Fall Semester 2026–2027 ATI230 – ATI Maternal-Newborn Proctored
Updated 2026 | 190+ Questions and Answers | ATI Maternal-Newborn
Nursing Comprehensive Study Guide, Practice Exam, Exam Prep Test
Bank, Pregnancy, Labor and Delivery, Postpartum Care, Newborn
Assessment, Neonatal Care, High-Risk Pregnancy, Obstetric
Emergencies, Breastfeeding, Clinical Judgment, NCLEX-RN Review,
Detailed Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who is at 38 weeks of gestation and
reports a sudden gush of clear fluid from the vagina. Which of the following
actions should the nurse take first?
A. Assess the fetal heart rate.
B. Perform a Nitrazine test to confirm the presence of amniotic fluid.
C. Check the client's temperature.
D. Notify the provider.
CORRECT ANSWER: A. Assess the fetal heart rate.
Rationale: The priority action is to assess fetal well-being. A sudden gush of fluid
indicates a possible rupture of membranes, which places the client and fetus at risk for
umbilical cord prolapse and infection. The first step is to evaluate the fetal heart rate to
detect any signs of distress. While the Nitrazine test, temperature check, and notifying
the provider are important subsequent steps, they are not the immediate priority.
Question 2: A nurse is assessing a newborn who is 12 hours old. Which of the
following findings should the nurse report to the provider?
A. Heart rate of 140/min while sleeping.
B. Respiratory rate of 60/min with slight grunting.
C. Axillary temperature of 36.5°C (97.7°F).
D. A single episode of passing meconium.
CORRECT ANSWER: B. Respiratory rate of 60/min with slight grunting.
Rationale: Grunting is a sign of respiratory distress in a newborn and should be reported
immediately. While a respiratory rate of 60/min is at the high end of normal (30-
60/min), the presence of grunting indicates the newborn is using extra effort to
maintain airway patency and oxygenation. The other options are normal findings for a
12-hour-old newborn.
Question 3: A nurse is providing teaching to a client who is at 10 weeks of
gestation and reports frequent nausea and vomiting. Which of the following
instructions should the nurse include?
,A. Eat small, frequent meals throughout the day.
B. Drink a large glass of water with each meal.
C. Lie down immediately after eating.
D. Increase intake of high-fat foods.
CORRECT ANSWER: A. Eat small, frequent meals throughout the day.
Rationale: Small, frequent meals help maintain stable blood glucose levels and prevent
the stomach from becoming empty, which can exacerbate nausea. Large glasses of
water can distend the stomach and worsen nausea. Lying down after meals can delay
gastric emptying. High-fat foods are difficult to digest and can trigger nausea.
Question 4: A nurse is caring for a client who is in active labor and has an
epidural in place. Which of the following is a priority nursing intervention?
A. Monitor the fetal heart rate every hour.
B. Assess the client's blood pressure every 5 to 10 minutes.
C. Encourage the client to ambulate in the room.
D. Maintain the client in a supine position.
CORRECT ANSWER: B. Assess the client's blood pressure every 5 to 10
minutes.
Rationale: Epidural anesthesia can cause sympathetic blockade, leading to maternal
hypotension. This is a serious complication that can decrease placental perfusion and
compromise the fetus. Therefore, frequent blood pressure monitoring (every 5-10
minutes) is a priority. Ambulation is not safe with an epidural due to motor block, and
the supine position can worsen hypotension by compressing the vena cava.
Question 5: A nurse is performing a vaginal examination on a client who is in
labor. The nurse palpates the fetal occiput in the left anterior quadrant of the
maternal pelvis. How should the nurse document this presentation?
A. LOP
B. LOA
C. ROP
D. ROA
CORRECT ANSWER: B. LOA
Rationale: The abbreviation LOA stands for Left Occiput Anterior. This indicates the
fetal occiput (the presenting part) is positioned on the left side of the maternal pelvis (L)
and is rotated toward the anterior portion of the pelvis (A). LOP is Left Occiput
Posterior, ROP is Right Occiput Posterior, and ROA is Right Occiput Anterior.
