ATI Maternal-Newborn Nursing 2026–2027 | ATI
RN Maternal Newborn Nursing Review & Proctored
Exam Study Guide | Pregnancy, Prenatal & High-
Risk Antepartum Care, Labor & Delivery, Fetal
Monitoring, Postpartum Nursing, Newborn
Assessment, Neonatal Complications, Maternal
Complications, Pharmacology, Patient Education,
Clinical Judgment, NGN-Style Practice Questions &
Detailed Rationales
Question 1: A nurse is caring for a client at 10 weeks' gestation who reports
nausea and vomiting. Which instruction should the nurse include in the
teaching plan?
A. Eat three large meals daily
B. Drink fluids with meals
C. Eat dry crackers before rising in the morning
D. Avoid eating until nausea subsides
CORRECT ANSWER: C. Eat dry crackers before rising in the morning
Rationale: Eating dry crackers before rising helps reduce morning sickness by absorbing
gastric acids before movement. Large meals and fluids with meals can worsen nausea.
Avoiding eating can lead to hypoglycemia and worsen symptoms.
Question 2: A pregnant client asks the nurse when she should expect to feel
fetal movement for the first time. The nurse should respond that quickening
typically occurs at:
A. 8 to 10 weeks
B. 16 to 20 weeks
C. 24 to 28 weeks
D. 30 to 32 weeks
CORRECT ANSWER: B. 16 to 20 weeks
Rationale: Quickening, the first perception of fetal movement, typically occurs between
16 and 20 weeks' gestation in primigravida clients. Earlier perception may occur in
multigravida clients.
Question 3: A nurse is assessing a client in the first trimester. Which finding
should the nurse report to the provider immediately?
A. Breast tenderness
B. Urinary frequency
C. Vaginal bleeding
D. Mild fatigue
CORRECT ANSWER: C. Vaginal bleeding
,Rationale: Vaginal bleeding in the first trimester may indicate miscarriage, ectopic
pregnancy, or other complications and must be reported immediately. Breast
tenderness, urinary frequency, and fatigue are normal pregnancy changes.
Question 4: A client at 36 weeks' gestation presents with painless, bright red
vaginal bleeding. The nurse should suspect:
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical dilation
CORRECT ANSWER: A. Placenta previa
Rationale: Placenta previa classically presents with painless, bright red vaginal bleeding
in the third trimester. Abruptio placentae typically presents with painful bleeding and a
rigid abdomen.
Question 5: A nurse is teaching a prenatal client about folic acid. The nurse
should explain that folic acid helps prevent:
A. Gestational diabetes
B. Neural tube defects
C. Preeclampsia
D. Preterm labor
CORRECT ANSWER: B. Neural tube defects
Rationale: Folic acid supplementation before and during early pregnancy significantly
reduces the risk of neural tube defects such as spina bifida and anencephaly.
Question 6: A client at 32 weeks' gestation reports a sudden gush of fluid from
the vagina. The nurse should first:
A. Perform a sterile vaginal exam
B. Check the fetal heart rate
C. Test the fluid with nitrazine paper
D. Ambulate the client
CORRECT ANSWER: B. Check the fetal heart rate
Rationale: When rupture of membranes is suspected, the priority is to assess fetal well-
being by checking the fetal heart rate. A sterile vaginal exam should be avoided to
prevent infection. Nitrazine testing can follow.
Question 7: A nurse is calculating the estimated date of delivery (EDD) for a
client whose last menstrual period began on March 10. Using Naegele's rule,
the EDD is:
A. December 10
B. December 17
,C. December 3
D. December 24
CORRECT ANSWER: B. December 17
Rationale: Naegele's rule: subtract 3 months from the first day of the last menstrual
period and add 7 days. March 10 minus 3 months = December 10; plus 7 days =
December 17.
Question 8: A nurse is assessing a newborn immediately after birth. Which
finding requires immediate intervention?
A. Heart rate of 130 beats/min
B. Respiratory rate of 50 breaths/min
C. Acrocyanosis
D. Grunting respirations
CORRECT ANSWER: D. Grunting respirations
Rationale: Grunting is a sign of respiratory distress in the newborn and requires
immediate intervention. Acrocyanosis is a normal finding in the first hours after birth.
Question 9: A postpartum client is experiencing excessive lochia rubra with
large clots. The nurse should first:
A. Massage the fundus
B. Administer oxytocin
C. Increase IV fluids
D. Document the finding
CORRECT ANSWER: A. Massage the fundus
Rationale: The first nursing action for suspected postpartum hemorrhage due to uterine
atony is to massage the fundus to promote contraction. This is a non-invasive,
immediate intervention.
