Newborn Proctored Exam & Content Mastery Series (CMS) Study Guide |
ATI Maternal Newborn Practice Questions, Answers & Detailed Rationales
| Maternal-Newborn Nursing Exam Prep, Pregnancy & Prenatal Care,
Antepartum Nursing, High-Risk Pregnancy, Maternal Complications, Fetal
Assessment & Monitoring, Labor & Delivery, Intrapartum Nursing,
Postpartum Nursing, Newborn Assessment, Newborn Care, Neonatal
Complications, Breastfeeding & Nutrition, Maternal-Newborn
Pharmacology, Patient Education, Clinical Judgment, Prioritization,
Delegation & NGN Case-Based Nursing Practice
Question 1: A nurse is caring for a client at 12 weeks of gestation who reports
nausea and vomiting. Which intervention should the nurse recommend?
A. Eat small, frequent meals throughout the day
B. Increase intake of spicy foods
C. Consume large meals at bedtime
D. Avoid all fluids until symptoms subside
CORRECT ANSWER: A. Eat small, frequent meals throughout the day
Rationale: Nausea and vomiting in early pregnancy is best managed by eating small,
frequent meals to prevent the stomach from becoming empty, which exacerbates
symptoms. Spicy foods may worsen nausea, large bedtime meals increase discomfort
due to slowed digestion, and fluid avoidance risks dehydration.
Question 2: A client in active labor is dilated to 7 cm. The fetal heart rate
shows late decelerations. What is the priority nursing action?
A. Reposition the client to the left side
B. Administer oxygen via face mask
C. Prepare for immediate delivery
D. Increase IV fluid rate
CORRECT ANSWER: B. Administer oxygen via face mask
Rationale: Late decelerations indicate uteroplacental insufficiency compromising fetal
oxygenation. The priority is maximizing oxygen delivery to the fetus by administering
100% oxygen via non-rebreather mask at 8-10 L/min. Repositioning is supportive but
not the immediate priority.
Question 3: A postpartum client reports heavy vaginal bleeding and a foul
odor. What should the nurse suspect?
A. Endometritis
B. Lochia rubra
C. Retained placenta
D. Urinary tract infection
,CORRECT ANSWER: A. Endometritis
Rationale: Heavy bleeding with foul odor suggests endometritis, a uterine infection
requiring antibiotics. Lochia rubra is normal bright red lochia without odor. Retained
placenta causes bleeding but not typically foul odor. UTI involves urinary symptoms, not
vaginal odor.
Question 4: A newborn's Apgar score is 7 at 1 minute. Which finding
contributes to this score?
A. Heart rate of 120 bpm
B. Weak cry and grimace
C. Blue extremities
D. Flexed posture
CORRECT ANSWER: A. Heart rate of 120 bpm
Rationale: Apgar scoring assesses heart rate (2 points for >100 bpm), respiration, muscle
tone, reflex irritability, and color. A heart rate of 120 bpm scores 2 points. Weak cry
scores 1 for respiration, blue extremities scores 1 for color, and flexed posture scores 2
for tone.
Question 5: A client at 38 weeks gestation has a positive urine protein dipstick.
What is the nurse's next action?
A. Notify the provider immediately
B. Encourage bed rest
C. Collect a 24-hour urine sample
D. Administer antihypertensive medication
CORRECT ANSWER: A. Notify the provider immediately
Rationale: Proteinuria at term suggests preeclampsia, a hypertensive emergency
requiring prompt provider notification for assessment and management. Bed rest is
supportive but not immediate. 24-hour urine confirms but delays action.
Antihypertensives are prescribed, not nurse-initiated.
Question 6: During the second stage of labor, a client is instructed to push.
What indicates effective pushing?
A. Descent of the fetal head during contractions
B. Maternal heart rate increase to 140 bpm
C. Relaxation between contractions
D. Verbalization of pain relief
CORRECT ANSWER: A. Descent of the fetal head during contractions
Rationale: Effective pushing advances fetal descent, visible as crowning or station
progression. Maternal tachycardia may indicate exhaustion, not effectiveness.
