ATI RN Maternal Newborn Proctored Exam 2026-2027 Study Guide — 50 High-
Yield MCQs & Verified Answers (Graded A+)
,Antepartum Care & Fetal Assessment (Questions 1–13)
Q1. A nurse is reviewing the prenatal record of a client at 28 weeks of gestation.
The client is Rh-negative. Which of the following interventions should the nurse
plan to implement?
A) Administer Rho(D) immune globulin immediately after delivery only.
[📌] B) Administer Rho(D) immune globulin at 28 weeks of gestation.
C) Perform an amniocentesis to evaluate fetal blood type.
D) Schedule the client for weekly biophysical profiles.
Rationale: Rho(D) immune globulin is administered prophylactically to Rh-
negative clients at 28 weeks of gestation to prevent isoimmunization, and again
within 72 hours after delivery if the newborn is Rh-positive.
Q2. A nurse is assessing a pregnant client who reports her last menstrual
period (LMP) began on May 8, 2026. Using Nägele's rule, what is the client's
estimated date of delivery (EDD)?
[📌] B) February 15, 2027
A) February 1, 2027
C) February 8, 2027
D) May 15, 2027
Rationale: Nägele's rule calculates the EDD by subtracting 3 calendar months
from the first day of the LMP and adding 7 days and 1 year to that date (May 8 -
3 months = February 8; February 8 + 7 days = February 15).
Q3. A nurse is performing an assessment on a client at 34 weeks of gestation.
Which of the following findings should the nurse report to the provider
immediately?
A) Periodic Braxton Hicks contractions
B) Dependent bilateral pitting ankle edema
[📌] C) Visual disturbances and epigastric pain
D) Increased vaginal discharge without odor
,Rationale: Visual disturbances, severe headaches, and epigastric pain are
classic signs of severe preeclampsia, indicating central nervous system
irritability and hepatic involvement that require rapid medical evaluation.
Q4. A nurse is teaching a pregnant client about scheduling an indirect Coombs
test. What is the purpose of this diagnostic evaluation?
[📌] A) To detect Rh antibodies in the maternal blood stream
B) To verify the presence of alpha-fetoprotein in amniotic fluid
C) To screen for gestational diabetes mellitus
D) To measure fetal lung maturity parameters
Rationale: The indirect Coombs test determines whether an Rh-negative mother
has developed antibodies to Rh-positive blood cells, measuring sensitization
risk.
Q5. A nurse is evaluating a client's understanding of an upcoming nonstress
test (NST). Which statement by the client indicates understanding?
A) "I will need to be completely under general anesthesia."
B) "The test measures how my cervix responds to stress."
[📌] C) "I should press the button every time I feel the baby move."
D) "I must remain completely NPO for 12 hours before the test."
Rationale: An NST evaluates fetal well-being by tracking fetal heart rate
accelerations associated with fetal movement, which the client logs using a
handheld marker.
Q6. What constitutes a "reactive" result on an electronic fetal nonstress test
(NST) for a fetus at 36 weeks of gestation?
[📌] A) Two or more FHR accelerations of at least 15 bpm lasting 15 seconds
within a 20-minute window
B) Absence of late decelerations during three spontaneous uterine contractions
C) An increase in baseline fetal heart rate up to 180 bpm for 5 minutes
D) Moderate baseline variability lasting less than 5 minutes total
Rationale: A reactive NST confirms fetal central nervous system integrity and
oxygenation when the FHR accelerates by at least 15 bpm above baseline for at
least 15 seconds, at least twice in 20 minutes.
Q7. A nurse is reviewing a contraction stress test (CST) result that is
interpreted as negative. How should the nurse explain this finding to the client?
A) The fetus cannot tolerate the stress of labor contractions.
[📌] B) There are no late decelerations observed with contractions, indicating
fetal well-being.
C) The test must be repeated within 2 hours due to uninterpretable readings.
D) Uterine hyperstimulation has compromised placental perfusion.
Rationale: A negative CST is a reassuring finding, meaning no late
decelerations occurred during three contractions in a 10-minute window,
indicating adequate uteroplacental function.
Q8. A nurse is reviewing a biophysical profile (BPP) score of 4 out of 10 for a
client at 38 weeks of gestation. What is the appropriate nursing action?
A) Discharge the client home with instructions to count fetal movements.
[📌] B) Prepare the client for immediate delivery or further induction protocols.
, C) Reschedule the client for a follow-up BPP evaluation in 2 weeks.
D) Administer an extra dose of Rho(D) immune globulin.
Rationale: A BPP score of 4 or less indicates strongly suspected fetal asphyxia,
demanding immediate hospitalization and consideration for expedited delivery.
