ATI CAPSTONE MATERNAL NEWBORN ASSESSMENT
EXAM 300 QUESTIONS AND CORRECT ANSWER WITH
RATIONALE LATEST 2026 ALREADY GRADED A+
This comprehensive set of 300 multiple-choice questions covers the ATI
Capstone Maternal Newborn Assessment, addressing antepartum,
intrapartum, postpartum, and newborn nursing. Topics include preeclampsia,
gestational diabetes, placental complications, labor and delivery interventions,
pharmacologic management (oxytocin, magnesium sulfate, RhoGAM),
newborn assessment (Apgar, hypoglycemia, hyperbilirubinemia, respiratory
distress), postpartum hemorrhage, infections, breastfeeding, contraception,
and patient education. Each question provides a clinical scenario with a
correct answer and detailed rationale. The content integrates
pathophysiology, pharmacology, and nursing interventions to prepare
students for NCLEX-style and Capstone testing. No questions are repeated,
ensuring comprehensive, varied coverage of essential maternal-newborn
concepts.
1. A nurse is performing a vaginal exam on a client in active labor and notes the
umbilical cord protruding through the cervix. Which action should the nurse take
first?
A) Administer oxytocin intravenously
B) Apply oxygen at 2 L/min via nasal cannula
C) Prepare for insertion of an intrauterine pressure catheter
D) Assist the client into the knee-chest position
Answer: D
Rationale: A prolapsed umbilical cord is an obstetric emergency. The priority
action is to relieve pressure on the cord by positioning the client in the knee-chest
or Trendelenburg position to maintain fetal oxygenation and prevent cord
compression.
2. A nurse is assessing a 48-hour-old newborn experiencing opioid withdrawal.
Which finding should the nurse expect?
A) Hypotonicity
B) Moderate tremors of the extremities
C) Axillary temperature 36.1°C (96.9°F)
,D) Excessive sleeping
Answer: B
Rationale: Neonatal abstinence syndrome (NAS) from opioid withdrawal typically
presents with central nervous system irritability, including moderate to severe
tremors, hypertonicity, high-pitched cry, and poor feeding.
3. A nurse is reviewing a client's medical record and notes the client is taking
tamoxifen. The nurse should identify this medication is used to treat which
condition?
A) Non-Hodgkin's lymphoma
B) Endometriosis
C) Breast cancer
D) Polycystic ovary syndrome
Answer: C
Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM) used for
the treatment and prevention of breast cancer. It blocks estrogen effects on breast
tissue.
4. A nurse is caring for a client receiving oxytocin to augment labor. Which
finding indicates the infusion should be discontinued?
A) Contraction frequency every 3 minutes
B) Contraction duration of 100 seconds
C) Fetal heart rate with moderate variability
D) Fetal heart rate of 118/min
Answer: B
Rationale: Oxytocin augmentation should be discontinued if contractions become
hyperstimulated, such as with a duration of 100 seconds or frequency of less than 2
minutes. Prolonged contractions can compromise placental perfusion and lead to
fetal distress.
5. A client at 29 weeks of gestation with phenylketonuria (PKU) is receiving
dietary teaching. Which food should the nurse suggest?
A) High-protein foods
B) Foods low in phenylalanine
C) Foods high in iron
D) Foods with extra calcium
Answer: B
Rationale: Clients with PKU must restrict phenylalanine intake to prevent fetal
intellectual disability and microcephaly. A low-phenylalanine diet is essential
during pregnancy.
,6. A nurse is assessing a client who is in labor and has an epidural for pain control.
Which manifestation is an adverse effect of epidural anesthesia?
A) Polyuria
B) Hypertension
C) Pruritus
D) Dry mouth
Answer: C
Rationale: Pruritus (itching) is a common adverse effect of epidural opioids such as
fentanyl or morphine. Other effects include hypotension, not hypertension, and
urinary retention.
7. A nurse is teaching a client about using an intrauterine device (IUD) for
contraception. Which statement indicates understanding?
A) "I will need to have the IUD replaced each year."
B) "I will need to apply spermicide prior to intercourse."
C) "I should expect my periods to stop while I have the IUD."
D) "I should check for the string each month after menstruation."
Answer: D
Rationale: Clients with an IUD should check for the string monthly after menses to
ensure the device is still in place. Hormonal IUDs may reduce bleeding, but not all
periods stop.
8. A nurse is assessing a 10-hour-old newborn. Which finding should be reported
to the provider?
