ATI Maternal Newborn Review 2026/2027 | ACTUAL-Style
Practice Questions & Answers, Maternity Nursing Study Guide,
Pregnancy, Labor and Delivery, Postpartum Care, Newborn
Assessment, and Detailed Rationales
Question 1: A nurse is assessing a client at 38 weeks of 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 reviewing the laboratory results of a client at 36
weeks of gestation. Which of the following findings should the nurse
report to the provider immediately?
A. Hemoglobin 11.2 g/dL
B. Platelet count 140,000/mm³
C. Fibrinogen level 300 mg/dL
D. Blood glucose 250 mg/dL after a 1-hour glucose challenge
CORRECT ANSWER: D. Blood glucose 250 mg/dL after a 1-hour glucose
challenge
Rationale: A 1-hour glucose challenge result of 250 mg/dL is markedly
elevated and suggests gestational diabetes mellitus requiring prompt
provider notification and further evaluation. Hemoglobin 11.2 g/dL,
platelets 140,000/mm³, and fibrinogen 300 mg/dL are within acceptable
ranges for pregnancy and do not require immediate reporting.
,Question 3: A nurse is teaching a prenatal client about fetal
development. At which of the following gestational ages does the fetal
heart first become audible with a Doppler stethoscope?
A. 6 to 8 weeks
B. 10 to 12 weeks
C. 16 to 18 weeks
D. 20 to 22 weeks
CORRECT ANSWER: B. 10 to 12 weeks
Rationale: The fetal heart tones are typically audible with a Doppler
stethoscope between 10 and 12 weeks of gestation. At 6 to 8 weeks the
heart is developing but usually not detectable by Doppler, while 16 to 18
weeks and beyond are later than the initial audible period.
Question 4: A nurse is assessing a client in the first trimester who
reports nausea and vomiting. Which of the following recommendations
should the nurse include in the teaching?
A. Drink large amounts of fluids with meals
B. Eat dry crackers before rising in the morning
C. Lie down immediately after eating
D. Skip breakfast to reduce stomach irritation
CORRECT ANSWER: B. Eat dry crackers before rising in the morning
Rationale: Eating dry crackers before getting out of bed helps reduce
morning nausea by stabilizing blood glucose and reducing gastric irritation.
Drinking large volumes with meals, lying down immediately after eating,
and skipping meals can worsen nausea and vomiting and are not
recommended.
Question 5: A nurse is caring for a client who is 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 140/90
mm Hg do not specifically indicate toxicity, though respiratory rate below
12/min would be concerning.
Question 6: A nurse is calculating the estimated date of delivery for a
client whose last menstrual period began on April 1st. Using Naegele's
rule, which of the following is the estimated date of delivery?
A. January 8
B. January 15
C. February 8
D. February 15
CORRECT ANSWER: A. January 8
Rationale: Naegele's rule calculates the estimated date of delivery by
subtracting 3 months from the first day of the last menstrual period and
adding 7 days plus 1 year. April 1st minus 3 months equals January 1st;
adding 7 days equals January 8th of the following year.
Question 7: A nurse is reviewing the health record of a client who is
pregnant. The provider documented that the client exhibits probable
signs of pregnancy. Which of the following findings should the nurse
expect?
A. Montgomery's glands
B. Goodell's sign
C. Quickening
D. Breast tenderness
CORRECT ANSWER: B. Goodell's sign
Rationale: Goodell's sign (softening of the cervical tip) is classified as a
probable sign of pregnancy because it is detected on physical examination
but can have other causes. Montgomery's glands, quickening, and breast
tenderness are presumptive signs based on subjective client reports.
Question 8: A nurse is teaching a client who is at 8 weeks of gestation
about nutrition during pregnancy. Which of the following statements
should the nurse include in the teaching?
, A. "You should consume 2 cups of milk daily."
B. "You should consume 6 ounces of protein foods daily."
C. "You should consume 2 cups of vegetables each day."
D. "You should consume 4 ounces of grains each day."
CORRECT ANSWER: B. "You should consume 6 ounces of protein foods
daily."
Rationale: Pregnant clients should consume approximately 5.5 to 6.5
ounces of protein foods daily, selecting high-protein sources such as
legumes, nuts, eggs, and lean meats. Dairy intake should be 3 cups daily,
vegetables 2.5 to 3 cups, and grains 6 to 8 ounces.
Question 9: A nurse is caring for a client who is at 11 weeks of gestation
and reports abdominal cramping. Which of the following actions
should the nurse take first?
A. Administer acetaminophen as prescribed
B. Request that the provider see the client immediately
C. Document the finding as a normal discomfort of pregnancy
D. Instruct the client to lie on her left side
CORRECT ANSWER: B. Request that the provider see the client
immediately
Rationale: Abdominal cramping at 11 weeks of gestation can indicate
ectopic pregnancy or spontaneous abortion. Using the urgent versus
nonurgent approach, the nurse should prioritize this client and request that
the provider evaluate her immediately.
Question 10: A nurse is performing Leopold maneuvers prior to
applying an external fetal monitor. Which of the following is the
purpose of this assessment?
