ATI Maternal Newborn Nursing Exam
2026/2027 | ACTUAL-Style Practice Questions
& Answers, Maternity Nursing, Obstetric Care,
Labor and Delivery, Postpartum Nursing,
Newborn Care, 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. Prepare the client for an immediate cesarean birth
B. Assess the fetal heart rate and characteristics of the fluid
C. Obtain a urine specimen for culture
D. Administer oxytocin intravenously
CORRECT ANSWER: B. Assess the fetal heart rate and characteristics
of the fluid
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being by monitoring the fetal
heart rate and evaluating the fluid for color, amount, and odor. This helps
detect complications such as cord prolapse or meconium staining.
Immediate cesarean birth and oxytocin administration are not first-line
actions without further assessment .
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. Blood pressure of 118/76 mm Hg
CORRECT ANSWER: B. Saturated perineal pad within 15 minutes
Rationale: A perineal pad saturated within 15 minutes indicates excessive
bleeding and possible postpartum hemorrhage, requiring immediate
intervention. A firm fundus at the umbilicus, lochia rubra with small clots,
and a blood pressure of 118/76 mm Hg are expected postpartum findings .
Question 8: A nurse is performing an assessment on a newborn 1 hour
after birth. Which of the following findings should the nurse report to
the provider as a potential sign of respiratory distress?
, A. Acrocyanosis of hands and feet
B. Nasal flaring and sternal retractions
C. Respiratory rate of 48 breaths/min
D. Abdominal breathing pattern
CORRECT ANSWER: B. Nasal flaring and sternal retractions
Rationale: Nasal flaring, intercostal/sternal retractions, grunting, and
tachypnea (>60 breaths/min) are hallmark clinical signs of respiratory
distress in a newborn. Acrocyanosis and abdominal breathing are normal
physiological findings in the early newborn period .
Question 9: A nurse is teaching a client who is at 32 weeks of gestation
and diagnosed with preeclampsia without severe features. Which of
the following instructions should the nurse include?
A. Restrict daily fluid intake to 500 mL
B. Perform daily fetal kick counts
C. Maintain strict, complete bed rest on your back
D. Discontinue taking prenatal vitamins
CORRECT ANSWER: B. Perform daily fetal kick counts
Rationale: Monitoring fetal movement (kick counts) daily is essential for
assessing fetal well-being in clients with preeclampsia. Supine bed rest
compresses the vena cava and should be avoided .
Question 10: A nurse is preparing to administer terbutaline to a client in
preterm labor. Which of the following maternal parameters must the
nurse assess prior to administration?
A. Heart rate
B. Respiratory rate
C. Deep tendon reflexes
D. Blood glucose level
CORRECT ANSWER: A. Heart rate
Rationale: Terbutaline is a beta-adrenergic agonist that can cause severe
tachycardia. It should be withheld if the maternal heart rate exceeds 120
bpm .
2026/2027 | ACTUAL-Style Practice Questions
& Answers, Maternity Nursing, Obstetric Care,
Labor and Delivery, Postpartum Nursing,
Newborn Care, 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. Prepare the client for an immediate cesarean birth
B. Assess the fetal heart rate and characteristics of the fluid
C. Obtain a urine specimen for culture
D. Administer oxytocin intravenously
CORRECT ANSWER: B. Assess the fetal heart rate and characteristics
of the fluid
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being by monitoring the fetal
heart rate and evaluating the fluid for color, amount, and odor. This helps
detect complications such as cord prolapse or meconium staining.
Immediate cesarean birth and oxytocin administration are not first-line
actions without further assessment .
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. Blood pressure of 118/76 mm Hg
CORRECT ANSWER: B. Saturated perineal pad within 15 minutes
Rationale: A perineal pad saturated within 15 minutes indicates excessive
bleeding and possible postpartum hemorrhage, requiring immediate
intervention. A firm fundus at the umbilicus, lochia rubra with small clots,
and a blood pressure of 118/76 mm Hg are expected postpartum findings .
Question 8: A nurse is performing an assessment on a newborn 1 hour
after birth. Which of the following findings should the nurse report to
the provider as a potential sign of respiratory distress?
, A. Acrocyanosis of hands and feet
B. Nasal flaring and sternal retractions
C. Respiratory rate of 48 breaths/min
D. Abdominal breathing pattern
CORRECT ANSWER: B. Nasal flaring and sternal retractions
Rationale: Nasal flaring, intercostal/sternal retractions, grunting, and
tachypnea (>60 breaths/min) are hallmark clinical signs of respiratory
distress in a newborn. Acrocyanosis and abdominal breathing are normal
physiological findings in the early newborn period .
Question 9: A nurse is teaching a client who is at 32 weeks of gestation
and diagnosed with preeclampsia without severe features. Which of
the following instructions should the nurse include?
A. Restrict daily fluid intake to 500 mL
B. Perform daily fetal kick counts
C. Maintain strict, complete bed rest on your back
D. Discontinue taking prenatal vitamins
CORRECT ANSWER: B. Perform daily fetal kick counts
Rationale: Monitoring fetal movement (kick counts) daily is essential for
assessing fetal well-being in clients with preeclampsia. Supine bed rest
compresses the vena cava and should be avoided .
Question 10: A nurse is preparing to administer terbutaline to a client in
preterm labor. Which of the following maternal parameters must the
nurse assess prior to administration?
A. Heart rate
B. Respiratory rate
C. Deep tendon reflexes
D. Blood glucose level
CORRECT ANSWER: A. Heart rate
Rationale: Terbutaline is a beta-adrenergic agonist that can cause severe
tachycardia. It should be withheld if the maternal heart rate exceeds 120
bpm .
