ATI RN MATERNAL NEWBORN CMS PROCTORED LATEST
EXAM 2025/2026 | Actual Exam All 70 Questions with Correct
Detailed Answers and Rationales | Already Graded A+ | Pass
Guaranteed
Domain 1: Antepartum Care (12 Questions)
Q1: A pregnant client at 28 weeks gestation reports increasing fatigue, pallor, and
difficulty concentrating. Laboratory results reveal hemoglobin 9.8 g/dL, hematocrit 30%,
and MCV 78 fL. The nurse should anticipate which intervention as priority?
A. Immediate blood transfusion to restore oxygen-carrying capacity
B. Oral ferrous sulfate supplementation and dietary counseling for iron deficiency
anemia [CORRECT]
C. Subcutaneous erythropoietin injections three times weekly
D. Intravenous iron dextran administration in the outpatient setting
Correct Answer: B
Rationale: The laboratory values indicate iron deficiency anemia (microcytic,
hypochromic anemia with low MCV) common in pregnancy due to expanded blood
volume and increased iron demands. Hemoglobin 9.8 g/dL represents moderate anemia
in pregnancy (mild: 10-10.9 g/dL, moderate: 7-9.9 g/dL, severe: <7 g/dL). First-line
treatment is oral iron supplementation (ferrous sulfate 325 mg daily or every other day)
combined with dietary counseling to increase heme iron sources (red meat, fortified
,cereals) and vitamin C to enhance absorption. This conservative approach is
appropriate for hemoglobin >7 g/dL without cardiac compromise.
Why A is incorrect: Blood transfusion is reserved for severe anemia (Hgb <7 g/dL) with
hemodynamic instability, active bleeding, or cardiac decompensation. This client's
values do not meet transfusion criteria.
Why C is incorrect: Erythropoietin stimulates red blood cell production but is not
first-line for iron deficiency anemia. It is used for anemia of chronic disease or renal
failure when iron stores are adequate.
Why D is incorrect: IV iron is reserved for clients who cannot tolerate oral iron, have
malabsorption disorders, or fail oral therapy after 4 weeks. It carries risks of anaphylaxis
and requires monitoring.
Q2: A client at 16 weeks gestation asks the nurse about appropriate exercise during
pregnancy. Which instruction should the nurse include? (Select all that apply)
A. Avoid exercises requiring supine positions after the first trimester [CORRECT]
B. Maintain target heart rate at 80% of maximum throughout pregnancy
C. Drink fluids before, during, and after exercise to prevent dehydration [CORRECT]
D. Continue high-impact aerobics if performed regularly before pregnancy
E. Stop exercise immediately if experiencing dizziness, shortness of breath, or vaginal
bleeding [CORRECT]
F. Perform exercises that involve lying flat on the back for core strengthening
Correct Answer: A, C, E
,Rationale:
● A is correct: After 20 weeks, the gravid uterus compresses the inferior vena cava
in supine positions, reducing venous return and cardiac output (supine
hypotensive syndrome). Side-lying or semi-recumbent positions are
recommended.
● C is correct: Adequate hydration prevents dehydration, maintains uteroplacental
perfusion, and regulates maternal temperature. Pregnant women should drink
8-12 ounces of fluid before exercise and continue hydration during activity.
● E is correct: Warning signs to discontinue exercise include dizziness, dyspnea
before exertion, chest pain, headache, muscle weakness, calf pain/swelling,
vaginal bleeding, amniotic fluid leakage, decreased fetal movement, and preterm
labor contractions.
Why B is incorrect: ACOG recommends moderate-intensity exercise (rating of perceived
exertion 13-14 on Borg scale or ability to maintain conversation) rather than specific
heart rate targets. The "target heart rate" concept is outdated for pregnancy; perceived
exertion is preferred.
Why D is incorrect: High-impact exercises increase risk of joint injury due to
ligamentous laxity from relaxin, and risk of abdominal trauma. Low-impact exercises
(walking, swimming, stationary cycling) are preferred.
