be done after 24 weeks."
Correct Answer: B
Rationale: AFP screening (maternal serum AFP) is a screening test for neural tube
defects (spina bifida, anencephaly) and also can indicate increased risk for Down
syndrome and other chromosomal abnormalities. It is not diagnostic and is
performed at 15-20 weeks.
5. A nurse is assessing a client at 32 weeks gestation who has preeclampsia. The
client's blood pressure is 165/105 mm Hg, and she has 3+ protein in her urine.
Which of the following findings would indicate worsening of the condition?
A) Deep tendon reflexes 2+
, B) Platelet count 150,000/mm³
C) Epigastric pain
D) Mild ankle edema
Correct Answer: C
Rationale: Epigastric pain (right upper quadrant) indicates liver capsule distension
and is a sign of severe preeclampsia/HELLP syndrome. This is a medical
emergency. Normal reflexes are 2+. Platelet count 150,000 is normal. Mild edema
is common.
6. A nurse is providing discharge teaching to a client at 28 weeks gestation who
has gestational diabetes. Which of the following statements indicates
understanding?
A) "I will need to take insulin for the rest of my life."
B) "My baby may have low blood sugar after birth."
C) "I should avoid all carbohydrates."
D) "I only need to check my blood sugar once per week."
Correct Answer: B
Rationale: Infants of mothers with gestational diabetes are at risk for neonatal
hypoglycemia due to fetal hyperinsulinism. Gestational diabetes usually resolves
after delivery. Carbohydrates are necessary but should be complex. Blood sugar
should be checked multiple times daily.
7. A nurse is assessing a client at 30 weeks gestation. The fundal height is 26 cm.
Which of the following should the nurse suspect?
A) Intrauterine growth restriction (IUGR)
B) Multiple gestation (twins)
C) Polyhydramnios
D) Normal finding
Correct Answer: A
Rationale: Fundal height in cm should approximately equal weeks of gestation ±2
cm. At 30 weeks, 26 cm is 4 cm below expected, suggesting intrauterine growth
Questions & Verified Answers with Rationales
1. A nurse is providing preconception counseling to a client who has type 1
diabetes mellitus. Which of the following glycosylated hemoglobin (HbA1c)
levels indicates optimal blood glucose control before conception?
A) 8.5%
B) 7.5%
C) 6.5%
D) 5.5%
Correct Answer: C
Rationale: For women with preexisting diabetes, an HbA1c of <6.5% (some
sources say <7%) is recommended before conception to reduce the risk of
congenital anomalies. Higher levels are associated with increased risk of
miscarriage and fetal malformations.
,2. A nurse is assessing a client at 10 weeks gestation. Which of the following
findings is a positive sign of pregnancy?
A) Positive pregnancy test
B) Visualization of the fetus on ultrasound
C) Chadwick's sign
D) Goodell's sign
Correct Answer: B
Rationale: Positive signs of pregnancy are those that can only be explained by
pregnancy. They include visualization of the fetus on ultrasound, auscultation of
fetal heart tones, and fetal movement palpated by the examiner. Positive
pregnancy test, Chadwick's sign, and Goodell's sign are probable signs.
,3. A nurse is caring for a client at 24 weeks gestation who has a diagnosis of
pyelonephritis. The client has a temperature of 102°F (38.9°C) and reports flank
pain. Which of the following actions should the nurse take first?
A) Administer acetaminophen for fever
B) Obtain a urine culture
C) Administer antibiotics as prescribed
D) Assess fetal heart rate
Correct Answer: D
Rationale: The priority is to assess fetal well-being because maternal fever and
infection can cause fetal tachycardia and distress. After assessing the fetal heart
rate, the nurse can administer antipyretics and antibiotics.
4. A nurse is providing teaching to a client at 16 weeks gestation about the
purpose of alpha-fetoprotein (AFP) screening. Which of the following
statements indicates understanding?
A) "The test will tell me if my baby has Down syndrome."
B) "The test screens for neural tube defects like spina bifida."
C) "The test is diagnostic for chromosomal abnormalities."
D) "The test must be done after 24 weeks."
Correct Answer: B
Rationale: AFP screening (maternal serum AFP) is a screening test for neural tube
defects (spina bifida, anencephaly) and also can indicate increased risk for Down
syndrome and other chromosomal abnormalities. It is not diagnostic and is
performed at 15-20 weeks.
5. A nurse is assessing a client at 32 weeks gestation who has preeclampsia. The
client's blood pressure is 165/105 mm Hg, and she has 3+ protein in her urine.
Which of the following findings would indicate worsening of the condition?
A) Deep tendon reflexes 2+
, B) Platelet count 150,000/mm³
C) Epigastric pain
D) Mild ankle edema
Correct Answer: C
Rationale: Epigastric pain (right upper quadrant) indicates liver capsule distension
and is a sign of severe preeclampsia/HELLP syndrome. This is a medical
emergency. Normal reflexes are 2+. Platelet count 150,000 is normal. Mild edema
is common.
6. A nurse is providing discharge teaching to a client at 28 weeks gestation who
has gestational diabetes. Which of the following statements indicates
understanding?
A) "I will need to take insulin for the rest of my life."
B) "My baby may have low blood sugar after birth."
C) "I should avoid all carbohydrates."
D) "I only need to check my blood sugar once per week."
Correct Answer: B
Rationale: Infants of mothers with gestational diabetes are at risk for neonatal
hypoglycemia due to fetal hyperinsulinism. Gestational diabetes usually resolves
after delivery. Carbohydrates are necessary but should be complex. Blood sugar
should be checked multiple times daily.
7. A nurse is assessing a client at 30 weeks gestation. The fundal height is 26 cm.
Which of the following should the nurse suspect?
A) Intrauterine growth restriction (IUGR)
B) Multiple gestation (twins)
C) Polyhydramnios
D) Normal finding
Correct Answer: A
Rationale: Fundal height in cm should approximately equal weeks of gestation ±2
cm. At 30 weeks, 26 cm is 4 cm below expected, suggesting intrauterine growth
