ATI Postpartum & Newborn – ATI Maternal-
Newborn Nursing Study Guide, Original Practice
Questions & Answers, Comprehensive Exam
Preparation, Detailed Rationales, Postpartum
Assessment, Uterine Involution, Lochia, Postpartum
Hemorrhage, Hypertensive Disorders, Breastfeeding
& Lactation, Newborn Assessment, Newborn
Adaptation, Thermoregulation, Newborn
Complications, Medications, Patient Education,
Safety & NGN-Style Clinical Judgment
Question 1: A nurse is assessing a client who is 12 hours postpartum. The
client reports a severe, throbbing headache and has a blood pressure of
160/110 mmHg. Which of the following findings should the nurse identify as a
contraindication to administering the prescribed magnesium sulfate?
A. Urinary output of 150 mL in the past 4 hours
B. Deep tendon reflexes of 2+
C. Respiratory rate of 16 breaths per minute
D. Serum magnesium level of 6 mEq/L
CORRECT ANSWER: A. Urinary output of 150 mL in the past 4 hours
Rationale: Magnesium sulfate is excreted by the kidneys. A urinary output of less than
30 mL per hour (or 120 mL in 4 hours) indicates decreased renal function, which is a
contraindication due to the risk of magnesium toxicity. The other options are within
acceptable parameters for a client receiving magnesium sulfate.
Question 2: A nurse is performing a newborn assessment and notes a heart
rate of 90 beats per minute while the infant is sleeping. Which of the following
actions should the nurse take first?
A. Document the finding as normal.
B. Administer oxygen via mask.
C. Stimulate the infant to arouse.
D. Assess the infant's oxygen saturation.
CORRECT ANSWER: D. Assess the infant's oxygen saturation.
Rationale: The normal resting heart rate for a newborn is 100-160 bpm, so 90 bpm is
bradycardic. The first action in a systematic assessment is to evaluate the infant's
oxygenation status with a pulse oximeter before initiating other interventions.
Stimulating the infant could cause a transient increase but does not address the
underlying issue.
Question 3: A postpartum client who is 2 days post-cesarean birth reports
sudden, sharp chest pain and shortness of breath. The nurse notes a heart rate
,of 118 bpm and respiratory rate of 28 breaths per minute. Which of the
following complications should the nurse suspect?
A. Postpartum hemorrhage
B. Pulmonary embolism
C. Uterine atony
D. Wound dehiscence
CORRECT ANSWER: B. Pulmonary embolism
Rationale: The classic signs of a pulmonary embolism include sudden onset of sharp
chest pain, dyspnea, tachypnea, and tachycardia. This is a life-threatening emergency
most common in the first two weeks postpartum, especially following a cesarean birth.
The other options do not present with respiratory symptoms as the primary
manifestation.
Question 4: A nurse is teaching a new mother about cord care. Which of the
following statements by the mother indicates a need for further teaching?
A. "I will keep the cord dry and exposed to air."
B. "I will fold the diaper below the cord stump."
C. "I will clean the base with alcohol after each diaper change."
D. "I will give my baby a tub bath until the cord falls off."
CORRECT ANSWER: D. "I will give my baby a tub bath until the cord falls off."
Rationale: The umbilical cord stump should be kept dry and clean. Sponge baths are
recommended until the cord falls off to prevent it from becoming wet and macerated,
which can lead to infection. Tub baths should be avoided until the cord has separated
completely.
Question 5: A nurse is assessing a 24-hour-old newborn. Which of the
following findings should the nurse report to the provider?
A. Axillary temperature of 36.8°C (98.2°F)
B. Respiratory rate of 52 breaths per minute
C. Blood-tinged mucus in the nares
D. Jaundice in the first 24 hours of life
CORRECT ANSWER: D. Jaundice in the first 24 hours of life
Rationale: Jaundice appearing within the first 24 hours of life is pathologic and should
be immediately reported. It is often indicative of hemolytic disease of the newborn, Rh
incompatibility, or ABO incompatibility. Physiologic jaundice typically appears after 24
hours.
