ATI Maternal Newborn Nursing 2026 Complete Study Pack
– Verified Exam Questions & Answers, Comprehensive
Notes, OB/Maternity Care, Labor & Delivery, Postpartum
& Neonatal Nursing Review Guide
Question 1: A nurse is assessing a client at 32 weeks of gestation during a prenatal visit.
Which finding should the nurse report to the provider immediately?
A. Mild ankle edema that resolves with elevation
B. Blood pressure of 138/88 mm Hg
C. Weight gain of 1 lb since last visit 2 weeks ago
D. Fundal height measuring 30 cm
CORRECT ANSWER: B. Blood pressure of 138/88 mm Hg
Rationale: A blood pressure reading of 138/88 mm Hg at 32 weeks gestation is concerning for
gestational hypertension or preeclampsia, especially if this represents an increase from
baseline. While mild edema and appropriate fundal height are expected findings, elevated
blood pressure requires immediate provider notification for further evaluation and intervention
to prevent progression to severe preeclampsia or eclampsia.
Question 2: A nurse is teaching a pregnant client about signs of preterm labor. Which
statement by the client indicates understanding of the teaching?
A. "I should call my provider if I have more than four contractions in one hour."
B. "Braxton Hicks contractions are a sign that labor is starting early."
C. "Pelvic pressure is normal and not concerning during the third trimester."
D. "I only need to worry about preterm labor if my water breaks."
CORRECT ANSWER: A. "I should call my provider if I have more than four contractions in one
hour."
Rationale: More than four to six contractions per hour before 37 weeks gestation may indicate
preterm labor and requires immediate evaluation. Braxton Hicks contractions are irregular and
typically painless, unlike true labor contractions. Pelvic pressure can be a sign of preterm labor,
not just a normal finding. Preterm labor can occur with or without rupture of membranes, so
clients should be educated on all warning signs.
Question 3: A nurse is caring for a client in the first stage of labor. The client's cervix is dilated
to 5 cm with contractions every 3 minutes lasting 60 seconds. In which phase of the first stage
of labor is the client?
A. Latent phase
B. Active phase
C. Transition phase
D. Second stage
CORRECT ANSWER: B. Active phase
Rationale: The active phase of the first stage of labor is characterized by cervical dilation from 4
to 7 cm, with contractions becoming more intense, regular, and frequent (every 3-5 minutes,
lasting 45-60 seconds). The latent phase involves dilation from 0-3 cm with milder contractions.
Transition phase occurs at 8-10 cm dilation. The second stage begins with full dilation and ends
with birth.
,Question 4: A nurse is preparing to administer oxytocin to a client for labor augmentation.
Which assessment finding is a contraindication to initiating oxytocin?
A. Fetal heart rate baseline of 140 beats per minute
B. Cervical dilation of 3 cm with 50% effacement
C. History of classical cesarean birth
D. Maternal temperature of 99.1°F (37.3°C)
CORRECT ANSWER: C. History of classical cesarean birth
Rationale: A history of classical (vertical) cesarean incision is a contraindication to oxytocin
administration and trial of labor after cesarean (TOLAC) due to the significantly increased risk of
uterine rupture. Fetal heart rate of 140 bpm is normal. Cervical dilation of 3 cm is appropriate
for augmentation consideration. A mild temperature elevation alone is not a contraindication
but should be monitored.
Question 5: A nurse is assessing a newborn 1 hour after birth. Which finding requires
immediate intervention?
A. Acrocyanosis of hands and feet
B. Respiratory rate of 58 breaths per minute
C. Central cyanosis of the lips and tongue
D. Heart rate of 150 beats per minute
CORRECT ANSWER: C. Central cyanosis of the lips and tongue
Rationale: Central cyanosis (bluish discoloration of the lips, tongue, and trunk) indicates
inadequate oxygenation and requires immediate assessment and intervention, such as
providing supplemental oxygen and evaluating for cardiac or respiratory abnormalities.
Acrocyanosis (blue hands and feet) is normal in the first 24-48 hours. A respiratory rate of
58/min and heart rate of 150 bpm are within normal newborn ranges.
Question 6: A nurse is teaching a postpartum client about perineal care. Which instruction
should the nurse include?
