ATI MATERNAL-NEWBORN NURSING EXAM
2026–2027 | RN STUDY GUIDE & TEST PREP |
HIGH-RISK PREGNANCY, FETAL
MONITORING, OBSTETRIC COMPLICATIONS
& NEWBORN CARE
ATI MATERNAL-NEWBORN NURSING EXAM 2026–2027 | RN STUDY GUIDE &
TEST PREP
DOCUMENT OVERVIEW
• Comprehensive question study guide with detailed evidence-based rationales
covering high-risk pregnancy, fetal monitoring, obstetric complications, and
newborn care to prepare for ATI certification and NCLEX-RN examination
• Master clinical decision-making through realistic scenarios, nursing interventions,
and critical assessment skills essential for safe maternal-newborn nursing practice
in clinical settings
EXAM QUESTIONS
QUESTION 1
A 28-year-old primigravida at 24 weeks gestation presents to the clinic with a blood
pressure of 148/95 mmHg. She reports no headache or visual disturbances. What is
the priority nursing intervention?
A) Administer magnesium sulfate immediately
B) Schedule delivery within 24 hours
C) Recheck blood pressure after 15 minutes of rest
D) Perform a 24-hour urine collection for protein
E) Admit to the hospital for continuous monitoring
CORRECT ANSWER: C) Recheck blood pressure after 15 minutes of rest
,RATIONALE: One elevated blood pressure reading does not constitute gestational
hypertension. According to ACOG guidelines, hypertension in pregnancy is defined
as two consecutive readings ≥140/90 mmHg taken at least 15 minutes apart.
Rechecking the blood pressure after the client rests helps differentiate between
white coat syndrome and true hypertension. Magnesium sulfate is indicated for
seizure prophylaxis in preeclampsia with severe features. Scheduling delivery and
admission are premature interventions without confirming a diagnosis. A 24-hour
urine collection would be appropriate only if hypertension is confirmed.
QUESTION 2
A pregnant client at 32 weeks gestation reports sudden onset of severe abdominal
pain and vaginal bleeding. Fetal heart tones are 180 bpm and irregular. What is the
most likely diagnosis?
A) Placenta previa
B) Placental abruption
C) Uterine rupture
D) Preterm labor with infection
E) Subchorionic hemorrhage
CORRECT ANSWER: B) Placental abruption
RATIONALE: The classic triad of placental abruption includes severe abdominal
pain, vaginal bleeding, and signs of fetal distress (tachycardia and irregular heart
rate). Placental abruption is a medical emergency requiring immediate intervention.
Placenta previa typically presents with painless bleeding. Uterine rupture would
present with more severe maternal shock and absent fetal heart tones. The sudden
onset and severity of symptoms with fetal distress are hallmark signs of abruption,
a life-threatening condition for both mother and fetus requiring expedited delivery.
QUESTION 3
,A 35-year-old client at 28 weeks gestation is diagnosed with gestational diabetes
mellitus. What is the priority teaching point for this client?
A) She will definitely need insulin throughout her pregnancy
B) Blood glucose monitoring four times daily with dietary modifications is essential
C) She should avoid all carbohydrates in her diet
D) Her baby will definitely have congenital anomalies
E) She can discontinue all monitoring after delivery
CORRECT ANSWER: B) Blood glucose monitoring four times daily with dietary
modifications is essential
RATIONALE: Gestational diabetes management centers on achieving euglycemia
through fasting glucose monitoring, postprandial glucose monitoring (4 times daily),
dietary modifications with medical nutrition therapy, and exercise. While some
clients may require insulin if diet and exercise fail to control glucose levels, not all
require insulin initially. Carbohydrate restriction is not recommended—
carbohydrates should be complex and carefully timed. GDM increases risk for
complications but does not guarantee fetal anomalies. Monitoring must continue
postpartum as GDM is a risk factor for type 2 diabetes. The priority is education
about monitoring and lifestyle modifications.
