ATI Maternity Proctored Exam Practice Questions and Answers with Rationales | 100
Questions | Newest Edition | A+ Grade
Question 1
A nurse is caring for a client at 32 weeks' gestation who reports a severe headache, blurred
vision, and epigastric pain. Which action should the nurse take first?
A. Encourage oral fluids.
B. Assess the client's blood pressure.
C. Administer acetaminophen.
D. Place the client in a supine position.
Answer: B. Assess the client's blood pressure.
Rationale:
Severe headache, visual disturbances, and epigastric pain are classic warning signs of
severe preeclampsia. Assessing the client's blood pressure is the priority because it helps
determine the severity of hypertension and guides immediate interventions to prevent
complications such as seizures, stroke, placental abruption, and fetal compromise.
Question 2
A client at 39 weeks' gestation reports a sudden gush of clear vaginal fluid. What is the
nurse's priority assessment?
A. Maternal temperature
B. Cervical dilation
C. Fetal heart rate
D. Contraction frequency
Answer: C. Fetal heart rate.
Rationale:
Following rupture of membranes, the umbilical cord may become compressed or
prolapse, reducing oxygen delivery to the fetus. Assessing the fetal heart rate immediately
allows the nurse to identify fetal distress and intervene promptly if abnormalities are
present.
,Question 3
A postpartum client has saturated one perineal pad within 15 minutes. Which intervention
should the nurse perform first?
A. Notify the provider.
B. Massage the uterine fundus.
C. Obtain a complete blood count.
D. Prepare the client for surgery.
Answer: B. Massage the uterine fundus.
Rationale:
Excessive postpartum bleeding is commonly caused by uterine atony. Massaging the
fundus stimulates uterine contractions, helping compress blood vessels and reduce
bleeding. This is the immediate nursing intervention before progressing to additional
treatments if hemorrhage continues.
Question 4
Which assessment finding in a newborn requires immediate intervention?
A. Acrocyanosis
B. Heart rate of 140/min
C. Respiratory rate of 48/min
D. Central cyanosis
Answer: D. Central cyanosis.
Rationale:
Central cyanosis indicates inadequate oxygenation and may signal respiratory or
cardiovascular compromise. Immediate evaluation and intervention are necessary to
restore adequate oxygen delivery and prevent serious complications.
Question 5
A client with gestational diabetes asks why blood glucose monitoring is necessary. Which
response by the nurse is most appropriate?
,A. It prevents all pregnancy complications.
B. It helps maintain blood glucose within the target range to reduce maternal and fetal
complications.
C. It determines whether labor should be induced.
D. It eliminates the need for dietary changes.
Answer: B. It helps maintain blood glucose within the target range to reduce maternal
and fetal complications.
Rationale:
Consistent blood glucose monitoring allows timely adjustments to diet, activity, or
medication. Maintaining target glucose levels reduces the risk of fetal macrosomia,
neonatal hypoglycemia, birth trauma, and maternal complications.
Question 6
A laboring client is receiving oxytocin for labor induction. Which finding requires immediate
nursing intervention?
A. Contractions every 2 minutes lasting 95 seconds
B. Cervix dilated to 6 cm
C. Maternal pulse of 90/min
D. Pain rating of 8 on a 10-point scale
Answer: A. Contractions every 2 minutes lasting 95 seconds.
Rationale:
Frequent, prolonged contractions indicate uterine tachysystole, which decreases
placental blood flow and increases the risk of fetal hypoxia. The oxytocin infusion should
be discontinued immediately while appropriate interventions are initiated.
Question 7
Which vaccine is routinely recommended during every pregnancy?
A. MMR
B. Varicella
, C. Tdap
D. HPV
Answer: C. Tdap.
Rationale:
The Tdap vaccine is recommended during each pregnancy, preferably between 27 and 36
weeks' gestation, to maximize maternal antibody production and passive immunity for the
newborn against pertussis.
Question 8
A client receiving magnesium sulfate develops absent deep tendon reflexes and a
respiratory rate of 10/min. Which medication should the nurse prepare to administer?
A. Terbutaline
B. Calcium gluconate
C. Oxytocin
D. Methylergonovine
Answer: B. Calcium gluconate.
Rationale:
Absent reflexes and respiratory depression are signs of magnesium sulfate toxicity.
Calcium gluconate is the antidote and should be readily available whenever magnesium
sulfate is administered.
Question 9
Variable fetal heart rate decelerations are most commonly associated with which
condition?
A. Placental insufficiency
B. Umbilical cord compression
C. Maternal fever
D. Fetal sleep cycle
Answer: B. Umbilical cord compression.
