ATI Maternal Newborn | Week 4 Study Guide (Intrapartum
Complications) 2026 |Questions |Answers |Rationales
1. A nurse is caring for a client who is in preterm labor at 32 weeks of gestation.
Which of the following medications should the nurse anticipate administering to
promote fetal lung maturity?
A. Betamethasone
B. Terbutaline
C. Nifedipine
D. Magnesium sulfate
Answer: A
Rationale: Betamethasone is a glucocorticoid administered intramuscularly to stimulate
fetal lung surfactant production in clients at risk for preterm delivery.
2. A nurse is monitoring a client receiving magnesium sulfate for preterm labor.
Which of the following findings should the nurse report to the provider as a sign
of magnesium toxicity?
A. Fetal heart rate of 140/min
B. Absent deep tendon reflexes
C. Urinary output of 40 mL/hr
D. Respiratory rate of 16/min
Answer: B
Rationale: Loss of deep tendon reflexes is an early sign of magnesium sulfate toxicity.
Other signs include respiratory depression and decreased urinary output.
,3. Which of the following positions should the nurse place a client in who has a
suspected prolapsed umbilical cord?
A. Knee-chest position
B. High-Fowler’s position
C. Left-lateral position
D. Lithotomy position
Answer: A
Rationale: The knee-chest or Trendelenburg position uses gravity to shift the fetus off the
umbilical cord, relieving pressure and improving fetal oxygenation.
4. A nurse is assessing a client who is at 30 weeks of gestation and reports
leaking fluid from the vagina. Which of the following tests should the nurse
perform to confirm preterm premature rupture of membranes (PPROM)?
A. Urinalysis
B. Nitrazine paper test
C. Contraction stress test
D. Kleihauer-Betke test
Answer: B
Rationale: Nitrazine paper turns blue in the presence of amniotic fluid (alkaline), whereas
it remains yellow or olive green in the presence of vaginal secretions (acidic).
5. A client in labor is experiencing shoulder dystocia. Which of the following
actions should the nurse perform first?
A. Apply fundal pressure
B. Administer oxytocin
C. Prepare for an emergency cesarean birth
D. Perform the McRoberts maneuver
Answer: D
, Rationale: The McRoberts maneuver involves flexing the client’s legs against her abdomen
to widen the pelvic outlet and is a primary intervention for shoulder dystocia.
6. What is the antidote for magnesium sulfate toxicity?
A. Naloxone
B. Protamine sulfate
C. Phytonadione
D. Calcium gluconate
Answer: D
Rationale: Calcium gluconate is the specific antagonist used to reverse the effects of
magnesium toxicity, such as respiratory depression.
7. A nurse is assessing a client with preterm labor who is receiving nifedipine.
Which of the following side effects should the nurse monitor for?
A. Hypertension
B. Hyperkalemia
C. Dizziness and orthostatic hypotension
D. Bradycardia
Answer: C
Rationale: Nifedipine is a calcium channel blocker that causes vasodilation, which can lead
to orthostatic hypotension and dizziness.
8. A nurse is caring for a client in labor who suddenly develops sharp chest pain
and becomes cyanotic. The nurse should suspect which of the following
complications?
A. Placenta previa
B. Uterine rupture
C. Amniotic fluid embolism
D. Precipitous labor
Answer: C
Complications) 2026 |Questions |Answers |Rationales
1. A nurse is caring for a client who is in preterm labor at 32 weeks of gestation.
Which of the following medications should the nurse anticipate administering to
promote fetal lung maturity?
A. Betamethasone
B. Terbutaline
C. Nifedipine
D. Magnesium sulfate
Answer: A
Rationale: Betamethasone is a glucocorticoid administered intramuscularly to stimulate
fetal lung surfactant production in clients at risk for preterm delivery.
2. A nurse is monitoring a client receiving magnesium sulfate for preterm labor.
Which of the following findings should the nurse report to the provider as a sign
of magnesium toxicity?
A. Fetal heart rate of 140/min
B. Absent deep tendon reflexes
C. Urinary output of 40 mL/hr
D. Respiratory rate of 16/min
Answer: B
Rationale: Loss of deep tendon reflexes is an early sign of magnesium sulfate toxicity.
Other signs include respiratory depression and decreased urinary output.
,3. Which of the following positions should the nurse place a client in who has a
suspected prolapsed umbilical cord?
A. Knee-chest position
B. High-Fowler’s position
C. Left-lateral position
D. Lithotomy position
Answer: A
Rationale: The knee-chest or Trendelenburg position uses gravity to shift the fetus off the
umbilical cord, relieving pressure and improving fetal oxygenation.
4. A nurse is assessing a client who is at 30 weeks of gestation and reports
leaking fluid from the vagina. Which of the following tests should the nurse
perform to confirm preterm premature rupture of membranes (PPROM)?
A. Urinalysis
B. Nitrazine paper test
C. Contraction stress test
D. Kleihauer-Betke test
Answer: B
Rationale: Nitrazine paper turns blue in the presence of amniotic fluid (alkaline), whereas
it remains yellow or olive green in the presence of vaginal secretions (acidic).
5. A client in labor is experiencing shoulder dystocia. Which of the following
actions should the nurse perform first?
A. Apply fundal pressure
B. Administer oxytocin
C. Prepare for an emergency cesarean birth
D. Perform the McRoberts maneuver
Answer: D
, Rationale: The McRoberts maneuver involves flexing the client’s legs against her abdomen
to widen the pelvic outlet and is a primary intervention for shoulder dystocia.
6. What is the antidote for magnesium sulfate toxicity?
A. Naloxone
B. Protamine sulfate
C. Phytonadione
D. Calcium gluconate
Answer: D
Rationale: Calcium gluconate is the specific antagonist used to reverse the effects of
magnesium toxicity, such as respiratory depression.
7. A nurse is assessing a client with preterm labor who is receiving nifedipine.
Which of the following side effects should the nurse monitor for?
A. Hypertension
B. Hyperkalemia
C. Dizziness and orthostatic hypotension
D. Bradycardia
Answer: C
Rationale: Nifedipine is a calcium channel blocker that causes vasodilation, which can lead
to orthostatic hypotension and dizziness.
8. A nurse is caring for a client in labor who suddenly develops sharp chest pain
and becomes cyanotic. The nurse should suspect which of the following
complications?
A. Placenta previa
B. Uterine rupture
C. Amniotic fluid embolism
D. Precipitous labor
Answer: C
