ATI RN Maternal Newborn Practice Test 2026/2027
| ATI Maternal Newborn Nursing Study Guide,
Practice Questions & Answers, Pregnancy, Labor &
Delivery, Postpartum, Newborn Care, Complications
& NCLEX-RN Exam Prep
Question 1: A nurse is assessing a client at 36 weeks of 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
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 positioning, because cord compression
can rapidly compromise fetal oxygenation.
Question 2: A nurse is caring for a client in the first stage of labor who is
experiencing contractions every 2 minutes lasting 60 seconds. The
fetal monitor reveals late decelerations. Which of the following
findings should the nurse identify as the priority?
A. Respiratory rate of 22/min
B. Fetal heart rate of 110/min with late decelerations
C. Maternal heart rate of 100/min
D. Blood pressure of 130/80 mm Hg
CORRECT ANSWER: B. Fetal heart rate of 110/min with late
decelerations
Rationale: Late decelerations indicate uteroplacental insufficiency and are
a nonreassuring fetal heart rate pattern requiring immediate intervention.
The nurse should reposition the client, administer oxygen, increase IV
fluids, and notify the provider. Maternal vital signs are important but do not
take priority over signs of fetal compromise.
,Question 3: A nurse is teaching a client at 12 weeks of gestation about
expected physiological changes. Which of the following statements by
the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "I may notice my gums bleeding when I brush my teeth."
C. "My hemoglobin level will increase during pregnancy."
D. "I will have less vaginal discharge than before pregnancy."
CORRECT ANSWER: B. "I may notice my gums bleeding when I brush
my teeth."
Rationale: Gingival hyperemia and bleeding are common during pregnancy
due to increased estrogen and blood flow to mucous membranes. Blood
pressure typically decreases slightly in the second trimester, hemoglobin
levels decrease due to hemodilution, and vaginal discharge (leukorrhea)
increases during pregnancy.
Question 4: A nurse is caring for a client who is 2 hours postpartum and
has a boggy uterus with heavy lochia. Which of the following actions
should the nurse take first?
A. Administer methylergonovine
B. Perform fundal massage
C. Increase the IV oxytocin rate
D. Notify the provider
CORRECT ANSWER: B. Perform fundal massage
Rationale: A boggy uterus indicates uterine atony, the most common cause
of postpartum hemorrhage. The first action is to massage the fundus to
stimulate uterine contraction. If massage is ineffective, then medications
such as oxytocin or methylergonovine may be administered, and the
provider notified.
Question 5: A nurse is assessing a newborn 1 minute after birth. The
newborn has a heart rate of 110/min, a weak cry, some flexion of
extremities, a grimace when stimulated, and a blue body with pink
extremities. What Apgar score should the nurse assign?
A. 4
B. 5
,C. 6
D. 7
CORRECT ANSWER: C. 6
Rationale: Apgar scoring: Heart rate 110 = 2 points; weak cry = 1 point;
some flexion = 1 point; grimace = 1 point; blue body with pink extremities
(acrocyanosis) = 1 point. Total = 6. This indicates moderate depression
requiring stimulation and monitoring.
Question 6: A nurse is reviewing the medical record of a client at 28
weeks of gestation who has gestational diabetes. Which of the
following findings should the nurse report to the provider?
A. Fasting blood glucose of 90 mg/dL
B. 1-hour glucose tolerance test of 150 mg/dL
C. Fetal heart rate of 140/min
D. Blood pressure of 118/76 mm Hg
CORRECT ANSWER: B. 1-hour glucose tolerance test of 150 mg/dL
Rationale: A 1-hour glucose challenge result of 150 mg/dL is elevated and
suggests gestational diabetes mellitus requiring further evaluation. Fasting
blood glucose of 90 mg/dL, fetal heart rate of 140/min, and blood pressure
of 118/76 mm Hg are within acceptable ranges for pregnancy.
