ATI Capstone Maternal-Newborn Assessment Exam Review | 2026/2027
ATI Capstone Maternal-Newborn Assessment Exam Review
70 Questions with Correct Answers and Rationales | 2026/2027 Edition
Elsevier ATI Content Mastery Series Capstone | NGN-Integrated
70 multiple-choice questions. Select the BEST answer for each question. Correct answers are highlighted in bold cyan.
Rationales follow each question.
Section I: Antepartum Nursing Management
1. A nurse is providing prenatal education to a client at 10 weeks' gestation. The client asks how often she will
need to schedule prenatal visits throughout her pregnancy. Which of the following schedules should the nurse
recommend based on current ACOG guidelines?
A) Every 4 weeks until 28 weeks, then every 2 weeks B) Every 6 weeks until 20 weeks, then every 4 weeks
until 36 weeks, then weekly until delivery
C) Monthly throughout the entire pregnancy D) Every 2 weeks until 32 weeks, then weekly
Correct Answer: A) Every 4 weeks until 28 weeks, then every 2 weeks until 36 weeks, then weekly
Rationale: The standard prenatal visit schedule per ACOG guidelines is every 4 weeks from the first visit through 28
weeks, every 2 weeks from 28 to 36 weeks, and weekly from 36 weeks until delivery. More frequent visits are indicated
for high-risk pregnancies. ATI emphasizes this schedule as a foundational concept in prenatal care.
2. A nurse is caring for a client at 28 weeks' gestation who reports occasional headaches, swelling in both feet by
the end of the day, and feeling dizzy when standing up quickly. The nurse reviews the client's vital signs: blood
pressure 118/76 mmHg, pulse 82/min. Which of the following should the nurse document about these findings?
A) These are expected findings of normal pregnancy at 28 weeks
B) These findings indicate the client is developing preeclampsia and requires immediate intervention
C) These findings suggest gestational diabetes and the client needs a glucose tolerance test
D) The dizziness indicates anemia and the client should start iron supplementation immediately
Correct Answer: A) These are expected findings of normal pregnancy at 28 weeks
Rationale: Mild dependent edema in the lower extremities at the end of the day, occasional headaches, and orthostatic
dizziness are common discomforts of normal pregnancy. The blood pressure is within the normal range, and there is no
proteinuria or hyperreflexia to suggest preeclampsia. ATI teaches nurses to differentiate between normal pregnancy
adaptations and signs of preeclampsia. Gestational diabetes screening is performed via oral glucose tolerance test
between 24-28 weeks but is not indicated by these symptoms alone.
3. A nurse is assessing a client at 34 weeks' gestation with a blood pressure of 152/98 mmHg, proteinuria of 2+,
and a report of a continuous headache with visual disturbances. Which of the following should the nurse identify
as the priority nursing action?
A) Encourage the client to rest in a left lateral position and recheck blood pressure in 1 hour
B) Administer acetaminophen for the headache and apply a warm compress to the eyes
C) Notify the healthcare provider immediately and prepare the client for possible hospital admission
D) Obtain a clean-catch urine specimen and send it to the laboratory for a culture and sensitivity
1
, ATI Capstone Maternal-Newborn Assessment Exam Review | 2026/2027
Correct Answer: C) Notify the healthcare provider immediately and prepare the client for possible hospital
admission
Rationale: This client presents with severe preeclampsia: blood pressure greater than 160/110 mmHg or blood
pressure greater than 140/90 mmHg with proteinuria plus headache and visual changes (central nervous system
symptoms). These findings indicate a risk of progression to eclampsia (seizure) and require immediate provider
notification and hospital admission for close monitoring and magnesium sulfate therapy. ATI identifies severe
preeclampsia as an obstetric emergency requiring urgent intervention.
4. A nurse is caring for a pregnant client at 26 weeks' gestation who just completed a 1-hour oral glucose tolerance
test with a result of 165 mg/dL. The nurse understands that which of the following is the next step in the
diagnostic process for gestational diabetes mellitus?