A. "Wipe from back to front after using the toilet."
B. "Use warm water and a peri-bottle after each voiding or bowel movement."
C. "Apply ice packs to the perineum for 30 minutes at a time during the first 24 hours."
D. "Avoid changing perineal pads more than every 6 hours to promote healing."
CORRECT ANSWER: B. "Use warm water and a peri-bottle after each voiding or bowel
movement."
Rationale: Using warm water with a peri-bottle after each voiding or bowel movement helps
cleanse the perineal area, reduce infection risk, and promote comfort. Wiping should be front
to back to prevent fecal contamination. Ice packs may be used initially but typically for 20
minutes on, 20 minutes off, not 30 minutes continuously. Perineal pads should be changed
frequently (every 2-4 hours or when soiled) to maintain hygiene and monitor lochia.
Question 7: A nurse is caring for a client with preeclampsia who is receiving magnesium
sulfate. Which assessment finding indicates magnesium toxicity?
A. Deep tendon reflexes of 2+
B. Urine output of 40 mL/hr
,C. Respiratory rate of 10 breaths per minute
D. Blood pressure of 148/92 mm Hg
CORRECT ANSWER: C. Respiratory rate of 10 breaths per minute
Rationale: Magnesium sulfate toxicity can cause respiratory depression (rate <12/min), absent
deep tendon reflexes, urine output <30 mL/hr, and cardiac arrest. A respiratory rate of 10/min
is a critical finding requiring immediate intervention, including stopping the infusion and
administering calcium gluconate. Reflexes of 2+ are normal. Urine output of 40 mL/hr is
acceptable. Elevated blood pressure reflects preeclampsia but not magnesium toxicity.
Question 8: A nurse is assessing a client at 10 weeks of gestation. Which finding is expected at
this stage?
A. Fetal heart tones audible with a Doppler
B. Fundus palpable at the symphysis pubis
C. Quickening reported by the client
D. Striae gravidarum on the abdomen
CORRECT ANSWER: A. Fetal heart tones audible with a Doppler
Rationale: Fetal heart tones can typically be detected with a Doppler device between 10-12
weeks gestation. The fundus is generally not palpable above the symphysis pubis until
approximately 12 weeks. Quickening (fetal movement) is usually felt between 16-20 weeks.
Striae gravidarum typically appear later in pregnancy as the abdomen expands.
Question 9: A nurse is providing discharge teaching to a postpartum client who is bottle-
feeding. Which statement by the client indicates a need for further teaching?
A. "I will wear a supportive bra 24 hours a day."
B. "I can take ibuprofen for breast engorgement pain."
C. "I should pump my breasts regularly to prevent milk production."
D. "I will apply cold cabbage leaves to my breasts for comfort."
CORRECT ANSWER: C. "I should pump my breasts regularly to prevent milk production."
Rationale: Pumping or stimulating the breasts signals the body to produce more milk, which is
counterproductive for a client who is bottle-feeding. To suppress lactation, the client should
avoid breast stimulation, wear a supportive bra, use cold compresses or cabbage leaves, and
take analgesics as needed. Statements A, B, and D reflect appropriate non-pharmacological and
pharmacological management of engorgement when not breastfeeding.
Question 10: A nurse is caring for a newborn with hyperbilirubinemia receiving phototherapy.
Which action should the nurse take?
A. Apply lotion to the newborn's skin before starting phototherapy
B. Ensure the newborn's eyes are covered with protective patches
C. Keep the newborn fully clothed to maintain body temperature
D. Limit fluid intake to prevent fluid overload
CORRECT ANSWER: B. Ensure the newborn's eyes are covered with protective patches
Rationale: During phototherapy, the newborn's eyes must be protected with opaque patches or
a mask to prevent retinal damage from the intense light. The skin should be clean and dry;
lotions can absorb heat and cause burns. The newborn should be undressed (except for a
, diaper) to maximize skin exposure to light. Fluid intake should be increased, not limited,
because phototherapy can increase insensible water loss and risk of dehydration.
Question 11: A nurse is assessing a client in the fourth stage of labor. Which finding indicates
a potential postpartum hemorrhage?
