ATI Maternal Newborn Nursing Exam
2026/2027 | Exam Questions and
Verified Answers with Detailed
Rationales
ATI MATERNAL NEWBORN NURSING EXAM 2026/2027
Exam Questions and Verified Answers with Detailed Rationales
====================================================================
============
OVERVIEW:
• This comprehensive study material contains 200 high-yield questions designed to
test critical thinking and clinical application across all major maternal-newborn
nursing domains, mirroring actual ATI exam format and difficulty levels.
• Use these questions for progressive learning by working through each topic
systematically, reviewing rationales deeply, and retesting weak areas to build
mastery and confidence before your certification exam.
====================================================================
============
QUESTIONS BEGIN:
QUESTION 1:
A pregnant client at 28 weeks gestation reports sudden onset of severe
epigastric pain, right upper quadrant tenderness, and visual disturbances.
Her blood pressure is 168/110 mmHg. Which complication should the nurse
suspect?
A) Acute appendicitis
B) Peptic ulcer disease
C) Preeclampsia with severe features
D) Hepatitis
,E) Cholecystitis
CORRECT ANSWER: C) Preeclampsia with severe features
RATIONALE: The cluster of findings—severe hypertension (168/110), epigastric
pain, right upper quadrant pain, and visual disturbances (scotomata)—are classic
indicators of preeclampsia with severe features. Epigastric and RUQ pain reflect
hepatic capsule distention from edema. Visual changes result from cerebral
vasospasm. This is a medical emergency requiring immediate intervention to
prevent eclampsia, stroke, or organ failure. Appendicitis would not cause
hypertension or visual disturbances. Peptic ulcer disease does not present with
hypertension. Hepatitis causes jaundice and elevated liver enzymes without the
acute hypertensive crisis. Cholecystitis typically presents with fever and positive
Murphy's sign, not the systemic features seen here.
QUESTION 2:
During a fetal biophysical profile assessment, the nurse notes a score of 6/10.
The client has no contraindications to labor. Which action should the nurse
anticipate?
A) Administer corticosteroids and discharge home
B) Perform an immediate cesarean delivery
C) Repeat the biophysical profile within 24 hours
D) Induce labor immediately
E) Continue routine prenatal care with weekly testing
CORRECT ANSWER: D) Induce labor immediately
RATIONALE: A biophysical profile score of 6/10 indicates mild fetal compromise
and is considered abnormal. According to ACOG guidelines, a score of 6/10
warrants delivery if the client is at term and has no contraindications to labor, as
continued intrauterine existence carries more risk than delivery. Inducing labor
allows for safer delivery with continuous fetal monitoring and medical support.
Repeating the test or continuing routine care delays necessary delivery. An
,immediate cesarean is not required with a score of 6/10; vaginal delivery should be
attempted first. Corticosteroids are given to enhance fetal lung maturity when
preterm delivery is anticipated, not at term.
QUESTION 3:
A multiparous woman in active labor experiences sudden sharp substernal
chest pain radiating to her back, along with dyspnea and hemodynamic
instability. Which complication is most likely?
A) Myocardial infarction
B) Amniotic fluid embolism
C) Aortic dissection
D) Pulmonary embolism
E) Acute coronary syndrome
CORRECT ANSWER: B) Amniotic fluid embolism
RATIONALE: Amniotic fluid embolism (AFE) presents acutely during labor or
immediately after delivery with sudden onset of chest pain, dyspnea, cardiovascular
collapse, and hemodynamic instability. It results from amniotic fluid entering
maternal circulation through small tears in the fetal membranes or uterine veins.
AFE is rare but life-threatening, occurring in approximately 1 in 40,000 deliveries.
Risk factors include multiparty, operative delivery, and cesarean birth. Myocardial
infarction and acute coronary syndrome are less common in young pregnant
women and present with different EKG changes. Aortic dissection presents with
tearing pain but is rare in pregnancy. Pulmonary embolism does not typically
present with substernal chest pain radiating to the back.
QUESTION 4:
A client receiving oxytocin augmentation for labor is noted to have tetanic
uterine contractions lasting 90 seconds with minimal relaxation between
, contractions. The fetal heart rate shows late decelerations. What is the
priority nursing action?
A) Increase the oxytocin infusion rate
B) Change the client's position to left lateral
C) Stop the oxytocin infusion immediately
D) Apply oxygen at 10 L/minute
E) Prepare for emergency cesarean delivery
CORRECT ANSWER: C) Stop the oxytocin infusion immediately
RATIONALE: Tetanic uterine contractions (lasting >90 seconds with inadequate
relaxation) combined with late decelerations indicate uterine hyperstimulation
causing fetal hypoxia. This is a medical emergency. The immediate priority is to
stop the oxytocin to reduce uterine contractility and restore placental perfusion.
Increasing oxytocin would worsen the situation. While position changes and oxygen
supplementation are supportive measures, they are secondary to stopping the
medication. Preparation for cesarean delivery may follow if fetal status does not
improve after stopping oxytocin and implementing other interventions.
QUESTION 5:
A postpartum client on postpartum day 2 develops a temperature of 38.5°C
(101.3°F), foul-smelling lochia, lower abdominal tenderness, and mild
tachycardia. Blood cultures are pending. Which antibiotic regimen is most
appropriate to initiate?
