2026 ATI Maternal Newborn Proctored Exam Prep
Complete Practice Question Bank VERSIONS
Question 1
A nurse is assessing a client who is 12 hours postpartum. The client's fundus is firm, at
the level of the umbilicus, and displaced to the right. Which of the following actions
should the nurse take first?
A. Massage the fundus vigorously.
B. Administer oxytocin as prescribed.
C. Assist the client to the bathroom to void.
D. Place the client in the Trendelenburg position.
Correct Answer: C. Assist the client to the bathroom to void.
Rationale: A fundus that is firm but displaced to the right is a classic sign of a distended
bladder. A full bladder pushes the uterus up and to the side, preventing it from contracting
effectively. The priority action is to have the client void, which will allow the uterus to
return to midline and contract properly. Massaging a firm fundus is unnecessary, and
medications are indicated only if the fundus remains boggy after the bladder is emptied.
Question 2
A nurse is caring for a client who is receiving oxytocin for labor augmentation. Which of
the following findings indicates that the nurse should discontinue the infusion
immediately?
A. Fetal heart rate of 150/min with moderate variability.
B. Contractions occurring every 3 minutes, lasting 60 seconds.
C. Uterine resting tone of 15 mm Hg.
D. Contractions lasting 100 seconds with no relaxation in between.
,Correct Answer: D. Contractions lasting 100 seconds with no relaxation in between.
Rationale: Oxytocin must be discontinued immediately if hyperstimulation occurs, defined
as contractions lasting longer than 90 seconds, occurring more frequently than every 2
minutes, or a uterine resting tone greater than 20 mm Hg. The uterus must relax between
contractions to allow for adequate placental perfusion. Option D describes tetanic
contractions, which is a medical emergency.
Question 3
A nurse is providing education to a client at 10 weeks of gestation regarding dietary
intake. Which statement by the client indicates an understanding of the teaching?
A. "I will take a folic acid supplement containing 600 mcg daily."
B. "I need to double my calorie intake since I am eating for two."
C. "I should limit my fluid intake to 1 liter per day to reduce edema."
D. "I can continue to eat deli meats as long as they are refrigerated."
*Correct Answer: A. "I will take a folic acid supplement containing 600 mcg daily." *
Rationale: The recommended daily allowance of folic acid during pregnancy is 600 mcg to
prevent neural tube defects. Clients do not need to double calories; they need an additional
340-450 calories per day in the second and third trimesters. Fluid intake should be 2-3
liters per day, and deli meats must be heated until steaming to prevent listeriosis.
Question 4
A nurse is caring for a client at 38 weeks of gestation who has a positive Group B
Streptococcus (GBS) culture. Which of the following medications should the nurse
anticipate administering during labor?
A. Penicillin G
B. Vancomycin
C. Gentamicin
D. Cephalexin
,*Correct Answer: A. Penicillin G *
Rationale: Penicillin G is the first-line antibiotic for intrapartum prophylaxis against GBS. If
the client is allergic to penicillin, the provider may order cefazolin (if low risk) or
clindamycin/vancomycin (if susceptibility is known). Gentamicin and cephalexin are not
standard for GBS prophylaxis.
Question 5
A nurse is assessing a newborn who is 2 hours old. Which of the following findings
should the nurse report to the provider?
A. Respiratory rate of 40/min with occasional grunting.
B. Acrocyanosis of the hands and feet.
C. Blood glucose of 45 mg/dL.
D. Axillary temperature of 36.5°C (97.7°F).
Correct Answer: A. Respiratory rate of 40/min with occasional grunting.
Rationale: Grunting is a sign of respiratory distress and indicates that the newborn is trying
to keep alveoli open by exhaling against a closed glottis. While a respiratory rate of 40/min
is within normal range (30-60/min), the presence of grunting is abnormal and requires
immediate evaluation. Acrocyanosis is normal in the first 24 hours, a glucose of 45 mg/dL
is above the threshold of 40 mg/dL, and a temperature of 36.5°C is acceptable.