Question 6: A postpartum nurse is evaluating the involution of the uterus. At
24 hours post-delivery, the fundus should be located at which of the following
positions?
,A. At the level of the umbilicus
B. One fingerbreadth below the umbilicus
C. Two fingerbreadths below the umbilicus
D. Midway between the umbilicus and the symphysis pubis
CORRECT ANSWER: A. At the level of the umbilicus
Rationale: Immediately after birth, the fundus is at the umbilicus. It remains at the level
of the umbilicus for approximately 24 hours and then descends by about one
fingerbreadth per day. By day 3, it is typically 2-3 fingerbreadths below the umbilicus.
Question 7: A nurse is caring for a newborn with a positive Coombs' test.
Which of the following findings should the nurse anticipate?
A. Hypoglycemia
B. Hyperbilirubinemia
C. Polycythemia
D. Hypocalcemia
CORRECT ANSWER: B. Hyperbilirubinemia
Rationale: A positive Coombs' test indicates that the newborn has antibodies attached
to the red blood cells, a condition seen in hemolytic disease (e.g., Rh or ABO
incompatibility). This leads to rapid hemolysis of red blood cells, increasing the bilirubin
load and resulting in hyperbilirubinemia.
Question 8: A nurse is administering Rh immune globulin (RhoGAM) to a
postpartum client. Which of the following is the primary purpose of this
medication?
A. Prevent fetal anemia.
B. Prevent maternal Rh sensitization.
C. Treat maternal Rh-positive blood.
D. Increase fetal red blood cell production.
CORRECT ANSWER: B. Prevent maternal Rh sensitization.
Rationale: Rh immune globulin is given to Rh-negative mothers who are unsensitized
to prevent the formation of Rh antibodies. It works by destroying any Rh-positive fetal
red blood cells that may have entered the maternal circulation before the mother's
immune system can produce permanent antibodies against them.
Question 9: A nurse is assessing the reflexes of a newborn. The nurse strokes
the lateral surface of the sole upward toward the toes and notes that the toes
hyperextend and fan out. Which reflex is the nurse testing?
A. Moro reflex
B. Babinski reflex
C. Grasp reflex
D. Stepping reflex
, CORRECT ANSWER: B. Babinski reflex
Rationale: The description of stroking the sole of the foot upward and observing toe
hyperextension and fanning is the Babinski reflex. This reflex is normal in newborns and
typically disappears by 12 months. The Moro reflex is a startle response, the grasp reflex
involves the hand, and the stepping reflex involves a walking motion.
Question 10: A postpartum client is experiencing heavy lochia with large clots
and a boggy uterus. After massaging the fundus, which of the following
medications should the nurse anticipate administering?
A. Methylergonovine maleate
B. Naloxone
C. Magnesium sulfate
D. Labetalol
CORRECT ANSWER: A. Methylergonovine maleate
Rationale: A boggy uterus and heavy bleeding indicate uterine atony.
Methylergonovine maleate is an oxytocic agent that causes sustained uterine
contractions, which help to control hemorrhage. Naloxone is an opioid antagonist,
magnesium sulfate is an anticonvulsant, and labetalol is an antihypertensive.
Question 11: A nurse is providing discharge teaching to the parents of a
newborn regarding sleep safety. Which of the following statements by the
parent indicates an understanding of the teaching?
A. "I will place my baby on his side to sleep."
B. "I will use a firm mattress in the crib."
C. "I will put a soft blanket in the crib for warmth."
D. "I will place the crib near a radiator to keep the room warm."
CORRECT ANSWER: B. "I will use a firm mattress in the crib."
Rationale: The safest sleep environment for a newborn is a firm, flat mattress with a
tight-fitting sheet. Soft bedding, pillows, blankets, and bumper pads should be avoided to
reduce the risk of Sudden Infant Death Syndrome (SIDS). Babies should be placed on
their backs to sleep.
Question 12: A nurse is evaluating the effectiveness of phototherapy for a
newborn with hyperbilirubinemia. Which of the following findings indicates
that the therapy is effective?