Why F is incorrect: This contradicts evidence-based practice. Supine positions after the
first trimester compromise hemodynamics and should be avoided.
Q3: A pregnant client at 32 weeks gestation presents with severe headache, visual
disturbances, and epigastric pain. Blood pressure is 162/104 mmHg, and urine dipstick
shows 3+ protein. Which nursing intervention is priority?
A. Administer oral nifedipine 10 mg to reduce blood pressure
B. Insert Foley catheter for strict intake and output monitoring
, C. Assess deep tendon reflexes and clonus for hyperreflexia [CORRECT]
D. Prepare for immediate vaginal delivery to resolve the condition
Correct Answer: C
Rationale: This client presents with classic signs of severe preeclampsia (BP ≥160/110,
proteinuria, cerebral symptoms [headache, visual changes], epigastric pain suggesting
liver capsule distention). Priority assessment includes neurologic status (hyperreflexia,
clonus) to determine progression to eclampsia. Hyperreflexia (3+ to 4+) and sustained
clonus indicate central nervous system irritability and impending seizure activity. This
assessment guides immediate magnesium sulfate administration decisions and seizure
precautions.
Why A is incorrect: While antihypertensives (labetalol, hydralazine, nifedipine) are
indicated for severe range BP, assessment of neurologic status takes priority to
determine severity and magnesium sulfate need. Additionally, nifedipine
immediate-release is not first-line; labetalol or hydralazine are preferred for acute
management.
Why B is incorrect: While I&O monitoring is important for fluid status assessment in
preeclampsia, it is not the priority over neurologic assessment. Oliguria (<30 mL/hr) is a
criterion for severe features, but reflexes indicate immediate life-threatening
complications.
Why D is incorrect: Delivery is the definitive treatment for preeclampsia, but immediate
delivery is not indicated at 32 weeks with severe features unless maternal condition
deteriorates or eclampsia occurs. Stabilization with magnesium sulfate,
antihypertensives, and possible corticosteroids for fetal lung maturity precede delivery
planning.
EXAM 2025/2026 | Actual Exam All 70 Questions with Correct
Detailed Answers and Rationales | Already Graded A+ | Pass
Guaranteed
Domain 1: Antepartum Care (12 Questions)
Q1: A pregnant client at 28 weeks gestation reports increasing fatigue, pallor, and
difficulty concentrating. Laboratory results reveal hemoglobin 9.8 g/dL, hematocrit 30%,
and MCV 78 fL. The nurse should anticipate which intervention as priority?
A. Immediate blood transfusion to restore oxygen-carrying capacity
B. Oral ferrous sulfate supplementation and dietary counseling for iron deficiency
anemia [CORRECT]
C. Subcutaneous erythropoietin injections three times weekly
D. Intravenous iron dextran administration in the outpatient setting
Correct Answer: B
Rationale: The laboratory values indicate iron deficiency anemia (microcytic,
hypochromic anemia with low MCV) common in pregnancy due to expanded blood
volume and increased iron demands. Hemoglobin 9.8 g/dL represents moderate anemia
in pregnancy (mild: 10-10.9 g/dL, moderate: 7-9.9 g/dL, severe: <7 g/dL). First-line
treatment is oral iron supplementation (ferrous sulfate 325 mg daily or every other day)
combined with dietary counseling to increase heme iron sources (red meat, fortified
,cereals) and vitamin C to enhance absorption. This conservative approach is
appropriate for hemoglobin >7 g/dL without cardiac compromise.
Why A is incorrect: Blood transfusion is reserved for severe anemia (Hgb <7 g/dL) with
hemodynamic instability, active bleeding, or cardiac decompensation. This client's
values do not meet transfusion criteria.
Why C is incorrect: Erythropoietin stimulates red blood cell production but is not
first-line for iron deficiency anemia. It is used for anemia of chronic disease or renal
failure when iron stores are adequate.
