ATI RN Maternity Proctored Exam
1. Antepartum & Fetal Development
, 1. A nurse is assessing a pregnant client at 12 weeks of gestation. Which of the
following findings is considered a positive sign of pregnancy?
o A) Goodell's sign
o B) Positive serum pregnancy test
o C) Fetal heart tones heard via Doppler ultrasound
o D) Braxton Hicks contractions
o Correct Answer: C) Fetal heart tones heard via Doppler ultrasound
o Rationale: 🟢 Fetal heart tones, fetal movement felt by an experienced clinician,
and visualization of the fetus on ultrasound are positive (objective) signs of
pregnancy. Goodell's sign and pregnancy tests are probable signs, while Braxton
Hicks contractions are probable signs.
2. A nurse is reviewing the lab results of a client at 10 weeks of gestation. The
client’s rubella titer indicates she is non-immune. Which of the following actions
should the nurse plan to take?
o A) Administer the MMR vaccine immediately.
o B) Inform the client that she will receive the MMR vaccine shortly after delivery.
o C) Schedule the client for an immediate amniocentesis.
o D) Isolate the client from all other pregnant individuals in the clinic.
o Correct Answer: B) Inform the client that she will receive the MMR vaccine
shortly after delivery.
o Rationale: 🟢 The Measles, Mumps, and Rubella (MMR) vaccine is a live virus
vaccine and is contraindicated during pregnancy due to the risk of congenital
rubella syndrome. It must be administered postpartum prior to discharge.
3. A nurse is teaching a client who is at 28 weeks of gestation about performing fetal
kick counts. Which of the following statements by the client indicates an
understanding of the teaching?
o A) "I should count the kicks once every week for an hour."
o B) "I need to notify my doctor if I feel fewer than 10 movements in 2 hours."
o C) "I will count movements only when the baby is very active."
o D) "If I don't feel 3 movements in 30 minutes, I should drink a hot beverage."
o Correct Answer: B) "I need to notify my doctor if I feel fewer than 10
movements in 2 hours."
o Rationale: 🟢 A count of fewer than 10 fetal movements within a 2-hour
window warrants immediate notification to the provider for further fetal
assessment, such as a non-stress test (NST).
4. A nurse is caring for a client who is at 34 weeks of gestation and undergoing a
non-stress test (NST). The nurse observes two fetal heart rate accelerations of
15/min above baseline, lasting at least 15 seconds, within a 20-minute window.
How should the nurse document this result?
o A) Nonreactive NST
o B) Reactive NST
o C) Unsatisfactory NST
o D) Positive contraction stress test
o Correct Answer: B) Reactive NST
,o Rationale: 🟢 A reactive NST is a normal, reassuring finding defined as at least 2
accelerations of the fetal heart rate (FHR) by at least 15 beats/min above
baseline, lasting for at least 15 seconds, within a 20-minute period.
5. A nurse is providing nutritional counseling to a pregnant client with a normal pre-
pregnancy Body Mass Index (BMI). The nurse should recommend a total weight
gain of how many pounds during pregnancy?
o A) 11 to 20 lbs
o B) 15 to 25 lbs
o C) 25 to 35 lbs
o D) 28 to 40 lbs
o Correct Answer: C) 25 to 35 lbs
o Rationale: 🟢 For a client with a normal pre-pregnancy BMI (18.5–24.9), the
recommended healthy weight gain during a singleton pregnancy is 25 to 35
pounds (approx. 11.3 to 15.9 kg).
2. Pregnancy Complications & High-Risk Conditions
6. A nurse is assessing a client at 32 weeks of gestation who reports sudden,
painless, bright red vaginal bleeding. Which of the following conditions should the
nurse suspect?
o A) Abruptio placentae
o B) Placenta previa
o C) Hydatidiform mole
o D) Ruptured ectopic pregnancy
o Correct Answer: B) Placenta previa
o Rationale: 🟢 Painless, bright red vaginal bleeding in the second or third
trimester is the hallmark clinical manifestation of placenta previa. Abruptio
placentae presents with painful, dark red bleeding and uterine rigidity.
7. A nurse is admitting a client at 36 weeks of gestation who has severe
preeclampsia. Which of the following orders should the nurse question?
o A) Administer magnesium sulfate IV per protocol.
o B) Maintain strict bed rest with a quiet environment.
o C) Perform a vaginal examination every 2 hours to monitor progress.
o D) Assess deep tendon reflexes and check for clonus every hour.
o Correct Answer: C) Perform a vaginal examination every 2 hours to monitor
progress.
o Rationale: 🟢 In a client with severe preeclampsia, frequent unindicated vaginal
exams can cause unnecessary stimulation, potentially triggering a seizure
(eclampsia). Central nervous system stimulation must be minimized.
