ATI Maternal Newborn Comprehensive Predictor
2026/2027 | ACTUAL-Style Practice Questions &
Answers, ATI RN Maternal-Newborn Nursing Exam
Prep, Pregnancy Complications, Labor and Delivery,
Postpartum Care, Newborn Assessment, High-Risk
Pregnancy, and Detailed Rationales
Question 1: A nurse is caring for a client at 38 weeks' gestation who
reports a sudden gush of fluid from the vagina. Which of the following
actions should the nurse take first?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Check the fetal heart rate and assess for cord prolapse
C. Obtain a specimen for nitrazine paper testing
D. Place the client in a supine position for a bedside ultrasound
CORRECT ANSWER: B. Check the fetal heart rate and assess for cord
prolapse
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being and rule out umbilical
cord prolapse, which is an obstetric emergency. Checking the fetal heart
rate and inspecting for cord presentation takes precedence over vaginal
examination, nitrazine testing, or ultrasound because cord compression
can rapidly compromise fetal oxygenation.
Question 2: A nurse is teaching a client at 10 weeks' gestation about
expected physiological changes during pregnancy. Which of the
following statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
CORRECT ANSWER: C. "I may experience nasal stuffiness due to
increased blood flow."
Rationale: During pregnancy, increased estrogen levels and vascular
congestion cause nasal mucosa swelling, leading to nasal stuffiness and
epistaxis. Blood pressure typically remains stable or slightly decreases,
heart rate increases, and hemoglobin levels decrease due to hemodilution.
,Question 3: A nurse is assessing a newborn immediately after birth.
Which of the following findings should the nurse report to the provider?
A. Heart rate of 130/min
B. Respiratory rate of 50/min
C. Central cyanosis
D. Acrocyanosis
CORRECT ANSWER: C. Central cyanosis
Rationale: Central cyanosis involving the trunk and mucous membranes
indicates inadequate oxygenation and requires immediate intervention.
Acrocyanosis (bluish extremities) is a normal finding in the first hours after
birth. A heart rate of 130/min and respiratory rate of 50/min are within
normal newborn ranges.
Question 4: A nurse is caring for a client in the first stage of labor who is
experiencing contractions every 3 minutes lasting 60 seconds. The
client reports intense pain. Which of the following nonpharmacological
interventions should the nurse suggest first?
A. Administer an epidural
B. Encourage slow, patterned breathing
C. Provide IV opioid analgesia
D. Restrict oral intake
CORRECT ANSWER: B. Encourage slow, patterned breathing
Rationale: Slow, patterned breathing is a nonpharmacological comfort
measure that promotes relaxation and reduces pain perception during
labor. Epidurals and IV opioids are pharmacological interventions.
Restricting oral intake does not address pain.
Question 5: A nurse is reviewing the medical record of a client at 36
weeks' gestation. Which of the following findings should the nurse
identify as a risk factor for postpartum hemorrhage?
A. Previous vaginal delivery
B. History of placenta previa
C. Maternal age of 25 years
D. Singleton pregnancy
CORRECT ANSWER: B. History of placenta previa
,Rationale: Placenta previa increases the risk of postpartum hemorrhage
due to abnormal placental implantation and potential uterine atony.
Previous vaginal delivery, maternal age of 25, and singleton pregnancy are
not significant risk factors for postpartum hemorrhage.
Question 6: A nurse is teaching a postpartum client about
breastfeeding. Which of the following statements indicates a need for
further teaching?
A. "I should feed my baby every 2 to 3 hours."
B. "I will ensure a deep latch to prevent nipple pain."
C. "I should supplement with formula to ensure adequate intake."
D. "I will wake my baby if they sleep longer than 4 hours."
CORRECT ANSWER: C. "I should supplement with formula to ensure
adequate intake."
Rationale: Routine formula supplementation is not recommended for
breastfeeding newborns unless medically indicated, as it can interfere with
milk supply and breastfeeding success. Feeding every 2 to 3 hours,
ensuring a deep latch, and waking a sleepy newborn are appropriate
breastfeeding practices.
Question 7: A nurse is assessing a client 2 hours after a spontaneous
vaginal delivery. Which of the following findings requires immediate
intervention?