Why D is incorrect: IV iron is reserved for clients who cannot tolerate oral iron, have
malabsorption disorders, or fail oral therapy after 4 weeks. It carries risks of anaphylaxis
and requires monitoring.
Q2: A client at 16 weeks gestation asks the nurse about appropriate exercise during
pregnancy. Which instruction should the nurse include? (Select all that apply)
A. Avoid exercises requiring supine positions after the first trimester [CORRECT]
B. Maintain target heart rate at 80% of maximum throughout pregnancy
C. Drink fluids before, during, and after exercise to prevent dehydration [CORRECT]
D. Continue high-impact aerobics if performed regularly before pregnancy
E. Stop exercise immediately if experiencing dizziness, shortness of breath, or vaginal
bleeding [CORRECT]
F. Perform exercises that involve lying flat on the back for core strengthening
Correct Answer: A, C, E
,Rationale:
● A is correct: After 20 weeks, the gravid uterus compresses the inferior vena cava
in supine positions, reducing venous return and cardiac output (supine
hypotensive syndrome). Side-lying or semi-recumbent positions are
recommended.
● C is correct: Adequate hydration prevents dehydration, maintains uteroplacental
perfusion, and regulates maternal temperature. Pregnant women should drink
8-12 ounces of fluid before exercise and continue hydration during activity.
● E is correct: Warning signs to discontinue exercise include dizziness, dyspnea
before exertion, chest pain, headache, muscle weakness, calf pain/swelling,
vaginal bleeding, amniotic fluid leakage, decreased fetal movement, and preterm
labor contractions.
Why B is incorrect: ACOG recommends moderate-intensity exercise (rating of perceived
exertion 13-14 on Borg scale or ability to maintain conversation) rather than specific
heart rate targets. The "target heart rate" concept is outdated for pregnancy; perceived
exertion is preferred.
Why D is incorrect: High-impact exercises increase risk of joint injury due to
ligamentous laxity from relaxin, and risk of abdominal trauma. Low-impact exercises
(walking, swimming, stationary cycling) are preferred.
Why F is incorrect: This contradicts evidence-based practice. Supine positions after the
first trimester compromise hemodynamics and should be avoided.
Q3: A pregnant client at 32 weeks gestation presents with severe headache, visual
disturbances, and epigastric pain. Blood pressure is 162/104 mmHg, and urine dipstick
shows 3+ protein. Which nursing intervention is priority?
A. Administer oral nifedipine 10 mg to reduce blood pressure
B. Insert Foley catheter for strict intake and output monitoring
, C. Assess deep tendon reflexes and clonus for hyperreflexia [CORRECT]
D. Prepare for immediate vaginal delivery to resolve the condition
Correct Answer: C
Rationale: This client presents with classic signs of severe preeclampsia (BP ≥160/110,
proteinuria, cerebral symptoms [headache, visual changes], epigastric pain suggesting
liver capsule distention). Priority assessment includes neurologic status (hyperreflexia,
clonus) to determine progression to eclampsia. Hyperreflexia (3+ to 4+) and sustained
clonus indicate central nervous system irritability and impending seizure activity. This
assessment guides immediate magnesium sulfate administration decisions and seizure
precautions.
Why A is incorrect: While antihypertensives (labetalol, hydralazine, nifedipine) are
indicated for severe range BP, assessment of neurologic status takes priority to
determine severity and magnesium sulfate need. Additionally, nifedipine
immediate-release is not first-line; labetalol or hydralazine are preferred for acute
management.
Why B is incorrect: While I&O monitoring is important for fluid status assessment in
preeclampsia, it is not the priority over neurologic assessment. Oliguria (<30 mL/hr) is a
criterion for severe features, but reflexes indicate immediate life-threatening
complications.
Why D is incorrect: Delivery is the definitive treatment for preeclampsia, but immediate
delivery is not indicated at 32 weeks with severe features unless maternal condition
deteriorates or eclampsia occurs. Stabilization with magnesium sulfate,
antihypertensives, and possible corticosteroids for fetal lung maturity precede delivery
planning.