Q9. A nurse is evaluating maternal serum alpha-fetoprotein (MSAFP) screening
results for a client at 16 weeks of gestation. An elevated MSAFP level is
associated with which risk?
[📌] A) Neural tube defects such as anencephaly or spina bifida
B) Down syndrome (Trisomy 21)
C) Gestational trophoblastic disease (molar pregnancy)
D) Maternal macrosomia
Rationale: Elevated levels of alpha-fetoprotein in maternal serum suggest open
neural tube defects or abdominal wall anomalies, while low levels are
associated with Down syndrome.
Q10. A client at 26 weeks of gestation undergoes a 1-hour oral glucose
tolerance test (OGTT). Which glucose level requires a 3-hour diagnostic OGTT?
A) 95 mg/dL
B) 110 mg/dL
C) 125 mg/dL
[📌] D) 145 mg/dL
Rationale: A blood glucose level of 130 to 140 mg/dL or higher on a 1-hour
screening test requires a diagnostic 3-hour oral glucose tolerance test to rule
out gestational diabetes.
Q11. A nurse is providing education to a pregnant client who has a prescription
for oral iron supplements. What instruction optimizes absorption?
A) Take the supplement directly with a full glass of whole milk.
[📌] B) Consume the iron supplement alongside a glass of orange juice on an
empty stomach.
C) Take the iron pill simultaneously with an antacid tablet.
D) Crush the medication and mix it into hot caffeinated tea.
Rationale: Vitamin C enhances the gastrointestinal absorption of iron, while
calcium, antacids, and tea inhibit its uptake.
Q12. A nurse is caring for a client with hyperemesis gravidarum. Which
laboratory finding should the nurse anticipate?
[📌] A) Ketonuria due to fat breakdown from starvation
B) Decreased urine specific gravity
C) Hyperkalemia from metabolic acidosis
D) Decreased hemoglobin and hematocrit values
Rationale: Severe, persistent vomiting restricts carbohydrate intake, forcing the
body to metabolize fat stores for energy, which produces ketones excreted in
the urine.
Q13. A client at 32 weeks of gestation is diagnosed with a total placenta previa.
Which provider order should the nurse question?
A) Mainline intravenous access maintenance
[📌] B) Perform a sterile vaginal examination to check cervical dilation.
Yield MCQs & Verified Answers (Graded A+)
,Antepartum Care & Fetal Assessment (Questions 1–13)
Q1. A nurse is reviewing the prenatal record of a client at 28 weeks of gestation.
The client is Rh-negative. Which of the following interventions should the nurse
plan to implement?
A) Administer Rho(D) immune globulin immediately after delivery only.
[📌] B) Administer Rho(D) immune globulin at 28 weeks of gestation.
C) Perform an amniocentesis to evaluate fetal blood type.
D) Schedule the client for weekly biophysical profiles.
Rationale: Rho(D) immune globulin is administered prophylactically to Rh-
negative clients at 28 weeks of gestation to prevent isoimmunization, and again
within 72 hours after delivery if the newborn is Rh-positive.
Q2. A nurse is assessing a pregnant client who reports her last menstrual
period (LMP) began on May 8, 2026. Using Nägele's rule, what is the client's
estimated date of delivery (EDD)?
[📌] B) February 15, 2027
A) February 1, 2027
C) February 8, 2027
D) May 15, 2027
Rationale: Nägele's rule calculates the EDD by subtracting 3 calendar months
from the first day of the LMP and adding 7 days and 1 year to that date (May 8 -
3 months = February 8; February 8 + 7 days = February 15).
Q3. A nurse is performing an assessment on a client at 34 weeks of gestation.
Which of the following findings should the nurse report to the provider
immediately?
A) Periodic Braxton Hicks contractions
B) Dependent bilateral pitting ankle edema
[📌] C) Visual disturbances and epigastric pain
D) Increased vaginal discharge without odor
,Rationale: Visual disturbances, severe headaches, and epigastric pain are
classic signs of severe preeclampsia, indicating central nervous system
irritability and hepatic involvement that require rapid medical evaluation.
Q4. A nurse is teaching a pregnant client about scheduling an indirect Coombs
test. What is the purpose of this diagnostic evaluation?
[📌] A) To detect Rh antibodies in the maternal blood stream
B) To verify the presence of alpha-fetoprotein in amniotic fluid
C) To screen for gestational diabetes mellitus
D) To measure fetal lung maturity parameters
Rationale: The indirect Coombs test determines whether an Rh-negative mother
has developed antibodies to Rh-positive blood cells, measuring sensitization
risk.
