ATI PN Maternal Newborn Practice Test
2026/2027 | ATI PN Maternal-Newborn
Nursing Study Guide, Practice Questions &
Answers, Antepartum, Intrapartum,
Postpartum, Newborn Care, Pregnancy
Complications & Comprehensive Exam Prep
Question 1: A nurse is assessing a client who is at 34 weeks of gestation
and is receiving magnesium sulfate for preeclampsia. Which of the
following findings should the nurse report to the provider?
A. Deep tendon reflexes 2+
B. Urine output 20 mL/hr
C. Respiratory rate 14/min
D. Magnesium level 6 mEq/L
CORRECT ANSWER: B. Urine output 20 mL/hr
Rationale: A urine output of less than 30 mL/hr is a sign of magnesium
toxicity because the medication is excreted by the kidneys. Deep tendon
reflexes of 2+ and a respiratory rate of 14/min are within normal limits for a
client receiving this medication. A magnesium level of 6 mEq/L is within the
therapeutic range for seizure prophylaxis in preeclampsia.
Question 2: A nurse is caring for a client who is in the first stage of labor
and has an internal fetal scalp electrode. The nurse observes late
decelerations on the monitor. Which of the following actions should
the nurse take first?
A. Increase the rate of the maintenance IV fluid
B. Change the client's position to a side-lying position
C. Administer oxygen via nonrebreather mask at 10 L/min
D. Notify the healthcare provider
CORRECT ANSWER: B. Change the client's position to a side-lying
position
Rationale: According to the nursing process, the nurse should first
implement the least invasive intervention to improve placental perfusion.
Changing the client's position to a side-lying position helps alleviate
pressure on the vena cava and improves blood flow to the placenta. While
oxygen administration and IV fluids are appropriate later steps,
repositioning is the immediate priority.
,Question 3: A nurse is providing discharge teaching to a client who is
postpartum and has a prescription for a rubella immunization. Which
of the following instructions should the nurse include?
A. The vaccine should be repeated in 3 months.
B. Do not breastfeed for 48 hours following the injection.
C. Expect a low-grade fever for the next week.
D. Avoid becoming pregnant for at least 28 days.
CORRECT ANSWER: D. Avoid becoming pregnant for at least 28 days.
Rationale: The rubella vaccine is a live virus and is teratogenic, meaning it
can cause birth defects if the client becomes pregnant shortly after
receiving it. Clients are advised to avoid pregnancy for at least 4 weeks (28
days) post-vaccination. Breastfeeding is not contraindicated with the
rubella vaccine, and a repeat dose is generally not required unless the
client remains non-immune.
Question 4: A nurse is assessing a newborn 1 hour after birth. Which of
the following findings should the nurse identify as a manifestation of
respiratory distress?
A. Nasal flaring
B. Acrocyanosis
C. Grunting
D. Chest retractions
CORRECT ANSWER: A. Nasal flaring, C. Grunting, D. Chest retractions
Rationale: Nasal flaring, grunting, and chest retractions are classic signs of
respiratory distress in a newborn and indicate the infant is working harder
to breathe. Acrocyanosis (bluish hands and feet) is a normal finding in the
first 24 to 48 hours of life due to peripheral circulation adjustments. A
respiratory rate of 50/min and abdominal breathing are normal findings for
a healthy newborn.
Question 5: A nurse is caring for a client who is at 38 weeks of gestation
and reports abdominal pain and vaginal bleeding. Which of the
following assessments is the priority?
A. Check maternal blood pressure
B. Assess fetal heart rate
,C. Determine the amount of vaginal bleeding
D. Perform a vaginal examination
CORRECT ANSWER: B. Assess fetal heart rate
Rationale: In the event of suspected abruptio placentae or placenta previa,
assessing fetal well-being is the primary concern to determine if immediate
delivery is necessary. Checking maternal vitals and bleeding amounts are
important but follow the assessment of fetal heart tones. Vaginal
examinations are contraindicated in the presence of unexplained vaginal
bleeding until placenta previa is ruled out.
Question 6: A nurse is assessing a client at 12 weeks of gestation for
signs of hyperemesis gravidarum. Which finding supports this
diagnosis?
A. Nausea only in the morning.
B. Weight loss of 6% of pre-pregnancy weight.
C. Vomiting once daily.
D. Serum potassium of 4.2 mEq/L.
CORRECT ANSWER: B. Weight loss of 6% of pre-pregnancy weight.
Rationale: Hyperemesis gravidarum is characterized by severe, persistent
vomiting causing >5% prepregnancy weight loss, dehydration, electrolyte
imbalances (e.g., hypokalemia), and ketonuria. Morning nausea with
minimal vomiting is common in normal pregnancy. A serum potassium of
4.2 mEq/L is within normal limits.