A) The client has gestational diabetes mellitus and should begin insulin therapy immediately
B) The client needs a 3-hour oral glucose tolerance test to confirm the diagnosis
C) The client should be referred for nutritional counseling and start a diabetic diet
D) The client should be scheduled for an amniocentesis to assess fetal lung maturity
Correct Answer: B) The client needs a 3-hour oral glucose tolerance test to confirm the diagnosis
Rationale: A 1-hour glucose tolerance test result of 165 mg/dL exceeds the threshold of 140 mg/dL and is considered
abnormal. However, the 1-hour test is a screening tool, not diagnostic. The next step is a 3-hour oral glucose tolerance
test with a 100-gram glucose load. A diagnosis of gestational diabetes mellitus requires at least two abnormal values
on the 3-hour test. ATI teaches the two-step screening approach for gestational diabetes.
5. A nurse is providing discharge teaching to a client who was evaluated for preterm labor at 30 weeks' gestation.
The client was found to have a closed cervix and negative fetal fibronectin test. Which of the following statements
by the client indicates a need for further teaching?
A) I should stay well-hydrated by drinking at least 8 glasses of water each day
B) If I notice any vaginal bleeding or fluid leaking, I should go to the hospital right away
C) Since the test was negative, I do not need to worry about having my baby early
D) I should report any regular uterine contractions that occur more than 6 times per hour
Correct Answer: C) Since the test was negative, I do not need to worry about having my baby early
Rationale: A negative fetal fibronectin (fFN) test means the client has a low risk of delivering within the next 7-14 days,
but it does not eliminate all risk of preterm birth for the remainder of the pregnancy. The client still needs to be vigilant
for signs and symptoms of preterm labor. Staying hydrated, reporting bleeding or fluid loss, and recognizing regular
contractions are all appropriate responses. ATI emphasizes that fFN testing provides short-term predictive value only.
6. A nurse is reviewing the laboratory results of a client at 15 weeks' gestation. The nurse notes the client's blood
type is Rh-negative and the antibody screen is negative. Which of the following should the nurse anticipate?
A) The client will need to receive Rho(D) immune globulin at this visit
B) The client will need to receive Rho(D) immune globulin at 28 weeks' gestation and again within 72 hours
after delivery
C) No further Rh immune globulin is needed because the antibody screen is negative
D) The client should be tested for Rh sensitization at every prenatal visit for the remainder of the pregnancy
Correct Answer: B) The client will need to receive Rho(D) immune globulin at 28 weeks' gestation and
again within 72 hours after delivery
2
, ATI Capstone Maternal-Newborn Assessment Exam Review | 2026/2027
Rationale: For an Rh-negative client with a negative antibody screen, Rho(D) immune globulin (RhoGAM) is routinely
administered at 28 weeks' gestation (to prevent sensitization during the third trimester) and again within 72 hours after
delivery if the infant is Rh-positive. It is not given at 15 weeks unless there has been an event that could cause maternal-
fetal bleeding, such as amniocentesis, trauma, or vaginal bleeding. ATI emphasizes the timing protocol for RhoGAM
administration.
7. A nurse is performing a prenatal assessment on a client at 24 weeks' gestation. The fundal height measurement
is at the umbilicus. Which of the following interpretations of this finding is correct?
A) The fundal height is appropriate for 24 weeks' gestation
B) The fundal height is below expected for 24 weeks and the client may have intrauterine growth restriction
C) The fundal height is above expected and the client should be evaluated for polyhydramnios
D) Fundal height measurement is not reliable until after 28 weeks' gestation
Correct Answer: A) The fundal height is appropriate for 24 weeks' gestation
Rationale: The fundal height, measured in centimeters from the pubic symphysis to the top of the uterus, typically
equals the number of weeks of gestation between 20 and 36 weeks (plus or minus 2 cm). At 20 weeks, the fundus is at
the umbilicus. By 24 weeks, it extends slightly above the umbilicus. However, the finding described as 'at the umbilicus'
at 24 weeks is a close approximation within the normal range. ATI teaches fundal height measurement as a key
screening tool for fetal growth.
