ATI Maternity | ATI RN Maternal Newborn Nursing
Study Guide & Exam Prep 2026/2027 | ATI
Maternal Newborn Assessment Review, Pregnancy
& Prenatal Care, Antepartum Complications, Labor
& Delivery, Fetal Monitoring, Postpartum Nursing,
Newborn Assessment, High-Risk Pregnancy,
Obstetric Emergencies, Breastfeeding, Maternal
Medications, Patient Education, Clinical Judgment,
Practice Questions, Answers & Detailed Rationales
Question 1: A client who is 35 weeks gestation is admitted with preeclampsia
with severe features. Which assessment finding indicates a potential
complication of magnesium sulfate therapy?
A. Urinary output of 35 mL/hr
B. Deep tendon reflexes 2+
C. Respiratory rate of 14 breaths/min
D. Serum magnesium level of 9 mg/dL
CORRECT ANSWER: D. Serum magnesium level of 9 mg/dL
Rationale: The therapeutic range for magnesium sulfate is 4-7 mg/dL. A serum level of 9
mg/dL is above the therapeutic range and approaches toxicity. Signs of magnesium
toxicity include loss of deep tendon reflexes (at 10 mg/dL), respiratory depression (at 12
mg/dL), and cardiac arrest (at 15 mg/dL). The other options are within expected
parameters.
Question 2: A nurse is assessing a newborn 2 hours after birth. Which finding
should be reported to the healthcare provider immediately?
A. Acrocyanosis of the extremities
B. A heart rate of 160 beats/min
C. Grunting respirations with nasal flaring
D. A respiratory rate of 50 breaths/min
CORRECT ANSWER: C. Grunting respirations with nasal flaring
Rationale: Grunting respirations with nasal flaring are signs of respiratory distress in a
newborn and require immediate intervention. Acrocyanosis is a normal finding in the
first 24 hours. A heart rate of 160 bpm and a respiratory rate of 50 breaths/min are
within normal limits for a newborn.
Question 3: A client in active labor is receiving oxytocin (Pitocin) via
continuous IV infusion. Which finding requires the nurse to immediately stop
the infusion?
A. Uterine contractions every 2 minutes, lasting 60 seconds each
B. Fetal heart rate baseline of 140 with moderate variability
,C. Contraction frequency of every 90 seconds, lasting 100 seconds each
D. Maternal blood pressure of 120/78 mmHg
CORRECT ANSWER: C. Contraction frequency of every 90 seconds, lasting 100
seconds each
Rationale: Oxytocin should be discontinued if uterine hyperstimulation occurs
(contractions lasting more than 90 seconds, occurring more frequently than every 2
minutes, or with a resting tone of greater than 20 mmHg). This pattern can lead to fetal
hypoxia. The other options represent normal or safe findings.
Question 4: A postpartum client is Rh-negative and delivered an Rh-positive
newborn. Which medication should the nurse anticipate administering?
A. Rho(D) immune globulin (RhoGAM)
B. Rh immunoglobulin (RhIg)
C. Methylergonovine (Methergine)
D. Oxytocin (Pitocin)
CORRECT ANSWER: A. Rho(D) immune globulin (RhoGAM)
Rationale: Rho(D) immune globulin (RhoGAM) is given to Rh-negative mothers who
have delivered an Rh-positive infant to prevent maternal isoimmunization and hemolytic
disease of the newborn in subsequent pregnancies. It is typically administered within 72
hours postpartum.
Question 5: A nurse is preparing a client for a nonstress test (NST). Which
instruction should the nurse provide to the client?
A. "You will need to have a full bladder for this test."
B. "You will be asked to walk on a treadmill during the test."
C. "The test will measure your baby's response to your contractions."
D. "You will be asked to press a button when you feel the baby move."
CORRECT ANSWER: D. "You will be asked to press a button when you feel the
baby move."
Rationale: In an NST, the client uses a marker to record fetal movements to correlate
with accelerations on the fetal heart rate tracing. A full bladder is often needed for a
biophysical profile or ultrasound, not an NST. A contraction stress test measures fetal
response to contractions.
Question 6: A newborn has a glucose level of 35 mg/dL. Which of the
following is the priority nursing action?
