ATI Maternal Newborn Retake
Exam latest 2026 NCLEX/ATI standards.
Topic 1: Antepartum (Prenatal Care & Complications)
1. A nurse is assessing a client at 12 weeks gestation. Which of the following
findings should the nurse report to the provider?
a) Heartburn after eating spicy foods
b) Dark red, painless vaginal bleeding
c) Increased urinary frequency
d) Leukorrhea without odor
Rationale: Dark red, painless bleeding is a classic sign of a threatened abortion or
subchorionic hemorrhage. Heartburn, urinary frequency, and leukorrhea are
expected discomforts of pregnancy.
2. A nurse is teaching a client about expected physiological changes during
pregnancy. Which statement indicates understanding?
a) "I will likely have a decrease in my metabolic rate."
b) "My blood pressure will decrease during the first trimester."
c) "My heart will increase in size, and my pulse will slow down."
d) "I will notice a white, odorless vaginal discharge."
Rationale: Leukorrhea (increased white, odorless discharge) is common due to
increased estrogen and vascularity. BP decreases in the second trimester, pulse
increases, and metabolic rate increases.
3. A nurse is reviewing lab results for a client at 10 weeks gestation. Which
value requires immediate intervention?
a) Hemoglobin 11.2 g/dL
b) Rubella titer < 1:8
c) White blood cell count 12,000/mm³
d) Hematocrit 34%
Rationale: A Rubella titer <1:8 indicates non-immunity. The client must be
vaccinated postpartum (avoid during pregnancy). Slight anemia and elevated
WBCs are normal in pregnancy.
,4. A nurse is providing education about folic acid. What is the primary
purpose?
a) Prevention of gestational diabetes
b) Prevention of neural tube defects
c) Prevention of preeclampsia
d) Prevention of postpartum hemorrhage
Rationale: Folic acid (400-800 mcg) is crucial for neural tube closure during the
first 28 days of gestation, before many women know they are pregnant.
5. A nurse is assessing a client for signs of preeclampsia. Which finding is an
early indicator?
a) Generalized edema
b) Proteinuria 2+
c) Blood pressure 148/92 mm Hg
d) Hyperreflexia
Rationale: Hypertension (≥140/90) is the hallmark diagnostic criteria. Edema is no
longer a reliable indicator. Proteinuria and hyperreflexia are later signs.
6. A nurse is caring for a client with gestational diabetes mellitus (GDM).
Which finding indicates effective glycemic control?
a) Postprandial blood glucose 160 mg/dL
b) Fasting blood glucose 85 mg/dL
c) Hemoglobin A1c 7.5%
d) Glucose in the urine
Rationale: Target fasting glucose for GDM is <95 mg/dL. Postprandial should be
<120-140. Urine glucose is not a reliable indicator for management.
7. A nurse is administering Rho(D) immune globulin (RhoGAM) to a client at
28 weeks gestation. What is the purpose?
a) Prevent fetal hemolysis in Rh-negative mother with Rh-positive fetus
b) Treat maternal anemia
c) Prevent preterm labor
d) Boost fetal lung maturity
Rationale: RhoGAM prevents the Rh-negative mother from forming antibodies
against Rh-positive fetal blood cells, protecting subsequent pregnancies.
, 8. A nurse suspects a placental abruption. Which finding supports this?
a) Dark red bleeding with rigid, board-like abdomen
b) Painless bright red bleeding
c) Fever and foul-smelling discharge
d) Prolonged decelerations on fetal monitoring
Rationale: Abruptio placentae involves premature separation of the placenta,
leading to concealed or revealed dark bleeding, severe pain, and uterine rigidity.
9. A client with hyperemesis gravidarum is admitted. Which lab finding is
most concerning?
a) Potassium 2.9 mEq/L
b) Sodium 138 mEq/L
c) Urine ketones 1+
d) Hematocrit 38%
Rationale: Severe hypokalemia (K < 3.0) can lead to cardiac dysrhythmias. This
requires IV replacement and cardiac monitoring.
10. A nurse is performing a nonstress test (NST). What indicates a reactive
result?
a) Two fetal heart rate accelerations of 10 bpm lasting 10 seconds in 20 minutes
b) Two fetal heart rate accelerations of 15 bpm lasting 15 seconds in 20
minutes
c) Variable decelerations present
d) Late decelerations present
Rationale: A reactive NST (reassuring) shows at least 2 accelerations of 15x15 in
a 20-minute window for a fetus >32 weeks.
Topic 2: Intrapartum (Labor & Delivery)
11. A nurse assesses a client in active labor. Cervix is 6 cm, 90% effaced, 0
station. FHR baseline 140 with moderate variability. The client suddenly
reports severe pain and the FHR drops to 80 with variable decelerations.