Question 6
A nurse is assessing a client who is 24 hours postpartum and breastfeeding. The client
reports breast engorgement. Which of the following interventions should the nurse
recommend?
A. Apply ice packs to the breasts before feeding.
B. Wear a tight-fitting bra continuously.
C. Apply warm compresses and express a small amount of milk before feeding.
D. Limit breastfeeding to every 4 hours to reduce stimulation.
, Correct Answer: C. Apply warm compresses and express a small amount of milk
before feeding.
Rationale: Warm compresses and manual expression of a small amount of milk soften the
areola, making it easier for the newborn to latch on. Ice packs should be applied after
feeding to reduce swelling. Tight bras can lead to mastitis, and breastfeeding should be on
demand (every 2-3 hours) to relieve engorgement.
Question 7
A nurse is caring for a client with preeclampsia who is receiving magnesium sulfate.
Which of the following findings indicates magnesium toxicity?
A. Deep tendon reflexes 2+
B. Urinary output of 40 mL/hr
C. Respiratory rate of 10/min
D. Serum magnesium level of 5 mEq/L
Correct Answer: C. Respiratory rate of 10/min.
Rationale: Magnesium toxicity causes respiratory depression (fewer than 12 breaths/min),
loss of deep tendon reflexes, and oliguria (less than 30 mL/hr). A serum magnesium level of
5-7 mEq/L is therapeutic; toxicity occurs at levels greater than 8 mEq/L. The antidote for
magnesium toxicity is calcium gluconate.
Question 8
A nurse is teaching a client about the signs of preterm labor. Which of the following
symptoms should the nurse instruct the client to report immediately?
A. Braxton-Hicks contractions that are irregular and painless.
B. Low back pain that changes with position.
C. A sensation of pelvic pressure or heaviness.
D. Fetal movement that is felt daily.
Correct Answer: C. A sensation of pelvic pressure or heaviness.
Complete Practice Question Bank VERSIONS
Question 1
A nurse is assessing a client who is 12 hours postpartum. The client's fundus is firm, at
the level of the umbilicus, and displaced to the right. Which of the following actions
should the nurse take first?
A. Massage the fundus vigorously.
B. Administer oxytocin as prescribed.
C. Assist the client to the bathroom to void.
D. Place the client in the Trendelenburg position.
Correct Answer: C. Assist the client to the bathroom to void.
Rationale: A fundus that is firm but displaced to the right is a classic sign of a distended
bladder. A full bladder pushes the uterus up and to the side, preventing it from contracting
effectively. The priority action is to have the client void, which will allow the uterus to
return to midline and contract properly. Massaging a firm fundus is unnecessary, and
medications are indicated only if the fundus remains boggy after the bladder is emptied.
Question 2
A nurse is caring for a client who is receiving oxytocin for labor augmentation. Which of
the following findings indicates that the nurse should discontinue the infusion
immediately?
A. Fetal heart rate of 150/min with moderate variability.
B. Contractions occurring every 3 minutes, lasting 60 seconds.
C. Uterine resting tone of 15 mm Hg.
D. Contractions lasting 100 seconds with no relaxation in between.
,Correct Answer: D. Contractions lasting 100 seconds with no relaxation in between.
Rationale: Oxytocin must be discontinued immediately if hyperstimulation occurs, defined
as contractions lasting longer than 90 seconds, occurring more frequently than every 2
minutes, or a uterine resting tone greater than 20 mm Hg. The uterus must relax between
contractions to allow for adequate placental perfusion. Option D describes tetanic
contractions, which is a medical emergency.
Question 3
A nurse is providing education to a client at 10 weeks of gestation regarding dietary
intake. Which statement by the client indicates an understanding of the teaching?