A. Initiate early feeding with formula or breast milk.
B. Administer intravenous dextrose 10% as prescribed.
C. Recheck the glucose level in 4 hours.
D. Document the finding as a normal variation.
CORRECT ANSWER: B. Administer intravenous dextrose 10% as prescribed.
,Rationale: A blood glucose level of 35 mg/dL in a newborn is considered severe
hypoglycemia (<40 mg/dL) and requires immediate IV dextrose therapy to prevent
neurologic damage. While early feeding is important, it is not sufficient to correct this
level rapidly.
Question 7: A client at 39 weeks gestation is admitted with spontaneous
rupture of membranes. Which assessment finding indicates a prolapsed
umbilical cord?
A. Fetal heart rate of 110 beats/min
B. Fetal heart rate decelerations with contractions
C. A visible or palpable cord in the vaginal vault
D. Thick, meconium-stained amniotic fluid
CORRECT ANSWER: C. A visible or palpable cord in the vaginal vault
Rationale: A prolapsed umbilical cord is identified by the cord being visible at the
introitus or palpated in the vagina. This is an obstetric emergency. Decelerations or
bradycardia can be associated but are not as definitive.
Question 8: The nurse is teaching a prenatal class about warning signs during
pregnancy. Which sign requires immediate notification of the healthcare
provider?
A. Epigastric pain
B. Nausea in the morning
C. Nasal congestion
D. Leg cramps
CORRECT ANSWER: A. Epigastric pain
Rationale: Epigastric pain is a warning sign of preeclampsia, potentially indicating liver
capsule distension or HELLP syndrome. It requires immediate evaluation. Nausea, nasal
congestion, and leg cramps are common discomforts of pregnancy.
Question 9: A client with gestational diabetes mellitus is 36 weeks gestation.
The nurse is reviewing her biophysical profile (BPP) results. Which component
is NOT part of a standard BPP?
A. Fetal breathing movements
B. Amniotic fluid volume
C. Fetal tone
D. Contraction stress test
CORRECT ANSWER: D. Contraction stress test
Rationale: A standard BPP consists of five components: fetal breathing movements, fetal
movements, fetal tone, amniotic fluid volume, and the nonstress test (NST). The
contraction stress test is a separate diagnostic test, not part of the BPP.
, Question 10: A nurse is caring for a client in the fourth stage of labor. Which
assessment is the priority during this stage?
A. Assessment of the newborn's Apgar score
B. Assessment of fundal firmness and lochia
C. Assessment of the client's pain level
D. Assessment of bonding behaviors
CORRECT ANSWER: B. Assessment of fundal firmness and lochia
Rationale: The fourth stage of labor is the first 1-4 hours postpartum, during which the
priority is to prevent hemorrhage. This is achieved by monitoring uterine tone (fundus)
and the amount of vaginal bleeding (lochia).
Question 11: A client reports she is 8 weeks pregnant and is experiencing
nausea and vomiting. Which instruction should the nurse provide to help
alleviate this discomfort?
A. "Drink large amounts of fluid with each meal."
B. "Eat dry crackers before getting out of bed in the morning."
C. "Lie flat immediately after eating."
D. "Take a prenatal vitamin with iron on an empty stomach."
CORRECT ANSWER: B. "Eat dry crackers before getting out of bed in the
morning."
Rationale: Eating dry, bland foods like crackers before arising can help manage nausea
associated with early pregnancy. Small, frequent meals and avoiding strong odors are
also helpful. Fluids should be taken between meals, not with them, and prenatal vitamins
with iron are better tolerated with food.
Question 12: A nurse is monitoring a client who received epidural anesthesia
during labor. Which finding is a potential adverse effect that the nurse should
monitor for?
A. Hypertension
B. Tachycardia
C. Hypotension
D. Hyperthermia
CORRECT ANSWER: C. Hypotension
Rationale: Hypotension is a common adverse effect of epidural anesthesia due to
sympathetic blockade and vasodilation. This can lead to decreased placental perfusion
and fetal bradycardia. Interventions include fluid boluses and positioning the client
laterally.
Question 13: At 1 minute of life, a newborn has a heart rate of 92, a cry that is
weak, some flexion of the extremities, a pink body with blue extremities, and
is actively sneezing. What is the 1-minute Apgar score?
