ATI RN Maternal Newborn Proctored Exam
2026/2027 OB Mastery Test Simulation Q&A
ACTUAL EXAM 2026/2027 | ATI RN
Maternal Newborn | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION 1: ANTEPARTUM CARE & COMPLICATIONS (Questions 1–22)
Q1: A nurse is caring for a client at 28 weeks gestation who reports headache, visual disturbances, and
right upper quadrant pain. BP is 158/96 mmHg, proteinuria 2+ on dipstick. Reflexes are 3+ with clonus.
What is the priority nursing action?
A. Administer oral nifedipine 30 mg
B. Start magnesium sulfate 4 g IV bolus, then 2 g/hr maintenance [CORRECT]
C. Place client in Trendelenburg position
D. Administer hydralazine 5 mg IV push
Correct Answer: B
Rationale: Severe features of preeclampsia (BP ≥160/110, visual disturbances, RUQ pain, hyperreflexia
with clonus) require immediate seizure prophylaxis with magnesium sulfate; hydralazine or labetalol are
used for persistent severe hypertension after magnesium initiation.
Q2: A client at 8 weeks gestation has a history of 2 spontaneous abortions, 1 term delivery, and 1 living
child. Using GTPAL, what is the correct gravida and para?
A. G3 T1 P0 A2 L1
B. G4 T1 P0 A2 L1 [CORRECT]
C. G4 T1 P1 A1 L1
D. G3 T1 P1 A1 L1
Correct Answer: B
Rationale: GTPAL counts all pregnancies including current (G=4: current + 2 SABs + 1 term); T=1 (one
,term delivery), P=0 (no preterm deliveries), A=2 (two abortions), L=1 (one living child). The current
pregnancy counts in gravida regardless of outcome.
Q3: A nurse is calculating the estimated date of delivery using Naegele's rule for a client whose LMP was
March 15, 2025. What is the EDD?
A. December 8, 2025
B. December 15, 2025
C. December 22, 2025 [CORRECT]
D. January 8, 2026
Correct Answer: C
Rationale: Naegele's rule: subtract 3 months from LMP (March → December), add 7 days (15 + 7 = 22),
and add 1 year (2025 → 2025 since December is within the same year); EDD is December 22, 2025.
Q4: A client at 16 weeks gestation asks when she should expect to feel fetal movement. What is the
nurse's best response?
A. "You should feel movement by 12 weeks gestation"
B. "Most first-time mothers feel movement between 18–20 weeks" [CORRECT]
C. "Fetal movement is not felt until 24 weeks"
D. "You should feel movement by 28 weeks with daily counting starting then"
Correct Answer: B
Rationale: Nulliparous women typically perceive fetal movement (quickening) between 18–20 weeks
gestation; multiparous women may feel movement earlier (16–18 weeks). Daily fetal movement
counting (kick counts) begins at 28 weeks.
Q5: A nurse is reviewing prenatal lab results for a client at 28 weeks. Which finding requires immediate
follow-up?
A. Hemoglobin 11.2 g/dL
B. Blood type A positive
C. 1-hour glucose screen 155 mg/dL [CORRECT]
D. Rubella titer 1:8 (immune)
Correct Answer: C
Rationale: A 1-hour glucose challenge test result ≥140 mg/dL (some use ≥130–135) requires a 3-hour
glucose tolerance test to diagnose gestational diabetes; 155 mg/dL is abnormal and needs follow-up.
,Hemoglobin 11.2 is mild anemia common in pregnancy, A-positive is normal, and rubella titer 1:8
indicates immunity.
Q6: A client at 32 weeks gestation with Rh-negative blood type has an indirect Coombs titer of 1:8. The
father is Rh-positive. What is the priority nursing action?
A. Administer Rho(D) immune globulin (RhoGAM) 300 mcg IM now [CORRECT]
B. Wait until 36 weeks to administer RhoGAM
C. Administer RhoGAM only after delivery if baby is Rh-positive
D. No RhoGAM needed since titer is low
Correct Answer: A
Rationale: Rh-negative women receive RhoGAM at 28 weeks gestation (standard antepartum dose) and
within 72 hours postpartum if infant is Rh-positive; a rising indirect Coombs titer indicates sensitization
risk, and antepartum RhoGAM prevents alloimmunization.
Q7: A nurse is caring for a client at 10 weeks gestation with severe nausea and vomiting, unable to keep
fluids down for 48 hours, weight loss of 5 lbs, and ketonuria. What is the priority intervention?
A. Recommend ginger supplements and small frequent meals
B. Start IV fluids with dextrose and antiemetics; admit for hyperemesis gravidarum [CORRECT]
C. Prescribe promethazine 25 mg PO and send home
D. Order an upper GI series to rule out other causes
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by persistent vomiting, weight loss >5%
prepregnancy weight, dehydration, and ketonuria requiring hospitalization for IV hydration, electrolyte
replacement, and antiemetic therapy; outpatient management is insufficient for this severity.
