ATI Maternal Newborn Nursing Exam Study Guide, ATI
Maternal Newborn Proctored Exam Questions & Answers,
Comprehensive Maternity Nursing Notes, NCLEX-Aligned
Practice, Obstetric & Neonatal Care Review
Question 1: A nurse is assessing a client at 32 weeks of gestation who reports experiencing
occasional, irregular uterine contractions. Which finding should the nurse identify as a sign of
preterm labor rather than Braxton Hicks contractions?
A. Contractions that subside with rest and hydration
B. Contractions that occur at irregular intervals and decrease with position change
C. Contractions accompanied by cervical dilation and effacement
D. Contractions that are painless and felt only in the abdomen
CORRECT ANSWER: C. Contractions accompanied by cervical dilation and effacement
Rationale: Preterm labor is characterized by regular uterine contractions accompanied by
cervical changes such as dilation and effacement before 37 weeks of gestation. Braxton Hicks
contractions are irregular, painless, and do not cause cervical changes. Rest, hydration, and
position changes typically alleviate Braxton Hicks but not true preterm labor contractions.
Question 2: A nurse is caring for a postpartum client who is 2 hours after delivery. The nurse
notes the fundus is boggy and displaced to the right. What is the priority nursing action?
A. Administer prescribed oxytocin
B. Assist the client to empty her bladder
C. Massage the fundus until firm
D. Notify the provider immediately
CORRECT ANSWER: B. Assist the client to empty her bladder
Rationale: A boggy, displaced fundus is often caused by a distended bladder, which prevents
adequate uterine contraction and increases the risk of postpartum hemorrhage. The priority
action is to assist the client to void, which typically allows the uterus to contract and return to
midline. Fundal massage may follow if the uterus remains boggy after voiding.
Question 3: A nurse is teaching a pregnant client about warning signs to report during
pregnancy. Which statement by the client indicates understanding of the teaching?
A. "I should report mild ankle swelling that resolves with elevation."
B. "I should report a headache that is relieved by acetaminophen."
C. "I should report visual changes such as seeing spots or blurred vision."
D. "I should report increased vaginal discharge that is clear and odorless."
CORRECT ANSWER: C. I should report visual changes such as seeing spots or blurred vision.
Rationale: Visual disturbances such as spots, blurred vision, or photophobia are warning signs
of preeclampsia and require immediate reporting. Mild ankle edema that resolves with
elevation, headaches relieved by acetaminophen, and clear odorless vaginal discharge are
common, non-urgent findings in pregnancy.
Question 4: A nurse is assessing a newborn 1 hour after birth. Which finding should the nurse
report to the provider?
A. Acrocyanosis of the hands and feet
B. Respiratory rate of 58 breaths per minute
,C. Central cyanosis of the lips and tongue
D. Heart rate of 145 beats per minute
CORRECT ANSWER: C. Central cyanosis of the lips and tongue
Rationale: Central cyanosis (bluish discoloration of the lips, tongue, or trunk) indicates
inadequate oxygenation and requires immediate evaluation. Acrocyanosis (blue hands and
feet) is normal in the first 24-48 hours. A respiratory rate of 30-60 breaths/min and heart rate
of 110-160 beats/min are within normal newborn ranges.
Question 5: A nurse is preparing to administer vitamin K to a newborn. The parent asks why
this medication is necessary. Which response should the nurse provide?
A. "Vitamin K prevents infection in the newborn."
B. "Vitamin K helps the newborn's liver mature."
C. "Vitamin K promotes blood clotting and prevents hemorrhagic disease."
D. "Vitamin K supports the development of the newborn's immune system."
CORRECT ANSWER: C. Vitamin K promotes blood clotting and prevents hemorrhagic disease.
Rationale: Newborns have low vitamin K stores at birth because it does not cross the placenta
well and breast milk is low in vitamin K. Administering vitamin K intramuscularly prevents
vitamin K deficiency bleeding (hemorrhagic disease of the newborn) by supporting synthesis of
clotting factors II, VII, IX, and X.
Question 6: A nurse is caring for a client in active labor who has an epidural block. The client's
blood pressure drops from 120/80 mm Hg to 90/60 mm Hg. What is the priority nursing
intervention?