A. Decreased urinary output
B. Increased serum bilirubin levels
C. Loose, green stools
D. Decreased platelet count
CORRECT ANSWER: C. Loose, green stools
Newborn Nursing Study Guide, Original Practice
Questions & Answers, Comprehensive Exam
Preparation, Detailed Rationales, Postpartum
Assessment, Uterine Involution, Lochia, Postpartum
Hemorrhage, Hypertensive Disorders, Breastfeeding
& Lactation, Newborn Assessment, Newborn
Adaptation, Thermoregulation, Newborn
Complications, Medications, Patient Education,
Safety & NGN-Style Clinical Judgment
Question 1: A nurse is assessing a client who is 12 hours postpartum. The
client reports a severe, throbbing headache and has a blood pressure of
160/110 mmHg. Which of the following findings should the nurse identify as a
contraindication to administering the prescribed magnesium sulfate?
A. Urinary output of 150 mL in the past 4 hours
B. Deep tendon reflexes of 2+
C. Respiratory rate of 16 breaths per minute
D. Serum magnesium level of 6 mEq/L
CORRECT ANSWER: A. Urinary output of 150 mL in the past 4 hours
Rationale: Magnesium sulfate is excreted by the kidneys. A urinary output of less than
30 mL per hour (or 120 mL in 4 hours) indicates decreased renal function, which is a
contraindication due to the risk of magnesium toxicity. The other options are within
acceptable parameters for a client receiving magnesium sulfate.
Question 2: A nurse is performing a newborn assessment and notes a heart
rate of 90 beats per minute while the infant is sleeping. Which of the following
actions should the nurse take first?
A. Document the finding as normal.
B. Administer oxygen via mask.
C. Stimulate the infant to arouse.
D. Assess the infant's oxygen saturation.
CORRECT ANSWER: D. Assess the infant's oxygen saturation.
Rationale: The normal resting heart rate for a newborn is 100-160 bpm, so 90 bpm is
bradycardic. The first action in a systematic assessment is to evaluate the infant's
oxygenation status with a pulse oximeter before initiating other interventions.
Stimulating the infant could cause a transient increase but does not address the
underlying issue.
Question 3: A postpartum client who is 2 days post-cesarean birth reports
sudden, sharp chest pain and shortness of breath. The nurse notes a heart rate
,of 118 bpm and respiratory rate of 28 breaths per minute. Which of the
following complications should the nurse suspect?
A. Postpartum hemorrhage
B. Pulmonary embolism
C. Uterine atony
D. Wound dehiscence
CORRECT ANSWER: B. Pulmonary embolism
Rationale: The classic signs of a pulmonary embolism include sudden onset of sharp
chest pain, dyspnea, tachypnea, and tachycardia. This is a life-threatening emergency
most common in the first two weeks postpartum, especially following a cesarean birth.
The other options do not present with respiratory symptoms as the primary
manifestation.
Question 4: A nurse is teaching a new mother about cord care. Which of the
following statements by the mother indicates a need for further teaching?
A. "I will keep the cord dry and exposed to air."
B. "I will fold the diaper below the cord stump."
C. "I will clean the base with alcohol after each diaper change."
D. "I will give my baby a tub bath until the cord falls off."
CORRECT ANSWER: D. "I will give my baby a tub bath until the cord falls off."
Rationale: The umbilical cord stump should be kept dry and clean. Sponge baths are
recommended until the cord falls off to prevent it from becoming wet and macerated,
which can lead to infection. Tub baths should be avoided until the cord has separated
completely.
Question 5: A nurse is assessing a 24-hour-old newborn. Which of the
following findings should the nurse report to the provider?
A. Axillary temperature of 36.8°C (98.2°F)
B. Respiratory rate of 52 breaths per minute
C. Blood-tinged mucus in the nares
D. Jaundice in the first 24 hours of life
CORRECT ANSWER: D. Jaundice in the first 24 hours of life
Rationale: Jaundice appearing within the first 24 hours of life is pathologic and should
be immediately reported. It is often indicative of hemolytic disease of the newborn, Rh
incompatibility, or ABO incompatibility. Physiologic jaundice typically appears after 24
hours.
Question 6: A postpartum nurse is evaluating the involution of the uterus. At
24 hours post-delivery, the fundus should be located at which of the following
positions?