Relaxation between contractions is normal but not indicative of effective pushing.
,Question 7: A nurse is teaching a client at 12 weeks gestation about prenatal
vitamins. Which statement indicates the client understands the teaching?
A. "I should take my vitamin on an empty stomach."
B. "I need to take extra iron to prevent anemia."
C. "I should stop taking the vitamin after the first trimester."
D. "Prenatal vitamins are optional if I eat well."
CORRECT ANSWER: B. "I need to take extra iron to prevent anemia."
Rationale: Prenatal vitamins contain iron to prevent anemia, folic acid to prevent neural
tube defects, and other essential nutrients. They should be taken throughout pregnancy.
Taking on an empty stomach may worsen nausea, and they are not optional.
Question 8: A client at 28 weeks gestation reports swelling in the face and
hands and a headache. What is the nurse's priority action?
A. Assess fetal heart rate
B. Check blood pressure
C. Encourage increased fluid intake
D. Advise bed rest at home
CORRECT ANSWER: B. Check blood pressure
Rationale: Swelling of the face/hands and headache may indicate preeclampsia. Blood
pressure assessment is the priority to identify hypertensive complications. Fetal heart
rate assessment is important but secondary to maternal stabilization.
Question 9: During labor, a client's contractions are every 2 minutes and
lasting 90 seconds. The fetal heart rate shows late decelerations. What should
the nurse do first?
A. Administer oxytocin
B. Increase IV fluids
C. Assist with pushing
D. Prepare for a C-section
CORRECT ANSWER: B. Increase IV fluids
Rationale: Late decelerations indicate uteroplacental insufficiency. The first intervention
is intrauterine resuscitation, including increasing IV fluids to improve placental
perfusion. Oxytocin would worsen the condition, and C-section is reserved for
unresolved distress.
Question 10: A newborn is delivered at 38 weeks with Apgar scores of 8 and 9
at 1 and 5 minutes. Which action should the nurse perform first?
A. Initiate skin-to-skin contact
B. Administer vitamin K
C. Obtain weight and measurements
D. Perform a heel stick glucose test
, CORRECT ANSWER: A. Initiate skin-to-skin contact
Rationale: The newborn is stable; skin-to-skin contact promotes bonding,
thermoregulation, and breastfeeding initiation. Vitamin K administration and
measurements can follow after initial bonding is established.
Question 11: A postpartum client is experiencing heavy lochia and a boggy
uterus. Which intervention should the nurse implement first?
A. Call the healthcare provider
B. Massage the fundus
C. Administer pain medication
D. Encourage ambulation
CORRECT ANSWER: B. Massage the fundus
Rationale: A boggy uterus with heavy bleeding indicates uterine atony. Fundal massage
helps the uterus contract and reduces hemorrhage. Calling the provider is important but
fundal massage is the immediate nursing intervention.
Question 12: A nurse is teaching a client about newborn immunizations.
Which vaccine is given within 24 hours of birth?
A. Hepatitis B
B. DTaP
C. MMR
D. Polio
CORRECT ANSWER: A. Hepatitis B
Rationale: The Hepatitis B vaccine is administered within 24 hours of birth to prevent
hepatitis B infection. DTaP, MMR, and Polio are given at later ages according to the
immunization schedule.
Question 13: A client at 34 weeks gestation reports decreased fetal movement.
What is the priority nursing action?
A. Encourage the client to rest
B. Perform a non-stress test
C. Schedule a routine ultrasound
D. Teach kick counts
CORRECT ANSWER: B. Perform a non-stress test
Rationale: Decreased fetal movement may indicate fetal compromise. A non-stress test
assesses fetal well-being immediately. Teaching kick counts is important for ongoing
monitoring but does not address the acute concern.
Question 14: A nurse is caring for a client with preterm premature rupture of
membranes (PPROM). Which action is appropriate?