Question 10: A nurse is teaching a breastfeeding mother about proper latch.
Which statement indicates understanding?
A. "I should feel a sharp pain throughout the feeding."
B. "The baby's chin should touch my breast first."
C. "I should hear clicking sounds during feeding."
D. "Only the nipple should be in the baby's mouth."
CORRECT ANSWER: B. "The baby's chin should touch my breast first."
Rationale: Proper latch involves the chin touching the breast first, with the mouth
covering most of the areola. Sharp pain and clicking sounds indicate improper latch.
Question 11: A client at 28 weeks' gestation is diagnosed with gestational
diabetes. The nurse should prioritize teaching about:
, A. Insulin administration
B. Dietary management and glucose monitoring
C. Bed rest
D. Fetal surgery
CORRECT ANSWER: B. Dietary management and glucose monitoring
Rationale: First-line management of gestational diabetes is dietary modification and
blood glucose monitoring. Insulin may be added if diet alone is insufficient.
Question 12: A nurse is assessing a client in labor. The client's cervix is 6 cm
dilated, 80% effaced, and the fetus is at 0 station. This describes which phase
of labor?
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
of 4 to 7 cm with rapid progression. Transition is 8 to 10 cm.
Question 13: A newborn is born at 38 weeks' gestation weighing 2,400 grams.
The nurse should classify this newborn as:
A. Appropriate for gestational age
B. Small for gestational age
C. Large for gestational age
D. Macrosomic
CORRECT ANSWER: B. Small for gestational age
Rationale: A newborn weighing less than 2,500 grams at term is classified as small for
gestational age. Appropriate for gestational age at 38 weeks is approximately 2,500 to
4,000 grams.
Question 14: A nurse is caring for a client receiving magnesium sulfate for
preeclampsia. Which finding indicates magnesium toxicity?
A. Blood pressure of 130/80 mm Hg
B. Respiratory rate of 10 breaths/min
C. Urine output of 40 mL/hr
D. Deep tendon reflexes of 2+
CORRECT ANSWER: B. Respiratory rate of 10 breaths/min
Rationale: Respiratory depression (rate less than 12 breaths/min) is an early sign of
magnesium sulfate toxicity. The antidote is calcium gluconate.
RN Maternal Newborn Nursing Review & Proctored
Exam Study Guide | Pregnancy, Prenatal & High-
Risk Antepartum Care, Labor & Delivery, Fetal
Monitoring, Postpartum Nursing, Newborn
Assessment, Neonatal Complications, Maternal
Complications, Pharmacology, Patient Education,
Clinical Judgment, NGN-Style Practice Questions &
Detailed Rationales
Question 1: A nurse is caring for a client at 10 weeks' gestation who reports
nausea and vomiting. Which instruction should the nurse include in the
teaching plan?
A. Eat three large meals daily
B. Drink fluids with meals
C. Eat dry crackers before rising in the morning
D. Avoid eating until nausea subsides
CORRECT ANSWER: C. Eat dry crackers before rising in the morning
Rationale: Eating dry crackers before rising helps reduce morning sickness by absorbing
gastric acids before movement. Large meals and fluids with meals can worsen nausea.
Avoiding eating can lead to hypoglycemia and worsen symptoms.
Question 2: A pregnant client asks the nurse when she should expect to feel
fetal movement for the first time. The nurse should respond that quickening
typically occurs at:
A. 8 to 10 weeks
B. 16 to 20 weeks
C. 24 to 28 weeks
D. 30 to 32 weeks
CORRECT ANSWER: B. 16 to 20 weeks
Rationale: Quickening, the first perception of fetal movement, typically occurs between
16 and 20 weeks' gestation in primigravida clients. Earlier perception may occur in
multigravida clients.
Question 3: A nurse is assessing a client in the first trimester. Which finding
should the nurse report to the provider immediately?
A. Breast tenderness
B. Urinary frequency
C. Vaginal bleeding
D. Mild fatigue
CORRECT ANSWER: C. Vaginal bleeding
,Rationale: Vaginal bleeding in the first trimester may indicate miscarriage, ectopic
pregnancy, or other complications and must be reported immediately. Breast
tenderness, urinary frequency, and fatigue are normal pregnancy changes.
Question 4: A client at 36 weeks' gestation presents with painless, bright red
vaginal bleeding. The nurse should suspect:
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical dilation
CORRECT ANSWER: A. Placenta previa
Rationale: Placenta previa classically presents with painless, bright red vaginal bleeding
in the third trimester. Abruptio placentae typically presents with painful bleeding and a
rigid abdomen.