A. To determine cervical dilation
B. To assess the position of the fetus
C. To evaluate amniotic fluid volume
D. To measure uterine contraction intensity
CORRECT ANSWER: B. To assess the position of the fetus
Rationale: Leopold maneuvers are performed to palpate the maternal
abdomen and determine fetal position and presentation. This information
Practice Questions & Answers, Maternity Nursing Study Guide,
Pregnancy, Labor and Delivery, Postpartum Care, Newborn
Assessment, and Detailed Rationales
Question 1: A nurse is assessing a client at 38 weeks of 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 reviewing the laboratory results of a client at 36
weeks of gestation. Which of the following findings should the nurse
report to the provider immediately?
A. Hemoglobin 11.2 g/dL
B. Platelet count 140,000/mm³
C. Fibrinogen level 300 mg/dL
D. Blood glucose 250 mg/dL after a 1-hour glucose challenge
CORRECT ANSWER: D. Blood glucose 250 mg/dL after a 1-hour glucose
challenge
Rationale: A 1-hour glucose challenge result of 250 mg/dL is markedly
elevated and suggests gestational diabetes mellitus requiring prompt
provider notification and further evaluation. Hemoglobin 11.2 g/dL,
platelets 140,000/mm³, and fibrinogen 300 mg/dL are within acceptable
ranges for pregnancy and do not require immediate reporting.
,Question 3: A nurse is teaching a prenatal client about fetal
development. At which of the following gestational ages does the fetal
heart first become audible with a Doppler stethoscope?
A. 6 to 8 weeks
B. 10 to 12 weeks
C. 16 to 18 weeks
D. 20 to 22 weeks
CORRECT ANSWER: B. 10 to 12 weeks
Rationale: The fetal heart tones are typically audible with a Doppler
stethoscope between 10 and 12 weeks of gestation. At 6 to 8 weeks the
heart is developing but usually not detectable by Doppler, while 16 to 18
weeks and beyond are later than the initial audible period.
Question 4: A nurse is assessing a client in the first trimester who
reports nausea and vomiting. Which of the following recommendations
should the nurse include in the teaching?
A. Drink large amounts of fluids with meals
B. Eat dry crackers before rising in the morning
C. Lie down immediately after eating
D. Skip breakfast to reduce stomach irritation
CORRECT ANSWER: B. Eat dry crackers before rising in the morning
Rationale: Eating dry crackers before getting out of bed helps reduce
morning nausea by stabilizing blood glucose and reducing gastric irritation.
Drinking large volumes with meals, lying down immediately after eating,
and skipping meals can worsen nausea and vomiting and are not
recommended.
Question 5: A nurse is caring for a client who is 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 140/90
mm Hg do not specifically indicate toxicity, though respiratory rate below
12/min would be concerning.
Question 6: A nurse is calculating the estimated date of delivery for a
client whose last menstrual period began on April 1st. Using Naegele's
rule, which of the following is the estimated date of delivery?
A. January 8
B. January 15
C. February 8
D. February 15
CORRECT ANSWER: A. January 8
Rationale: Naegele's rule calculates the estimated date of delivery by
subtracting 3 months from the first day of the last menstrual period and
adding 7 days plus 1 year. April 1st minus 3 months equals January 1st;
adding 7 days equals January 8th of the following year.
Question 7: A nurse is reviewing the health record of a client who is
pregnant. The provider documented that the client exhibits probable
signs of pregnancy. Which of the following findings should the nurse
expect?
A. Montgomery's glands
B. Goodell's sign
C. Quickening
D. Breast tenderness
CORRECT ANSWER: B. Goodell's sign
Rationale: Goodell's sign (softening of the cervical tip) is classified as a
probable sign of pregnancy because it is detected on physical examination
but can have other causes. Montgomery's glands, quickening, and breast
tenderness are presumptive signs based on subjective client reports.
Question 8: A nurse is teaching a client who is at 8 weeks of gestation
about nutrition during pregnancy. Which of the following statements
should the nurse include in the teaching?
, A. "You should consume 2 cups of milk daily."
B. "You should consume 6 ounces of protein foods daily."
C. "You should consume 2 cups of vegetables each day."
D. "You should consume 4 ounces of grains each day."
CORRECT ANSWER: B. "You should consume 6 ounces of protein foods
daily."
Rationale: Pregnant clients should consume approximately 5.5 to 6.5
ounces of protein foods daily, selecting high-protein sources such as
legumes, nuts, eggs, and lean meats. Dairy intake should be 3 cups daily,
vegetables 2.5 to 3 cups, and grains 6 to 8 ounces.
Question 9: A nurse is caring for a client who is at 11 weeks of gestation
and reports abdominal cramping. Which of the following actions
should the nurse take first?
A. Administer acetaminophen as prescribed
B. Request that the provider see the client immediately
C. Document the finding as a normal discomfort of pregnancy
D. Instruct the client to lie on her left side
CORRECT ANSWER: B. Request that the provider see the client
immediately
Rationale: Abdominal cramping at 11 weeks of gestation can indicate
ectopic pregnancy or spontaneous abortion. Using the urgent versus
nonurgent approach, the nurse should prioritize this client and request that
the provider evaluate her immediately.
Question 10: A nurse is performing Leopold maneuvers prior to
applying an external fetal monitor. Which of the following is the
purpose of this assessment?
A. To determine cervical dilation
B. To assess the position of the fetus
C. To evaluate amniotic fluid volume
D. To measure uterine contraction intensity
CORRECT ANSWER: B. To assess the position of the fetus
Rationale: Leopold maneuvers are performed to palpate the maternal
abdomen and determine fetal position and presentation. This information