A) Cephalexin 500 mg orally four times daily
B) Clindamycin and gentamicin intravenously
C) Ampicillin orally twice daily
D) Metronidazole topically to perineum
E) Doxycycline orally daily
2026/2027 | Exam Questions and
Verified Answers with Detailed
Rationales
ATI MATERNAL NEWBORN NURSING EXAM 2026/2027
Exam Questions and Verified Answers with Detailed Rationales
====================================================================
============
OVERVIEW:
• This comprehensive study material contains 200 high-yield questions designed to
test critical thinking and clinical application across all major maternal-newborn
nursing domains, mirroring actual ATI exam format and difficulty levels.
• Use these questions for progressive learning by working through each topic
systematically, reviewing rationales deeply, and retesting weak areas to build
mastery and confidence before your certification exam.
====================================================================
============
QUESTIONS BEGIN:
QUESTION 1:
A pregnant client at 28 weeks gestation reports sudden onset of severe
epigastric pain, right upper quadrant tenderness, and visual disturbances.
Her blood pressure is 168/110 mmHg. Which complication should the nurse
suspect?
A) Acute appendicitis
B) Peptic ulcer disease
C) Preeclampsia with severe features
D) Hepatitis
,E) Cholecystitis
CORRECT ANSWER: C) Preeclampsia with severe features
RATIONALE: The cluster of findings—severe hypertension (168/110), epigastric
pain, right upper quadrant pain, and visual disturbances (scotomata)—are classic
indicators of preeclampsia with severe features. Epigastric and RUQ pain reflect
hepatic capsule distention from edema. Visual changes result from cerebral
vasospasm. This is a medical emergency requiring immediate intervention to
prevent eclampsia, stroke, or organ failure. Appendicitis would not cause
hypertension or visual disturbances. Peptic ulcer disease does not present with
hypertension. Hepatitis causes jaundice and elevated liver enzymes without the
acute hypertensive crisis. Cholecystitis typically presents with fever and positive
Murphy's sign, not the systemic features seen here.
QUESTION 2:
During a fetal biophysical profile assessment, the nurse notes a score of 6/10.
The client has no contraindications to labor. Which action should the nurse
anticipate?
A) Administer corticosteroids and discharge home
B) Perform an immediate cesarean delivery
C) Repeat the biophysical profile within 24 hours
D) Induce labor immediately
E) Continue routine prenatal care with weekly testing
CORRECT ANSWER: D) Induce labor immediately
RATIONALE: A biophysical profile score of 6/10 indicates mild fetal compromise
and is considered abnormal. According to ACOG guidelines, a score of 6/10
warrants delivery if the client is at term and has no contraindications to labor, as
continued intrauterine existence carries more risk than delivery. Inducing labor
allows for safer delivery with continuous fetal monitoring and medical support.
Repeating the test or continuing routine care delays necessary delivery. An
,immediate cesarean is not required with a score of 6/10; vaginal delivery should be
attempted first. Corticosteroids are given to enhance fetal lung maturity when
preterm delivery is anticipated, not at term.
QUESTION 3:
A multiparous woman in active labor experiences sudden sharp substernal
chest pain radiating to her back, along with dyspnea and hemodynamic
instability. Which complication is most likely?
A) Myocardial infarction
B) Amniotic fluid embolism
C) Aortic dissection
D) Pulmonary embolism
E) Acute coronary syndrome
CORRECT ANSWER: B) Amniotic fluid embolism
RATIONALE: Amniotic fluid embolism (AFE) presents acutely during labor or
immediately after delivery with sudden onset of chest pain, dyspnea, cardiovascular
collapse, and hemodynamic instability. It results from amniotic fluid entering
maternal circulation through small tears in the fetal membranes or uterine veins.
AFE is rare but life-threatening, occurring in approximately 1 in 40,000 deliveries.
Risk factors include multiparty, operative delivery, and cesarean birth. Myocardial
infarction and acute coronary syndrome are less common in young pregnant
women and present with different EKG changes. Aortic dissection presents with
tearing pain but is rare in pregnancy. Pulmonary embolism does not typically
present with substernal chest pain radiating to the back.
QUESTION 4:
A client receiving oxytocin augmentation for labor is noted to have tetanic
uterine contractions lasting 90 seconds with minimal relaxation between
, contractions. The fetal heart rate shows late decelerations. What is the
priority nursing action?
A) Increase the oxytocin infusion rate
B) Change the client's position to left lateral
C) Stop the oxytocin infusion immediately
D) Apply oxygen at 10 L/minute
E) Prepare for emergency cesarean delivery
CORRECT ANSWER: C) Stop the oxytocin infusion immediately
RATIONALE: Tetanic uterine contractions (lasting >90 seconds with inadequate
relaxation) combined with late decelerations indicate uterine hyperstimulation
causing fetal hypoxia. This is a medical emergency. The immediate priority is to
stop the oxytocin to reduce uterine contractility and restore placental perfusion.
Increasing oxytocin would worsen the situation. While position changes and oxygen
supplementation are supportive measures, they are secondary to stopping the
medication. Preparation for cesarean delivery may follow if fetal status does not
improve after stopping oxytocin and implementing other interventions.
QUESTION 5:
A postpartum client on postpartum day 2 develops a temperature of 38.5°C
(101.3°F), foul-smelling lochia, lower abdominal tenderness, and mild
tachycardia. Blood cultures are pending. Which antibiotic regimen is most
appropriate to initiate?
A) Cephalexin 500 mg orally four times daily
B) Clindamycin and gentamicin intravenously
C) Ampicillin orally twice daily
D) Metronidazole topically to perineum
E) Doxycycline orally daily