Question 7: A nurse teaches a client with pregestational diabetes about
glycemic goals during pregnancy. Which target is correct?
A. Fasting blood glucose 110-130 mg/dL.
B. 1-hour postprandial < 140 mg/dL.
C. HbA1c less than 8%.
D. Bedtime glucose < 60 mg/dL.
CORRECT ANSWER: B. 1-hour postprandial < 140 mg/dL.
Rationale: Recommended targets: fasting 70-95 mg/dL, 1-hour
postprandial < 140 mg/dL, 2-hour < 120 mg/dL. HbA1c goal is < 6-6.5%
(ideally < 6%) to reduce congenital anomalies and perinatal complications.
, Question 8: A nurse performs a nonstress test at 32 weeks for a client
with oligohydramnios. The fetal heart rate tracing shows two
accelerations of 20 bpm lasting 20 seconds in 20 minutes. How should
the nurse document this result?
A. Reactive nonstress test.
B. Nonreactive nonstress test.
C. Positive contraction stress test.
D. Equivocal test.
CORRECT ANSWER: A. Reactive nonstress test.
Rationale: A reactive NST at ≥32 weeks requires ≥2 accelerations of ≥15
bpm (moderate variability) lasting ≥15 seconds within 20 minutes. This
tracing meets criteria; no further testing is immediately needed unless
other risks exist.
Question 9: A client at 30 weeks asks about the Tdap vaccine. Which
response is accurate?
A. "You should receive Tdap in the third trimester of every pregnancy."
B. "Tdap is only recommended if you never received it as a child."
C. "The vaccine can cause autism in your baby."
D. "You will receive Tdap immediately after delivery instead of during
pregnancy."
CORRECT ANSWER: A. "You should receive Tdap in the third trimester
of every pregnancy."
Rationale: ACOG recommends Tdap between 27-36 weeks of each
pregnancy to maximize passive antibody transfer to the fetus, protecting
the newborn against pertussis. Vaccine safety is well established; no
association with autism.
Question 10: A nurse is caring for a client who has hyperemesis
gravidarum and is receiving IV fluid replacement. Which of the
following findings should the nurse report to the provider?
A. Blood pressure 105/64 mmHg
B. Heart rate 98/min
C. Urine output of 280 ml within 8 hr
D. Urine negative for ketones
2026/2027 | ATI PN Maternal-Newborn
Nursing Study Guide, Practice Questions &
Answers, Antepartum, Intrapartum,
Postpartum, Newborn Care, Pregnancy
Complications & Comprehensive Exam Prep
Question 1: A nurse is assessing a client who is at 34 weeks of gestation
and is receiving magnesium sulfate for preeclampsia. Which of the
following findings should the nurse report to the provider?
A. Deep tendon reflexes 2+
B. Urine output 20 mL/hr
C. Respiratory rate 14/min
D. Magnesium level 6 mEq/L
CORRECT ANSWER: B. Urine output 20 mL/hr
Rationale: A urine output of less than 30 mL/hr is a sign of magnesium
toxicity because the medication is excreted by the kidneys. Deep tendon
reflexes of 2+ and a respiratory rate of 14/min are within normal limits for a
client receiving this medication. A magnesium level of 6 mEq/L is within the
therapeutic range for seizure prophylaxis in preeclampsia.
Question 2: A nurse is caring for a client who is in the first stage of labor
and has an internal fetal scalp electrode. The nurse observes late
decelerations on the monitor. Which of the following actions should
the nurse take first?
A. Increase the rate of the maintenance IV fluid
B. Change the client's position to a side-lying position
C. Administer oxygen via nonrebreather mask at 10 L/min
D. Notify the healthcare provider
CORRECT ANSWER: B. Change the client's position to a side-lying
position
Rationale: According to the nursing process, the nurse should first
implement the least invasive intervention to improve placental perfusion.
Changing the client's position to a side-lying position helps alleviate
pressure on the vena cava and improves blood flow to the placenta. While
oxygen administration and IV fluids are appropriate later steps,
repositioning is the immediate priority.
,Question 3: A nurse is providing discharge teaching to a client who is
postpartum and has a prescription for a rubella immunization. Which
of the following instructions should the nurse include?
A. The vaccine should be repeated in 3 months.
B. Do not breastfeed for 48 hours following the injection.
C. Expect a low-grade fever for the next week.
D. Avoid becoming pregnant for at least 28 days.
CORRECT ANSWER: D. Avoid becoming pregnant for at least 28 days.
