ATI Maternal Newborn Comprehensive Predictor
2026/2027 | ACTUAL-Style Practice Questions &
Answers, ATI RN Maternal-Newborn Exam Prep,
Pregnancy Complications, Prenatal Assessment,
Labor and Delivery, Fetal Monitoring, Postpartum
Care, Newborn Nursing, and Detailed Rationales
Question 1: A nurse is caring for a client at 32 weeks of gestation who
reports sudden painless bright red vaginal bleeding. Which of the
following conditions should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Vasa previa
CORRECT ANSWER: B. Placenta previa
Rationale: Placenta previa classically presents with painless, bright red
vaginal bleeding in the third trimester. Abruptio placentae typically
presents with painful bleeding and a tender, rigid uterus. Uterine rupture is
associated with severe abdominal pain, loss of fetal station, and often
occurs during labor. Vasa previa causes painless bleeding but is associated
with fetal vessel rupture and rapid fetal compromise.
Question 2: A nurse is assessing a newborn 1 minute after birth. The
newborn has a heart rate of 110/min, a weak cry, some flexion of
extremities, a grimace when stimulated, and a blue body with pink
extremities. What Apgar score should the nurse assign?
A. 4
B. 5
C. 6
D. 7
CORRECT ANSWER: C. 6
Rationale: Apgar scoring: Heart rate 110 = 2 points; weak cry = 1 point
(respiratory effort); some flexion = 1 point (muscle tone); grimace = 1 point
(reflex irritability); blue body with pink extremities = 1 point (acrocyanosis).
Total = 2 + 1 + 1 + 1 + 1 = 6.
,Question 3: A nurse is teaching a client at 28 weeks of gestation about
the warning signs of preterm labor. Which of the following statements
by the client indicates understanding?
A. "I should expect my baby to move less as I get closer to delivery."
B. "A low, dull backache that doesn't go away could be a sign of preterm
labor."
C. "It is normal to have increased vaginal discharge that is thick and
bloody."
D. "I should only call my provider if my water breaks."
CORRECT ANSWER: B. "A low, dull backache that doesn't go away
could be a sign of preterm labor."
Rationale: Persistent low backache is a warning sign of preterm labor.
Decreased fetal movement is not expected and should be reported. Thick
bloody discharge may indicate cervical changes or other complications.
Waiting for rupture of membranes delays intervention for preterm labor.
Question 4: A nurse is reviewing laboratory results for a client at 36
weeks of gestation. Which finding should the nurse report to the
provider immediately?
A. Hemoglobin 11.5 g/dL
B. Platelet count 95,000/mm³
C. White blood cell count 12,000/mm³
D. Blood glucose 95 mg/dL
CORRECT ANSWER: B. Platelet count 95,000/mm³
Rationale: A platelet count below 150,000/mm³ indicates
thrombocytopenia, which may be associated with HELLP syndrome,
gestational thrombocytopenia, or immune thrombocytopenia. This finding
requires immediate evaluation. Hemoglobin of 11.5 g/dL is within normal
limits for pregnancy. Mild leukocytosis (up to 15,000/mm³) is expected in
pregnancy. Blood glucose of 95 mg/dL is normal.
Question 5: A nurse is caring for a client receiving oxytocin for labor
induction. The nurse notes contractions lasting 90 seconds occurring
every 2 minutes. Which action should the nurse take first?
A. Continue to monitor the contraction pattern.
B. Stop the oxytocin infusion.
,C. Increase the IV fluid rate.
D. Administer oxygen via face mask.
CORRECT ANSWER: B. Stop the oxytocin infusion.
Rationale: Contractions lasting longer than 90 seconds and occurring more
frequently than every 2 minutes indicate uterine tachysystole, which can
impair uteroplacental perfusion and cause fetal hypoxia. The priority action
is to stop the oxytocin infusion to reduce uterine activity. Oxygen and IV
fluids may be administered subsequently, but stopping the medication is
the first intervention.
Question 6: A nurse is assessing a client who is 2 hours postpartum.
The fundus is boggy and displaced to the right, above the umbilicus.
Which action should the nurse take first?
A. Massage the fundus.
B. Assist the client to void.
C. Administer methylergonovine.
D. Notify the provider.
CORRECT ANSWER: B. Assist the client to void.
Rationale: A boggy fundus displaced to the right and above the umbilicus
indicates a full bladder preventing uterine contraction. The first action is to
have the client void or catheterize if unable to void. After bladder emptying,
the fundus should be reassessed and massaged if still boggy. Medications
and provider notification follow if uterine atony persists.