Q5. A nurse is evaluating a client's understanding of an upcoming nonstress
test (NST). Which statement by the client indicates understanding?
A) "I will need to be completely under general anesthesia."
B) "The test measures how my cervix responds to stress."
[📌] C) "I should press the button every time I feel the baby move."
D) "I must remain completely NPO for 12 hours before the test."
Rationale: An NST evaluates fetal well-being by tracking fetal heart rate
accelerations associated with fetal movement, which the client logs using a
handheld marker.
Q6. What constitutes a "reactive" result on an electronic fetal nonstress test
(NST) for a fetus at 36 weeks of gestation?
[📌] A) Two or more FHR accelerations of at least 15 bpm lasting 15 seconds
within a 20-minute window
B) Absence of late decelerations during three spontaneous uterine contractions
C) An increase in baseline fetal heart rate up to 180 bpm for 5 minutes
D) Moderate baseline variability lasting less than 5 minutes total
Rationale: A reactive NST confirms fetal central nervous system integrity and
oxygenation when the FHR accelerates by at least 15 bpm above baseline for at
least 15 seconds, at least twice in 20 minutes.
Q7. A nurse is reviewing a contraction stress test (CST) result that is
interpreted as negative. How should the nurse explain this finding to the client?
A) The fetus cannot tolerate the stress of labor contractions.
[📌] B) There are no late decelerations observed with contractions, indicating
fetal well-being.
C) The test must be repeated within 2 hours due to uninterpretable readings.
D) Uterine hyperstimulation has compromised placental perfusion.
Rationale: A negative CST is a reassuring finding, meaning no late
decelerations occurred during three contractions in a 10-minute window,
indicating adequate uteroplacental function.
Q8. A nurse is reviewing a biophysical profile (BPP) score of 4 out of 10 for a
client at 38 weeks of gestation. What is the appropriate nursing action?
A) Discharge the client home with instructions to count fetal movements.
[📌] B) Prepare the client for immediate delivery or further induction protocols.
, C) Reschedule the client for a follow-up BPP evaluation in 2 weeks.
D) Administer an extra dose of Rho(D) immune globulin.
Rationale: A BPP score of 4 or less indicates strongly suspected fetal asphyxia,
demanding immediate hospitalization and consideration for expedited delivery.
Q9. A nurse is evaluating maternal serum alpha-fetoprotein (MSAFP) screening
results for a client at 16 weeks of gestation. An elevated MSAFP level is
associated with which risk?
[📌] A) Neural tube defects such as anencephaly or spina bifida
B) Down syndrome (Trisomy 21)
C) Gestational trophoblastic disease (molar pregnancy)
D) Maternal macrosomia
Rationale: Elevated levels of alpha-fetoprotein in maternal serum suggest open
neural tube defects or abdominal wall anomalies, while low levels are
associated with Down syndrome.
Q10. A client at 26 weeks of gestation undergoes a 1-hour oral glucose
tolerance test (OGTT). Which glucose level requires a 3-hour diagnostic OGTT?
A) 95 mg/dL
B) 110 mg/dL
C) 125 mg/dL
[📌] D) 145 mg/dL
Rationale: A blood glucose level of 130 to 140 mg/dL or higher on a 1-hour
screening test requires a diagnostic 3-hour oral glucose tolerance test to rule
out gestational diabetes.
Q11. A nurse is providing education to a pregnant client who has a prescription
for oral iron supplements. What instruction optimizes absorption?
A) Take the supplement directly with a full glass of whole milk.
[📌] B) Consume the iron supplement alongside a glass of orange juice on an
empty stomach.
C) Take the iron pill simultaneously with an antacid tablet.
D) Crush the medication and mix it into hot caffeinated tea.
Rationale: Vitamin C enhances the gastrointestinal absorption of iron, while
calcium, antacids, and tea inhibit its uptake.
Q12. A nurse is caring for a client with hyperemesis gravidarum. Which
laboratory finding should the nurse anticipate?
[📌] A) Ketonuria due to fat breakdown from starvation
B) Decreased urine specific gravity
C) Hyperkalemia from metabolic acidosis
D) Decreased hemoglobin and hematocrit values
Rationale: Severe, persistent vomiting restricts carbohydrate intake, forcing the
body to metabolize fat stores for energy, which produces ketones excreted in
the urine.
Q13. A client at 32 weeks of gestation is diagnosed with a total placenta previa.
Which provider order should the nurse question?
A) Mainline intravenous access maintenance
[📌] B) Perform a sterile vaginal examination to check cervical dilation.
