ATI Maternal Newborn 2026/2027 | ATI RN Maternal-
Newborn Nursing Proctored Exam Study Guide & Practice
Questions | ATI Maternal Newborn Exam Prep, Pregnancy
& Antepartum Care, High-Risk Pregnancy, Labor &
Delivery, Fetal Monitoring, Intrapartum Nursing,
Postpartum Assessment, Newborn Assessment & Care,
Neonatal Complications, Obstetric Emergencies, Maternal
Complications, Medication Safety, Patient Education,
Clinical Judgment, Prioritization, NGN-Style Case Studies
& Detailed Rationales
Question 1: A nurse is caring for a client at 38 weeks gestation who
reports a sudden gush of fluid from the vagina. Which of the
following actions should the nurse take first?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Check the fetal heart rate and assess for cord prolapse
C. Obtain a specimen for nitrazine paper testing
D. Place the client in a supine position for a bedside ultrasound
CORRECT ANSWER: B. Check the fetal heart rate and assess for
cord prolapse
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being and rule out umbilical
cord prolapse, which is an obstetric emergency. Checking the fetal heart
rate and inspecting for cord presentation takes precedence over vaginal
examination, nitrazine testing, or ultrasound, because cord compression
can rapidly compromise fetal oxygenation.
Question 2: A nurse is reviewing the laboratory results of a client at
36 weeks gestation. Which of the following findings should the
nurse report to the provider immediately?
A. Hemoglobin 11.2 g/dL
B. Platelet count 140,000/mm³
C. Fibrinogen level 300 mg/dL
D. Blood glucose 250 mg/dL after a 1-hour glucose challenge
CORRECT ANSWER: D. Blood glucose 250 mg/dL after a 1-hour
glucose challenge
Rationale: A 1-hour glucose challenge result of 250 mg/dL is markedly
elevated and suggests gestational diabetes mellitus requiring prompt
,provider notification and further evaluation. Hemoglobin 11.2 g/dL,
platelets 140,000/mm³, and fibrinogen 300 mg/dL are within acceptable
ranges for pregnancy and do not require immediate reporting.
Question 3: A nurse is teaching a prenatal client about fetal
development. At which of the following gestational ages does the
fetal heart first become audible with a Doppler stethoscope?
A. 6 to 8 weeks
B. 10 to 12 weeks
C. 16 to 18 weeks
D. 20 to 22 weeks
CORRECT ANSWER: B. 10 to 12 weeks
Rationale: The fetal heart tones are typically audible with a Doppler
stethoscope between 10 and 12 weeks gestation. At 6 to 8 weeks the heart
is developing but usually not detectable by Doppler, while 16 to 18 weeks
and beyond are later than the initial audible period, making 10 to 12 weeks
the correct answer.
Question 4: A nurse is assessing a client in the first trimester who
reports nausea and vomiting. Which of the following
recommendations should the nurse include in the teaching?
A. Drink large amounts of fluids with meals
B. Eat dry crackers before rising in the morning
C. Lie down immediately after eating
D. Skip breakfast to reduce stomach irritation
CORRECT ANSWER: B. Eat dry crackers before rising in the
morning
Rationale: Eating dry crackers before getting out of bed helps reduce
morning nausea by stabilizing blood glucose and reducing gastric irritation.
Drinking large volumes with meals, lying down immediately after eating,
and skipping meals can worsen nausea and vomiting and are not
recommended.
Question 5: A nurse is caring for a client who is receiving
magnesium sulfate for preeclampsia. Which of the following
findings indicates magnesium toxicity?
,A. Urine output of 50 mL/hr
B. Respiratory rate of 12/min
C. Absence of deep tendon reflexes
D. Blood pressure of 140/90 mm Hg
CORRECT ANSWER: C. Absence of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is an early sign of magnesium
sulfate toxicity, followed by respiratory depression and cardiac arrest. Urine
output of 50 mL/hr, respiratory rate of 12/min, and blood pressure 140/90
mm Hg do not specifically indicate toxicity, though respiratory rate below
12/min would be concerning.
Question 6: A nurse is preparing to administer Rho(D) immune
globulin to a client who is Rh-negative. Which of the following
criteria must be met before administration?
A. The client must be Rh-positive
B. The client must have a negative indirect Coombs test
C. The client must be at 40 weeks gestation
D. The client must have an elevated hematocrit
CORRECT ANSWER: B. The client must have a negative indirect
Coombs test
Rationale: Rho(D) immune globulin is given to Rh-negative clients who are
not already sensitized, which is confirmed by a negative indirect Coombs
test. Administering to an Rh-positive client is unnecessary, 40 weeks is not
a requirement, and hematocrit level is unrelated to Rho(D) immune globulin
administration.