Q8: A client at 20 weeks gestation reports painless vaginal bleeding. Ultrasound shows placenta covering
the internal os. The client is hemodynamically stable. What is the priority nursing intervention?
A. Prepare for immediate cesarean delivery
B. Maintain bed rest, avoid vaginal exams, and monitor bleeding [CORRECT]
C. Perform a sterile vaginal exam to assess cervical dilation
D. Administer oxytocin to induce labor
Correct Answer: B
Rationale: Placenta previa presents with painless bleeding; vaginal exams are contraindicated due to
, risk of precipitating hemorrhage. Management for stable patients includes bed rest, monitoring, and
delivery by cesarean when fetal maturity is achieved or bleeding becomes severe.
Q9: A client at 34 weeks gestation presents with sudden-onset severe abdominal pain, rigid uterus, and
vaginal bleeding. FHR shows late decelerations. What is the most likely diagnosis?
A. Placenta previa
B. Placental abruption [CORRECT]
C. Preterm labor
D. Uterine rupture
Correct Answer: B
Rationale: Placental abruption presents with painful bleeding, uterine tenderness/rigidity, and fetal
distress (late decelerations); placenta previa causes painless bleeding, preterm labor presents with
regular contractions, and uterine rupture occurs intrapartum with loss of fetal station.
Q10: A nurse is teaching a client at 12 weeks gestation about foods to avoid. Which foods should the
client avoid? (Select all that apply)
A. Deli meats and unpasteurized cheeses [CORRECT]
B. Raw or undercooked fish [CORRECT]
C. Alcohol in any amount [CORRECT]
D. Pasteurized milk
E. Cooked vegetables
Correct Answer: A, B, C
Rationale: Pregnant women should avoid deli meats (Listeria risk), unpasteurized dairy products,
raw/undercooked seafood (parasite/bacterial risk), and all alcohol (FASD risk). Pasteurized milk and
cooked vegetables are safe.
Q11: A client at 24 weeks gestation with type 1 diabetes has a fasting blood glucose of 142 mg/dL and 2-
hour postprandial of 198 mg/dL. What is the nurse's priority teaching?
A. "Your blood sugars are well-controlled for pregnancy"
B. "Insulin requirements decrease in the second trimester"
C. "Tighter glycemic control is needed; target fasting <95 mg/dL and 2-hour <120 mg/dL" [CORRECT]
D. "Oral hypoglycemic agents are safe in pregnancy"
Correct Answer: C
Rationale: Pregnancy glycemic targets are stricter than non-pregnant: fasting <95 mg/dL, 1-hour
2026/2027 OB Mastery Test Simulation Q&A
ACTUAL EXAM 2026/2027 | ATI RN
Maternal Newborn | Verified Q&A | Pass
Guaranteed - A+ Graded
SECTION 1: ANTEPARTUM CARE & COMPLICATIONS (Questions 1–22)
Q1: A nurse is caring for a client at 28 weeks gestation who reports headache, visual disturbances, and
right upper quadrant pain. BP is 158/96 mmHg, proteinuria 2+ on dipstick. Reflexes are 3+ with clonus.
What is the priority nursing action?
A. Administer oral nifedipine 30 mg
B. Start magnesium sulfate 4 g IV bolus, then 2 g/hr maintenance [CORRECT]
C. Place client in Trendelenburg position
D. Administer hydralazine 5 mg IV push
Correct Answer: B
Rationale: Severe features of preeclampsia (BP ≥160/110, visual disturbances, RUQ pain, hyperreflexia
with clonus) require immediate seizure prophylaxis with magnesium sulfate; hydralazine or labetalol are
used for persistent severe hypertension after magnesium initiation.
Q2: A client at 8 weeks gestation has a history of 2 spontaneous abortions, 1 term delivery, and 1 living
child. Using GTPAL, what is the correct gravida and para?
A. G3 T1 P0 A2 L1
B. G4 T1 P0 A2 L1 [CORRECT]
C. G4 T1 P1 A1 L1
D. G3 T1 P1 A1 L1
Correct Answer: B
Rationale: GTPAL counts all pregnancies including current (G=4: current + 2 SABs + 1 term); T=1 (one
,term delivery), P=0 (no preterm deliveries), A=2 (two abortions), L=1 (one living child). The current
pregnancy counts in gravida regardless of outcome.
Q3: A nurse is calculating the estimated date of delivery using Naegele's rule for a client whose LMP was
March 15, 2025. What is the EDD?
A. December 8, 2025
B. December 15, 2025
C. December 22, 2025 [CORRECT]
D. January 8, 2026
Correct Answer: C
Rationale: Naegele's rule: subtract 3 months from LMP (March → December), add 7 days (15 + 7 = 22),
and add 1 year (2025 → 2025 since December is within the same year); EDD is December 22, 2025.
Q4: A client at 16 weeks gestation asks when she should expect to feel fetal movement. What is the
nurse's best response?