Question 5: A nurse is teaching a prenatal client about folic acid. The nurse
should explain that folic acid helps prevent:
A. Gestational diabetes
B. Neural tube defects
C. Preeclampsia
D. Preterm labor
CORRECT ANSWER: B. Neural tube defects
Rationale: Folic acid supplementation before and during early pregnancy significantly
reduces the risk of neural tube defects such as spina bifida and anencephaly.
Question 6: A client at 32 weeks' gestation reports a sudden gush of fluid from
the vagina. The nurse should first:
A. Perform a sterile vaginal exam
B. Check the fetal heart rate
C. Test the fluid with nitrazine paper
D. Ambulate the client
CORRECT ANSWER: B. Check the fetal heart rate
Rationale: When rupture of membranes is suspected, the priority is to assess fetal well-
being by checking the fetal heart rate. A sterile vaginal exam should be avoided to
prevent infection. Nitrazine testing can follow.
Question 7: A nurse is calculating the estimated date of delivery (EDD) for a
client whose last menstrual period began on March 10. Using Naegele's rule,
the EDD is:
A. December 10
B. December 17
,C. December 3
D. December 24
CORRECT ANSWER: B. December 17
Rationale: Naegele's rule: subtract 3 months from the first day of the last menstrual
period and add 7 days. March 10 minus 3 months = December 10; plus 7 days =
December 17.
Question 8: A nurse is assessing a newborn immediately after birth. Which
finding requires immediate intervention?
A. Heart rate of 130 beats/min
B. Respiratory rate of 50 breaths/min
C. Acrocyanosis
D. Grunting respirations
CORRECT ANSWER: D. Grunting respirations
Rationale: Grunting is a sign of respiratory distress in the newborn and requires
immediate intervention. Acrocyanosis is a normal finding in the first hours after birth.
Question 9: A postpartum client is experiencing excessive lochia rubra with
large clots. The nurse should first:
A. Massage the fundus
B. Administer oxytocin
C. Increase IV fluids
D. Document the finding
CORRECT ANSWER: A. Massage the fundus
Rationale: The first nursing action for suspected postpartum hemorrhage due to uterine
atony is to massage the fundus to promote contraction. This is a non-invasive,
immediate intervention.
Question 10: A nurse is teaching a breastfeeding mother about proper latch.
Which statement indicates understanding?
A. "I should feel a sharp pain throughout the feeding."
B. "The baby's chin should touch my breast first."
C. "I should hear clicking sounds during feeding."
D. "Only the nipple should be in the baby's mouth."
CORRECT ANSWER: B. "The baby's chin should touch my breast first."
Rationale: Proper latch involves the chin touching the breast first, with the mouth
covering most of the areola. Sharp pain and clicking sounds indicate improper latch.
Question 11: A client at 28 weeks' gestation is diagnosed with gestational
diabetes. The nurse should prioritize teaching about:
, A. Insulin administration
B. Dietary management and glucose monitoring
C. Bed rest
D. Fetal surgery
CORRECT ANSWER: B. Dietary management and glucose monitoring
Rationale: First-line management of gestational diabetes is dietary modification and
blood glucose monitoring. Insulin may be added if diet alone is insufficient.
Question 12: A nurse is assessing a client in labor. The client's cervix is 6 cm
dilated, 80% effaced, and the fetus is at 0 station. This describes which phase
of labor?
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
of 4 to 7 cm with rapid progression. Transition is 8 to 10 cm.
Question 13: A newborn is born at 38 weeks' gestation weighing 2,400 grams.
The nurse should classify this newborn as:
A. Appropriate for gestational age
B. Small for gestational age
C. Large for gestational age
D. Macrosomic
CORRECT ANSWER: B. Small for gestational age
Rationale: A newborn weighing less than 2,500 grams at term is classified as small for
gestational age. Appropriate for gestational age at 38 weeks is approximately 2,500 to
4,000 grams.
Question 14: A nurse is caring for a client receiving magnesium sulfate for
preeclampsia. Which finding indicates magnesium toxicity?
A. Blood pressure of 130/80 mm Hg
B. Respiratory rate of 10 breaths/min
C. Urine output of 40 mL/hr
D. Deep tendon reflexes of 2+
CORRECT ANSWER: B. Respiratory rate of 10 breaths/min
Rationale: Respiratory depression (rate less than 12 breaths/min) is an early sign of
magnesium sulfate toxicity. The antidote is calcium gluconate.
