ATI Maternal Newborn 2026/2027 | ATI RN Maternal-
Newborn Nursing Proctored Exam Study Guide & Practice
Questions | ATI Maternal Newborn Exam Prep, Pregnancy &
Prenatal Care, Antepartum Nursing, Labor & Delivery, Fetal
Monitoring, High-Risk Pregnancy, Obstetric Complications,
Postpartum Care, Newborn Assessment, Neonatal Nursing,
Breastfeeding, Maternal Medications, Newborn Medications,
Patient Education, Clinical Judgment, Prioritization, NGN-
Style Case Studies, NCLEX-Style Questions & Detailed
Rationales
Question 1: A nurse is assessing a client who is at 38 weeks of
gestation and 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
B. Check the fetal heart rate
C. Obtain a specimen for nitrazine testing
D. Position the client in a supine position
CORRECT ANSWER: B. Check the fetal heart rate
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being by checking the fetal
heart rate. This identifies potential umbilical cord prolapse or fetal distress,
which are life-threatening emergencies. Vaginal examination, nitrazine
testing, and positioning are important but secondary to confirming fetal
status.
Question 2: A nurse is caring for a client in the first stage of labor
who is experiencing contractions every 2 to 3 minutes. Which of
the following findings should the nurse report to the provider
immediately?
A. Maternal heart rate of 92/min
B. Fetal heart rate baseline of 140/min
C. Late decelerations on the fetal monitor
D. Maternal respiratory rate of 20/min
CORRECT ANSWER: C. Late decelerations on the fetal monitor
Rationale: Late decelerations are a nonreassuring fetal heart rate pattern
that indicates uteroplacental insufficiency. They require immediate
intervention such as repositioning, oxygen administration, and notification
,of the provider. The other findings are within normal limits and do not
require immediate reporting.
Question 3: A nurse is teaching a client who is at 10 weeks of
gestation about expected physiological changes during pregnancy.
Which of the following statements by the client indicates
understanding?
A. "I should expect my blood pressure to increase significantly."
B. "I may experience nasal congestion due to increased blood flow."
C. "My heart rate will decrease throughout pregnancy."
D. "I will urinate less frequently as pregnancy progresses."
CORRECT ANSWER: B. "I may experience nasal congestion due to
increased blood flow."
Rationale: Nasal congestion is a common physiological change in
pregnancy caused by increased estrogen and blood volume, which lead to
edema and vasodilation of the nasal mucosa. Blood pressure typically
remains stable or decreases slightly, heart rate increases, and urinary
frequency increases due to pressure on the bladder.
Question 4: A nurse is assessing a newborn immediately after
delivery. Which of the following findings should the nurse identify
as a sign of respiratory distress?
A. Respiratory rate of 40/min
B. Acrocyanosis of the hands and feet
C. Nasal flaring and grunting
D. Heart rate of 130/min
CORRECT ANSWER: C. Nasal flaring and grunting
Rationale: Nasal flaring, grunting, and intercostal retractions are classic
signs of respiratory distress in a newborn. A respiratory rate of 40/min,
acrocyanosis, and a heart rate of 130/min are normal newborn findings.
Question 5: A nurse is providing discharge teaching to a client who
is 24 hours postpartum following a vaginal delivery. Which of the
following instructions should the nurse include regarding perineal
care?
A. "Use a sitz bath for 30 minutes three times daily."
B. "Wipe from back to front after using the bathroom."
,C. "Apply ice packs to the perineum for the first 24 hours."
D. "Avoid using a peri-bottle until bleeding stops."
CORRECT ANSWER: C. "Apply ice packs to the perineum for the
first 24 hours."
Rationale: Ice packs are recommended during the first 24 hours
postpartum to reduce perineal edema and pain. Wiping should be front to
back to prevent infection. Sitz baths are typically used after 24 hours. A
peri-bottle should be used after each voiding to cleanse the perineum.
Question 6: A nurse is caring for a client who is receiving oxytocin
for induction of labor. Which of the following findings should the
nurse identify as a complication of oxytocin administration?
A. Contractions lasting 45 seconds
B. Uterine resting tone of 10 mm Hg
C. Contractions occurring every 3 minutes
D. Uterine hyperstimulation with fetal distress
CORRECT ANSWER: D. Uterine hyperstimulation with fetal distress
Rationale: Oxytocin can cause uterine hyperstimulation, defined as
contractions lasting longer than 90 seconds or occurring more frequently
than every 2 minutes, leading to fetal distress. The other findings are within
normal limits for labor.
