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ATI Proctored Exam - Maternal Newborn 2026:
COMPREHENSIVE FINAL PREP: VERIFIED
QUESTIONS & EXPERT ANSWERS ULTIMATE
EXAM PASS PACK – LATEST 2026/2027
UPDATES
. Preeclampsia Screening Findings
Q: A nurse in an antepartum clinic is caring for a client who is at 24 weeks of gestation.
Which of the following findings should the nurse report to the provider?
• A) Leukorrhea
• B) Epistaxis
• C) Frequent headaches
• D) Periodic numbness of the fingers
Correct Answer: C) Frequent headaches
Rationale: Frequent headaches, swelling of the face and fingers, visual disturbances, and
epigastric pain are classic warning signs associated with preeclampsia.
• Incorrect Answers: A & B (Leukorrhea and epistaxis are common, benign discomforts
of pregnancy driven by increased estrogen and vascularity). D (Periodic numbness of
fingers is a common discomfort resulting from nerve compression and does not
require urgent reporting).
2. Oligohydramnios and Fetal Anomalies
Q: A nurse is caring for a client who has oligohydramnios. Which of the following fetal
anomalies should the nurse expect?
• A) Fetal cardiac anomalies
• B) Renal agenesis
• C) Fetal neural tube defects
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• D) Fetal hydrocephalus
Correct Answer: B) Renal agenesis
Rationale: Oligohydramnios is defined as an amniotic fluid volume $<300$ mL during the
third trimester. Because fetal urine comprises the majority of amniotic fluid volume in later
pregnancy, conditions causing renal system dysfunction, obstructive uropathy, or renal
agenesis (absence of kidneys) lead directly to oligohydramnios.
• Incorrect Answers: A, C, & D (Cardiac anomalies, neural tube defects, and
hydrocephalus do not directly affect the production or standard volume of amniotic
fluid).
3. Displaced Postpartum Fundus Interventions
Q: A nurse is assessing a client on the first postpartum day. Findings include the following:
fundus firm, located one fingerbreadth above and to the right of the umbilicus; moderate
lochia rubra with small clots; temperature 37.3°C (99.2°F); and pulse rate 52/min. Which of
the following actions should the nurse take?
• A) Report the vital signs to the provider immediately
• B) Massage the fundus vigorously
• C) Ask the client when she last voided
• D) Request a prescription for an oxytocic agent
Correct Answer: C) Ask the client when she last voided
Rationale: A postpartum fundus that is firm but deviated to the right and elevated above
the umbilicus indicates a full, distended bladder. A full bladder displaces the uterus due to
stretched supporting pelvic muscles. The nurse must assist the client to void to allow the
uterus to return to its proper midline position.
• Incorrect Answers: A (The vital signs are within expected limits; mild temperature
elevation can occur during early postpartum). B (Fundal massage is indicated only if
the fundus is boggy). D (Oxytocics are reserved for a boggy fundus or excessive
bleeding).
4. Complications of Spinal Anesthesia
Q: A nurse is monitoring a client who is receiving spinal anesthesia during labor. The nurse
should identify which of the following findings as a complication of the infusion?
• A) Maternal hypertension
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• B) Fetal tachycardia
• C) Increased fetal heart rate variability
• D) Maternal hypotension
Correct Answer: D) Maternal hypotension
Rationale: Maternal hypotension is a common adverse effect of a spinal block caused by
sympathetic nervous system blockade, leading to vasodilation. To prevent or mitigate this,
the nurse can position the client side-lying or place a wedge under the hip to displace the
uterus off the vena cava.
• Incorrect Answers: A (Spinal anesthesia causes hypotension, not hypertension). B &
C (Spinal-induced maternal hypotension is more likely to cause fetal bradycardia and
minimal or absent fetal heart rate variability due to reduced placental perfusion).
5. Severe Preeclampsia Fluid Status Assessment
Q: A nurse is caring for a client at 35 weeks of gestation who has severe preeclampsia.
Which of the following assessments provides the most accurate information regarding the
client's fluid and electrolyte status?
• A) Blood pressure
• B) Intake and output (I&O)
• C) Daily weight
• D) Severity of pitting edema
Correct Answer: C) Daily weight
Rationale: Evidence-based practice indicates that daily weight is the single most objective
and accurate clinical parameter to evaluate acute fluid fluctuations and electrolyte retention
shifts in a client with severe preeclampsia.