Study Guide & Exam Prep 2026/2027 | ATI
Maternal Newborn Assessment Review, Pregnancy
& Prenatal Care, Antepartum Complications, Labor
& Delivery, Fetal Monitoring, Postpartum Nursing,
Newborn Assessment, High-Risk Pregnancy,
Obstetric Emergencies, Breastfeeding, Maternal
Medications, Patient Education, Clinical Judgment,
Practice Questions, Answers & Detailed Rationales
Question 1: A client who is 35 weeks gestation is admitted with preeclampsia
with severe features. Which assessment finding indicates a potential
complication of magnesium sulfate therapy?
A. Urinary output of 35 mL/hr
B. Deep tendon reflexes 2+
C. Respiratory rate of 14 breaths/min
D. Serum magnesium level of 9 mg/dL
CORRECT ANSWER: D. Serum magnesium level of 9 mg/dL
Rationale: The therapeutic range for magnesium sulfate is 4-7 mg/dL. A serum level of 9
mg/dL is above the therapeutic range and approaches toxicity. Signs of magnesium
toxicity include loss of deep tendon reflexes (at 10 mg/dL), respiratory depression (at 12
mg/dL), and cardiac arrest (at 15 mg/dL). The other options are within expected
parameters.
Question 2: A nurse is assessing a newborn 2 hours after birth. Which finding
should be reported to the healthcare provider immediately?
A. Acrocyanosis of the extremities
B. A heart rate of 160 beats/min
C. Grunting respirations with nasal flaring
D. A respiratory rate of 50 breaths/min
CORRECT ANSWER: C. Grunting respirations with nasal flaring
Rationale: Grunting respirations with nasal flaring are signs of respiratory distress in a
newborn and require immediate intervention. Acrocyanosis is a normal finding in the
first 24 hours. A heart rate of 160 bpm and a respiratory rate of 50 breaths/min are
within normal limits for a newborn.
Question 3: A client in active labor is receiving oxytocin (Pitocin) via
continuous IV infusion. Which finding requires the nurse to immediately stop
the infusion?
A. Uterine contractions every 2 minutes, lasting 60 seconds each
B. Fetal heart rate baseline of 140 with moderate variability
,C. Contraction frequency of every 90 seconds, lasting 100 seconds each
D. Maternal blood pressure of 120/78 mmHg
CORRECT ANSWER: C. Contraction frequency of every 90 seconds, lasting 100
seconds each
Rationale: Oxytocin should be discontinued if uterine hyperstimulation occurs
(contractions lasting more than 90 seconds, occurring more frequently than every 2
minutes, or with a resting tone of greater than 20 mmHg). This pattern can lead to fetal
hypoxia. The other options represent normal or safe findings.
Question 4: A postpartum client is Rh-negative and delivered an Rh-positive
newborn. Which medication should the nurse anticipate administering?
A. Rho(D) immune globulin (RhoGAM)
B. Rh immunoglobulin (RhIg)
C. Methylergonovine (Methergine)
D. Oxytocin (Pitocin)
CORRECT ANSWER: A. Rho(D) immune globulin (RhoGAM)
Rationale: Rho(D) immune globulin (RhoGAM) is given to Rh-negative mothers who
have delivered an Rh-positive infant to prevent maternal isoimmunization and hemolytic
disease of the newborn in subsequent pregnancies. It is typically administered within 72
hours postpartum.
Question 5: A nurse is preparing a client for a nonstress test (NST). Which
instruction should the nurse provide to the client?
A. "You will need to have a full bladder for this test."
B. "You will be asked to walk on a treadmill during the test."
C. "The test will measure your baby's response to your contractions."
D. "You will be asked to press a button when you feel the baby move."
CORRECT ANSWER: D. "You will be asked to press a button when you feel the
baby move."
Rationale: In an NST, the client uses a marker to record fetal movements to correlate
with accelerations on the fetal heart rate tracing. A full bladder is often needed for a
biophysical profile or ultrasound, not an NST. A contraction stress test measures fetal
response to contractions.
Question 6: A newborn has a glucose level of 35 mg/dL. Which of the
following is the priority nursing action?
