ATI Maternal Newborn Proctored Exam Prep | Complete
Practice Question Bank 5 VERSIONS
1. A nurse is caring for a client who is 24 hours postpartum and reports a sudden,
sharp chest pain with dyspnea. Which of the following complications should the
nurse suspect first?
A. Pulmonary embolism
B. Postpartum hemorrhage
C. Mastitis
D. Endometritis
Correct Answer: A. Pulmonary embolism.
Rationale: Sudden chest pain and dyspnea in a postpartum client are classic signs of a
pulmonary embolism (PE), a life-threatening complication. The nurse should immediately
assess oxygen saturation, administer oxygen, and notify the provider. Postpartum clients
are at increased risk for thromboembolism due to hypercoagulability.
2. A nurse is providing teaching to a client at 12 weeks gestation about the purpose
of nuchal translucency screening. The nurse should explain that this screening is
used to assess for which of the following?
A. Gestational diabetes
B. Neural tube defects
C. Chromosomal abnormalities (e.g., Down syndrome)
D. Rh incompatibility
*Correct Answer: C. Chromosomal abnormalities (e.g., Down syndrome). *
,Rationale: Nuchal translucency (NT) screening, performed at 11–13 weeks, measures the
fluid-filled space at the back of the fetal neck. Increased thickness is associated with an
elevated risk of chromosomal abnormalities, including Down syndrome and trisomy 18. It
does not screen for diabetes, neural tube defects, or Rh status.
3. A nurse is assessing a client in the latent phase of the first stage of labor. Which
of the following findings is consistent with this phase?
A. Cervical dilation of 4 cm
B. Contractions every 2 minutes
C. Cervical dilation of 8 cm
D. Contractions lasting 70 seconds
Correct Answer: A. Cervical dilation of 4 cm.
Rationale: The latent phase is the initial part of the first stage of labor, characterized by
cervical dilation from 0–6 cm (often 0–4 cm in older classifications), contractions every 5–
10 minutes, and mild to moderate intensity. Options B, C, and D are characteristic of the
active or transition phases.
4. A nurse is caring for a client who is 3 hours postpartum and has a third-degree
perineal laceration. Which of the following findings indicates a complication of this
laceration?
A. Moderate lochia rubra
B. Perineal edema
C. Inability to urinate
D. Fecal incontinence
Correct Answer: D. Fecal incontinence.
Rationale: A third-degree perineal laceration extends through the anal sphincter. A
complication of this injury is fecal incontinence or loss of sphincter control. The nurse
should assess for this and notify the provider. Edema and moderate bleeding are expected;
inability to void may occur with any laceration but is not specific to third-degree.
,5. A nurse is administering methylergonovine to a postpartum client for uterine
atony. Which of the following is a contraindication to this medication?
A. Hypertension
B. Hypotension
C. Tachycardia
D. Bradycardia
Correct Answer: A. Hypertension.
Rationale: Methylergonovine (Methergine) is a uterotonic that causes vasoconstriction. It is
contraindicated in clients with hypertension, preeclampsia, or cardiovascular disease
because it can cause severe hypertension and stroke. It is also contraindicated in clients
with known hypersensitivity.
6. A nurse is assessing a newborn who was born at 35 weeks gestation. The nurse
notes the infant has a weak suck reflex and difficulty coordinating swallowing.
Which of the following is the priority nursing action?
A. Feed the newborn via gavage.
B. Place the newborn in a prone position.
C. Initiate phototherapy.
D. Administer vitamin K.
Correct Answer: A. Feed the newborn via gavage.
Rationale: Premature infants (<34–36 weeks) often lack the coordination for safe oral
feeding. Gavage (tube) feeding is the priority to ensure adequate nutrition and prevent
aspiration. Vitamin K is important but not the immediate priority related to feeding
difficulty.
7. A nurse is assessing a client at 34 weeks gestation who has placenta previa. The
client is currently stable with no active bleeding. Which of the following should the
nurse anticipate?
, A. Scheduled cesarean birth at 36–37 weeks
B. Immediate induction of labor
C. Vaginal delivery at term
D. Administration of tocolytics
Correct Answer: A. Scheduled cesarean birth at 36–37 weeks.
Rationale: For a stable client with placenta previa, a scheduled cesarean birth is typically
planned at 36–37 weeks of gestation (or earlier if bleeding occurs) to prevent the onset of
labor and hemorrhage. Vaginal delivery is contraindicated, and tocolytics are not the
primary management.
8. A nurse is providing teaching to a client who is 28 weeks gestation about
preterm labor prevention. Which of the following statements indicates
understanding?
A. "I should avoid all physical activity."
B. "I should report any pelvic pressure or low back pain."
C. "I should drink at least 4 liters of water daily."
D. "I should expect contractions to be painless."
*Correct Answer: B. "I should report any pelvic pressure or low back pain." *
Rationale: Pelvic pressure, low back pain, menstrual-like cramps, and uterine contractions
are warning signs of preterm labor. The client should report these immediately. Moderate
activity is encouraged; excessive fluid intake is not recommended.
9. A nurse is assessing a client who is 10 days postpartum and reports a fever, chills,
and abdominal pain. The uterine fundus is tender and subinvoluted. Which of the
following is the most likely diagnosis?