• Incorrect Answers: A, B, & D (While monitoring blood pressure, tracking I&O, and
grading edema are necessary components of preeclampsia care, they are less
accurate and more subject to measurement error or lagging trends compared to
tracking daily weight).
6. First Response to Postpartum Lochia and Clots
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Q: A nurse is caring for a client who is 2 hours postpartum. The nurse notes the client's
perineal pad has a large amount of lochia rubra with several clots. Which of the following
actions should the nurse perform first?
• A) Have the client empty her bladder
• B) Massage the fundus
• C) Check the client's vital signs
• D) Administer carboprost intramuscularly
Correct Answer: B) Massage the fundus
Rationale: The primary cause of early postpartum hemorrhage is uterine atony (a relaxed,
boggy uterus). Applying the risk-reduction priority framework, the greatest immediate
threat to the client's life is hemorrhage. Massaging the fundus stimulates uterine
contractions immediately to compress bleeding vessels.
• Incorrect Answers: A & C (Assisting the client to void and obtaining vital signs are
important, but they lag behind active physical intervention to stop blood loss). D
(Carboprost is an appropriate pharmacological intervention for hemorrhage but
should only be given after manual massage has failed).
7. Management of Episiotomy Discomfort
Q: A nurse is caring for a client who is postpartum and reports that her episiotomy incision
is pulling and stinging. Which of the following actions should the nurse take?
• A) Instruct the client to perform Kegel exercises immediately
• B) Apply topical anesthetic cream every 2 hours
• C) Provide a sitz bath with warm water for the client
• D) Encourage the client to remain completely immobile in bed
Correct Answer: C) Provide a sitz bath with warm water for the client
Rationale: A warm-water sitz bath provides localized, moist heat that promotes
vasodilation, increases blood flow to the perineum, and accelerates healing while directly
relieving the pulling and stinging sensations of an episiotomy.
• Incorrect Answers: A (Kegel exercises strengthen pelvic floor muscles but do not
relieve acute, superficial incisional stinging). B (Topical anesthetic creams are useful
but should be restricted to 3–4 times daily, not every 2 hours).
ATI Proctored Exam - Maternal Newborn 2026:
COMPREHENSIVE FINAL PREP: VERIFIED
QUESTIONS & EXPERT ANSWERS ULTIMATE
EXAM PASS PACK – LATEST 2026/2027
UPDATES
. Preeclampsia Screening Findings
Q: A nurse in an antepartum clinic is caring for a client who is at 24 weeks of gestation.
Which of the following findings should the nurse report to the provider?
• A) Leukorrhea
• B) Epistaxis
• C) Frequent headaches
• D) Periodic numbness of the fingers
Correct Answer: C) Frequent headaches
Rationale: Frequent headaches, swelling of the face and fingers, visual disturbances, and
epigastric pain are classic warning signs associated with preeclampsia.
• Incorrect Answers: A & B (Leukorrhea and epistaxis are common, benign discomforts
of pregnancy driven by increased estrogen and vascularity). D (Periodic numbness of
fingers is a common discomfort resulting from nerve compression and does not
require urgent reporting).
2. Oligohydramnios and Fetal Anomalies
Q: A nurse is caring for a client who has oligohydramnios. Which of the following fetal
anomalies should the nurse expect?
• A) Fetal cardiac anomalies
• B) Renal agenesis
• C) Fetal neural tube defects
,vb
• D) Fetal hydrocephalus
Correct Answer: B) Renal agenesis
Rationale: Oligohydramnios is defined as an amniotic fluid volume $<300$ mL during the
third trimester. Because fetal urine comprises the majority of amniotic fluid volume in later
pregnancy, conditions causing renal system dysfunction, obstructive uropathy, or renal
agenesis (absence of kidneys) lead directly to oligohydramnios.
• Incorrect Answers: A, C, & D (Cardiac anomalies, neural tube defects, and
hydrocephalus do not directly affect the production or standard volume of amniotic
fluid).
3. Displaced Postpartum Fundus Interventions
Q: A nurse is assessing a client on the first postpartum day. Findings include the following:
fundus firm, located one fingerbreadth above and to the right of the umbilicus; moderate
lochia rubra with small clots; temperature 37.3°C (99.2°F); and pulse rate 52/min. Which of
the following actions should the nurse take?