Question 7: A nurse is assessing a client who is at 36 weeks of
gestation and reports a headache, blurred vision, and epigastric
pain. Which of the following conditions should the nurse suspect?
A. Gestational diabetes mellitus
B. Preeclampsia with severe features
C. Placenta previa
D. Hyperemesis gravidarum
CORRECT ANSWER: B. Preeclampsia with severe features
Rationale: Headache, visual disturbances, and epigastric pain are classic
signs of preeclampsia with severe features, indicating possible HELLP
syndrome or impending eclampsia. Gestational diabetes, placenta previa,
and hyperemesis gravidarum do not present with these symptoms.
, Question 8: A nurse is caring for a newborn who is 2 hours old and
has a blood glucose level of 40 mg/dL. Which of the following
actions should the nurse take?
A. Administer intravenous dextrose
B. Feed the newborn formula or breast milk
C. Recheck the glucose in 4 hours
D. Notify the provider immediately
CORRECT ANSWER: B. Feed the newborn formula or breast milk
Rationale: A blood glucose level below 45 mg/dL in a newborn indicates
hypoglycemia. For asymptomatic newborns with levels between 25 and 45
mg/dL, the initial intervention is to feed the newborn breast milk or
formula and recheck glucose in 30 to 60 minutes. IV dextrose is reserved
for symptomatic or severely hypoglycemic newborns.
Question 9: A nurse is teaching a client who is at 28 weeks of
gestation about fetal movement counting. Which of the following
instructions should the nurse include?
A. "Count fetal movements for 2 hours every morning."
B. "You should feel at least 10 movements in 2 hours."
C. "Call your provider if you feel fewer than 5 movements in 1 hour."
D. "Fetal movement counting is only needed after 36 weeks."
CORRECT ANSWER: B. "You should feel at least 10 movements in 2
hours."
Rationale: Fetal movement counting (kick counts) is typically performed
daily after 28 weeks. The client should feel at least 10 movements in 2
hours. If fewer than 10 movements are felt, the client should contact the
provider. Counting is not limited to mornings or after 36 weeks.
Question 10: A nurse is caring for a client who is in the second
stage of labor. Which of the following actions should the nurse take
to support the client during pushing?
A. Instruct the client to hold her breath for 20 seconds while pushing
B. Encourage the client to push with each contraction
C. Apply fundal pressure to assist with delivery
D. Position the client in a lithotomy position with legs flat
Newborn Nursing Proctored Exam Study Guide & Practice
Questions | ATI Maternal Newborn Exam Prep, Pregnancy &
Prenatal Care, Antepartum Nursing, Labor & Delivery, Fetal
Monitoring, High-Risk Pregnancy, Obstetric Complications,
Postpartum Care, Newborn Assessment, Neonatal Nursing,
Breastfeeding, Maternal Medications, Newborn Medications,
Patient Education, Clinical Judgment, Prioritization, NGN-
Style Case Studies, NCLEX-Style Questions & Detailed
Rationales
Question 1: A nurse is assessing a client who is at 38 weeks of
gestation and 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
B. Check the fetal heart rate
C. Obtain a specimen for nitrazine testing
D. Position the client in a supine position
CORRECT ANSWER: B. Check the fetal heart rate
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being by checking the fetal
heart rate. This identifies potential umbilical cord prolapse or fetal distress,
which are life-threatening emergencies. Vaginal examination, nitrazine
testing, and positioning are important but secondary to confirming fetal
status.
Question 2: A nurse is caring for a client in the first stage of labor
who is experiencing contractions every 2 to 3 minutes. Which of
the following findings should the nurse report to the provider
immediately?
A. Maternal heart rate of 92/min
B. Fetal heart rate baseline of 140/min
C. Late decelerations on the fetal monitor
D. Maternal respiratory rate of 20/min
CORRECT ANSWER: C. Late decelerations on the fetal monitor
Rationale: Late decelerations are a nonreassuring fetal heart rate pattern
that indicates uteroplacental insufficiency. They require immediate
intervention such as repositioning, oxygen administration, and notification
,of the provider. The other findings are within normal limits and do not
require immediate reporting.
Question 3: A nurse is teaching a client who is at 10 weeks of
gestation about expected physiological changes during pregnancy.
Which of the following statements by the client indicates
understanding?
A. "I should expect my blood pressure to increase significantly."
B. "I may experience nasal congestion due to increased blood flow."
C. "My heart rate will decrease throughout pregnancy."
D. "I will urinate less frequently as pregnancy progresses."
CORRECT ANSWER: B. "I may experience nasal congestion due to
increased blood flow."