Question 7: A nurse is teaching a client 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. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
CORRECT ANSWER: C. "I may experience nasal stuffiness due to
increased blood flow."
Rationale: During pregnancy, increased estrogen levels and vascular
congestion cause nasal mucosa swelling, leading to nasal stuffiness and
epistaxis. Blood pressure typically remains stable or slightly decreases,
heart rate increases, and hemoglobin levels decrease due to hemodilution.
, Question 8: A nurse is assessing a newborn immediately after birth.
Which of the following findings should the nurse report to the provider?
A. Heart rate of 130/min
B. Respiratory rate of 50/min
C. Central cyanosis
D. Acrocyanosis
CORRECT ANSWER: C. Central cyanosis
Rationale: Central cyanosis involving the trunk and mucous membranes
indicates inadequate oxygenation and requires immediate intervention.
Acrocyanosis (bluish extremities) is a normal finding in the first hours after
birth. A heart rate of 130/min and respiratory rate of 50/min are within
normal newborn ranges.
Question 9: A nurse is caring for a client in the first stage of labor who is
experiencing contractions every 3 minutes lasting 60 seconds. The
client reports intense pain. Which of the following nonpharmacological
interventions should the nurse suggest first?
A. Administer an epidural
B. Encourage slow, patterned breathing
C. Provide IV opioid analgesia
D. Restrict oral intake
CORRECT ANSWER: B. Encourage slow, patterned breathing
Rationale: Slow, patterned breathing is a nonpharmacological comfort
measure that promotes relaxation and reduces pain perception during
labor. Epidurals and IV opioids are pharmacological interventions.
Restricting oral intake does not address pain.
Question 10: A nurse is reviewing the medical record of a client at 36
weeks of gestation. Which of the following findings should the nurse
identify as a risk factor for postpartum hemorrhage?
A. Previous vaginal delivery
B. History of placenta previa
C. Maternal age of 25 years
D. Singleton pregnancy
CORRECT ANSWER: B. History of placenta previa
| ATI Maternal Newborn Nursing Study Guide,
Practice Questions & Answers, Pregnancy, Labor &
Delivery, Postpartum, Newborn Care, Complications
& NCLEX-RN Exam Prep
Question 1: A nurse is assessing a client at 36 weeks of 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
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 positioning, because cord compression
can rapidly compromise fetal oxygenation.
Question 2: A nurse is caring for a client in the first stage of labor who is
experiencing contractions every 2 minutes lasting 60 seconds. The
fetal monitor reveals late decelerations. Which of the following
findings should the nurse identify as the priority?
A. Respiratory rate of 22/min
B. Fetal heart rate of 110/min with late decelerations
C. Maternal heart rate of 100/min
D. Blood pressure of 130/80 mm Hg
CORRECT ANSWER: B. Fetal heart rate of 110/min with late
decelerations
Rationale: Late decelerations indicate uteroplacental insufficiency and are
a nonreassuring fetal heart rate pattern requiring immediate intervention.
The nurse should reposition the client, administer oxygen, increase IV
fluids, and notify the provider. Maternal vital signs are important but do not
take priority over signs of fetal compromise.
,Question 3: A nurse is teaching a client at 12 weeks of gestation about
expected physiological changes. Which of the following statements by
the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "I may notice my gums bleeding when I brush my teeth."
C. "My hemoglobin level will increase during pregnancy."
D. "I will have less vaginal discharge than before pregnancy."
CORRECT ANSWER: B. "I may notice my gums bleeding when I brush
my teeth."
Rationale: Gingival hyperemia and bleeding are common during pregnancy
due to increased estrogen and blood flow to mucous membranes. Blood
pressure typically decreases slightly in the second trimester, hemoglobin
levels decrease due to hemodilution, and vaginal discharge (leukorrhea)
increases during pregnancy.
Question 4: A nurse is caring for a client who is 2 hours postpartum and
has a boggy uterus with heavy lochia. Which of the following actions
should the nurse take first?