A. Increase the IV fluid rate
B. Place the client in a left lateral position
C. Administer prescribed ephedrine
D. Notify the anesthesiologist
CORRECT ANSWER: B. Place the client in a left lateral position
Rationale: Epidural anesthesia can cause sympathetic blockade leading to hypotension. The
priority intervention is to position the client in left lateral tilt to relieve aortocaval compression
and improve venous return, which often restores blood pressure. IV fluids should already be
running prophylactically; medications and provider notification follow if hypotension persists.
Question 7: A nurse is assessing a postpartum client who is 24 hours after a cesarean birth.
Which finding indicates the client is experiencing expected postoperative recovery?
A. Absent bowel sounds in all four quadrants
B. Temperature of 38.2° C (100.8° F)
C. Moderate lochia rubra with small clots
D. Pain rated 8/10 despite analgesia
CORRECT ANSWER: C. Moderate lochia rubra with small clots
Rationale: Moderate lochia rubra with small clots is an expected finding in the first 24-72 hours
postpartum. Absent bowel sounds may indicate ileus and require monitoring. A temperature
>38° C (100.4° F) after the first 24 hours may indicate infection. Pain should be manageable
with prescribed analgesics; uncontrolled pain requires reassessment.
,Question 8: A nurse is teaching a client about nonpharmacological pain management
techniques during labor. Which technique should the nurse recommend for the latent phase
of labor?
A. Patterned breathing exercises
B. Guided imagery and relaxation
C. Epidural analgesia
D. Pudendal nerve block
CORRECT ANSWER: B. Guided imagery and relaxation
Rationale: Guided imagery and relaxation are effective nonpharmacological techniques for the
latent phase of labor when contractions are mild to moderate. Patterned breathing is more
useful in active labor. Epidural analgesia and pudendal nerve block are pharmacological
interventions, not nonpharmacological techniques.
Question 9: A nurse is caring for a newborn with hyperbilirubinemia who is receiving
phototherapy. Which action should the nurse include in the plan of care?
A. Apply lotion to the newborn's skin before phototherapy
B. Cover the newborn's eyes with opaque patches
C. Limit fluid intake to prevent fluid overload
D. Dress the newborn in lightweight clothing during treatment
CORRECT ANSWER: B. Cover the newborn's eyes with opaque patches
Rationale: During phototherapy, the newborn's eyes must be protected with opaque patches to
prevent retinal damage from the intense light. Lotion should not be applied as it can increase
the risk of burns. Fluid intake should be increased to promote bilirubin excretion. The newborn
should be undressed (except for diaper) to maximize skin exposure to light.
Question 10: A nurse is assessing a client at 10 weeks of gestation who reports nausea and
vomiting. Which recommendation should the nurse provide to alleviate symptoms?
A. Drink large amounts of fluid with meals
B. Eat dry crackers or toast before getting out of bed
C. Avoid carbohydrates and focus on high-protein snacks
D. Take prenatal vitamins on an empty stomach in the morning
CORRECT ANSWER: B. Eat dry crackers or toast before getting out of bed
Rationale: Eating dry, bland carbohydrates like crackers or toast before rising can help reduce
morning sickness by stabilizing blood glucose and absorbing gastric acid. Fluids should be
consumed between meals, not with meals, to avoid gastric distention. Prenatal vitamins are
best taken with food to minimize nausea. A balanced diet with complex carbohydrates is
recommended.
Question 11: A nurse is monitoring a client receiving magnesium sulfate for preeclampsia.
Which assessment finding indicates magnesium toxicity?
A. Deep tendon reflexes of 2+
B. Urine output of 40 mL/hr
C. Respiratory rate of 10 breaths per minute
D. Blood pressure of 140/90 mm Hg
CORRECT ANSWER: C. Respiratory rate of 10 breaths per minute
, Rationale: Magnesium sulfate depresses the central nervous system and can cause respiratory
depression, a sign of toxicity. Other signs include absent deep tendon reflexes, urine output <30
mL/hr, and lethargy. A respiratory rate below 12 breaths/min requires immediate intervention,
including discontinuation of magnesium and administration of calcium gluconate.
Question 12: A nurse is caring for a postpartum client who is breastfeeding. The client reports
nipple soreness. Which instruction should the nurse provide?