,Question 6: A nurse is assessing a client who is postpartum and has a third-
degree perineal laceration. Which of the following findings should the nurse
expect?
A. The laceration extends through the perineal muscles and the anal sphincter.
B. The laceration involves the vaginal mucosa and perineal skin.
C. The laceration extends through the rectal mucosa.
D. The laceration requires minimal suturing.
CORRECT ANSWER: A. The laceration extends through the perineal muscles
and the anal sphincter.
Rationale: A third-degree perineal laceration extends through the perineal body and
involves the anal sphincter. A first-degree laceration involves only the vaginal mucosa
and perineal skin. A fourth-degree laceration extends through the rectal mucosa. Third-
degree lacerations require extensive repair and carry a risk of future bowel
incontinence.
Question 7: A nurse is caring for a client who has preeclampsia and is
receiving magnesium sulfate via continuous IV infusion. Which of the
following assessment findings indicates magnesium toxicity?
A. Respiratory rate of 16/min.
B. Urinary output of 40 mL/hr.
C. Deep tendon reflexes 2+.
D. Absence of patellar reflexes.
CORRECT ANSWER: D. Absence of patellar reflexes.
Rationale: Magnesium sulfate toxicity affects the neuromuscular junction, leading to a
loss of deep tendon reflexes (DTRs). The first sign of toxicity is often a decrease or
absence of reflexes, followed by respiratory depression and oliguria. A respiratory rate
of 16/min, UO of 40 mL/hr, and DTRs of 2+ are all considered normal and therapeutic
findings.
Question 8: A nurse is providing discharge teaching to the parents of a
newborn who had a circumcision using the Plastibell device. Which of the
following instructions should the nurse include?
A. Remove the Plastibell device in 2 days.
B. Apply a new diaper tightly over the penis.
C. The yellow exudate that forms is a normal part of healing.
D. Cleanse the penis with soap and water twice daily.
CORRECT ANSWER: C. The yellow exudate that forms is a normal part of
healing.
, Rationale: A yellow exudate or crust will form around the Plastibell ring within 24 hours
of the procedure; this is a normal part of the healing process and should not be
removed. The Plastibell will fall off on its own, usually within 5 to 8 days, and should not
be pulled off. The diaper should be applied loosely to prevent pressure on the site, and
cleansing should be done with warm water, not soap, to avoid irritation.
Question 9: A nurse is assessing a client who is 24 hours postpartum. The
client's fundus is firm, at the level of the umbilicus, and deviated to the right.
What is the most likely cause of this finding?
A. Uterine atony.
B. A full bladder.
C. Retained placental fragments.
D. Uterine inversion.
CORRECT ANSWER: B. A full bladder.
Rationale: A fundus that is firm but deviated to the side (usually the right) is a classic
sign of a full bladder displacing the uterus. A full bladder prevents the uterus from
contracting effectively and can lead to increased bleeding. The nurse should have the
client void and then reassess the fundal position. Uterine atony would present with a
boggy, soft fundus.
Question 10: A nurse is reviewing the laboratory results of a newborn who is
24 hours old. Which of the following bilirubin levels should the nurse report to
the provider?
A. Total bilirubin 4 mg/dL
B. Total bilirubin 6 mg/dL
C. Total bilirubin 10 mg/dL
D. Total bilirubin 12 mg/dL
CORRECT ANSWER: D. Total bilirubin 12 mg/dL.
Rationale: The normal total serum bilirubin level for a 24-hour-old newborn is typically
less than 5 to 6 mg/dL. A level of 12 mg/dL at 24 hours is significantly elevated and
warrants immediate reporting and investigation for pathologic jaundice, which could
indicate hemolytic disease or other underlying conditions.
Question 11: A nurse is caring for a client in the first stage of labor who is
experiencing extreme pain and anxiety. The nurse notes late decelerations on
the fetal monitor. What is the priority nursing action?