A. Fundus firm and at the midline
B. Lochia rubra with small clots
C. Saturation of one perineal pad in 15 minutes
D. Blood pressure of 110/70 mm Hg
CORRECT ANSWER: C. Saturation of one perineal pad in 15 minutes
Rationale: Saturation of a perineal pad in 15 minutes or less is a sign of excessive bleeding and
potential postpartum hemorrhage, requiring immediate intervention. A firm, midline fundus is
expected. Lochia rubra with small clots is normal in the immediate postpartum period. A blood
pressure of 110/70 mm Hg is within normal limits; hypotension would be a later sign of
significant blood loss.
Question 12: A nurse is teaching a pregnant client about nutrition. Which statement by the
client indicates understanding?
A. "I should increase my caloric intake by 500 calories per day during the first trimester."
B. "I need to avoid all fish to prevent mercury exposure."
C. "I should take a prenatal vitamin with folic acid daily."
D. "I can continue to drink one cup of coffee per day without concern."
CORRECT ANSWER: C. "I should take a prenatal vitamin with folic acid daily."
Rationale: Daily prenatal vitamins containing folic acid (400-800 mcg) are recommended before
conception and throughout pregnancy to prevent neural tube defects. Caloric needs increase
by approximately 340 calories/day in the second trimester and 450 calories/day in the third,
not the first. Low-mercury fish (e.g., salmon, shrimp) are encouraged 2-3 servings/week for
omega-3 fatty acids. Caffeine should be limited to <200 mg/day (about one 12-oz coffee), but
complete avoidance is not required; however, the safest answer is the folic acid
recommendation.
Question 13: A nurse is caring for a client with gestational diabetes. Which instruction should
the nurse include in the teaching plan?
A. "Monitor your blood glucose level once daily in the morning."
B. "Eat three large meals per day to maintain stable glucose levels."
C. "Perform moderate exercise for 30 minutes most days of the week."
D. "Avoid carbohydrates completely to control blood sugar."
CORRECT ANSWER: C. "Perform moderate exercise for 30 minutes most days of the week."
Rationale: Regular moderate exercise helps improve insulin sensitivity and glucose control in
gestational diabetes. Blood glucose monitoring typically involves fasting and postprandial
checks (multiple times daily). Small, frequent meals with balanced carbohydrates are
recommended, not three large meals or complete carbohydrate elimination, which can lead to
ketosis. Carbohydrates should be distributed evenly and chosen from complex sources.
– Verified Exam Questions & Answers, Comprehensive
Notes, OB/Maternity Care, Labor & Delivery, Postpartum
& Neonatal Nursing Review Guide
Question 1: A nurse is assessing a client at 32 weeks of gestation during a prenatal visit.
Which finding should the nurse report to the provider immediately?
A. Mild ankle edema that resolves with elevation
B. Blood pressure of 138/88 mm Hg
C. Weight gain of 1 lb since last visit 2 weeks ago
D. Fundal height measuring 30 cm
CORRECT ANSWER: B. Blood pressure of 138/88 mm Hg
Rationale: A blood pressure reading of 138/88 mm Hg at 32 weeks gestation is concerning for
gestational hypertension or preeclampsia, especially if this represents an increase from
baseline. While mild edema and appropriate fundal height are expected findings, elevated
blood pressure requires immediate provider notification for further evaluation and intervention
to prevent progression to severe preeclampsia or eclampsia.
Question 2: A nurse is teaching a pregnant client about signs of preterm labor. Which
statement by the client indicates understanding of the teaching?
A. "I should call my provider if I have more than four contractions in one hour."
B. "Braxton Hicks contractions are a sign that labor is starting early."
C. "Pelvic pressure is normal and not concerning during the third trimester."
D. "I only need to worry about preterm labor if my water breaks."
CORRECT ANSWER: A. "I should call my provider if I have more than four contractions in one
hour."
Rationale: More than four to six contractions per hour before 37 weeks gestation may indicate
preterm labor and requires immediate evaluation. Braxton Hicks contractions are irregular and
typically painless, unlike true labor contractions. Pelvic pressure can be a sign of preterm labor,
not just a normal finding. Preterm labor can occur with or without rupture of membranes, so
clients should be educated on all warning signs.
Question 3: A nurse is caring for a client in the first stage of labor. The client's cervix is dilated
to 5 cm with contractions every 3 minutes lasting 60 seconds. In which phase of the first stage
of labor is the client?