A. Administer methylergonovine
B. Perform fundal massage
C. Increase the IV oxytocin rate
D. Notify the provider
CORRECT ANSWER: B. Perform fundal massage
Rationale: A boggy uterus indicates uterine atony, the most common cause
of postpartum hemorrhage. The first action is to massage the fundus to
stimulate uterine contraction. If massage is ineffective, then medications
such as oxytocin or methylergonovine may be administered, and the
provider notified.
Question 5: A nurse is assessing a newborn 1 minute after birth. The
newborn has a heart rate of 110/min, a weak cry, some flexion of
extremities, a grimace when stimulated, and a blue body with pink
extremities. What Apgar score should the nurse assign?
A. 4
B. 5
,C. 6
D. 7
CORRECT ANSWER: C. 6
Rationale: Apgar scoring: Heart rate 110 = 2 points; weak cry = 1 point;
some flexion = 1 point; grimace = 1 point; blue body with pink extremities
(acrocyanosis) = 1 point. Total = 6. This indicates moderate depression
requiring stimulation and monitoring.
Question 6: A nurse is reviewing the medical record of a client at 28
weeks of gestation who has gestational diabetes. Which of the
following findings should the nurse report to the provider?
A. Fasting blood glucose of 90 mg/dL
B. 1-hour glucose tolerance test of 150 mg/dL
C. Fetal heart rate of 140/min
D. Blood pressure of 118/76 mm Hg
CORRECT ANSWER: B. 1-hour glucose tolerance test of 150 mg/dL
Rationale: A 1-hour glucose challenge result of 150 mg/dL is elevated and
suggests gestational diabetes mellitus requiring further evaluation. Fasting
blood glucose of 90 mg/dL, fetal heart rate of 140/min, and blood pressure
of 118/76 mm Hg are within acceptable ranges for pregnancy.
Question 7: A nurse is teaching a client 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. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
CORRECT ANSWER: C. "I may experience nasal stuffiness due to
increased blood flow."
Rationale: During pregnancy, increased estrogen levels and vascular
congestion cause nasal mucosa swelling, leading to nasal stuffiness and
epistaxis. Blood pressure typically remains stable or slightly decreases,
heart rate increases, and hemoglobin levels decrease due to hemodilution.
, Question 8: A nurse is assessing a newborn immediately after birth.
Which of the following findings should the nurse report to the provider?
A. Heart rate of 130/min
B. Respiratory rate of 50/min
C. Central cyanosis
D. Acrocyanosis
CORRECT ANSWER: C. Central cyanosis
Rationale: Central cyanosis involving the trunk and mucous membranes
indicates inadequate oxygenation and requires immediate intervention.
Acrocyanosis (bluish extremities) is a normal finding in the first hours after
birth. A heart rate of 130/min and respiratory rate of 50/min are within
normal newborn ranges.
Question 9: A nurse is caring for a client in the first stage of labor who is
experiencing contractions every 3 minutes lasting 60 seconds. The
client reports intense pain. Which of the following nonpharmacological
interventions should the nurse suggest first?
A. Administer an epidural
B. Encourage slow, patterned breathing
C. Provide IV opioid analgesia
D. Restrict oral intake
CORRECT ANSWER: B. Encourage slow, patterned breathing
Rationale: Slow, patterned breathing is a nonpharmacological comfort
measure that promotes relaxation and reduces pain perception during
labor. Epidurals and IV opioids are pharmacological interventions.
Restricting oral intake does not address pain.
Question 10: A nurse is reviewing the medical record of a client at 36
weeks of gestation. Which of the following findings should the nurse
identify as a risk factor for postpartum hemorrhage?
A. Previous vaginal delivery
B. History of placenta previa
C. Maternal age of 25 years
D. Singleton pregnancy
CORRECT ANSWER: B. History of placenta previa