, 8. A nurse is monitoring a client receiving a magnesium sulfate IV infusion for
preeclampsia. Which of the following findings indicates magnesium toxicity?
o A) Deep tendon reflexes of 2+
o B) Urinary output of 45 mL/hr
o C) Respiratory rate of 10/min
o D) Serum magnesium level of 5.5 mEq/L
o Correct Answer: C) Respiratory rate of 10/min
o Rationale: 🟢 Signs of magnesium sulfate toxicity include bradypnea
(respiratory rate < 12/min), loss of deep tendon reflexes, altered mental status,
and severe oliguria. The therapeutic range for magnesium is 4 to 7 mEq/L.
9. A nurse is preparing to administer calcium gluconate to a client. For which of the
following reasons is this medication given in a maternity unit?
o A) To treat maternal hypocalcemia
o B) To reverse magnesium sulfate toxicity
o C) To induce uterine contractions
o D) To stop preterm labor contractions
o Correct Answer: B) To reverse magnesium sulfate toxicity
o Rationale: 🟢 Calcium gluconate is the specific antidote used to reverse the
central nervous system and respiratory depressive effects of magnesium sulfate
toxicity.
10. A nurse is caring for a client at 14 weeks of gestation with hyperemesis
gravidarum. Which of the following laboratory findings should the nurse expect?
o A) Urine positive for ketones
o B) Serum potassium level of 5.2 mEq/L
o C) Low urine specific gravity
o D) Decreased hematocrit level
o Correct Answer: A) Urine positive for ketones
o Rationale: 🟢 Severe, intractable vomiting in hyperemesis gravidarum leads to
dehydration, starvation, and the breakdown of body fat stores, which causes
ketonuria.
11. A nurse is evaluating a client at 26 weeks of gestation for gestational diabetes
using a 1-hour oral glucose tolerance test (OGTT). Which of the following blood
glucose results indicates the need for further 3-hour diagnostic testing?
o A) 95 mg/dL
o B) 115 mg/dL
o C) 125 mg/dL
o D) 145 mg/dL
o Correct Answer: D) 145 mg/dL
o Rationale: 🟢 A blood glucose level of 130 to 140 mg/dL or higher on a 1-hour
glucose screening test is considered positive and requires a follow-up 3-hour oral
glucose tolerance test to establish a diagnosis of gestational diabetes.
12. A nurse is caring for a client who is Rh-negative at 28 weeks of gestation. Which
of the following statements by the nurse describes the correct indication for
Rho(D) immune globulin administration?
o A) "It is given to prevent your immune system from producing antibodies against
Rh-positive fetal blood cells."
1. Antepartum & Fetal Development
, 1. A nurse is assessing a pregnant client at 12 weeks of gestation. Which of the
following findings is considered a positive sign of pregnancy?
o A) Goodell's sign
o B) Positive serum pregnancy test
o C) Fetal heart tones heard via Doppler ultrasound
o D) Braxton Hicks contractions
o Correct Answer: C) Fetal heart tones heard via Doppler ultrasound
o Rationale: 🟢 Fetal heart tones, fetal movement felt by an experienced clinician,
and visualization of the fetus on ultrasound are positive (objective) signs of
pregnancy. Goodell's sign and pregnancy tests are probable signs, while Braxton
Hicks contractions are probable signs.
2. A nurse is reviewing the lab results of a client at 10 weeks of gestation. The
client’s rubella titer indicates she is non-immune. Which of the following actions
should the nurse plan to take?
o A) Administer the MMR vaccine immediately.
o B) Inform the client that she will receive the MMR vaccine shortly after delivery.
o C) Schedule the client for an immediate amniocentesis.
o D) Isolate the client from all other pregnant individuals in the clinic.
o Correct Answer: B) Inform the client that she will receive the MMR vaccine
shortly after delivery.
o Rationale: 🟢 The Measles, Mumps, and Rubella (MMR) vaccine is a live virus
vaccine and is contraindicated during pregnancy due to the risk of congenital
rubella syndrome. It must be administered postpartum prior to discharge.
3. A nurse is teaching a client who is at 28 weeks of gestation about performing fetal
kick counts. Which of the following statements by the client indicates an
understanding of the teaching?
o A) "I should count the kicks once every week for an hour."
o B) "I need to notify my doctor if I feel fewer than 10 movements in 2 hours."
o C) "I will count movements only when the baby is very active."
o D) "If I don't feel 3 movements in 30 minutes, I should drink a hot beverage."
o Correct Answer: B) "I need to notify my doctor if I feel fewer than 10
movements in 2 hours."
o Rationale: 🟢 A count of fewer than 10 fetal movements within a 2-hour
window warrants immediate notification to the provider for further fetal
assessment, such as a non-stress test (NST).
4. A nurse is caring for a client who is at 34 weeks of gestation and undergoing a
non-stress test (NST). The nurse observes two fetal heart rate accelerations of
15/min above baseline, lasting at least 15 seconds, within a 20-minute window.