A. "You should feel movement by 12 weeks gestation"
B. "Most first-time mothers feel movement between 18–20 weeks" [CORRECT]
C. "Fetal movement is not felt until 24 weeks"
D. "You should feel movement by 28 weeks with daily counting starting then"
Correct Answer: B
Rationale: Nulliparous women typically perceive fetal movement (quickening) between 18–20 weeks
gestation; multiparous women may feel movement earlier (16–18 weeks). Daily fetal movement
counting (kick counts) begins at 28 weeks.
Q5: A nurse is reviewing prenatal lab results for a client at 28 weeks. Which finding requires immediate
follow-up?
A. Hemoglobin 11.2 g/dL
B. Blood type A positive
C. 1-hour glucose screen 155 mg/dL [CORRECT]
D. Rubella titer 1:8 (immune)
Correct Answer: C
Rationale: A 1-hour glucose challenge test result ≥140 mg/dL (some use ≥130–135) requires a 3-hour
glucose tolerance test to diagnose gestational diabetes; 155 mg/dL is abnormal and needs follow-up.
,Hemoglobin 11.2 is mild anemia common in pregnancy, A-positive is normal, and rubella titer 1:8
indicates immunity.
Q6: A client at 32 weeks gestation with Rh-negative blood type has an indirect Coombs titer of 1:8. The
father is Rh-positive. What is the priority nursing action?
A. Administer Rho(D) immune globulin (RhoGAM) 300 mcg IM now [CORRECT]
B. Wait until 36 weeks to administer RhoGAM
C. Administer RhoGAM only after delivery if baby is Rh-positive
D. No RhoGAM needed since titer is low
Correct Answer: A
Rationale: Rh-negative women receive RhoGAM at 28 weeks gestation (standard antepartum dose) and
within 72 hours postpartum if infant is Rh-positive; a rising indirect Coombs titer indicates sensitization
risk, and antepartum RhoGAM prevents alloimmunization.
Q7: A nurse is caring for a client at 10 weeks gestation with severe nausea and vomiting, unable to keep
fluids down for 48 hours, weight loss of 5 lbs, and ketonuria. What is the priority intervention?
A. Recommend ginger supplements and small frequent meals
B. Start IV fluids with dextrose and antiemetics; admit for hyperemesis gravidarum [CORRECT]
C. Prescribe promethazine 25 mg PO and send home
D. Order an upper GI series to rule out other causes
Correct Answer: B
Rationale: Hyperemesis gravidarum is characterized by persistent vomiting, weight loss >5%
prepregnancy weight, dehydration, and ketonuria requiring hospitalization for IV hydration, electrolyte
replacement, and antiemetic therapy; outpatient management is insufficient for this severity.
Q8: A client at 20 weeks gestation reports painless vaginal bleeding. Ultrasound shows placenta covering
the internal os. The client is hemodynamically stable. What is the priority nursing intervention?
A. Prepare for immediate cesarean delivery
B. Maintain bed rest, avoid vaginal exams, and monitor bleeding [CORRECT]
C. Perform a sterile vaginal exam to assess cervical dilation
D. Administer oxytocin to induce labor
Correct Answer: B
Rationale: Placenta previa presents with painless bleeding; vaginal exams are contraindicated due to
, risk of precipitating hemorrhage. Management for stable patients includes bed rest, monitoring, and
delivery by cesarean when fetal maturity is achieved or bleeding becomes severe.
Q9: A client at 34 weeks gestation presents with sudden-onset severe abdominal pain, rigid uterus, and
vaginal bleeding. FHR shows late decelerations. What is the most likely diagnosis?
A. Placenta previa
B. Placental abruption [CORRECT]
C. Preterm labor
D. Uterine rupture
Correct Answer: B
Rationale: Placental abruption presents with painful bleeding, uterine tenderness/rigidity, and fetal
distress (late decelerations); placenta previa causes painless bleeding, preterm labor presents with
regular contractions, and uterine rupture occurs intrapartum with loss of fetal station.
Q10: A nurse is teaching a client at 12 weeks gestation about foods to avoid. Which foods should the
client avoid? (Select all that apply)
A. Deli meats and unpasteurized cheeses [CORRECT]
B. Raw or undercooked fish [CORRECT]
C. Alcohol in any amount [CORRECT]
D. Pasteurized milk
E. Cooked vegetables
Correct Answer: A, B, C
Rationale: Pregnant women should avoid deli meats (Listeria risk), unpasteurized dairy products,
raw/undercooked seafood (parasite/bacterial risk), and all alcohol (FASD risk). Pasteurized milk and
cooked vegetables are safe.
Q11: A client at 24 weeks gestation with type 1 diabetes has a fasting blood glucose of 142 mg/dL and 2-
hour postprandial of 198 mg/dL. What is the nurse's priority teaching?
A. "Your blood sugars are well-controlled for pregnancy"
B. "Insulin requirements decrease in the second trimester"
C. "Tighter glycemic control is needed; target fasting <95 mg/dL and 2-hour <120 mg/dL" [CORRECT]
D. "Oral hypoglycemic agents are safe in pregnancy"
Correct Answer: C
Rationale: Pregnancy glycemic targets are stricter than non-pregnant: fasting <95 mg/dL, 1-hour