A) Axillary temperature 36.5°C (97.7°F)
B) Nasal flaring
C) Heart rate 158/min
D) One void since birth
Answer: B
Rationale: Nasal flaring in a newborn indicates respiratory distress and should be
reported immediately. A heart rate of 158 is within normal range (110-160), and
one void by 10 hours is normal.
9. A client who gave birth 1 week ago states, "I love my baby, but I feel so let
down and I seem to cry for no reason." The nurse should identify this as:
A) Postpartum depression
B) Taking-in phase
C) Postpartum blues
D) Taking-hold phase
, Answer: C
Rationale: Postpartum blues occur in up to 80% of new mothers within the first 2
weeks. Symptoms include mood swings, tearfulness, and feeling let down. It is
transient and self-limiting, unlike postpartum depression which lasts longer.
10. A nurse is teaching a group of women about risk factors for ovarian cancer.
Which factors should the nurse include? (Select all that apply)
A) Nulliparity
B) History of breastfeeding
C) Previous use of oral contraceptives
D) History of breast cancer
E) Hormone replacement therapy
Answer: A, D, E
Rationale: Risk factors for ovarian cancer include nulliparity (never having given
birth), personal or family history of breast or ovarian cancer, and hormone
replacement therapy. Breastfeeding and oral contraceptive use are protective
factors.
11. A client at 38 weeks of gestation with a history of cocaine use is experiencing
continuous abdominal pain and vaginal bleeding. The nurse should suspect:
A) Abruptio placentae
B) Hydatidiform mole
C) Preterm labor
D) Placenta previa
Answer: A
Rationale: Cocaine use is a risk factor for abruptio placentae, which presents with
continuous abdominal pain, uterine rigidity, and vaginal bleeding. Placenta previa
typically presents with painless bleeding.
12. A postpartum client with a deep-vein thrombosis is receiving subcutaneous
heparin. Which action should the nurse take?
A) Request a prescription for PRN aspirin
B) Massage the injection site thoroughly after administration
C) Instruct the client that they cannot breastfeed while receiving heparin
D) Administer the injection in the client's abdomen
Answer: D
Rationale: Heparin is administered subcutaneously in the abdomen, rotating sites.
Aspirin is not recommended with anticoagulants. Massaging the site can cause
hematoma; heparin does not cross breast milk.
EXAM 300 QUESTIONS AND CORRECT ANSWER WITH
RATIONALE LATEST 2026 ALREADY GRADED A+
This comprehensive set of 300 multiple-choice questions covers the ATI
Capstone Maternal Newborn Assessment, addressing antepartum,
intrapartum, postpartum, and newborn nursing. Topics include preeclampsia,
gestational diabetes, placental complications, labor and delivery interventions,
pharmacologic management (oxytocin, magnesium sulfate, RhoGAM),
newborn assessment (Apgar, hypoglycemia, hyperbilirubinemia, respiratory
distress), postpartum hemorrhage, infections, breastfeeding, contraception,
and patient education. Each question provides a clinical scenario with a
correct answer and detailed rationale. The content integrates
pathophysiology, pharmacology, and nursing interventions to prepare
students for NCLEX-style and Capstone testing. No questions are repeated,
ensuring comprehensive, varied coverage of essential maternal-newborn
concepts.
1. A nurse is performing a vaginal exam on a client in active labor and notes the
umbilical cord protruding through the cervix. Which action should the nurse take
first?
A) Administer oxytocin intravenously
B) Apply oxygen at 2 L/min via nasal cannula
C) Prepare for insertion of an intrauterine pressure catheter
D) Assist the client into the knee-chest position
Answer: D
Rationale: A prolapsed umbilical cord is an obstetric emergency. The priority
action is to relieve pressure on the cord by positioning the client in the knee-chest
or Trendelenburg position to maintain fetal oxygenation and prevent cord
compression.
2. A nurse is assessing a 48-hour-old newborn experiencing opioid withdrawal.
Which finding should the nurse expect?
A) Hypotonicity
B) Moderate tremors of the extremities
C) Axillary temperature 36.1°C (96.9°F)
,D) Excessive sleeping
Answer: B
Rationale: Neonatal abstinence syndrome (NAS) from opioid withdrawal typically
presents with central nervous system irritability, including moderate to severe
tremors, hypertonicity, high-pitched cry, and poor feeding.
3. A nurse is reviewing a client's medical record and notes the client is taking
tamoxifen. The nurse should identify this medication is used to treat which
condition?