• A) Report the vital signs to the provider immediately
• B) Massage the fundus vigorously
• C) Ask the client when she last voided
• D) Request a prescription for an oxytocic agent
Correct Answer: C) Ask the client when she last voided
Rationale: A postpartum fundus that is firm but deviated to the right and elevated above
the umbilicus indicates a full, distended bladder. A full bladder displaces the uterus due to
stretched supporting pelvic muscles. The nurse must assist the client to void to allow the
uterus to return to its proper midline position.
• Incorrect Answers: A (The vital signs are within expected limits; mild temperature
elevation can occur during early postpartum). B (Fundal massage is indicated only if
the fundus is boggy). D (Oxytocics are reserved for a boggy fundus or excessive
bleeding).
4. Complications of Spinal Anesthesia
Q: A nurse is monitoring a client who is receiving spinal anesthesia during labor. The nurse
should identify which of the following findings as a complication of the infusion?
• A) Maternal hypertension
,vb
• B) Fetal tachycardia
• C) Increased fetal heart rate variability
• D) Maternal hypotension
Correct Answer: D) Maternal hypotension
Rationale: Maternal hypotension is a common adverse effect of a spinal block caused by
sympathetic nervous system blockade, leading to vasodilation. To prevent or mitigate this,
the nurse can position the client side-lying or place a wedge under the hip to displace the
uterus off the vena cava.
• Incorrect Answers: A (Spinal anesthesia causes hypotension, not hypertension). B &
C (Spinal-induced maternal hypotension is more likely to cause fetal bradycardia and
minimal or absent fetal heart rate variability due to reduced placental perfusion).
5. Severe Preeclampsia Fluid Status Assessment
Q: A nurse is caring for a client at 35 weeks of gestation who has severe preeclampsia.
Which of the following assessments provides the most accurate information regarding the
client's fluid and electrolyte status?
• A) Blood pressure
• B) Intake and output (I&O)
• C) Daily weight
• D) Severity of pitting edema
Correct Answer: C) Daily weight
Rationale: Evidence-based practice indicates that daily weight is the single most objective
and accurate clinical parameter to evaluate acute fluid fluctuations and electrolyte retention
shifts in a client with severe preeclampsia.
• Incorrect Answers: A, B, & D (While monitoring blood pressure, tracking I&O, and
grading edema are necessary components of preeclampsia care, they are less
accurate and more subject to measurement error or lagging trends compared to
tracking daily weight).
6. First Response to Postpartum Lochia and Clots
, vb
Q: A nurse is caring for a client who is 2 hours postpartum. The nurse notes the client's
perineal pad has a large amount of lochia rubra with several clots. Which of the following
actions should the nurse perform first?
• A) Have the client empty her bladder
• B) Massage the fundus
• C) Check the client's vital signs
• D) Administer carboprost intramuscularly
Correct Answer: B) Massage the fundus
Rationale: The primary cause of early postpartum hemorrhage is uterine atony (a relaxed,
boggy uterus). Applying the risk-reduction priority framework, the greatest immediate
threat to the client's life is hemorrhage. Massaging the fundus stimulates uterine
contractions immediately to compress bleeding vessels.
• Incorrect Answers: A & C (Assisting the client to void and obtaining vital signs are
important, but they lag behind active physical intervention to stop blood loss). D
(Carboprost is an appropriate pharmacological intervention for hemorrhage but
should only be given after manual massage has failed).
7. Management of Episiotomy Discomfort
Q: A nurse is caring for a client who is postpartum and reports that her episiotomy incision
is pulling and stinging. Which of the following actions should the nurse take?
• A) Instruct the client to perform Kegel exercises immediately
• B) Apply topical anesthetic cream every 2 hours
• C) Provide a sitz bath with warm water for the client
• D) Encourage the client to remain completely immobile in bed
Correct Answer: C) Provide a sitz bath with warm water for the client
Rationale: A warm-water sitz bath provides localized, moist heat that promotes
vasodilation, increases blood flow to the perineum, and accelerates healing while directly
relieving the pulling and stinging sensations of an episiotomy.
• Incorrect Answers: A (Kegel exercises strengthen pelvic floor muscles but do not
relieve acute, superficial incisional stinging). B (Topical anesthetic creams are useful
but should be restricted to 3–4 times daily, not every 2 hours).