Question 7: A nurse is monitoring a client in active labor. Which of
the following findings should the nurse identify as a reassuring
fetal heart rate pattern?
A. Late decelerations
B. Variable decelerations with a return to baseline
C. Fetal heart rate baseline of 110/min with moderate variability
D. Prolonged deceleration lasting 3 minutes
CORRECT ANSWER: C. Fetal heart rate baseline of 110/min with
moderate variability
, Rationale: A baseline fetal heart rate of 110/min with moderate variability
is a reassuring pattern indicating adequate fetal oxygenation and an intact
autonomic nervous system. Late decelerations, variable decelerations, and
prolonged decelerations are nonreassuring patterns requiring further
evaluation.
Question 8: A nurse is caring for a client who is 24 hours
postpartum and reports perineal pain. Which of the following
interventions should the nurse recommend?
A. Apply a warm compress to the perineum
B. Sit directly on the affected area
C. Use a sitz bath several times a day
D. Avoid analgesics to prevent masking infection
CORRECT ANSWER: C. Use a sitz bath several times a day
Rationale: Sitz baths promote perineal healing, increase circulation, and
reduce discomfort after delivery. Warm compresses are used during labor
rather than postpartum for pain, sitting directly on the area increases
pressure and pain, and analgesics are appropriate for postpartum pain
management.
Question 9: A nurse is assessing a newborn immediately after birth.
Which of the following findings should the nurse report to the
provider?
A. Acrocyanosis of the hands and feet
B. Heart rate of 120/min
C. Respiratory rate of 80/min with grunting
D. Vernix caseosa on the skin
CORRECT ANSWER: C. Respiratory rate of 80/min with grunting
Rationale: A respiratory rate of 80/min with grunting indicates respiratory
distress in a newborn and requires immediate provider notification.
Acrocyanosis, heart rate 120/min, and vernix caseosa are normal newborn
findings that do not require reporting.
Question 10: A nurse is teaching a client about breastfeeding.
Which of the following statements by the client indicates a need for
further teaching?
Newborn Nursing Proctored Exam Study Guide & Practice
Questions | ATI Maternal Newborn Exam Prep, Pregnancy
& Antepartum Care, High-Risk Pregnancy, Labor &
Delivery, Fetal Monitoring, Intrapartum Nursing,
Postpartum Assessment, Newborn Assessment & Care,
Neonatal Complications, Obstetric Emergencies, Maternal
Complications, Medication Safety, Patient Education,
Clinical Judgment, Prioritization, NGN-Style Case Studies
& Detailed Rationales
Question 1: A nurse is caring for a client at 38 weeks gestation who
reports a sudden gush of fluid from the vagina. Which of the
following actions should the nurse take first?
A. Perform a sterile vaginal examination to assess cervical dilation
B. Check the fetal heart rate and assess for cord prolapse
C. Obtain a specimen for nitrazine paper testing
D. Place the client in a supine position for a bedside ultrasound
CORRECT ANSWER: B. Check the fetal heart rate and assess for
cord prolapse
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being and rule out umbilical
cord prolapse, which is an obstetric emergency. Checking the fetal heart
rate and inspecting for cord presentation takes precedence over vaginal
examination, nitrazine testing, or ultrasound, because cord compression
can rapidly compromise fetal oxygenation.
Question 2: A nurse is reviewing the laboratory results of a client at
36 weeks gestation. Which of the following findings should the
nurse report to the provider immediately?
A. Hemoglobin 11.2 g/dL
B. Platelet count 140,000/mm³
C. Fibrinogen level 300 mg/dL
D. Blood glucose 250 mg/dL after a 1-hour glucose challenge
CORRECT ANSWER: D. Blood glucose 250 mg/dL after a 1-hour
glucose challenge
Rationale: A 1-hour glucose challenge result of 250 mg/dL is markedly
elevated and suggests gestational diabetes mellitus requiring prompt
,provider notification and further evaluation. Hemoglobin 11.2 g/dL,
platelets 140,000/mm³, and fibrinogen 300 mg/dL are within acceptable
ranges for pregnancy and do not require immediate reporting.
Question 3: A nurse is teaching a prenatal client about fetal
development. At which of the following gestational ages does the
fetal heart first become audible with a Doppler stethoscope?
