Maternal ATI Practice Test 2026 With OFFICIAL STUDY RESOURCE: FULL TEST BANK WITH RATIONALES 2026 COMPLETE EXAM SOLUTION - MULTIPLE VERSIONS INCLUDED

A nurse is planning care for a client with a prescription for oxytocin induction of labor. Which of the following clinical findings constitutes a strict contraindication to the use of this medication? • A) Prolonged rupture of membranes at 38 weeks of gestation • B) Documented intrauterine growth restriction (IUGR) • C) Post-term pregnancy extending past 42 weeks of gestation • D) Active maternal genital herpes simplex virus (HSV) lesions Correct Answer: D) Active genital herpes Rationale: Oxytocin is used to stimulate uterine contractions for vaginal delivery. It is strictly contraindicated in the presence of active maternal genital herpes lesions because the virus can be transmitted directly to the newborn during descent through the birth canal, causing severe neonatal herpes. An elective cesarean birth is required. Question 2 A nurse is assessing a client during the immediate postpartum period and notes a soft, boggy uterus accompanied by an increased lochial flow. Which of the following medications should the nurse plan to administer to promote effective uterine contractions? • A) Terbutaline • B) Nifedipine • C) Magnesium sulfate • D) Methylergonovine Correct Answer: D) Methylergonovine Rationale: Methylergonovine is an ergot alkaloid that stimulates sustained uterine contractions to control postpartum hemorrhage caused by uterine atony. Terbutaline (A), nifedipine (B), and magnesium sulfate (C) are tocolytics or smooth muscle relaxants that function to stop uterine contractions, which would worsen postpartum bleeding. Question 3 A nurse is caring for a client who is 8 hours postpartum and experiencing an acute postpartum hemorrhage. Which of the following independent and collaborative interventions should the nurse implement after notifying the provider? (Select all that apply.) • A) Perform continuous fundal massage. • B) Administer supplemental oxygen at 2 L/min via a nasal cannula. • C) Administer oxytocin diluted in intravenous maintenance fluids. • D) Insert an indwelling urinary catheter. • E) Place the client in a lateral position with her legs elevated approximately 30°. Correct Answer Options: A, C, D, E Rationale: * Fundal massage (A) expels pooled clots and stimulates myometrial contraction. • Oxytocin (C) provides targeted uterotonic action. • Catheterization (D) empties the bladder to prevent uterine displacement and allows precise tracking of urinary output. • Modified Trendelenburg/lateral positioning (E) optimizes venous return during hypovolemia. • Supplemental oxygen (B) is a correct intervention for hemorrhage but should be delivered at high flows ($8text{ to }10text{ L/min}$) via a nonrebreather mask rather than low flow via nasal cannula. High-Risk Neonatal Care & Physical Assessment Question 4 A nurse is discussing the physiological risk factors associated with the development of necrotizing enterocolitis (NEC) in newborns with a newly licensed nurse. Which of the following conditions should the nurse identify as a primary risk factor? A) Post-term birth configuration • B) Fetal macrosomia • C) Neonatal respiratory distress syndrome (RDS) • D) Maternal gestational diabetes Correct Answer: C) Respiratory distress syndrome Rationale: Necrotizing enterocolitis (NEC) is an ischemic inflammatory bowel disease occurring primarily in preterm infants. Conditions like Respiratory Distress Syndrome (RDS) cause systemic hypoxia, which triggers a protective shunting of blood away from the gastrointestinal tract to the brain and heart. The resulting intestinal ischemia compromises the mucosal barrier, increasing the risk for NEC. Question 5 A nurse is performing an initial physical assessment of a newborn following an uncomplicated vaginal delivery. Which of the following clinical findings represents an abnormality that must be reported to the provider? • A) Small, pinpoint, non-blanching reddish-purple spots scattered across the chest pad. • B) A transient bluish discoloration affecting the feet and hands. • C) Palpable overlapping cranial suture lines. • D) A thick, white, cheese-like substance covering the skin folds. Correct Answer: A) Small, pinpoint, reddish-purple spots on the chest Rationale: Pinpoint, non-blanching reddish-purple spots are petechiae. Generalized petechiae can indicate serious systemic pathologies such as congenital infection, thrombocytopenia, or neonatal clotting factor deficiencies, and must be reported immediately. Acrocyanosis (B), molded/overlapping sutures (C), and vernix caseosa (D) are normal newborn findings. Question 6 A nurse is assessing the respiratory status of a newborn infant 2 hours following birth. Which of the following clinical manifestations should the nurse document as an indication of neonatal respiratory distress? • A) Persistent acrocyanosis • B) Audible expiratory grunting C) A resting respiratory rate of 56 breaths/min • D) Periodic, irregular respiratory rhythms Correct Answer: B) Expiratory grunting Rationale: Expiratory grunting occurs when an infant partially closes the glottis to create endexpiratory pressure, working to keep fluid-filled or collapsed alveoli open. It is a classic sign of respiratory distress. A respiratory rate of 56/min (C) and periodic breathing (D) are within the normal newborn parameters ($30text{ to }60text{ breaths/min}$ with brief pauses). Infectious Diseases & Public Health Reporting Question 7 A nurse is reviewing the laboratory diagnostics for four postpartum clients. Which of the following confirmed maternal infections is a nationally notifiable disease that must be reported to the local public health department? • A) Bacterial vaginosis • B) Trichomoniasis • C) Candidiasis • D) Gonorrhea Correct Answer: D) Gonorrhea Rationale: Neisseria gonorrhoeae (gonorrhea) is a highly transmissible sexually transmitted infection tracked by public health departments to monitor epidemiological trends, trace sexual contacts, and prevent widespread communities from outbreaks. Bacterial vaginosis (A), trichomoniasis (B), and candidiasis (C) do not require mandatory public reporting. Question 8 A nurse is teaching a client who is at 12 weeks of gestation and has human immunodeficiency virus (HIV). Which of the following statements should the nurse incorporate into the educational plan? • A) "You should breastfeed your newborn to provide maternal passive immunity against infections." • B) "You must abstain from all forms of sexual intercourse throughout the duration of your pregnancy." • C) "You and your infant will be placed in strict respiratory isolation after delivery." D) "You should continue to take your prescribed zidovudine therapy throughout the entire pregnancy." Correct Answer: D) "You should continue to take zidovudine throughout the pregnancy." Rationale: Continuous maternal adherence to antiretroviral therapy (ART), such as zidovudine, significantly reduces the risk of vertical transmission of HIV from mother to fetus. Breastfeeding (A) is contraindicated for HIV-positive mothers in resource-abundant countries due to the risk of transmission via breast milk. Obstetric Interventions & Triaging Priorities Question 9 A nurse is caring for a client at 33 weeks of gestation who presents to the triage unit reporting sudden, painful, dark red vaginal bleeding accompanied by a rigid abdomen and contractions that do not stop. Which action should the nurse execute first? • A) Locate and evaluate the fetal heart tones via Doppler ultrasound. • B) Assess the exact maternal uterine contraction frequency and duration. • C) Measure the baseline maternal vital signs. • D) Prepare the client for an emergency biophysical profile. Correct Answer: A) Check the fetal heart tones Rationale: The presentation of painful, dark red vaginal bleeding, uterine hypertonicity, and persistent contractions strongly indicates a placental abruption (abruptio placentae). Because this condition detaches the placenta from the uterine wall and cuts off fetal oxygenation, the immediate priority is to evaluate fetal viability by checking fetal heart tones. Question 10 A nurse is preparing a client who is at 35 weeks of gestation to undergo a diagnostic amniocentesis. Which of the following statements should the nurse make to prepare the client? • A) "You will need to drink 3 to 5 full glasses of water immediately prior to the procedure to fill your bladder." • B) "This procedure carries no risk of rupturing your membranes or initiating premature labor." • C) "You will feel a sensation of light pressure while we collect a capillary blood