A. Administer prescribed pain medication.
B. Position the client on her left side.
Updated 2026 | 190+ Questions and Answers | ATI Maternal-Newborn
Nursing Comprehensive Study Guide, Practice Exam, Exam Prep Test
Bank, Pregnancy, Labor and Delivery, Postpartum Care, Newborn
Assessment, Neonatal Care, High-Risk Pregnancy, Obstetric
Emergencies, Breastfeeding, Clinical Judgment, NCLEX-RN Review,
Detailed Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who is at 38 weeks of gestation and
reports a sudden gush of clear fluid from the vagina. Which of the following
actions should the nurse take first?
A. Assess the fetal heart rate.
B. Perform a Nitrazine test to confirm the presence of amniotic fluid.
C. Check the client's temperature.
D. Notify the provider.
CORRECT ANSWER: A. Assess the fetal heart rate.
Rationale: The priority action is to assess fetal well-being. A sudden gush of fluid
indicates a possible rupture of membranes, which places the client and fetus at risk for
umbilical cord prolapse and infection. The first step is to evaluate the fetal heart rate to
detect any signs of distress. While the Nitrazine test, temperature check, and notifying
the provider are important subsequent steps, they are not the immediate priority.
Question 2: A nurse is assessing a newborn who is 12 hours old. Which of the
following findings should the nurse report to the provider?
A. Heart rate of 140/min while sleeping.
B. Respiratory rate of 60/min with slight grunting.
C. Axillary temperature of 36.5°C (97.7°F).
D. A single episode of passing meconium.
CORRECT ANSWER: B. Respiratory rate of 60/min with slight grunting.
Rationale: Grunting is a sign of respiratory distress in a newborn and should be reported
immediately. While a respiratory rate of 60/min is at the high end of normal (30-
60/min), the presence of grunting indicates the newborn is using extra effort to
maintain airway patency and oxygenation. The other options are normal findings for a
12-hour-old newborn.
Question 3: A nurse is providing teaching to a client who is at 10 weeks of
gestation and reports frequent nausea and vomiting. Which of the following
instructions should the nurse include?
,A. Eat small, frequent meals throughout the day.
B. Drink a large glass of water with each meal.
C. Lie down immediately after eating.
D. Increase intake of high-fat foods.
CORRECT ANSWER: A. Eat small, frequent meals throughout the day.
Rationale: Small, frequent meals help maintain stable blood glucose levels and prevent
the stomach from becoming empty, which can exacerbate nausea. Large glasses of
water can distend the stomach and worsen nausea. Lying down after meals can delay
gastric emptying. High-fat foods are difficult to digest and can trigger nausea.
Question 4: A nurse is caring for a client who is in active labor and has an
epidural in place. Which of the following is a priority nursing intervention?
A. Monitor the fetal heart rate every hour.
B. Assess the client's blood pressure every 5 to 10 minutes.
C. Encourage the client to ambulate in the room.
D. Maintain the client in a supine position.
CORRECT ANSWER: B. Assess the client's blood pressure every 5 to 10
minutes.
Rationale: Epidural anesthesia can cause sympathetic blockade, leading to maternal
hypotension. This is a serious complication that can decrease placental perfusion and
compromise the fetus. Therefore, frequent blood pressure monitoring (every 5-10
minutes) is a priority. Ambulation is not safe with an epidural due to motor block, and
the supine position can worsen hypotension by compressing the vena cava.
Question 5: A nurse is performing a vaginal examination on a client who is in
labor. The nurse palpates the fetal occiput in the left anterior quadrant of the
maternal pelvis. How should the nurse document this presentation?
A. LOP
B. LOA
C. ROP
D. ROA
CORRECT ANSWER: B. LOA
Rationale: The abbreviation LOA stands for Left Occiput Anterior. This indicates the
fetal occiput (the presenting part) is positioned on the left side of the maternal pelvis (L)
and is rotated toward the anterior portion of the pelvis (A). LOP is Left Occiput
Posterior, ROP is Right Occiput Posterior, and ROA is Right Occiput Anterior.