How should the nurse document this result?
o A) Nonreactive NST
o B) Reactive NST
o C) Unsatisfactory NST
o D) Positive contraction stress test
o Correct Answer: B) Reactive NST
,o Rationale: 🟢 A reactive NST is a normal, reassuring finding defined as at least 2
accelerations of the fetal heart rate (FHR) by at least 15 beats/min above
baseline, lasting for at least 15 seconds, within a 20-minute period.
5. A nurse is providing nutritional counseling to a pregnant client with a normal pre-
pregnancy Body Mass Index (BMI). The nurse should recommend a total weight
gain of how many pounds during pregnancy?
o A) 11 to 20 lbs
o B) 15 to 25 lbs
o C) 25 to 35 lbs
o D) 28 to 40 lbs
o Correct Answer: C) 25 to 35 lbs
o Rationale: 🟢 For a client with a normal pre-pregnancy BMI (18.5–24.9), the
recommended healthy weight gain during a singleton pregnancy is 25 to 35
pounds (approx. 11.3 to 15.9 kg).
2. Pregnancy Complications & High-Risk Conditions
6. A nurse is assessing a client at 32 weeks of gestation who reports sudden,
painless, bright red vaginal bleeding. Which of the following conditions should the
nurse suspect?
o A) Abruptio placentae
o B) Placenta previa
o C) Hydatidiform mole
o D) Ruptured ectopic pregnancy
o Correct Answer: B) Placenta previa
o Rationale: 🟢 Painless, bright red vaginal bleeding in the second or third
trimester is the hallmark clinical manifestation of placenta previa. Abruptio
placentae presents with painful, dark red bleeding and uterine rigidity.
7. A nurse is admitting a client at 36 weeks of gestation who has severe
preeclampsia. Which of the following orders should the nurse question?
o A) Administer magnesium sulfate IV per protocol.
o B) Maintain strict bed rest with a quiet environment.
o C) Perform a vaginal examination every 2 hours to monitor progress.
o D) Assess deep tendon reflexes and check for clonus every hour.
o Correct Answer: C) Perform a vaginal examination every 2 hours to monitor
progress.
o Rationale: 🟢 In a client with severe preeclampsia, frequent unindicated vaginal
exams can cause unnecessary stimulation, potentially triggering a seizure
(eclampsia). Central nervous system stimulation must be minimized.
, 8. A nurse is monitoring a client receiving a magnesium sulfate IV infusion for
preeclampsia. Which of the following findings indicates magnesium toxicity?
o A) Deep tendon reflexes of 2+
o B) Urinary output of 45 mL/hr
o C) Respiratory rate of 10/min
o D) Serum magnesium level of 5.5 mEq/L
o Correct Answer: C) Respiratory rate of 10/min
o Rationale: 🟢 Signs of magnesium sulfate toxicity include bradypnea
(respiratory rate < 12/min), loss of deep tendon reflexes, altered mental status,
and severe oliguria. The therapeutic range for magnesium is 4 to 7 mEq/L.
9. A nurse is preparing to administer calcium gluconate to a client. For which of the
following reasons is this medication given in a maternity unit?
o A) To treat maternal hypocalcemia
o B) To reverse magnesium sulfate toxicity
o C) To induce uterine contractions
o D) To stop preterm labor contractions
o Correct Answer: B) To reverse magnesium sulfate toxicity
o Rationale: 🟢 Calcium gluconate is the specific antidote used to reverse the
central nervous system and respiratory depressive effects of magnesium sulfate
toxicity.
10. A nurse is caring for a client at 14 weeks of gestation with hyperemesis
gravidarum. Which of the following laboratory findings should the nurse expect?
o A) Urine positive for ketones
o B) Serum potassium level of 5.2 mEq/L
o C) Low urine specific gravity
o D) Decreased hematocrit level
o Correct Answer: A) Urine positive for ketones
o Rationale: 🟢 Severe, intractable vomiting in hyperemesis gravidarum leads to
dehydration, starvation, and the breakdown of body fat stores, which causes
ketonuria.
11. A nurse is evaluating a client at 26 weeks of gestation for gestational diabetes
using a 1-hour oral glucose tolerance test (OGTT). Which of the following blood
glucose results indicates the need for further 3-hour diagnostic testing?
o A) 95 mg/dL
o B) 115 mg/dL
o C) 125 mg/dL
o D) 145 mg/dL
o Correct Answer: D) 145 mg/dL
o Rationale: 🟢 A blood glucose level of 130 to 140 mg/dL or higher on a 1-hour
glucose screening test is considered positive and requires a follow-up 3-hour oral
glucose tolerance test to establish a diagnosis of gestational diabetes.
12. A nurse is caring for a client who is Rh-negative at 28 weeks of gestation. Which
of the following statements by the nurse describes the correct indication for
Rho(D) immune globulin administration?
o A) "It is given to prevent your immune system from producing antibodies against
Rh-positive fetal blood cells."