A. 6 to 8 weeks
B. 10 to 12 weeks
C. 16 to 18 weeks
D. 20 to 22 weeks
CORRECT ANSWER: B. 10 to 12 weeks
Rationale: The fetal heart tones are typically audible with a Doppler
stethoscope between 10 and 12 weeks gestation. At 6 to 8 weeks the heart
is developing but usually not detectable by Doppler, while 16 to 18 weeks
and beyond are later than the initial audible period, making 10 to 12 weeks
the correct answer.
Question 4: A nurse is assessing a client in the first trimester who
reports nausea and vomiting. Which of the following
recommendations should the nurse include in the teaching?
A. Drink large amounts of fluids with meals
B. Eat dry crackers before rising in the morning
C. Lie down immediately after eating
D. Skip breakfast to reduce stomach irritation
CORRECT ANSWER: B. Eat dry crackers before rising in the
morning
Rationale: Eating dry crackers before getting out of bed helps reduce
morning nausea by stabilizing blood glucose and reducing gastric irritation.
Drinking large volumes with meals, lying down immediately after eating,
and skipping meals can worsen nausea and vomiting and are not
recommended.
Question 5: A nurse is caring for a client who is receiving
magnesium sulfate for preeclampsia. Which of the following
findings indicates magnesium toxicity?
,A. Urine output of 50 mL/hr
B. Respiratory rate of 12/min
C. Absence of deep tendon reflexes
D. Blood pressure of 140/90 mm Hg
CORRECT ANSWER: C. Absence of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is an early sign of magnesium
sulfate toxicity, followed by respiratory depression and cardiac arrest. Urine
output of 50 mL/hr, respiratory rate of 12/min, and blood pressure 140/90
mm Hg do not specifically indicate toxicity, though respiratory rate below
12/min would be concerning.
Question 6: A nurse is preparing to administer Rho(D) immune
globulin to a client who is Rh-negative. Which of the following
criteria must be met before administration?
A. The client must be Rh-positive
B. The client must have a negative indirect Coombs test
C. The client must be at 40 weeks gestation
D. The client must have an elevated hematocrit
CORRECT ANSWER: B. The client must have a negative indirect
Coombs test
Rationale: Rho(D) immune globulin is given to Rh-negative clients who are
not already sensitized, which is confirmed by a negative indirect Coombs
test. Administering to an Rh-positive client is unnecessary, 40 weeks is not
a requirement, and hematocrit level is unrelated to Rho(D) immune globulin
administration.
Question 7: A nurse is monitoring a client in active labor. Which of
the following findings should the nurse identify as a reassuring
fetal heart rate pattern?
A. Late decelerations
B. Variable decelerations with a return to baseline
C. Fetal heart rate baseline of 110/min with moderate variability
D. Prolonged deceleration lasting 3 minutes
CORRECT ANSWER: C. Fetal heart rate baseline of 110/min with
moderate variability
, Rationale: A baseline fetal heart rate of 110/min with moderate variability
is a reassuring pattern indicating adequate fetal oxygenation and an intact
autonomic nervous system. Late decelerations, variable decelerations, and
prolonged decelerations are nonreassuring patterns requiring further
evaluation.
Question 8: A nurse is caring for a client who is 24 hours
postpartum and reports perineal pain. Which of the following
interventions should the nurse recommend?
A. Apply a warm compress to the perineum
B. Sit directly on the affected area
C. Use a sitz bath several times a day
D. Avoid analgesics to prevent masking infection
CORRECT ANSWER: C. Use a sitz bath several times a day
Rationale: Sitz baths promote perineal healing, increase circulation, and
reduce discomfort after delivery. Warm compresses are used during labor
rather than postpartum for pain, sitting directly on the area increases
pressure and pain, and analgesics are appropriate for postpartum pain
management.
Question 9: A nurse is assessing a newborn immediately after birth.
Which of the following findings should the nurse report to the
provider?
A. Acrocyanosis of the hands and feet
B. Heart rate of 120/min
C. Respiratory rate of 80/min with grunting
D. Vernix caseosa on the skin
CORRECT ANSWER: C. Respiratory rate of 80/min with grunting
Rationale: A respiratory rate of 80/min with grunting indicates respiratory
distress in a newborn and requires immediate provider notification.
Acrocyanosis, heart rate 120/min, and vernix caseosa are normal newborn
findings that do not require reporting.
Question 10: A nurse is teaching a client about breastfeeding.
Which of the following statements by the client indicates a need for
further teaching?