QUESTION 4
During fetal heart rate monitoring, the nurse observes a pattern showing FHR
baseline 140 bpm, with three accelerations of 15 bpm lasting 15 seconds within 20
minutes. Variability is moderate. What is this pattern called?
A) Reassuring pattern
B) Reactive non-stress test
C) Variable decelerations
D) Fetal tachycardia
E) Loss of variability
, CORRECT ANSWER: B) Reactive non-stress test
RATIONALE: A reactive non-stress test is characterized by a baseline heart rate of
120-160 bpm, two or more accelerations of at least 15 bpm above baseline lasting
at least 15 seconds within a 20-minute period, and moderate variability. This
pattern indicates fetal well-being and reassurance of adequate placental function
and fetal oxygenation. A reassuring pattern may be used generally, but the specific
term for this response is reactive NST. Variable decelerations are drops in FHR.
Fetal tachycardia is a baseline >160 bpm. This pattern is normal and indicates no
intervention is needed.
QUESTION 5
A client at 34 weeks gestation with preeclampsia is admitted and started on
magnesium sulfate. Which clinical finding would indicate magnesium toxicity?
A) Brisk patellar reflexes
B) Absence of patellar reflexes
C) Urinary output of 200 mL/hour
D) Respiratory rate of 18 breaths/minute
E) Blood pressure of 140/90 mmHg
CORRECT ANSWER: B) Absence of patellar reflexes
RATIONALE: The absence of patellar reflexes (loss of deep tendon reflexes) is a sign
of magnesium toxicity. Therapeutic magnesium levels produce diminished reflexes;
toxicity causes absent reflexes. This is an important assessment point before each
dose. Early signs of toxicity include decreased reflexes, flushed skin, and decreased
urine output (<30 mL/hour). Brisk reflexes indicate adequate magnesium levels.
Respiratory depression occurs with severe toxicity. Normal respiratory rate and
blood pressure readings do not indicate toxicity. When reflexes are absent,
magnesium sulfate should be held and the healthcare provider notified.
2026–2027 | RN STUDY GUIDE & TEST PREP |
HIGH-RISK PREGNANCY, FETAL
MONITORING, OBSTETRIC COMPLICATIONS
& NEWBORN CARE
ATI MATERNAL-NEWBORN NURSING EXAM 2026–2027 | RN STUDY GUIDE &
TEST PREP
DOCUMENT OVERVIEW
• Comprehensive question study guide with detailed evidence-based rationales
covering high-risk pregnancy, fetal monitoring, obstetric complications, and
newborn care to prepare for ATI certification and NCLEX-RN examination
• Master clinical decision-making through realistic scenarios, nursing interventions,
and critical assessment skills essential for safe maternal-newborn nursing practice
in clinical settings
EXAM QUESTIONS
QUESTION 1
A 28-year-old primigravida at 24 weeks gestation presents to the clinic with a blood
pressure of 148/95 mmHg. She reports no headache or visual disturbances. What is
the priority nursing intervention?
A) Administer magnesium sulfate immediately
B) Schedule delivery within 24 hours
C) Recheck blood pressure after 15 minutes of rest
D) Perform a 24-hour urine collection for protein
E) Admit to the hospital for continuous monitoring
CORRECT ANSWER: C) Recheck blood pressure after 15 minutes of rest
,RATIONALE: One elevated blood pressure reading does not constitute gestational
hypertension. According to ACOG guidelines, hypertension in pregnancy is defined
as two consecutive readings ≥140/90 mmHg taken at least 15 minutes apart.
Rechecking the blood pressure after the client rests helps differentiate between
white coat syndrome and true hypertension. Magnesium sulfate is indicated for
seizure prophylaxis in preeclampsia with severe features. Scheduling delivery and
admission are premature interventions without confirming a diagnosis. A 24-hour
urine collection would be appropriate only if hypertension is confirmed.