Rationale: The rubella vaccine is a live virus and is teratogenic, meaning it
can cause birth defects if the client becomes pregnant shortly after
receiving it. Clients are advised to avoid pregnancy for at least 4 weeks (28
days) post-vaccination. Breastfeeding is not contraindicated with the
rubella vaccine, and a repeat dose is generally not required unless the
client remains non-immune.
Question 4: A nurse is assessing a newborn 1 hour after birth. Which of
the following findings should the nurse identify as a manifestation of
respiratory distress?
A. Nasal flaring
B. Acrocyanosis
C. Grunting
D. Chest retractions
CORRECT ANSWER: A. Nasal flaring, C. Grunting, D. Chest retractions
Rationale: Nasal flaring, grunting, and chest retractions are classic signs of
respiratory distress in a newborn and indicate the infant is working harder
to breathe. Acrocyanosis (bluish hands and feet) is a normal finding in the
first 24 to 48 hours of life due to peripheral circulation adjustments. A
respiratory rate of 50/min and abdominal breathing are normal findings for
a healthy newborn.
Question 5: A nurse is caring for a client who is at 38 weeks of gestation
and reports abdominal pain and vaginal bleeding. Which of the
following assessments is the priority?
A. Check maternal blood pressure
B. Assess fetal heart rate
,C. Determine the amount of vaginal bleeding
D. Perform a vaginal examination
CORRECT ANSWER: B. Assess fetal heart rate
Rationale: In the event of suspected abruptio placentae or placenta previa,
assessing fetal well-being is the primary concern to determine if immediate
delivery is necessary. Checking maternal vitals and bleeding amounts are
important but follow the assessment of fetal heart tones. Vaginal
examinations are contraindicated in the presence of unexplained vaginal
bleeding until placenta previa is ruled out.
Question 6: A nurse is assessing a client at 12 weeks of gestation for
signs of hyperemesis gravidarum. Which finding supports this
diagnosis?
A. Nausea only in the morning.
B. Weight loss of 6% of pre-pregnancy weight.
C. Vomiting once daily.
D. Serum potassium of 4.2 mEq/L.
CORRECT ANSWER: B. Weight loss of 6% of pre-pregnancy weight.
Rationale: Hyperemesis gravidarum is characterized by severe, persistent
vomiting causing >5% prepregnancy weight loss, dehydration, electrolyte
imbalances (e.g., hypokalemia), and ketonuria. Morning nausea with
minimal vomiting is common in normal pregnancy. A serum potassium of
4.2 mEq/L is within normal limits.
Question 7: A nurse teaches a client with pregestational diabetes about
glycemic goals during pregnancy. Which target is correct?
A. Fasting blood glucose 110-130 mg/dL.
B. 1-hour postprandial < 140 mg/dL.
C. HbA1c less than 8%.
D. Bedtime glucose < 60 mg/dL.
CORRECT ANSWER: B. 1-hour postprandial < 140 mg/dL.
Rationale: Recommended targets: fasting 70-95 mg/dL, 1-hour
postprandial < 140 mg/dL, 2-hour < 120 mg/dL. HbA1c goal is < 6-6.5%
(ideally < 6%) to reduce congenital anomalies and perinatal complications.
, Question 8: A nurse performs a nonstress test at 32 weeks for a client
with oligohydramnios. The fetal heart rate tracing shows two
accelerations of 20 bpm lasting 20 seconds in 20 minutes. How should
the nurse document this result?
A. Reactive nonstress test.
B. Nonreactive nonstress test.
C. Positive contraction stress test.
D. Equivocal test.
CORRECT ANSWER: A. Reactive nonstress test.
Rationale: A reactive NST at ≥32 weeks requires ≥2 accelerations of ≥15
bpm (moderate variability) lasting ≥15 seconds within 20 minutes. This
tracing meets criteria; no further testing is immediately needed unless
other risks exist.
Question 9: A client at 30 weeks asks about the Tdap vaccine. Which
response is accurate?
A. "You should receive Tdap in the third trimester of every pregnancy."
B. "Tdap is only recommended if you never received it as a child."
C. "The vaccine can cause autism in your baby."
D. "You will receive Tdap immediately after delivery instead of during
pregnancy."
CORRECT ANSWER: A. "You should receive Tdap in the third trimester
of every pregnancy."
Rationale: ACOG recommends Tdap between 27-36 weeks of each
pregnancy to maximize passive antibody transfer to the fetus, protecting
the newborn against pertussis. Vaccine safety is well established; no
association with autism.
Question 10: A nurse is caring for a client who has hyperemesis
gravidarum and is receiving IV fluid replacement. Which of the
following findings should the nurse report to the provider?
A. Blood pressure 105/64 mmHg
B. Heart rate 98/min
C. Urine output of 280 ml within 8 hr
D. Urine negative for ketones