A. Latent phase
B. Active phase
C. Transition phase
D. Second stage
CORRECT ANSWER: B. Active phase
Rationale: The active phase of the first stage of labor is characterized by cervical dilation from 4
to 7 cm, with contractions becoming more intense, regular, and frequent (every 3-5 minutes,
lasting 45-60 seconds). The latent phase involves dilation from 0-3 cm with milder contractions.
Transition phase occurs at 8-10 cm dilation. The second stage begins with full dilation and ends
with birth.
,Question 4: A nurse is preparing to administer oxytocin to a client for labor augmentation.
Which assessment finding is a contraindication to initiating oxytocin?
A. Fetal heart rate baseline of 140 beats per minute
B. Cervical dilation of 3 cm with 50% effacement
C. History of classical cesarean birth
D. Maternal temperature of 99.1°F (37.3°C)
CORRECT ANSWER: C. History of classical cesarean birth
Rationale: A history of classical (vertical) cesarean incision is a contraindication to oxytocin
administration and trial of labor after cesarean (TOLAC) due to the significantly increased risk of
uterine rupture. Fetal heart rate of 140 bpm is normal. Cervical dilation of 3 cm is appropriate
for augmentation consideration. A mild temperature elevation alone is not a contraindication
but should be monitored.
Question 5: A nurse is assessing a newborn 1 hour after birth. Which finding requires
immediate intervention?
A. Acrocyanosis of hands and feet
B. Respiratory rate of 58 breaths per minute
C. Central cyanosis of the lips and tongue
D. Heart rate of 150 beats per minute
CORRECT ANSWER: C. Central cyanosis of the lips and tongue
Rationale: Central cyanosis (bluish discoloration of the lips, tongue, and trunk) indicates
inadequate oxygenation and requires immediate assessment and intervention, such as
providing supplemental oxygen and evaluating for cardiac or respiratory abnormalities.
Acrocyanosis (blue hands and feet) is normal in the first 24-48 hours. A respiratory rate of
58/min and heart rate of 150 bpm are within normal newborn ranges.
Question 6: A nurse is teaching a postpartum client about perineal care. Which instruction
should the nurse include?
A. "Wipe from back to front after using the toilet."
B. "Use warm water and a peri-bottle after each voiding or bowel movement."
C. "Apply ice packs to the perineum for 30 minutes at a time during the first 24 hours."
D. "Avoid changing perineal pads more than every 6 hours to promote healing."
CORRECT ANSWER: B. "Use warm water and a peri-bottle after each voiding or bowel
movement."
Rationale: Using warm water with a peri-bottle after each voiding or bowel movement helps
cleanse the perineal area, reduce infection risk, and promote comfort. Wiping should be front
to back to prevent fecal contamination. Ice packs may be used initially but typically for 20
minutes on, 20 minutes off, not 30 minutes continuously. Perineal pads should be changed
frequently (every 2-4 hours or when soiled) to maintain hygiene and monitor lochia.
Question 7: A nurse is caring for a client with preeclampsia who is receiving magnesium
sulfate. Which assessment finding indicates magnesium toxicity?
A. Deep tendon reflexes of 2+
B. Urine output of 40 mL/hr
,C. Respiratory rate of 10 breaths per minute
D. Blood pressure of 148/92 mm Hg
CORRECT ANSWER: C. Respiratory rate of 10 breaths per minute
Rationale: Magnesium sulfate toxicity can cause respiratory depression (rate <12/min), absent
deep tendon reflexes, urine output <30 mL/hr, and cardiac arrest. A respiratory rate of 10/min
is a critical finding requiring immediate intervention, including stopping the infusion and
administering calcium gluconate. Reflexes of 2+ are normal. Urine output of 40 mL/hr is
acceptable. Elevated blood pressure reflects preeclampsia but not magnesium toxicity.
Question 8: A nurse is assessing a client at 10 weeks of gestation. Which finding is expected at
this stage?
A. Fetal heart tones audible with a Doppler
B. Fundus palpable at the symphysis pubis
C. Quickening reported by the client
D. Striae gravidarum on the abdomen
CORRECT ANSWER: A. Fetal heart tones audible with a Doppler
Rationale: Fetal heart tones can typically be detected with a Doppler device between 10-12
weeks gestation. The fundus is generally not palpable above the symphysis pubis until
approximately 12 weeks. Quickening (fetal movement) is usually felt between 16-20 weeks.