,A. At the level of the umbilicus
B. One fingerbreadth below the umbilicus
C. Two fingerbreadths below the umbilicus
D. Midway between the umbilicus and the symphysis pubis
CORRECT ANSWER: A. At the level of the umbilicus
Rationale: Immediately after birth, the fundus is at the umbilicus. It remains at the level
of the umbilicus for approximately 24 hours and then descends by about one
fingerbreadth per day. By day 3, it is typically 2-3 fingerbreadths below the umbilicus.
Question 7: A nurse is caring for a newborn with a positive Coombs' test.
Which of the following findings should the nurse anticipate?
A. Hypoglycemia
B. Hyperbilirubinemia
C. Polycythemia
D. Hypocalcemia
CORRECT ANSWER: B. Hyperbilirubinemia
Rationale: A positive Coombs' test indicates that the newborn has antibodies attached
to the red blood cells, a condition seen in hemolytic disease (e.g., Rh or ABO
incompatibility). This leads to rapid hemolysis of red blood cells, increasing the bilirubin
load and resulting in hyperbilirubinemia.
Question 8: A nurse is administering Rh immune globulin (RhoGAM) to a
postpartum client. Which of the following is the primary purpose of this
medication?
A. Prevent fetal anemia.
B. Prevent maternal Rh sensitization.
C. Treat maternal Rh-positive blood.
D. Increase fetal red blood cell production.
CORRECT ANSWER: B. Prevent maternal Rh sensitization.
Rationale: Rh immune globulin is given to Rh-negative mothers who are unsensitized
to prevent the formation of Rh antibodies. It works by destroying any Rh-positive fetal
red blood cells that may have entered the maternal circulation before the mother's
immune system can produce permanent antibodies against them.
Question 9: A nurse is assessing the reflexes of a newborn. The nurse strokes
the lateral surface of the sole upward toward the toes and notes that the toes
hyperextend and fan out. Which reflex is the nurse testing?
A. Moro reflex
B. Babinski reflex
C. Grasp reflex
D. Stepping reflex
, CORRECT ANSWER: B. Babinski reflex
Rationale: The description of stroking the sole of the foot upward and observing toe
hyperextension and fanning is the Babinski reflex. This reflex is normal in newborns and
typically disappears by 12 months. The Moro reflex is a startle response, the grasp reflex
involves the hand, and the stepping reflex involves a walking motion.
Question 10: A postpartum client is experiencing heavy lochia with large clots
and a boggy uterus. After massaging the fundus, which of the following
medications should the nurse anticipate administering?
A. Methylergonovine maleate
B. Naloxone
C. Magnesium sulfate
D. Labetalol
CORRECT ANSWER: A. Methylergonovine maleate
Rationale: A boggy uterus and heavy bleeding indicate uterine atony.
Methylergonovine maleate is an oxytocic agent that causes sustained uterine
contractions, which help to control hemorrhage. Naloxone is an opioid antagonist,
magnesium sulfate is an anticonvulsant, and labetalol is an antihypertensive.
Question 11: A nurse is providing discharge teaching to the parents of a
newborn regarding sleep safety. Which of the following statements by the
parent indicates an understanding of the teaching?
A. "I will place my baby on his side to sleep."
B. "I will use a firm mattress in the crib."
C. "I will put a soft blanket in the crib for warmth."
D. "I will place the crib near a radiator to keep the room warm."
CORRECT ANSWER: B. "I will use a firm mattress in the crib."
Rationale: The safest sleep environment for a newborn is a firm, flat mattress with a
tight-fitting sheet. Soft bedding, pillows, blankets, and bumper pads should be avoided to
reduce the risk of Sudden Infant Death Syndrome (SIDS). Babies should be placed on
their backs to sleep.
Question 12: A nurse is evaluating the effectiveness of phototherapy for a
newborn with hyperbilirubinemia. Which of the following findings indicates
that the therapy is effective?
A. Decreased urinary output
B. Increased serum bilirubin levels
C. Loose, green stools
D. Decreased platelet count
CORRECT ANSWER: C. Loose, green stools