,Question 6: A nurse is assessing a client who is postpartum and has a third-
degree perineal laceration. Which of the following findings should the nurse
expect?
A. The laceration extends through the perineal muscles and the anal sphincter.
B. The laceration involves the vaginal mucosa and perineal skin.
C. The laceration extends through the rectal mucosa.
D. The laceration requires minimal suturing.
CORRECT ANSWER: A. The laceration extends through the perineal muscles
and the anal sphincter.
Rationale: A third-degree perineal laceration extends through the perineal body and
involves the anal sphincter. A first-degree laceration involves only the vaginal mucosa
and perineal skin. A fourth-degree laceration extends through the rectal mucosa. Third-
degree lacerations require extensive repair and carry a risk of future bowel
incontinence.
Question 7: A nurse is caring for a client who has preeclampsia and is
receiving magnesium sulfate via continuous IV infusion. Which of the
following assessment findings indicates magnesium toxicity?
A. Respiratory rate of 16/min.
B. Urinary output of 40 mL/hr.
C. Deep tendon reflexes 2+.
D. Absence of patellar reflexes.
CORRECT ANSWER: D. Absence of patellar reflexes.
Rationale: Magnesium sulfate toxicity affects the neuromuscular junction, leading to a
loss of deep tendon reflexes (DTRs). The first sign of toxicity is often a decrease or
absence of reflexes, followed by respiratory depression and oliguria. A respiratory rate
of 16/min, UO of 40 mL/hr, and DTRs of 2+ are all considered normal and therapeutic
findings.
Question 8: A nurse is providing discharge teaching to the parents of a
newborn who had a circumcision using the Plastibell device. Which of the
following instructions should the nurse include?
A. Remove the Plastibell device in 2 days.
B. Apply a new diaper tightly over the penis.
C. The yellow exudate that forms is a normal part of healing.
D. Cleanse the penis with soap and water twice daily.
CORRECT ANSWER: C. The yellow exudate that forms is a normal part of
healing.
, Rationale: A yellow exudate or crust will form around the Plastibell ring within 24 hours
of the procedure; this is a normal part of the healing process and should not be
removed. The Plastibell will fall off on its own, usually within 5 to 8 days, and should not
be pulled off. The diaper should be applied loosely to prevent pressure on the site, and
cleansing should be done with warm water, not soap, to avoid irritation.
Question 9: A nurse is assessing a client who is 24 hours postpartum. The
client's fundus is firm, at the level of the umbilicus, and deviated to the right.
What is the most likely cause of this finding?
A. Uterine atony.
B. A full bladder.
C. Retained placental fragments.
D. Uterine inversion.
CORRECT ANSWER: B. A full bladder.
Rationale: A fundus that is firm but deviated to the side (usually the right) is a classic
sign of a full bladder displacing the uterus. A full bladder prevents the uterus from
contracting effectively and can lead to increased bleeding. The nurse should have the
client void and then reassess the fundal position. Uterine atony would present with a
boggy, soft fundus.
Question 10: A nurse is reviewing the laboratory results of a newborn who is
24 hours old. Which of the following bilirubin levels should the nurse report to
the provider?
A. Total bilirubin 4 mg/dL
B. Total bilirubin 6 mg/dL
C. Total bilirubin 10 mg/dL
D. Total bilirubin 12 mg/dL
CORRECT ANSWER: D. Total bilirubin 12 mg/dL.
Rationale: The normal total serum bilirubin level for a 24-hour-old newborn is typically
less than 5 to 6 mg/dL. A level of 12 mg/dL at 24 hours is significantly elevated and
warrants immediate reporting and investigation for pathologic jaundice, which could
indicate hemolytic disease or other underlying conditions.
Question 11: A nurse is caring for a client in the first stage of labor who is
experiencing extreme pain and anxiety. The nurse notes late decelerations on
the fetal monitor. What is the priority nursing action?
A. Administer prescribed pain medication.
B. Position the client on her left side.