8. A pregnant client at 18 weeks' gestation is scheduled for an amniocentesis. The nurse explains the purpose and
potential risks of the procedure. Which of the following complications should the nurse include in the teaching?
A) Maternal hypertension and preeclampsia B) Fetal loss, preterm premature rupture of
membranes, and maternal infection
C) Gestational diabetes and placenta previa D) Cord prolapse and fetal bradycardia during the
procedure
Correct Answer: B) Fetal loss, preterm premature rupture of membranes, and maternal infection
Rationale: Amniocentesis, typically performed after 15 weeks' gestation for genetic testing, carries risks including fetal
loss (miscarriage), preterm premature rupture of membranes (PPROM), maternal infection (amnionitis), and amniotic
fluid embolism. The risk of fetal loss is approximately 0.1-0.3%. ATI emphasizes informed consent and discussing risks
prior to any invasive prenatal diagnostic procedure.
9. A nurse is caring for a client at 36 weeks' gestation who is undergoing a biophysical profile (BPP). The nurse
understands that which of the following is included in the BPP scoring system?
A) Cervical length assessment and fetal movement count
B) Nonstress test (NST), amniotic fluid volume, fetal breathing, fetal body movements, and fetal tone
C) Maternal blood pressure, proteinuria, and deep tendon reflexes
D) Fetal heart rate variability, accelerations, and decelerations during a contraction stress test
Correct Answer: B) Nonstress test (NST), amniotic fluid volume, fetal breathing, fetal body movements,
and fetal tone
Rationale: The biophysical profile (BPP) is a prenatal test that assesses fetal well-being using five components, each
scored 0 or 2 points for a maximum total of 10. The components are: fetal heart rate reactivity via nonstress test (NST),
amniotic fluid volume (measured via ultrasound as maximum vertical pocket or amniotic fluid index), fetal breathing
movements, fetal body movements (gross), and fetal tone (extension and flexion). A score of 8-10 is considered normal.
ATI identifies BPP as a comprehensive assessment of fetal status.
3
ATI Capstone Maternal-Newborn Assessment Exam Review
70 Questions with Correct Answers and Rationales | 2026/2027 Edition
Elsevier ATI Content Mastery Series Capstone | NGN-Integrated
70 multiple-choice questions. Select the BEST answer for each question. Correct answers are highlighted in bold cyan.
Rationales follow each question.
Section I: Antepartum Nursing Management
1. A nurse is providing prenatal education to a client at 10 weeks' gestation. The client asks how often she will
need to schedule prenatal visits throughout her pregnancy. Which of the following schedules should the nurse
recommend based on current ACOG guidelines?
A) Every 4 weeks until 28 weeks, then every 2 weeks B) Every 6 weeks until 20 weeks, then every 4 weeks
until 36 weeks, then weekly until delivery
C) Monthly throughout the entire pregnancy D) Every 2 weeks until 32 weeks, then weekly
Correct Answer: A) Every 4 weeks until 28 weeks, then every 2 weeks until 36 weeks, then weekly
Rationale: The standard prenatal visit schedule per ACOG guidelines is every 4 weeks from the first visit through 28
weeks, every 2 weeks from 28 to 36 weeks, and weekly from 36 weeks until delivery. More frequent visits are indicated
for high-risk pregnancies. ATI emphasizes this schedule as a foundational concept in prenatal care.
2. A nurse is caring for a client at 28 weeks' gestation who reports occasional headaches, swelling in both feet by
the end of the day, and feeling dizzy when standing up quickly. The nurse reviews the client's vital signs: blood
pressure 118/76 mmHg, pulse 82/min. Which of the following should the nurse document about these findings?
