2026/2027
,2026/2027
ATI Maternal Newborn OB
Complete Certification Prep and
Advanced Study Guide: Detailed
Topic Modules, Extensive Test Bank
Review, Practice Questions, and
Final Exam Readiness Manual
Question 16:
D. Question 1
A client at 39 weeks of gestation is diagnosed with polyhydramnios. Which fetal
condition can contribute to this finding?
A. Bilateral renal agenesis
B. Chronic placental insufficiency
C. Gastrointestinal obstruction
D. Intrauterine growth restriction
Correct Answer: C. Gastrointestinal obstruction
Rationale: Gastrointestinal abnormalities, such as esophageal or duodenal atresia, can
interfere with fetal swallowing and absorption of amniotic fluid, causing an excessive
accumulation known as polyhydramnios. Renal agenesis decreases fetal urine
production and is associated with oligohydramnios. Placental insufficiency and fetal
growth restriction are also more commonly associated with reduced amniotic fluid.
DI. Question 2
A client at 33 weeks of gestation presents with painless vaginal bleeding and has been
diagnosed with placenta previa. Which prescribed intervention should the nurse
question?
A. Obtain a complete blood count
B. Insert a large-bore intravenous catheter
C. Begin continuous external fetal monitoring
D. Perform a digital vaginal examination
Correct Answer: D. Perform a digital vaginal examination
,2026/2027
Rationale: A digital vaginal examination is contraindicated when placenta previa is
suspected or confirmed because manipulation of the cervix may disrupt the placenta
and cause severe hemorrhage. Establishing large-bore IV access allows rapid
administration of fluids or blood products if needed. A complete blood count helps
assess blood loss, while fetal monitoring evaluates fetal well-being.
DII. Question 3
During an early prenatal appointment, which symptom should a pregnant client be
instructed to report immediately?
A. Mild leg cramps at night
B. Increased nonirritating vaginal discharge
C. Morning nausea
D. Blurred or double vision
Correct Answer: D. Blurred or double vision
Rationale: Visual disturbances such as blurred or double vision can indicate severe
hypertension, preeclampsia, or another serious neurologic complication. These
symptoms require prompt evaluation. Morning nausea, mild leg cramps, and
increased leukorrhea are common pregnancy findings when they occur without other
concerning symptoms.
DIII. Question 4
A client receiving oxytocin develops contractions every 2 minutes, with each
contraction lasting approximately 100 to 110 seconds. The fetal heart rate pattern
remains reassuring. What should the nurse do?
A. Increase the oxytocin rate
B. Encourage the client to push
C. Reduce or discontinue the oxytocin infusion
D. Increase the routine maintenance IV fluids
Correct Answer: C. Reduce or discontinue the oxytocin infusion
Rationale: Contractions that occur excessively frequently or last longer than 90
seconds indicate uterine tachysystole. The nurse should reduce or stop the oxytocin
according to the clinical protocol to allow adequate uterine relaxation and placental
perfusion. Increasing oxytocin could worsen the tachysystole. Pushing should not
begin until the cervix is completely dilated.
, 2026/2027
DIV. Question 5
A client reports amenorrhea, breast tenderness, and a positive home pregnancy test.
Which finding provides positive evidence of pregnancy?
A. Chadwick sign
B. Positive urinary hCG test
C. Enlargement of the abdomen
D. Fetal movement palpated by a trained examiner
Correct Answer: D. Fetal movement palpated by a trained examiner
Rationale: Fetal movement detected by a trained examiner is a positive sign of
pregnancy because it can only be produced by a fetus. Amenorrhea and abdominal
enlargement are presumptive findings because they can have causes other than
pregnancy. Chadwick sign and elevated hCG are probable signs but are not
considered definitive evidence.
DV. Question 6
A pregnant client with HIV asks how she can reduce the risk of transmitting HIV to
her fetus. Which instruction should the nurse provide?
A. Discontinue antiretroviral medication during early pregnancy
B. Continue prescribed antiretroviral therapy throughout pregnancy
C. Avoid all sexual activity until after delivery
D. Breastfeed because breast milk provides passive immunity
Correct Answer: B. Continue prescribed antiretroviral therapy throughout
pregnancy
Rationale: Maintaining prescribed antiretroviral therapy suppresses the maternal viral
load and substantially decreases the risk of perinatal HIV transmission. Antiretroviral
medications should not be discontinued without guidance from the treating provider.
HIV can also be transmitted through breast milk, so infant-feeding decisions should
follow current clinical recommendations.
DVI. Question 7
An ultrasound examination shows severe oligohydramnios during the second
trimester. Which fetal abnormality is most likely to contribute to this condition?