Question 7: A nurse is teaching a client about Rho(D) immune globulin.
Which statement by the client indicates understanding?
A. "I will receive this medication if my baby is Rh-negative."
B. "This medication prevents me from developing antibodies against Rh-
positive blood."
C. "I should receive this medication only during my first pregnancy."
D. "This medication is given to my baby after birth."
CORRECT ANSWER: B. "This medication prevents me from developing
antibodies against Rh-positive blood."
Rationale: Rho(D) immune globulin is given to Rh-negative mothers to
prevent sensitization to Rh-positive fetal blood cells. It is administered at
, 28 weeks of gestation and within 72 hours after birth if the newborn is Rh-
positive. It is not given to the newborn and is indicated for all pregnancies
with Rh-negative mothers carrying Rh-positive fetuses.
Question 8: A nurse is assessing a newborn who was born at 38 weeks
of gestation. Which finding should the nurse report to the provider?
A. Acrocyanosis
B. Milia on the nose
C. Generalized petechiae
D. Vernix caseosa in skin folds
CORRECT ANSWER: C. Generalized petechiae
Rationale: Generalized petechiae may indicate a clotting disorder,
thrombocytopenia, or infection and should be reported. Acrocyanosis,
milia, and vernix caseosa are normal newborn findings.
Question 9: A nurse is caring for a client in the first stage of labor who
has an epidural infusion. The client suddenly develops hypotension.
Which action should the nurse take first?
A. Increase the epidural infusion rate.
B. Administer oxygen at 2 L/min via nasal cannula.
C. Position the client in a lateral position and increase IV fluids.
D. Notify the provider immediately.
CORRECT ANSWER: C. Position the client in a lateral position and
increase IV fluids.
Rationale: Epidural anesthesia can cause sympathetic blockade leading to
hypotension. The first intervention is to position the client laterally to
relieve aortocaval compression and increase IV fluid rate to improve
venous return and cardiac output. Oxygen may be provided, but positioning
and fluid administration are the priority. Notifying the provider follows initial
interventions.
Question 10: A nurse is reviewing the medical record of a client at 10
weeks of gestation. The client reports severe nausea and vomiting with
a 7% weight loss and ketonuria. Which condition should the nurse
suspect?
2026/2027 | ACTUAL-Style Practice Questions &
Answers, ATI RN Maternal-Newborn Exam Prep,
Pregnancy Complications, Prenatal Assessment,
Labor and Delivery, Fetal Monitoring, Postpartum
Care, Newborn Nursing, and Detailed Rationales
Question 1: A nurse is caring for a client at 32 weeks of gestation who
reports sudden painless bright red vaginal bleeding. Which of the
following conditions should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Vasa previa
CORRECT ANSWER: B. Placenta previa
Rationale: Placenta previa classically presents with painless, bright red
vaginal bleeding in the third trimester. Abruptio placentae typically
presents with painful bleeding and a tender, rigid uterus. Uterine rupture is
associated with severe abdominal pain, loss of fetal station, and often
occurs during labor. Vasa previa causes painless bleeding but is associated
with fetal vessel rupture and rapid fetal compromise.
Question 2: A nurse is assessing a newborn 1 minute after birth. The
newborn has a heart rate of 110/min, a weak cry, some flexion of
extremities, a grimace when stimulated, and a blue body with pink
extremities. What Apgar score should the nurse assign?
A. 4
B. 5
C. 6
D. 7
CORRECT ANSWER: C. 6
Rationale: Apgar scoring: Heart rate 110 = 2 points; weak cry = 1 point
(respiratory effort); some flexion = 1 point (muscle tone); grimace = 1 point
(reflex irritability); blue body with pink extremities = 1 point (acrocyanosis).
Total = 2 + 1 + 1 + 1 + 1 = 6.
,Question 3: A nurse is teaching a client at 28 weeks of gestation about
the warning signs of preterm labor. Which of the following statements
by the client indicates understanding?
A. "I should expect my baby to move less as I get closer to delivery."
B. "A low, dull backache that doesn't go away could be a sign of preterm
labor."
C. "It is normal to have increased vaginal discharge that is thick and
bloody."
D. "I should only call my provider if my water breaks."
CORRECT ANSWER: B. "A low, dull backache that doesn't go away
could be a sign of preterm labor."
Rationale: Persistent low backache is a warning sign of preterm labor.
Decreased fetal movement is not expected and should be reported. Thick
bloody discharge may indicate cervical changes or other complications.