What is the priority action?
a) Increase oxytocin infusion
b) Reposition the client to left lateral
Exam latest 2026 NCLEX/ATI standards.
Topic 1: Antepartum (Prenatal Care & Complications)
1. A nurse is assessing a client at 12 weeks gestation. Which of the following
findings should the nurse report to the provider?
a) Heartburn after eating spicy foods
b) Dark red, painless vaginal bleeding
c) Increased urinary frequency
d) Leukorrhea without odor
Rationale: Dark red, painless bleeding is a classic sign of a threatened abortion or
subchorionic hemorrhage. Heartburn, urinary frequency, and leukorrhea are
expected discomforts of pregnancy.
2. A nurse is teaching a client about expected physiological changes during
pregnancy. Which statement indicates understanding?
a) "I will likely have a decrease in my metabolic rate."
b) "My blood pressure will decrease during the first trimester."
c) "My heart will increase in size, and my pulse will slow down."
d) "I will notice a white, odorless vaginal discharge."
Rationale: Leukorrhea (increased white, odorless discharge) is common due to
increased estrogen and vascularity. BP decreases in the second trimester, pulse
increases, and metabolic rate increases.
3. A nurse is reviewing lab results for a client at 10 weeks gestation. Which
value requires immediate intervention?
a) Hemoglobin 11.2 g/dL
b) Rubella titer < 1:8
c) White blood cell count 12,000/mm³
d) Hematocrit 34%
Rationale: A Rubella titer <1:8 indicates non-immunity. The client must be
vaccinated postpartum (avoid during pregnancy). Slight anemia and elevated
WBCs are normal in pregnancy.
,4. A nurse is providing education about folic acid. What is the primary
purpose?
a) Prevention of gestational diabetes
b) Prevention of neural tube defects
c) Prevention of preeclampsia
d) Prevention of postpartum hemorrhage
Rationale: Folic acid (400-800 mcg) is crucial for neural tube closure during the
first 28 days of gestation, before many women know they are pregnant.
5. A nurse is assessing a client for signs of preeclampsia. Which finding is an
early indicator?
a) Generalized edema
b) Proteinuria 2+
c) Blood pressure 148/92 mm Hg
d) Hyperreflexia
Rationale: Hypertension (≥140/90) is the hallmark diagnostic criteria. Edema is no
longer a reliable indicator. Proteinuria and hyperreflexia are later signs.
6. A nurse is caring for a client with gestational diabetes mellitus (GDM).
Which finding indicates effective glycemic control?
a) Postprandial blood glucose 160 mg/dL
b) Fasting blood glucose 85 mg/dL
c) Hemoglobin A1c 7.5%
d) Glucose in the urine
Rationale: Target fasting glucose for GDM is <95 mg/dL. Postprandial should be
<120-140. Urine glucose is not a reliable indicator for management.
7. A nurse is administering Rho(D) immune globulin (RhoGAM) to a client at
28 weeks gestation. What is the purpose?
a) Prevent fetal hemolysis in Rh-negative mother with Rh-positive fetus
b) Treat maternal anemia
c) Prevent preterm labor
d) Boost fetal lung maturity
Rationale: RhoGAM prevents the Rh-negative mother from forming antibodies
against Rh-positive fetal blood cells, protecting subsequent pregnancies.
, 8. A nurse suspects a placental abruption. Which finding supports this?
a) Dark red bleeding with rigid, board-like abdomen
b) Painless bright red bleeding
c) Fever and foul-smelling discharge
d) Prolonged decelerations on fetal monitoring
Rationale: Abruptio placentae involves premature separation of the placenta,
leading to concealed or revealed dark bleeding, severe pain, and uterine rigidity.
9. A client with hyperemesis gravidarum is admitted. Which lab finding is
most concerning?
a) Potassium 2.9 mEq/L
b) Sodium 138 mEq/L
c) Urine ketones 1+
d) Hematocrit 38%
Rationale: Severe hypokalemia (K < 3.0) can lead to cardiac dysrhythmias. This
requires IV replacement and cardiac monitoring.
10. A nurse is performing a nonstress test (NST). What indicates a reactive
result?
a) Two fetal heart rate accelerations of 10 bpm lasting 10 seconds in 20 minutes
b) Two fetal heart rate accelerations of 15 bpm lasting 15 seconds in 20
minutes
c) Variable decelerations present
d) Late decelerations present
Rationale: A reactive NST (reassuring) shows at least 2 accelerations of 15x15 in
a 20-minute window for a fetus >32 weeks.
Topic 2: Intrapartum (Labor & Delivery)
11. A nurse assesses a client in active labor. Cervix is 6 cm, 90% effaced, 0
station. FHR baseline 140 with moderate variability. The client suddenly
reports severe pain and the FHR drops to 80 with variable decelerations.
What is the priority action?
a) Increase oxytocin infusion
b) Reposition the client to left lateral