sample directly from the baby." D) "You should expect to feel some mild discomfort or cramping during the needle insertion." Correct Answer: D) "You will feel some mild discomfort during the procedure." Rationale: An amniocentesis involves inserting a needle through the abdominal and uterine walls to withdraw amniotic fluid. This typically induces a mild sensation of pressure or uterine cramping. In late pregnancy (third trimester), the bladder must be emptied (unlike the first trimester, A) to prevent accidental puncture by the needle. Question 11 A nurse is caring for a client who delivered vaginally 24 hours ago. Which of the following assessment findings must be reported to the provider as an indication of a potential complication? • A) A cumulative urinary output of 2,000 mL since delivery. • B) Deep tendon reflexes (DTRs) evaluated at a 3+ rating. • C) The uterine fundus palpated firmly at the level of the umbilicus. • D) Bilateral breast tissue that feels soft upon palpation. Correct Answer: B) 3+ deep tendon reflexes Rationale: Deep tendon reflexes rated at 3+ or greater indicate central nervous system hyperreflexia, which can signify the development of postpartum preeclampsia. This requires immediate notification to the provider. Postpartum diuresis (A) is normal, the fundus at 24 hours should be near the umbilicus (C), and breasts remain soft (D) prior to primary engorgement/lactogenesis stage II. Question 12 A nurse is planning educational sessions for a group of prenatal clients in a childbirth preparation class. Which of the following warning signs should the nurse instruct the clients to report immediately to their healthcare provider? • A) A mild increase in white, non-irritating vaginal leukorrhea. • B) Occasional shortness of breath during exertion. • C) Generalized swelling affecting the face, eyelids, and fingers. • D) Intermittent lower back pain localized to the lumbar region. Correct Answer: C) Swelling of the face and fingers Rationale: Sudden or generalized edema affecting the face, eyes, and hands indicates fluid retention from gestational hypertensive disorders (preeclampsia). Clients must be taught to report this immediately. Leukorrhea (A), exertional dyspnea due to diaphragmatic displacement (B), and back pain from lordosis (D) are common discomforts of pregnancy. Question 13 A nurse is preparing a client to receive a spinal anesthetic block prior to an elective cesarean delivery. Which of the following actions should the nurse plan to perform? • A) Infuse a 500 to 1,000 mL bolus of 0.9% sodium chloride or Lactated Ringer's immediately prior to the procedure. • B) Monitor the fetal heart rate pattern for a minimum of 10 minutes prior to the procedure. • C) Position the client completely upright and erect on the edge of the bed during administration. • D) Monitor maternal vital signs every 15 minutes after the anesthetic is placed. Correct Answer: A) Infuse a 500 mL bolus of 0.9% sodium chloride immediately prior to the procedure Rationale: Spinal anesthesia blocks sympathetic vasomotor fibers, causing widespread vasodilation and a rapid drop in maternal blood pressure. To prevent this severe hypotension, the nurse must administer an intravenous fluid bolus of 500 to 1,000 mL of crystalloids 15 to 30 minutes before the procedure. Vital signs must be monitored much more frequently after placement (e.g., every 2 to 5 minutes initially, not every 15 minutes as in D). Question 14 A nurse is assisting the provider with an artificial rupture of membranes (amniotomy) for a client who is in active labor. Which of the following actions should the nurse prioritize? • A) Assess the fetal heart rate immediately before and after the procedure. • B) Monitor the client's temperature every 4 hours after the procedure. • C) Medicate the client for severe pain 30 minutes prior to the amniotomy. • D) Perform sterile cervical assessments every 2 hours after the procedure. Correct Answer: A) Assess the fetal heart rate before and after the procedure Rationale: The primary danger immediately following an amniotomy is umbilical cord prolapse, which can occur as the fluid gushes out, trapping the cord under the presenting part. Assessing the fetal heart rate (FHR) immediately after the procedure is critical; a sudden drop or variable decelerations indicate cord compression.