A. Fundus firm at the umbilicus
B. Saturated perineal pad within 15 minutes
C. Lochia rubra with small clots
D. Mild afterpains during breastfeeding
CORRECT ANSWER: B. Saturated perineal pad within 15 minutes
Rationale: Saturating a perineal pad within 15 minutes indicates excessive
bleeding and possible postpartum hemorrhage. The nurse should massage
the fundus, assess for retained placental fragments, and notify the
provider. Lochia rubra with small clots, a firm fundus at the umbilicus, and
mild afterpains are expected findings.
Question 8: A nurse is caring for a client receiving magnesium sulfate
for preeclampsia. Which of the following findings indicates magnesium
toxicity?
, A. Urine output of 50 mL/hr
B. Respiratory rate of 12/min
C. Absence of deep tendon reflexes
D. Blood pressure of 140/90 mm Hg
CORRECT ANSWER: C. Absence of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is an early sign of magnesium
sulfate toxicity, followed by respiratory depression and cardiac arrest. Urine
output of 50 mL/hr, respiratory rate of 12/min, and blood pressure of
140/90 mm Hg do not specifically indicate toxicity, though respiratory rate
below 12/min would be concerning.
Question 9: A nurse is preparing to administer Rho(D) immune globulin
to a client who is Rh-negative. Which of the following criteria must be
met before administration?
A. The client must be Rh-positive
B. The client must have a negative indirect Coombs test
C. The client must be at 40 weeks gestation
D. The client must have an elevated hematocrit
CORRECT ANSWER: B. The client must have a negative indirect
Coombs test
Rationale: Rho(D) immune globulin is administered to Rh-negative mothers
who are not already sensitized (indirect Coombs negative) to prevent
isoimmunization. Administration to an already sensitized client is
ineffective. The medication is given at 28 weeks gestation and within 72
hours postpartum.
Question 10: A nurse is assessing a client at 36 weeks gestation who
reports sudden, painless, bright red vaginal bleeding. Which condition
does the nurse suspect?
A. Abruptio placentae
B. Preterm labor
C. Placenta previa
D. Ectopic pregnancy
CORRECT ANSWER: C. Placenta previa
2026/2027 | ACTUAL-Style Practice Questions &
Answers, ATI RN Maternal-Newborn Nursing Exam
Prep, Pregnancy Complications, Labor and Delivery,
Postpartum Care, Newborn Assessment, High-Risk
Pregnancy, and Detailed Rationales
Question 1: A nurse is caring for a client at 38 weeks' gestation who
reports a sudden gush of fluid from the vagina. Which of the following
actions should the nurse take first?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Check the fetal heart rate and assess for cord prolapse
C. Obtain a specimen for nitrazine paper testing
D. Place the client in a supine position for a bedside ultrasound
CORRECT ANSWER: B. Check the fetal heart rate and assess for cord
prolapse
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being and rule out umbilical
cord prolapse, which is an obstetric emergency. Checking the fetal heart
rate and inspecting for cord presentation takes precedence over vaginal
examination, nitrazine testing, or ultrasound because cord compression
can rapidly compromise fetal oxygenation.
Question 2: A nurse is teaching a client at 10 weeks' gestation about
expected physiological changes during pregnancy. Which of the
following statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
CORRECT ANSWER: C. "I may experience nasal stuffiness due to
increased blood flow."
Rationale: During pregnancy, increased estrogen levels and vascular
congestion cause nasal mucosa swelling, leading to nasal stuffiness and
epistaxis. Blood pressure typically remains stable or slightly decreases,
heart rate increases, and hemoglobin levels decrease due to hemodilution.
,Question 3: A nurse is assessing a newborn immediately after birth.
Which of the following findings should the nurse report to the provider?
A. Heart rate of 130/min
B. Respiratory rate of 50/min
C. Central cyanosis
D. Acrocyanosis
CORRECT ANSWER: C. Central cyanosis
Rationale: Central cyanosis involving the trunk and mucous membranes
indicates inadequate oxygenation and requires immediate intervention.
Acrocyanosis (bluish extremities) is a normal finding in the first hours after
birth. A heart rate of 130/min and respiratory rate of 50/min are within
normal newborn ranges.