A. Initiate early feeding with formula or breast milk.
B. Administer intravenous dextrose 10% as prescribed.
C. Recheck the glucose level in 4 hours.
D. Document the finding as a normal variation.
CORRECT ANSWER: B. Administer intravenous dextrose 10% as prescribed.
,Rationale: A blood glucose level of 35 mg/dL in a newborn is considered severe
hypoglycemia (<40 mg/dL) and requires immediate IV dextrose therapy to prevent
neurologic damage. While early feeding is important, it is not sufficient to correct this
level rapidly.
Question 7: A client at 39 weeks gestation is admitted with spontaneous
rupture of membranes. Which assessment finding indicates a prolapsed
umbilical cord?
A. Fetal heart rate of 110 beats/min
B. Fetal heart rate decelerations with contractions
C. A visible or palpable cord in the vaginal vault
D. Thick, meconium-stained amniotic fluid
CORRECT ANSWER: C. A visible or palpable cord in the vaginal vault
Rationale: A prolapsed umbilical cord is identified by the cord being visible at the
introitus or palpated in the vagina. This is an obstetric emergency. Decelerations or
bradycardia can be associated but are not as definitive.
Question 8: The nurse is teaching a prenatal class about warning signs during
pregnancy. Which sign requires immediate notification of the healthcare
provider?
A. Epigastric pain
B. Nausea in the morning
C. Nasal congestion
D. Leg cramps
CORRECT ANSWER: A. Epigastric pain
Rationale: Epigastric pain is a warning sign of preeclampsia, potentially indicating liver
capsule distension or HELLP syndrome. It requires immediate evaluation. Nausea, nasal
congestion, and leg cramps are common discomforts of pregnancy.
Question 9: A client with gestational diabetes mellitus is 36 weeks gestation.
The nurse is reviewing her biophysical profile (BPP) results. Which component
is NOT part of a standard BPP?
A. Fetal breathing movements
B. Amniotic fluid volume
C. Fetal tone
D. Contraction stress test
CORRECT ANSWER: D. Contraction stress test
Rationale: A standard BPP consists of five components: fetal breathing movements, fetal
movements, fetal tone, amniotic fluid volume, and the nonstress test (NST). The
contraction stress test is a separate diagnostic test, not part of the BPP.
, Question 10: A nurse is caring for a client in the fourth stage of labor. Which
assessment is the priority during this stage?
A. Assessment of the newborn's Apgar score
B. Assessment of fundal firmness and lochia
C. Assessment of the client's pain level
D. Assessment of bonding behaviors
CORRECT ANSWER: B. Assessment of fundal firmness and lochia
Rationale: The fourth stage of labor is the first 1-4 hours postpartum, during which the
priority is to prevent hemorrhage. This is achieved by monitoring uterine tone (fundus)
and the amount of vaginal bleeding (lochia).
Question 11: A client reports she is 8 weeks pregnant and is experiencing
nausea and vomiting. Which instruction should the nurse provide to help
alleviate this discomfort?
A. "Drink large amounts of fluid with each meal."
B. "Eat dry crackers before getting out of bed in the morning."
C. "Lie flat immediately after eating."
D. "Take a prenatal vitamin with iron on an empty stomach."
CORRECT ANSWER: B. "Eat dry crackers before getting out of bed in the
morning."
Rationale: Eating dry, bland foods like crackers before arising can help manage nausea
associated with early pregnancy. Small, frequent meals and avoiding strong odors are
also helpful. Fluids should be taken between meals, not with them, and prenatal vitamins
with iron are better tolerated with food.
Question 12: A nurse is monitoring a client who received epidural anesthesia
during labor. Which finding is a potential adverse effect that the nurse should
monitor for?
A. Hypertension
B. Tachycardia
C. Hypotension
D. Hyperthermia
CORRECT ANSWER: C. Hypotension
Rationale: Hypotension is a common adverse effect of epidural anesthesia due to
sympathetic blockade and vasodilation. This can lead to decreased placental perfusion
and fetal bradycardia. Interventions include fluid boluses and positioning the client
laterally.
Question 13: At 1 minute of life, a newborn has a heart rate of 92, a cry that is
weak, some flexion of the extremities, a pink body with blue extremities, and
is actively sneezing. What is the 1-minute Apgar score?