A. "Apply warm compresses to the nipples before feeding."
B. "Break the suction by inserting a finger into the corner of the baby's mouth after feeding."
C. "Use soap and water to clean the nipples after each feeding."
D. "Limit each feeding to 5 minutes per breast to allow healing."
CORRECT ANSWER: B. Break the suction by inserting a finger into the corner of the baby's
mouth after feeding.
Rationale: Breaking suction gently before removing the infant from the breast prevents trauma
to the nipple. Warm compresses are used for engorgement, not soreness. Soap can dry and
irritate nipples; water alone is sufficient. Limiting feeding time can lead to inadequate milk
removal and engorgement; proper latch is the key intervention for soreness.
Question 13: A nurse is assessing a newborn's umbilical cord. Which finding should the nurse
report to the provider?
A. Three vessels: two arteries and one vein
B. Cord that is moist and pink at the base
C. Foul-smelling drainage from the cord stump
D. Cord stump that is drying and turning black
CORRECT ANSWER: C. Foul-smelling drainage from the cord stump
Rationale: Foul-smelling drainage, redness, or swelling at the umbilical cord base indicates
infection (omphalitis) and requires prompt evaluation. A normal cord has three vessels (two
arteries, one vein). Moisture at the base can be normal initially; the stump typically dries and
darkens as it heals.
Question 14: A nurse is teaching a pregnant client about fetal movement counting. Which
statement by the client indicates understanding?
A. "I should count movements once a week after 28 weeks."
B. "I should report if I feel fewer than 10 movements in 2 hours."
C. "I should perform counts after a large meal when the baby is most active."
D. "I should lie on my back during the count to feel movements best."
CORRECT ANSWER: B. I should report if I feel fewer than 10 movements in 2 hours.
Rationale: Clients are taught to report fewer than 10 fetal movements in 2 hours during a kick
count, as decreased movement may indicate fetal compromise. Counts are typically done daily
after 28 weeks. Side-lying position is preferred over supine to avoid vena cava compression.
Counts can be done at any time, though many babies are active after meals.
Question 15: A nurse is caring for a client in labor whose fetal heart rate pattern shows late
decelerations. Which action should the nurse take first?
A. Administer oxygen via nonrebreather mask
B. Increase the IV fluid rate
Maternal Newborn Proctored Exam Questions & Answers,
Comprehensive Maternity Nursing Notes, NCLEX-Aligned
Practice, Obstetric & Neonatal Care Review
Question 1: A nurse is assessing a client at 32 weeks of gestation who reports experiencing
occasional, irregular uterine contractions. Which finding should the nurse identify as a sign of
preterm labor rather than Braxton Hicks contractions?
A. Contractions that subside with rest and hydration
B. Contractions that occur at irregular intervals and decrease with position change
C. Contractions accompanied by cervical dilation and effacement
D. Contractions that are painless and felt only in the abdomen
CORRECT ANSWER: C. Contractions accompanied by cervical dilation and effacement
Rationale: Preterm labor is characterized by regular uterine contractions accompanied by
cervical changes such as dilation and effacement before 37 weeks of gestation. Braxton Hicks
contractions are irregular, painless, and do not cause cervical changes. Rest, hydration, and
position changes typically alleviate Braxton Hicks but not true preterm labor contractions.
Question 2: A nurse is caring for a postpartum client who is 2 hours after delivery. The nurse
notes the fundus is boggy and displaced to the right. What is the priority nursing action?
A. Administer prescribed oxytocin
B. Assist the client to empty her bladder
C. Massage the fundus until firm
D. Notify the provider immediately
CORRECT ANSWER: B. Assist the client to empty her bladder
Rationale: A boggy, displaced fundus is often caused by a distended bladder, which prevents
adequate uterine contraction and increases the risk of postpartum hemorrhage. The priority
action is to assist the client to void, which typically allows the uterus to contract and return to
midline. Fundal massage may follow if the uterus remains boggy after voiding.
Question 3: A nurse is teaching a pregnant client about warning signs to report during
pregnancy. Which statement by the client indicates understanding of the teaching?
A. "I should report mild ankle swelling that resolves with elevation."
B. "I should report a headache that is relieved by acetaminophen."
C. "I should report visual changes such as seeing spots or blurred vision."
D. "I should report increased vaginal discharge that is clear and odorless."
CORRECT ANSWER: C. I should report visual changes such as seeing spots or blurred vision.