A. Mastitis
B. Endometritis
C. Urinary tract infection
D. Deep vein thrombosis
Practice Question Bank 5 VERSIONS
1. A nurse is caring for a client who is 24 hours postpartum and reports a sudden,
sharp chest pain with dyspnea. Which of the following complications should the
nurse suspect first?
A. Pulmonary embolism
B. Postpartum hemorrhage
C. Mastitis
D. Endometritis
Correct Answer: A. Pulmonary embolism.
Rationale: Sudden chest pain and dyspnea in a postpartum client are classic signs of a
pulmonary embolism (PE), a life-threatening complication. The nurse should immediately
assess oxygen saturation, administer oxygen, and notify the provider. Postpartum clients
are at increased risk for thromboembolism due to hypercoagulability.
2. A nurse is providing teaching to a client at 12 weeks gestation about the purpose
of nuchal translucency screening. The nurse should explain that this screening is
used to assess for which of the following?
A. Gestational diabetes
B. Neural tube defects
C. Chromosomal abnormalities (e.g., Down syndrome)
D. Rh incompatibility
*Correct Answer: C. Chromosomal abnormalities (e.g., Down syndrome). *
,Rationale: Nuchal translucency (NT) screening, performed at 11–13 weeks, measures the
fluid-filled space at the back of the fetal neck. Increased thickness is associated with an
elevated risk of chromosomal abnormalities, including Down syndrome and trisomy 18. It
does not screen for diabetes, neural tube defects, or Rh status.
3. A nurse is assessing a client in the latent phase of the first stage of labor. Which
of the following findings is consistent with this phase?
A. Cervical dilation of 4 cm
B. Contractions every 2 minutes
C. Cervical dilation of 8 cm
D. Contractions lasting 70 seconds
Correct Answer: A. Cervical dilation of 4 cm.
Rationale: The latent phase is the initial part of the first stage of labor, characterized by
cervical dilation from 0–6 cm (often 0–4 cm in older classifications), contractions every 5–
10 minutes, and mild to moderate intensity. Options B, C, and D are characteristic of the
active or transition phases.
4. A nurse is caring for a client who is 3 hours postpartum and has a third-degree
perineal laceration. Which of the following findings indicates a complication of this
laceration?
A. Moderate lochia rubra
B. Perineal edema
C. Inability to urinate
D. Fecal incontinence
Correct Answer: D. Fecal incontinence.
Rationale: A third-degree perineal laceration extends through the anal sphincter. A
complication of this injury is fecal incontinence or loss of sphincter control. The nurse
should assess for this and notify the provider. Edema and moderate bleeding are expected;
inability to void may occur with any laceration but is not specific to third-degree.
,5. A nurse is administering methylergonovine to a postpartum client for uterine
atony. Which of the following is a contraindication to this medication?
A. Hypertension
B. Hypotension
C. Tachycardia
D. Bradycardia
Correct Answer: A. Hypertension.
Rationale: Methylergonovine (Methergine) is a uterotonic that causes vasoconstriction. It is
contraindicated in clients with hypertension, preeclampsia, or cardiovascular disease
because it can cause severe hypertension and stroke. It is also contraindicated in clients
with known hypersensitivity.
6. A nurse is assessing a newborn who was born at 35 weeks gestation. The nurse
notes the infant has a weak suck reflex and difficulty coordinating swallowing.
Which of the following is the priority nursing action?
A. Feed the newborn via gavage.
B. Place the newborn in a prone position.
C. Initiate phototherapy.
D. Administer vitamin K.
Correct Answer: A. Feed the newborn via gavage.
Rationale: Premature infants (<34–36 weeks) often lack the coordination for safe oral
feeding. Gavage (tube) feeding is the priority to ensure adequate nutrition and prevent
aspiration. Vitamin K is important but not the immediate priority related to feeding
difficulty.
7. A nurse is assessing a client at 34 weeks gestation who has placenta previa. The
client is currently stable with no active bleeding. Which of the following should the
nurse anticipate?
, A. Scheduled cesarean birth at 36–37 weeks
B. Immediate induction of labor
C. Vaginal delivery at term
D. Administration of tocolytics
Correct Answer: A. Scheduled cesarean birth at 36–37 weeks.
Rationale: For a stable client with placenta previa, a scheduled cesarean birth is typically
planned at 36–37 weeks of gestation (or earlier if bleeding occurs) to prevent the onset of
labor and hemorrhage. Vaginal delivery is contraindicated, and tocolytics are not the
primary management.
8. A nurse is providing teaching to a client who is 28 weeks gestation about
preterm labor prevention. Which of the following statements indicates
understanding?
A. "I should avoid all physical activity."
B. "I should report any pelvic pressure or low back pain."
C. "I should drink at least 4 liters of water daily."
D. "I should expect contractions to be painless."
*Correct Answer: B. "I should report any pelvic pressure or low back pain." *
Rationale: Pelvic pressure, low back pain, menstrual-like cramps, and uterine contractions
are warning signs of preterm labor. The client should report these immediately. Moderate
activity is encouraged; excessive fluid intake is not recommended.
9. A nurse is assessing a client who is 10 days postpartum and reports a fever, chills,
and abdominal pain. The uterine fundus is tender and subinvoluted. Which of the
following is the most likely diagnosis?
A. Mastitis
B. Endometritis
C. Urinary tract infection
D. Deep vein thrombosis