A) Non-Hodgkin's lymphoma
B) Endometriosis
C) Breast cancer
D) Polycystic ovary syndrome
Answer: C
Rationale: Tamoxifen is a selective estrogen receptor modulator (SERM) used for
the treatment and prevention of breast cancer. It blocks estrogen effects on breast
tissue.
4. A nurse is caring for a client receiving oxytocin to augment labor. Which
finding indicates the infusion should be discontinued?
A) Contraction frequency every 3 minutes
B) Contraction duration of 100 seconds
C) Fetal heart rate with moderate variability
D) Fetal heart rate of 118/min
Answer: B
Rationale: Oxytocin augmentation should be discontinued if contractions become
hyperstimulated, such as with a duration of 100 seconds or frequency of less than 2
minutes. Prolonged contractions can compromise placental perfusion and lead to
fetal distress.
5. A client at 29 weeks of gestation with phenylketonuria (PKU) is receiving
dietary teaching. Which food should the nurse suggest?
A) High-protein foods
B) Foods low in phenylalanine
C) Foods high in iron
D) Foods with extra calcium
Answer: B
Rationale: Clients with PKU must restrict phenylalanine intake to prevent fetal
intellectual disability and microcephaly. A low-phenylalanine diet is essential
during pregnancy.
,6. A nurse is assessing a client who is in labor and has an epidural for pain control.
Which manifestation is an adverse effect of epidural anesthesia?
A) Polyuria
B) Hypertension
C) Pruritus
D) Dry mouth
Answer: C
Rationale: Pruritus (itching) is a common adverse effect of epidural opioids such as
fentanyl or morphine. Other effects include hypotension, not hypertension, and
urinary retention.
7. A nurse is teaching a client about using an intrauterine device (IUD) for
contraception. Which statement indicates understanding?
A) "I will need to have the IUD replaced each year."
B) "I will need to apply spermicide prior to intercourse."
C) "I should expect my periods to stop while I have the IUD."
D) "I should check for the string each month after menstruation."
Answer: D
Rationale: Clients with an IUD should check for the string monthly after menses to
ensure the device is still in place. Hormonal IUDs may reduce bleeding, but not all
periods stop.
8. A nurse is assessing a 10-hour-old newborn. Which finding should be reported
to the provider?
A) Axillary temperature 36.5°C (97.7°F)
B) Nasal flaring
C) Heart rate 158/min
D) One void since birth
Answer: B
Rationale: Nasal flaring in a newborn indicates respiratory distress and should be
reported immediately. A heart rate of 158 is within normal range (110-160), and
one void by 10 hours is normal.
9. A client who gave birth 1 week ago states, "I love my baby, but I feel so let
down and I seem to cry for no reason." The nurse should identify this as:
A) Postpartum depression
B) Taking-in phase
C) Postpartum blues
D) Taking-hold phase
, Answer: C
Rationale: Postpartum blues occur in up to 80% of new mothers within the first 2
weeks. Symptoms include mood swings, tearfulness, and feeling let down. It is
transient and self-limiting, unlike postpartum depression which lasts longer.
10. A nurse is teaching a group of women about risk factors for ovarian cancer.
Which factors should the nurse include? (Select all that apply)
A) Nulliparity
B) History of breastfeeding
C) Previous use of oral contraceptives
D) History of breast cancer
E) Hormone replacement therapy
Answer: A, D, E
Rationale: Risk factors for ovarian cancer include nulliparity (never having given
birth), personal or family history of breast or ovarian cancer, and hormone
replacement therapy. Breastfeeding and oral contraceptive use are protective
factors.
11. A client at 38 weeks of gestation with a history of cocaine use is experiencing
continuous abdominal pain and vaginal bleeding. The nurse should suspect:
A) Abruptio placentae
B) Hydatidiform mole
C) Preterm labor
D) Placenta previa
Answer: A
Rationale: Cocaine use is a risk factor for abruptio placentae, which presents with
continuous abdominal pain, uterine rigidity, and vaginal bleeding. Placenta previa
typically presents with painless bleeding.
12. A postpartum client with a deep-vein thrombosis is receiving subcutaneous
heparin. Which action should the nurse take?
A) Request a prescription for PRN aspirin
B) Massage the injection site thoroughly after administration
C) Instruct the client that they cannot breastfeed while receiving heparin
D) Administer the injection in the client's abdomen
Answer: D
Rationale: Heparin is administered subcutaneously in the abdomen, rotating sites.
Aspirin is not recommended with anticoagulants. Massaging the site can cause
hematoma; heparin does not cross breast milk.