Striae gravidarum typically appear later in pregnancy as the abdomen expands.
Question 9: A nurse is providing discharge teaching to a postpartum client who is bottle-
feeding. Which statement by the client indicates a need for further teaching?
A. "I will wear a supportive bra 24 hours a day."
B. "I can take ibuprofen for breast engorgement pain."
C. "I should pump my breasts regularly to prevent milk production."
D. "I will apply cold cabbage leaves to my breasts for comfort."
CORRECT ANSWER: C. "I should pump my breasts regularly to prevent milk production."
Rationale: Pumping or stimulating the breasts signals the body to produce more milk, which is
counterproductive for a client who is bottle-feeding. To suppress lactation, the client should
avoid breast stimulation, wear a supportive bra, use cold compresses or cabbage leaves, and
take analgesics as needed. Statements A, B, and D reflect appropriate non-pharmacological and
pharmacological management of engorgement when not breastfeeding.
Question 10: A nurse is caring for a newborn with hyperbilirubinemia receiving phototherapy.
Which action should the nurse take?
A. Apply lotion to the newborn's skin before starting phototherapy
B. Ensure the newborn's eyes are covered with protective patches
C. Keep the newborn fully clothed to maintain body temperature
D. Limit fluid intake to prevent fluid overload
CORRECT ANSWER: B. Ensure the newborn's eyes are covered with protective patches
Rationale: During phototherapy, the newborn's eyes must be protected with opaque patches or
a mask to prevent retinal damage from the intense light. The skin should be clean and dry;
lotions can absorb heat and cause burns. The newborn should be undressed (except for a
, diaper) to maximize skin exposure to light. Fluid intake should be increased, not limited,
because phototherapy can increase insensible water loss and risk of dehydration.
Question 11: A nurse is assessing a client in the fourth stage of labor. Which finding indicates
a potential postpartum hemorrhage?
A. Fundus firm and at the midline
B. Lochia rubra with small clots
C. Saturation of one perineal pad in 15 minutes
D. Blood pressure of 110/70 mm Hg
CORRECT ANSWER: C. Saturation of one perineal pad in 15 minutes
Rationale: Saturation of a perineal pad in 15 minutes or less is a sign of excessive bleeding and
potential postpartum hemorrhage, requiring immediate intervention. A firm, midline fundus is
expected. Lochia rubra with small clots is normal in the immediate postpartum period. A blood
pressure of 110/70 mm Hg is within normal limits; hypotension would be a later sign of
significant blood loss.
Question 12: A nurse is teaching a pregnant client about nutrition. Which statement by the
client indicates understanding?
A. "I should increase my caloric intake by 500 calories per day during the first trimester."
B. "I need to avoid all fish to prevent mercury exposure."
C. "I should take a prenatal vitamin with folic acid daily."
D. "I can continue to drink one cup of coffee per day without concern."
CORRECT ANSWER: C. "I should take a prenatal vitamin with folic acid daily."
Rationale: Daily prenatal vitamins containing folic acid (400-800 mcg) are recommended before
conception and throughout pregnancy to prevent neural tube defects. Caloric needs increase
by approximately 340 calories/day in the second trimester and 450 calories/day in the third,
not the first. Low-mercury fish (e.g., salmon, shrimp) are encouraged 2-3 servings/week for
omega-3 fatty acids. Caffeine should be limited to <200 mg/day (about one 12-oz coffee), but
complete avoidance is not required; however, the safest answer is the folic acid
recommendation.
Question 13: A nurse is caring for a client with gestational diabetes. Which instruction should
the nurse include in the teaching plan?
A. "Monitor your blood glucose level once daily in the morning."
B. "Eat three large meals per day to maintain stable glucose levels."
C. "Perform moderate exercise for 30 minutes most days of the week."
D. "Avoid carbohydrates completely to control blood sugar."
CORRECT ANSWER: C. "Perform moderate exercise for 30 minutes most days of the week."
Rationale: Regular moderate exercise helps improve insulin sensitivity and glucose control in
gestational diabetes. Blood glucose monitoring typically involves fasting and postprandial
checks (multiple times daily). Small, frequent meals with balanced carbohydrates are
recommended, not three large meals or complete carbohydrate elimination, which can lead to
ketosis. Carbohydrates should be distributed evenly and chosen from complex sources.