Waiting for rupture of membranes delays intervention for preterm labor.
Question 4: A nurse is reviewing laboratory results for a client at 36
weeks of gestation. Which finding should the nurse report to the
provider immediately?
A. Hemoglobin 11.5 g/dL
B. Platelet count 95,000/mm³
C. White blood cell count 12,000/mm³
D. Blood glucose 95 mg/dL
CORRECT ANSWER: B. Platelet count 95,000/mm³
Rationale: A platelet count below 150,000/mm³ indicates
thrombocytopenia, which may be associated with HELLP syndrome,
gestational thrombocytopenia, or immune thrombocytopenia. This finding
requires immediate evaluation. Hemoglobin of 11.5 g/dL is within normal
limits for pregnancy. Mild leukocytosis (up to 15,000/mm³) is expected in
pregnancy. Blood glucose of 95 mg/dL is normal.
Question 5: A nurse is caring for a client receiving oxytocin for labor
induction. The nurse notes contractions lasting 90 seconds occurring
every 2 minutes. Which action should the nurse take first?
A. Continue to monitor the contraction pattern.
B. Stop the oxytocin infusion.
,C. Increase the IV fluid rate.
D. Administer oxygen via face mask.
CORRECT ANSWER: B. Stop the oxytocin infusion.
Rationale: Contractions lasting longer than 90 seconds and occurring more
frequently than every 2 minutes indicate uterine tachysystole, which can
impair uteroplacental perfusion and cause fetal hypoxia. The priority action
is to stop the oxytocin infusion to reduce uterine activity. Oxygen and IV
fluids may be administered subsequently, but stopping the medication is
the first intervention.
Question 6: A nurse is assessing a client who is 2 hours postpartum.
The fundus is boggy and displaced to the right, above the umbilicus.
Which action should the nurse take first?
A. Massage the fundus.
B. Assist the client to void.
C. Administer methylergonovine.
D. Notify the provider.
CORRECT ANSWER: B. Assist the client to void.
Rationale: A boggy fundus displaced to the right and above the umbilicus
indicates a full bladder preventing uterine contraction. The first action is to
have the client void or catheterize if unable to void. After bladder emptying,
the fundus should be reassessed and massaged if still boggy. Medications
and provider notification follow if uterine atony persists.
Question 7: A nurse is teaching a client about Rho(D) immune globulin.
Which statement by the client indicates understanding?
A. "I will receive this medication if my baby is Rh-negative."
B. "This medication prevents me from developing antibodies against Rh-
positive blood."
C. "I should receive this medication only during my first pregnancy."
D. "This medication is given to my baby after birth."
CORRECT ANSWER: B. "This medication prevents me from developing
antibodies against Rh-positive blood."
Rationale: Rho(D) immune globulin is given to Rh-negative mothers to
prevent sensitization to Rh-positive fetal blood cells. It is administered at
, 28 weeks of gestation and within 72 hours after birth if the newborn is Rh-
positive. It is not given to the newborn and is indicated for all pregnancies
with Rh-negative mothers carrying Rh-positive fetuses.
Question 8: A nurse is assessing a newborn who was born at 38 weeks
of gestation. Which finding should the nurse report to the provider?
A. Acrocyanosis
B. Milia on the nose
C. Generalized petechiae
D. Vernix caseosa in skin folds
CORRECT ANSWER: C. Generalized petechiae
Rationale: Generalized petechiae may indicate a clotting disorder,
thrombocytopenia, or infection and should be reported. Acrocyanosis,
milia, and vernix caseosa are normal newborn findings.
Question 9: A nurse is caring for a client in the first stage of labor who
has an epidural infusion. The client suddenly develops hypotension.
Which action should the nurse take first?
A. Increase the epidural infusion rate.
B. Administer oxygen at 2 L/min via nasal cannula.
C. Position the client in a lateral position and increase IV fluids.
D. Notify the provider immediately.
CORRECT ANSWER: C. Position the client in a lateral position and
increase IV fluids.
Rationale: Epidural anesthesia can cause sympathetic blockade leading to
hypotension. The first intervention is to position the client laterally to
relieve aortocaval compression and increase IV fluid rate to improve
venous return and cardiac output. Oxygen may be provided, but positioning
and fluid administration are the priority. Notifying the provider follows initial
interventions.
Question 10: A nurse is reviewing the medical record of a client at 10
weeks of gestation. The client reports severe nausea and vomiting with
a 7% weight loss and ketonuria. Which condition should the nurse
suspect?