A. Hydrocephalus
B. Renal agenesis
,2026/2027
ATI Maternal Newborn OB
Complete Certification Prep and
Advanced Study Guide: Detailed
Topic Modules, Extensive Test Bank
Review, Practice Questions, and
Final Exam Readiness Manual
Question 16:
D. Question 1
A client at 39 weeks of gestation is diagnosed with polyhydramnios. Which fetal
condition can contribute to this finding?
A. Bilateral renal agenesis
B. Chronic placental insufficiency
C. Gastrointestinal obstruction
D. Intrauterine growth restriction
Correct Answer: C. Gastrointestinal obstruction
Rationale: Gastrointestinal abnormalities, such as esophageal or duodenal atresia, can
interfere with fetal swallowing and absorption of amniotic fluid, causing an excessive
accumulation known as polyhydramnios. Renal agenesis decreases fetal urine
production and is associated with oligohydramnios. Placental insufficiency and fetal
growth restriction are also more commonly associated with reduced amniotic fluid.
DI. Question 2
A client at 33 weeks of gestation presents with painless vaginal bleeding and has been
diagnosed with placenta previa. Which prescribed intervention should the nurse
question?
A. Obtain a complete blood count
B. Insert a large-bore intravenous catheter
C. Begin continuous external fetal monitoring
D. Perform a digital vaginal examination
Correct Answer: D. Perform a digital vaginal examination
,2026/2027
Rationale: A digital vaginal examination is contraindicated when placenta previa is
suspected or confirmed because manipulation of the cervix may disrupt the placenta
and cause severe hemorrhage. Establishing large-bore IV access allows rapid
administration of fluids or blood products if needed. A complete blood count helps
assess blood loss, while fetal monitoring evaluates fetal well-being.
DII. Question 3
During an early prenatal appointment, which symptom should a pregnant client be
instructed to report immediately?
A. Mild leg cramps at night
B. Increased nonirritating vaginal discharge
C. Morning nausea
D. Blurred or double vision
Correct Answer: D. Blurred or double vision
Rationale: Visual disturbances such as blurred or double vision can indicate severe
hypertension, preeclampsia, or another serious neurologic complication. These
symptoms require prompt evaluation. Morning nausea, mild leg cramps, and
increased leukorrhea are common pregnancy findings when they occur without other
concerning symptoms.
DIII. Question 4
A client receiving oxytocin develops contractions every 2 minutes, with each
contraction lasting approximately 100 to 110 seconds. The fetal heart rate pattern
remains reassuring. What should the nurse do?
A. Increase the oxytocin rate
B. Encourage the client to push
C. Reduce or discontinue the oxytocin infusion
D. Increase the routine maintenance IV fluids
Correct Answer: C. Reduce or discontinue the oxytocin infusion
Rationale: Contractions that occur excessively frequently or last longer than 90
seconds indicate uterine tachysystole. The nurse should reduce or stop the oxytocin
according to the clinical protocol to allow adequate uterine relaxation and placental
perfusion. Increasing oxytocin could worsen the tachysystole. Pushing should not
begin until the cervix is completely dilated.
, 2026/2027
DIV. Question 5
A client reports amenorrhea, breast tenderness, and a positive home pregnancy test.
Which finding provides positive evidence of pregnancy?
A. Chadwick sign
B. Positive urinary hCG test
C. Enlargement of the abdomen
D. Fetal movement palpated by a trained examiner
Correct Answer: D. Fetal movement palpated by a trained examiner
Rationale: Fetal movement detected by a trained examiner is a positive sign of
pregnancy because it can only be produced by a fetus. Amenorrhea and abdominal
enlargement are presumptive findings because they can have causes other than
pregnancy. Chadwick sign and elevated hCG are probable signs but are not
considered definitive evidence.
DV. Question 6
A pregnant client with HIV asks how she can reduce the risk of transmitting HIV to
her fetus. Which instruction should the nurse provide?
A. Discontinue antiretroviral medication during early pregnancy
B. Continue prescribed antiretroviral therapy throughout pregnancy
C. Avoid all sexual activity until after delivery
D. Breastfeed because breast milk provides passive immunity
Correct Answer: B. Continue prescribed antiretroviral therapy throughout
pregnancy
Rationale: Maintaining prescribed antiretroviral therapy suppresses the maternal viral
load and substantially decreases the risk of perinatal HIV transmission. Antiretroviral
medications should not be discontinued without guidance from the treating provider.
HIV can also be transmitted through breast milk, so infant-feeding decisions should
follow current clinical recommendations.
DVI. Question 7
An ultrasound examination shows severe oligohydramnios during the second
trimester. Which fetal abnormality is most likely to contribute to this condition?
A. Hydrocephalus
B. Renal agenesis