A) These are expected findings of normal pregnancy at 28 weeks
B) These findings indicate the client is developing preeclampsia and requires immediate intervention
C) These findings suggest gestational diabetes and the client needs a glucose tolerance test
D) The dizziness indicates anemia and the client should start iron supplementation immediately
Correct Answer: A) These are expected findings of normal pregnancy at 28 weeks
Rationale: Mild dependent edema in the lower extremities at the end of the day, occasional headaches, and orthostatic
dizziness are common discomforts of normal pregnancy. The blood pressure is within the normal range, and there is no
proteinuria or hyperreflexia to suggest preeclampsia. ATI teaches nurses to differentiate between normal pregnancy
adaptations and signs of preeclampsia. Gestational diabetes screening is performed via oral glucose tolerance test
between 24-28 weeks but is not indicated by these symptoms alone.
3. A nurse is assessing a client at 34 weeks' gestation with a blood pressure of 152/98 mmHg, proteinuria of 2+,
and a report of a continuous headache with visual disturbances. Which of the following should the nurse identify
as the priority nursing action?
A) Encourage the client to rest in a left lateral position and recheck blood pressure in 1 hour
B) Administer acetaminophen for the headache and apply a warm compress to the eyes
C) Notify the healthcare provider immediately and prepare the client for possible hospital admission
D) Obtain a clean-catch urine specimen and send it to the laboratory for a culture and sensitivity
1
, ATI Capstone Maternal-Newborn Assessment Exam Review | 2026/2027
Correct Answer: C) Notify the healthcare provider immediately and prepare the client for possible hospital
admission
Rationale: This client presents with severe preeclampsia: blood pressure greater than 160/110 mmHg or blood
pressure greater than 140/90 mmHg with proteinuria plus headache and visual changes (central nervous system
symptoms). These findings indicate a risk of progression to eclampsia (seizure) and require immediate provider
notification and hospital admission for close monitoring and magnesium sulfate therapy. ATI identifies severe
preeclampsia as an obstetric emergency requiring urgent intervention.
4. A nurse is caring for a pregnant client at 26 weeks' gestation who just completed a 1-hour oral glucose tolerance
test with a result of 165 mg/dL. The nurse understands that which of the following is the next step in the
diagnostic process for gestational diabetes mellitus?
A) The client has gestational diabetes mellitus and should begin insulin therapy immediately
B) The client needs a 3-hour oral glucose tolerance test to confirm the diagnosis
C) The client should be referred for nutritional counseling and start a diabetic diet
D) The client should be scheduled for an amniocentesis to assess fetal lung maturity
Correct Answer: B) The client needs a 3-hour oral glucose tolerance test to confirm the diagnosis
Rationale: A 1-hour glucose tolerance test result of 165 mg/dL exceeds the threshold of 140 mg/dL and is considered
abnormal. However, the 1-hour test is a screening tool, not diagnostic. The next step is a 3-hour oral glucose tolerance
test with a 100-gram glucose load. A diagnosis of gestational diabetes mellitus requires at least two abnormal values
on the 3-hour test. ATI teaches the two-step screening approach for gestational diabetes.
5. A nurse is providing discharge teaching to a client who was evaluated for preterm labor at 30 weeks' gestation.
The client was found to have a closed cervix and negative fetal fibronectin test. Which of the following statements
by the client indicates a need for further teaching?
A) I should stay well-hydrated by drinking at least 8 glasses of water each day
B) If I notice any vaginal bleeding or fluid leaking, I should go to the hospital right away
C) Since the test was negative, I do not need to worry about having my baby early
D) I should report any regular uterine contractions that occur more than 6 times per hour
Correct Answer: C) Since the test was negative, I do not need to worry about having my baby early
Rationale: A negative fetal fibronectin (fFN) test means the client has a low risk of delivering within the next 7-14 days,
but it does not eliminate all risk of preterm birth for the remainder of the pregnancy. The client still needs to be vigilant
for signs and symptoms of preterm labor. Staying hydrated, reporting bleeding or fluid loss, and recognizing regular
contractions are all appropriate responses. ATI emphasizes that fFN testing provides short-term predictive value only.
6. A nurse is reviewing the laboratory results of a client at 15 weeks' gestation. The nurse notes the client's blood
type is Rh-negative and the antibody screen is negative. Which of the following should the nurse anticipate?