QUESTION 2
A pregnant client at 32 weeks gestation reports sudden onset of severe abdominal
pain and vaginal bleeding. Fetal heart tones are 180 bpm and irregular. What is the
most likely diagnosis?
A) Placenta previa
B) Placental abruption
C) Uterine rupture
D) Preterm labor with infection
E) Subchorionic hemorrhage
CORRECT ANSWER: B) Placental abruption
RATIONALE: The classic triad of placental abruption includes severe abdominal
pain, vaginal bleeding, and signs of fetal distress (tachycardia and irregular heart
rate). Placental abruption is a medical emergency requiring immediate intervention.
Placenta previa typically presents with painless bleeding. Uterine rupture would
present with more severe maternal shock and absent fetal heart tones. The sudden
onset and severity of symptoms with fetal distress are hallmark signs of abruption,
a life-threatening condition for both mother and fetus requiring expedited delivery.
QUESTION 3
,A 35-year-old client at 28 weeks gestation is diagnosed with gestational diabetes
mellitus. What is the priority teaching point for this client?
A) She will definitely need insulin throughout her pregnancy
B) Blood glucose monitoring four times daily with dietary modifications is essential
C) She should avoid all carbohydrates in her diet
D) Her baby will definitely have congenital anomalies
E) She can discontinue all monitoring after delivery
CORRECT ANSWER: B) Blood glucose monitoring four times daily with dietary
modifications is essential
RATIONALE: Gestational diabetes management centers on achieving euglycemia
through fasting glucose monitoring, postprandial glucose monitoring (4 times daily),
dietary modifications with medical nutrition therapy, and exercise. While some
clients may require insulin if diet and exercise fail to control glucose levels, not all
require insulin initially. Carbohydrate restriction is not recommended—
carbohydrates should be complex and carefully timed. GDM increases risk for
complications but does not guarantee fetal anomalies. Monitoring must continue
postpartum as GDM is a risk factor for type 2 diabetes. The priority is education
about monitoring and lifestyle modifications.
QUESTION 4
During fetal heart rate monitoring, the nurse observes a pattern showing FHR
baseline 140 bpm, with three accelerations of 15 bpm lasting 15 seconds within 20
minutes. Variability is moderate. What is this pattern called?
A) Reassuring pattern
B) Reactive non-stress test
C) Variable decelerations
D) Fetal tachycardia
E) Loss of variability
, CORRECT ANSWER: B) Reactive non-stress test
RATIONALE: A reactive non-stress test is characterized by a baseline heart rate of
120-160 bpm, two or more accelerations of at least 15 bpm above baseline lasting
at least 15 seconds within a 20-minute period, and moderate variability. This
pattern indicates fetal well-being and reassurance of adequate placental function
and fetal oxygenation. A reassuring pattern may be used generally, but the specific
term for this response is reactive NST. Variable decelerations are drops in FHR.
Fetal tachycardia is a baseline >160 bpm. This pattern is normal and indicates no
intervention is needed.
QUESTION 5
A client at 34 weeks gestation with preeclampsia is admitted and started on
magnesium sulfate. Which clinical finding would indicate magnesium toxicity?
A) Brisk patellar reflexes
B) Absence of patellar reflexes
C) Urinary output of 200 mL/hour
D) Respiratory rate of 18 breaths/minute
E) Blood pressure of 140/90 mmHg
CORRECT ANSWER: B) Absence of patellar reflexes
RATIONALE: The absence of patellar reflexes (loss of deep tendon reflexes) is a sign
of magnesium toxicity. Therapeutic magnesium levels produce diminished reflexes;
toxicity causes absent reflexes. This is an important assessment point before each
dose. Early signs of toxicity include decreased reflexes, flushed skin, and decreased
urine output (<30 mL/hour). Brisk reflexes indicate adequate magnesium levels.
Respiratory depression occurs with severe toxicity. Normal respiratory rate and
blood pressure readings do not indicate toxicity. When reflexes are absent,
magnesium sulfate should be held and the healthcare provider notified.