Rationale: Visual disturbances such as spots, blurred vision, or photophobia are warning signs
of preeclampsia and require immediate reporting. Mild ankle edema that resolves with
elevation, headaches relieved by acetaminophen, and clear odorless vaginal discharge are
common, non-urgent findings in pregnancy.
Question 4: A nurse is assessing a newborn 1 hour after birth. Which finding should the nurse
report to the provider?
A. Acrocyanosis of the hands and feet
B. Respiratory rate of 58 breaths per minute
,C. Central cyanosis of the lips and tongue
D. Heart rate of 145 beats per minute
CORRECT ANSWER: C. Central cyanosis of the lips and tongue
Rationale: Central cyanosis (bluish discoloration of the lips, tongue, or trunk) indicates
inadequate oxygenation and requires immediate evaluation. Acrocyanosis (blue hands and
feet) is normal in the first 24-48 hours. A respiratory rate of 30-60 breaths/min and heart rate
of 110-160 beats/min are within normal newborn ranges.
Question 5: A nurse is preparing to administer vitamin K to a newborn. The parent asks why
this medication is necessary. Which response should the nurse provide?
A. "Vitamin K prevents infection in the newborn."
B. "Vitamin K helps the newborn's liver mature."
C. "Vitamin K promotes blood clotting and prevents hemorrhagic disease."
D. "Vitamin K supports the development of the newborn's immune system."
CORRECT ANSWER: C. Vitamin K promotes blood clotting and prevents hemorrhagic disease.
Rationale: Newborns have low vitamin K stores at birth because it does not cross the placenta
well and breast milk is low in vitamin K. Administering vitamin K intramuscularly prevents
vitamin K deficiency bleeding (hemorrhagic disease of the newborn) by supporting synthesis of
clotting factors II, VII, IX, and X.
Question 6: A nurse is caring for a client in active labor who has an epidural block. The client's
blood pressure drops from 120/80 mm Hg to 90/60 mm Hg. What is the priority nursing
intervention?
A. Increase the IV fluid rate
B. Place the client in a left lateral position
C. Administer prescribed ephedrine
D. Notify the anesthesiologist
CORRECT ANSWER: B. Place the client in a left lateral position
Rationale: Epidural anesthesia can cause sympathetic blockade leading to hypotension. The
priority intervention is to position the client in left lateral tilt to relieve aortocaval compression
and improve venous return, which often restores blood pressure. IV fluids should already be
running prophylactically; medications and provider notification follow if hypotension persists.
Question 7: A nurse is assessing a postpartum client who is 24 hours after a cesarean birth.
Which finding indicates the client is experiencing expected postoperative recovery?
A. Absent bowel sounds in all four quadrants
B. Temperature of 38.2° C (100.8° F)
C. Moderate lochia rubra with small clots
D. Pain rated 8/10 despite analgesia
CORRECT ANSWER: C. Moderate lochia rubra with small clots
Rationale: Moderate lochia rubra with small clots is an expected finding in the first 24-72 hours
postpartum. Absent bowel sounds may indicate ileus and require monitoring. A temperature
>38° C (100.4° F) after the first 24 hours may indicate infection. Pain should be manageable
with prescribed analgesics; uncontrolled pain requires reassessment.
,Question 8: A nurse is teaching a client about nonpharmacological pain management
techniques during labor. Which technique should the nurse recommend for the latent phase
of labor?
A. Patterned breathing exercises
B. Guided imagery and relaxation
C. Epidural analgesia
D. Pudendal nerve block
CORRECT ANSWER: B. Guided imagery and relaxation
Rationale: Guided imagery and relaxation are effective nonpharmacological techniques for the
latent phase of labor when contractions are mild to moderate. Patterned breathing is more
useful in active labor. Epidural analgesia and pudendal nerve block are pharmacological
interventions, not nonpharmacological techniques.
Question 9: A nurse is caring for a newborn with hyperbilirubinemia who is receiving
phototherapy. Which action should the nurse include in the plan of care?