Rationale: Nasal congestion is a common physiological change in
pregnancy caused by increased estrogen and blood volume, which lead to
edema and vasodilation of the nasal mucosa. Blood pressure typically
remains stable or decreases slightly, heart rate increases, and urinary
frequency increases due to pressure on the bladder.
Question 4: A nurse is assessing a newborn immediately after
delivery. Which of the following findings should the nurse identify
as a sign of respiratory distress?
A. Respiratory rate of 40/min
B. Acrocyanosis of the hands and feet
C. Nasal flaring and grunting
D. Heart rate of 130/min
CORRECT ANSWER: C. Nasal flaring and grunting
Rationale: Nasal flaring, grunting, and intercostal retractions are classic
signs of respiratory distress in a newborn. A respiratory rate of 40/min,
acrocyanosis, and a heart rate of 130/min are normal newborn findings.
Question 5: A nurse is providing discharge teaching to a client who
is 24 hours postpartum following a vaginal delivery. Which of the
following instructions should the nurse include regarding perineal
care?
A. "Use a sitz bath for 30 minutes three times daily."
B. "Wipe from back to front after using the bathroom."
,C. "Apply ice packs to the perineum for the first 24 hours."
D. "Avoid using a peri-bottle until bleeding stops."
CORRECT ANSWER: C. "Apply ice packs to the perineum for the
first 24 hours."
Rationale: Ice packs are recommended during the first 24 hours
postpartum to reduce perineal edema and pain. Wiping should be front to
back to prevent infection. Sitz baths are typically used after 24 hours. A
peri-bottle should be used after each voiding to cleanse the perineum.
Question 6: A nurse is caring for a client who is receiving oxytocin
for induction of labor. Which of the following findings should the
nurse identify as a complication of oxytocin administration?
A. Contractions lasting 45 seconds
B. Uterine resting tone of 10 mm Hg
C. Contractions occurring every 3 minutes
D. Uterine hyperstimulation with fetal distress
CORRECT ANSWER: D. Uterine hyperstimulation with fetal distress
Rationale: Oxytocin can cause uterine hyperstimulation, defined as
contractions lasting longer than 90 seconds or occurring more frequently
than every 2 minutes, leading to fetal distress. The other findings are within
normal limits for labor.
Question 7: A nurse is assessing a client who is at 36 weeks of
gestation and reports a headache, blurred vision, and epigastric
pain. Which of the following conditions should the nurse suspect?
A. Gestational diabetes mellitus
B. Preeclampsia with severe features
C. Placenta previa
D. Hyperemesis gravidarum
CORRECT ANSWER: B. Preeclampsia with severe features
Rationale: Headache, visual disturbances, and epigastric pain are classic
signs of preeclampsia with severe features, indicating possible HELLP
syndrome or impending eclampsia. Gestational diabetes, placenta previa,
and hyperemesis gravidarum do not present with these symptoms.
, Question 8: A nurse is caring for a newborn who is 2 hours old and
has a blood glucose level of 40 mg/dL. Which of the following
actions should the nurse take?
A. Administer intravenous dextrose
B. Feed the newborn formula or breast milk
C. Recheck the glucose in 4 hours
D. Notify the provider immediately
CORRECT ANSWER: B. Feed the newborn formula or breast milk
Rationale: A blood glucose level below 45 mg/dL in a newborn indicates
hypoglycemia. For asymptomatic newborns with levels between 25 and 45
mg/dL, the initial intervention is to feed the newborn breast milk or
formula and recheck glucose in 30 to 60 minutes. IV dextrose is reserved
for symptomatic or severely hypoglycemic newborns.
Question 9: A nurse is teaching a client who is at 28 weeks of
gestation about fetal movement counting. Which of the following
instructions should the nurse include?
A. "Count fetal movements for 2 hours every morning."
B. "You should feel at least 10 movements in 2 hours."
C. "Call your provider if you feel fewer than 5 movements in 1 hour."
D. "Fetal movement counting is only needed after 36 weeks."
CORRECT ANSWER: B. "You should feel at least 10 movements in 2
hours."
Rationale: Fetal movement counting (kick counts) is typically performed
daily after 28 weeks. The client should feel at least 10 movements in 2
hours. If fewer than 10 movements are felt, the client should contact the
provider. Counting is not limited to mornings or after 36 weeks.
Question 10: A nurse is caring for a client who is in the second
stage of labor. Which of the following actions should the nurse take
to support the client during pushing?
A. Instruct the client to hold her breath for 20 seconds while pushing
B. Encourage the client to push with each contraction
C. Apply fundal pressure to assist with delivery
D. Position the client in a lithotomy position with legs flat