Questions | Newest Edition | A+ Grade
Question 1
A nurse is caring for a client at 32 weeks' gestation who reports a severe headache, blurred
vision, and epigastric pain. Which action should the nurse take first?
A. Encourage oral fluids.
B. Assess the client's blood pressure.
C. Administer acetaminophen.
D. Place the client in a supine position.
Answer: B. Assess the client's blood pressure.
Rationale:
Severe headache, visual disturbances, and epigastric pain are classic warning signs of
severe preeclampsia. Assessing the client's blood pressure is the priority because it helps
determine the severity of hypertension and guides immediate interventions to prevent
complications such as seizures, stroke, placental abruption, and fetal compromise.
Question 2
A client at 39 weeks' gestation reports a sudden gush of clear vaginal fluid. What is the
nurse's priority assessment?
A. Maternal temperature
B. Cervical dilation
C. Fetal heart rate
D. Contraction frequency
Answer: C. Fetal heart rate.
Rationale:
Following rupture of membranes, the umbilical cord may become compressed or
prolapse, reducing oxygen delivery to the fetus. Assessing the fetal heart rate immediately
allows the nurse to identify fetal distress and intervene promptly if abnormalities are
present.
,Question 3
A postpartum client has saturated one perineal pad within 15 minutes. Which intervention
should the nurse perform first?
A. Notify the provider.
B. Massage the uterine fundus.
C. Obtain a complete blood count.
D. Prepare the client for surgery.
Answer: B. Massage the uterine fundus.
Rationale:
Excessive postpartum bleeding is commonly caused by uterine atony. Massaging the
fundus stimulates uterine contractions, helping compress blood vessels and reduce
bleeding. This is the immediate nursing intervention before progressing to additional
treatments if hemorrhage continues.
Question 4
Which assessment finding in a newborn requires immediate intervention?
A. Acrocyanosis
B. Heart rate of 140/min
C. Respiratory rate of 48/min
D. Central cyanosis
Answer: D. Central cyanosis.
Rationale:
Central cyanosis indicates inadequate oxygenation and may signal respiratory or
cardiovascular compromise. Immediate evaluation and intervention are necessary to
restore adequate oxygen delivery and prevent serious complications.
Question 5
A client with gestational diabetes asks why blood glucose monitoring is necessary. Which
response by the nurse is most appropriate?
,A. It prevents all pregnancy complications.
B. It helps maintain blood glucose within the target range to reduce maternal and fetal
complications.
C. It determines whether labor should be induced.
D. It eliminates the need for dietary changes.
Answer: B. It helps maintain blood glucose within the target range to reduce maternal
and fetal complications.
Rationale:
Consistent blood glucose monitoring allows timely adjustments to diet, activity, or
medication. Maintaining target glucose levels reduces the risk of fetal macrosomia,
neonatal hypoglycemia, birth trauma, and maternal complications.
Question 6
A laboring client is receiving oxytocin for labor induction. Which finding requires immediate
nursing intervention?
A. Contractions every 2 minutes lasting 95 seconds
B. Cervix dilated to 6 cm
C. Maternal pulse of 90/min
D. Pain rating of 8 on a 10-point scale
Answer: A. Contractions every 2 minutes lasting 95 seconds.
Rationale:
Frequent, prolonged contractions indicate uterine tachysystole, which decreases
placental blood flow and increases the risk of fetal hypoxia. The oxytocin infusion should
be discontinued immediately while appropriate interventions are initiated.
Question 7
Which vaccine is routinely recommended during every pregnancy?
A. MMR
B. Varicella
, C. Tdap
D. HPV
Answer: C. Tdap.
Rationale:
The Tdap vaccine is recommended during each pregnancy, preferably between 27 and 36
weeks' gestation, to maximize maternal antibody production and passive immunity for the
newborn against pertussis.
Question 8
A client receiving magnesium sulfate develops absent deep tendon reflexes and a
respiratory rate of 10/min. Which medication should the nurse prepare to administer?
A. Terbutaline
B. Calcium gluconate
C. Oxytocin
D. Methylergonovine
Answer: B. Calcium gluconate.
Rationale:
Absent reflexes and respiratory depression are signs of magnesium sulfate toxicity.
Calcium gluconate is the antidote and should be readily available whenever magnesium
sulfate is administered.
Question 9
Variable fetal heart rate decelerations are most commonly associated with which
condition?
A. Placental insufficiency
B. Umbilical cord compression
C. Maternal fever
D. Fetal sleep cycle
Answer: B. Umbilical cord compression.