A. "I will take a folic acid supplement containing 600 mcg daily."
B. "I need to double my calorie intake since I am eating for two."
C. "I should limit my fluid intake to 1 liter per day to reduce edema."
D. "I can continue to eat deli meats as long as they are refrigerated."
*Correct Answer: A. "I will take a folic acid supplement containing 600 mcg daily." *
Rationale: The recommended daily allowance of folic acid during pregnancy is 600 mcg to
prevent neural tube defects. Clients do not need to double calories; they need an additional
340-450 calories per day in the second and third trimesters. Fluid intake should be 2-3
liters per day, and deli meats must be heated until steaming to prevent listeriosis.
Question 4
A nurse is caring for a client at 38 weeks of gestation who has a positive Group B
Streptococcus (GBS) culture. Which of the following medications should the nurse
anticipate administering during labor?
A. Penicillin G
B. Vancomycin
C. Gentamicin
D. Cephalexin
,*Correct Answer: A. Penicillin G *
Rationale: Penicillin G is the first-line antibiotic for intrapartum prophylaxis against GBS. If
the client is allergic to penicillin, the provider may order cefazolin (if low risk) or
clindamycin/vancomycin (if susceptibility is known). Gentamicin and cephalexin are not
standard for GBS prophylaxis.
Question 5
A nurse is assessing a newborn who is 2 hours old. Which of the following findings
should the nurse report to the provider?
A. Respiratory rate of 40/min with occasional grunting.
B. Acrocyanosis of the hands and feet.
C. Blood glucose of 45 mg/dL.
D. Axillary temperature of 36.5°C (97.7°F).
Correct Answer: A. Respiratory rate of 40/min with occasional grunting.
Rationale: Grunting is a sign of respiratory distress and indicates that the newborn is trying
to keep alveoli open by exhaling against a closed glottis. While a respiratory rate of 40/min
is within normal range (30-60/min), the presence of grunting is abnormal and requires
immediate evaluation. Acrocyanosis is normal in the first 24 hours, a glucose of 45 mg/dL
is above the threshold of 40 mg/dL, and a temperature of 36.5°C is acceptable.
Question 6
A nurse is assessing a client who is 24 hours postpartum and breastfeeding. The client
reports breast engorgement. Which of the following interventions should the nurse
recommend?
A. Apply ice packs to the breasts before feeding.
B. Wear a tight-fitting bra continuously.
C. Apply warm compresses and express a small amount of milk before feeding.
D. Limit breastfeeding to every 4 hours to reduce stimulation.
, Correct Answer: C. Apply warm compresses and express a small amount of milk
before feeding.
Rationale: Warm compresses and manual expression of a small amount of milk soften the
areola, making it easier for the newborn to latch on. Ice packs should be applied after
feeding to reduce swelling. Tight bras can lead to mastitis, and breastfeeding should be on
demand (every 2-3 hours) to relieve engorgement.
Question 7
A nurse is caring for a client with preeclampsia who is receiving magnesium sulfate.
Which of the following findings indicates magnesium toxicity?
A. Deep tendon reflexes 2+
B. Urinary output of 40 mL/hr
C. Respiratory rate of 10/min
D. Serum magnesium level of 5 mEq/L
Correct Answer: C. Respiratory rate of 10/min.
Rationale: Magnesium toxicity causes respiratory depression (fewer than 12 breaths/min),
loss of deep tendon reflexes, and oliguria (less than 30 mL/hr). A serum magnesium level of
5-7 mEq/L is therapeutic; toxicity occurs at levels greater than 8 mEq/L. The antidote for
magnesium toxicity is calcium gluconate.
Question 8
A nurse is teaching a client about the signs of preterm labor. Which of the following
symptoms should the nurse instruct the client to report immediately?
A. Braxton-Hicks contractions that are irregular and painless.
B. Low back pain that changes with position.
C. A sensation of pelvic pressure or heaviness.
D. Fetal movement that is felt daily.
Correct Answer: C. A sensation of pelvic pressure or heaviness.
