ATI Maternal Newborn Practice Tests 2026/2027 | ACTUAL-Style
ATI RN Proctored Exam Practice Questions & Answers, Maternal-
Newborn Nursing Study Guide, Pregnancy Complications,
Antepartum Assessment, Labor and Delivery, Fetal Heart Rate
Monitoring, Postpartum Care, Newborn Assessment,
Breastfeeding, Clinical Judgment, and Detailed Rationales
Question 1: A nurse is caring for a client at 38 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 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 of 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 a positive direct Coombs test
CORRECT ANSWER: B. The client must have a negative indirect
Coombs test
Rationale: Rho(D) immune globulin is administered to Rh-negative clients
who are not already sensitized to Rh-positive blood. A negative indirect
Coombs test confirms the absence of Rh antibodies, ensuring the client is
not already sensitized. Administering to an Rh-positive client or one with a
positive Coombs test would be inappropriate.
Question 7: A nurse is teaching a client at 10 weeks' 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' 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 RN Proctored Exam Practice Questions & Answers, Maternal-
Newborn Nursing Study Guide, Pregnancy Complications,
Antepartum Assessment, Labor and Delivery, Fetal Heart Rate
Monitoring, Postpartum Care, Newborn Assessment,
Breastfeeding, Clinical Judgment, and Detailed Rationales
Question 1: A nurse is caring for a client at 38 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 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 of 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 a positive direct Coombs test
CORRECT ANSWER: B. The client must have a negative indirect
Coombs test
Rationale: Rho(D) immune globulin is administered to Rh-negative clients
who are not already sensitized to Rh-positive blood. A negative indirect
Coombs test confirms the absence of Rh antibodies, ensuring the client is
not already sensitized. Administering to an Rh-positive client or one with a
positive Coombs test would be inappropriate.
Question 7: A nurse is teaching a client at 10 weeks' 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' 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