Question 4: A nurse is caring for a client in the first stage of labor who is
experiencing contractions every 3 minutes lasting 60 seconds. The
client reports intense pain. Which of the following nonpharmacological
interventions should the nurse suggest first?
A. Administer an epidural
B. Encourage slow, patterned breathing
C. Provide IV opioid analgesia
D. Restrict oral intake
CORRECT ANSWER: B. Encourage slow, patterned breathing
Rationale: Slow, patterned breathing is a nonpharmacological comfort
measure that promotes relaxation and reduces pain perception during
labor. Epidurals and IV opioids are pharmacological interventions.
Restricting oral intake does not address pain.
Question 5: A nurse is reviewing the medical record of a client at 36
weeks' gestation. Which of the following findings should the nurse
identify as a risk factor for postpartum hemorrhage?
A. Previous vaginal delivery
B. History of placenta previa
C. Maternal age of 25 years
D. Singleton pregnancy
CORRECT ANSWER: B. History of placenta previa
,Rationale: Placenta previa increases the risk of postpartum hemorrhage
due to abnormal placental implantation and potential uterine atony.
Previous vaginal delivery, maternal age of 25, and singleton pregnancy are
not significant risk factors for postpartum hemorrhage.
Question 6: A nurse is teaching a postpartum client about
breastfeeding. Which of the following statements indicates a need for
further teaching?
A. "I should feed my baby every 2 to 3 hours."
B. "I will ensure a deep latch to prevent nipple pain."
C. "I should supplement with formula to ensure adequate intake."
D. "I will wake my baby if they sleep longer than 4 hours."
CORRECT ANSWER: C. "I should supplement with formula to ensure
adequate intake."
Rationale: Routine formula supplementation is not recommended for
breastfeeding newborns unless medically indicated, as it can interfere with
milk supply and breastfeeding success. Feeding every 2 to 3 hours,
ensuring a deep latch, and waking a sleepy newborn are appropriate
breastfeeding practices.
Question 7: A nurse is assessing a client 2 hours after a spontaneous
vaginal delivery. Which of the following findings requires immediate
intervention?
A. Fundus firm at the umbilicus
B. Saturated perineal pad within 15 minutes
C. Lochia rubra with small clots
D. Mild afterpains during breastfeeding
CORRECT ANSWER: B. Saturated perineal pad within 15 minutes
Rationale: Saturating a perineal pad within 15 minutes indicates excessive
bleeding and possible postpartum hemorrhage. The nurse should massage
the fundus, assess for retained placental fragments, and notify the
provider. Lochia rubra with small clots, a firm fundus at the umbilicus, and
mild afterpains are expected findings.
Question 8: A nurse is caring for a client receiving magnesium sulfate
for preeclampsia. Which of the following findings indicates magnesium
toxicity?
, A. Urine output of 50 mL/hr
B. Respiratory rate of 12/min
C. Absence of deep tendon reflexes
D. Blood pressure of 140/90 mm Hg
CORRECT ANSWER: C. Absence of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is an early sign of magnesium
sulfate toxicity, followed by respiratory depression and cardiac arrest. Urine
output of 50 mL/hr, respiratory rate of 12/min, and blood pressure of
140/90 mm Hg do not specifically indicate toxicity, though respiratory rate
below 12/min would be concerning.
Question 9: A nurse is preparing to administer Rho(D) immune globulin
to a client who is Rh-negative. Which of the following criteria must be
met before administration?
A. The client must be Rh-positive
B. The client must have a negative indirect Coombs test
C. The client must be at 40 weeks gestation
D. The client must have an elevated hematocrit
CORRECT ANSWER: B. The client must have a negative indirect
Coombs test
Rationale: Rho(D) immune globulin is administered to Rh-negative mothers
who are not already sensitized (indirect Coombs negative) to prevent
isoimmunization. Administration to an already sensitized client is
ineffective. The medication is given at 28 weeks gestation and within 72
hours postpartum.
Question 10: A nurse is assessing a client at 36 weeks gestation who
reports sudden, painless, bright red vaginal bleeding. Which condition
does the nurse suspect?
A. Abruptio placentae
B. Preterm labor
C. Placenta previa
D. Ectopic pregnancy
CORRECT ANSWER: C. Placenta previa