A. Apply lotion to the newborn's skin before phototherapy
B. Cover the newborn's eyes with opaque patches
C. Limit fluid intake to prevent fluid overload
D. Dress the newborn in lightweight clothing during treatment
CORRECT ANSWER: B. Cover the newborn's eyes with opaque patches
Rationale: During phototherapy, the newborn's eyes must be protected with opaque patches to
prevent retinal damage from the intense light. Lotion should not be applied as it can increase
the risk of burns. Fluid intake should be increased to promote bilirubin excretion. The newborn
should be undressed (except for diaper) to maximize skin exposure to light.
Question 10: A nurse is assessing a client at 10 weeks of gestation who reports nausea and
vomiting. Which recommendation should the nurse provide to alleviate symptoms?
A. Drink large amounts of fluid with meals
B. Eat dry crackers or toast before getting out of bed
C. Avoid carbohydrates and focus on high-protein snacks
D. Take prenatal vitamins on an empty stomach in the morning
CORRECT ANSWER: B. Eat dry crackers or toast before getting out of bed
Rationale: Eating dry, bland carbohydrates like crackers or toast before rising can help reduce
morning sickness by stabilizing blood glucose and absorbing gastric acid. Fluids should be
consumed between meals, not with meals, to avoid gastric distention. Prenatal vitamins are
best taken with food to minimize nausea. A balanced diet with complex carbohydrates is
recommended.
Question 11: A nurse is monitoring a client receiving magnesium sulfate for preeclampsia.
Which assessment finding indicates magnesium toxicity?
A. Deep tendon reflexes of 2+
B. Urine output of 40 mL/hr
C. Respiratory rate of 10 breaths per minute
D. Blood pressure of 140/90 mm Hg
CORRECT ANSWER: C. Respiratory rate of 10 breaths per minute
, Rationale: Magnesium sulfate depresses the central nervous system and can cause respiratory
depression, a sign of toxicity. Other signs include absent deep tendon reflexes, urine output <30
mL/hr, and lethargy. A respiratory rate below 12 breaths/min requires immediate intervention,
including discontinuation of magnesium and administration of calcium gluconate.
Question 12: A nurse is caring for a postpartum client who is breastfeeding. The client reports
nipple soreness. Which instruction should the nurse provide?
A. "Apply warm compresses to the nipples before feeding."
B. "Break the suction by inserting a finger into the corner of the baby's mouth after feeding."
C. "Use soap and water to clean the nipples after each feeding."
D. "Limit each feeding to 5 minutes per breast to allow healing."
CORRECT ANSWER: B. Break the suction by inserting a finger into the corner of the baby's
mouth after feeding.
Rationale: Breaking suction gently before removing the infant from the breast prevents trauma
to the nipple. Warm compresses are used for engorgement, not soreness. Soap can dry and
irritate nipples; water alone is sufficient. Limiting feeding time can lead to inadequate milk
removal and engorgement; proper latch is the key intervention for soreness.
Question 13: A nurse is assessing a newborn's umbilical cord. Which finding should the nurse
report to the provider?
A. Three vessels: two arteries and one vein
B. Cord that is moist and pink at the base
C. Foul-smelling drainage from the cord stump
D. Cord stump that is drying and turning black
CORRECT ANSWER: C. Foul-smelling drainage from the cord stump
Rationale: Foul-smelling drainage, redness, or swelling at the umbilical cord base indicates
infection (omphalitis) and requires prompt evaluation. A normal cord has three vessels (two
arteries, one vein). Moisture at the base can be normal initially; the stump typically dries and
darkens as it heals.
Question 14: A nurse is teaching a pregnant client about fetal movement counting. Which
statement by the client indicates understanding?
A. "I should count movements once a week after 28 weeks."
B. "I should report if I feel fewer than 10 movements in 2 hours."
C. "I should perform counts after a large meal when the baby is most active."
D. "I should lie on my back during the count to feel movements best."
CORRECT ANSWER: B. I should report if I feel fewer than 10 movements in 2 hours.
Rationale: Clients are taught to report fewer than 10 fetal movements in 2 hours during a kick
count, as decreased movement may indicate fetal compromise. Counts are typically done daily
after 28 weeks. Side-lying position is preferred over supine to avoid vena cava compression.
Counts can be done at any time, though many babies are active after meals.
Question 15: A nurse is caring for a client in labor whose fetal heart rate pattern shows late
decelerations. Which action should the nurse take first?
A. Administer oxygen via nonrebreather mask
B. Increase the IV fluid rate