A) The client will need to receive Rho(D) immune globulin at this visit
B) The client will need to receive Rho(D) immune globulin at 28 weeks' gestation and again within 72 hours
after delivery
C) No further Rh immune globulin is needed because the antibody screen is negative
D) The client should be tested for Rh sensitization at every prenatal visit for the remainder of the pregnancy
Correct Answer: B) The client will need to receive Rho(D) immune globulin at 28 weeks' gestation and
again within 72 hours after delivery
2
, ATI Capstone Maternal-Newborn Assessment Exam Review | 2026/2027
Rationale: For an Rh-negative client with a negative antibody screen, Rho(D) immune globulin (RhoGAM) is routinely
administered at 28 weeks' gestation (to prevent sensitization during the third trimester) and again within 72 hours after
delivery if the infant is Rh-positive. It is not given at 15 weeks unless there has been an event that could cause maternal-
fetal bleeding, such as amniocentesis, trauma, or vaginal bleeding. ATI emphasizes the timing protocol for RhoGAM
administration.
7. A nurse is performing a prenatal assessment on a client at 24 weeks' gestation. The fundal height measurement
is at the umbilicus. Which of the following interpretations of this finding is correct?
A) The fundal height is appropriate for 24 weeks' gestation
B) The fundal height is below expected for 24 weeks and the client may have intrauterine growth restriction
C) The fundal height is above expected and the client should be evaluated for polyhydramnios
D) Fundal height measurement is not reliable until after 28 weeks' gestation
Correct Answer: A) The fundal height is appropriate for 24 weeks' gestation
Rationale: The fundal height, measured in centimeters from the pubic symphysis to the top of the uterus, typically
equals the number of weeks of gestation between 20 and 36 weeks (plus or minus 2 cm). At 20 weeks, the fundus is at
the umbilicus. By 24 weeks, it extends slightly above the umbilicus. However, the finding described as 'at the umbilicus'
at 24 weeks is a close approximation within the normal range. ATI teaches fundal height measurement as a key
screening tool for fetal growth.
8. A pregnant client at 18 weeks' gestation is scheduled for an amniocentesis. The nurse explains the purpose and
potential risks of the procedure. Which of the following complications should the nurse include in the teaching?
A) Maternal hypertension and preeclampsia B) Fetal loss, preterm premature rupture of
membranes, and maternal infection
C) Gestational diabetes and placenta previa D) Cord prolapse and fetal bradycardia during the
procedure
Correct Answer: B) Fetal loss, preterm premature rupture of membranes, and maternal infection
Rationale: Amniocentesis, typically performed after 15 weeks' gestation for genetic testing, carries risks including fetal
loss (miscarriage), preterm premature rupture of membranes (PPROM), maternal infection (amnionitis), and amniotic
fluid embolism. The risk of fetal loss is approximately 0.1-0.3%. ATI emphasizes informed consent and discussing risks
prior to any invasive prenatal diagnostic procedure.
9. A nurse is caring for a client at 36 weeks' gestation who is undergoing a biophysical profile (BPP). The nurse
understands that which of the following is included in the BPP scoring system?
A) Cervical length assessment and fetal movement count
B) Nonstress test (NST), amniotic fluid volume, fetal breathing, fetal body movements, and fetal tone
C) Maternal blood pressure, proteinuria, and deep tendon reflexes
D) Fetal heart rate variability, accelerations, and decelerations during a contraction stress test
Correct Answer: B) Nonstress test (NST), amniotic fluid volume, fetal breathing, fetal body movements,
and fetal tone
Rationale: The biophysical profile (BPP) is a prenatal test that assesses fetal well-being using five components, each
scored 0 or 2 points for a maximum total of 10. The components are: fetal heart rate reactivity via nonstress test (NST),
amniotic fluid volume (measured via ultrasound as maximum vertical pocket or amniotic fluid index), fetal breathing
movements, fetal body movements (gross), and fetal tone (extension and flexion). A score of 8-10 is considered normal.
ATI identifies BPP as a comprehensive assessment of fetal status.
3
