ATI Maternal Newborn Maternity & Obstetric Nursing 2026/2027
| ACTUAL-Style Practice Questions & Answers, ATI RN Exam Prep,
Prenatal Care, Pregnancy Complications, Labor and Delivery, Fetal
Monitoring, Postpartum Nursing, Newborn Care, and Detailed
Rationales
Question 1: A client at 38 weeks gestation reports a sudden gush of
fluid from the vagina. Which assessment should the nurse perform
first?
A. Check the fetal heart rate
B. Perform a sterile vaginal examination
C. Assess the color and odor of the fluid
D. Obtain a maternal blood pressure
CORRECT ANSWER: A. Check the fetal heart rate
Rationale: When rupture of membranes occurs, the priority nursing action
is to assess fetal well-being by checking the fetal heart rate for signs of
distress, such as variable decelerations from cord compression. Vaginal
examination is contraindicated until placenta previa is ruled out and
should not be the first action. Assessing fluid characteristics and maternal
vital signs are important but secondary to fetal assessment.
Question 2: A nurse is teaching a client about fetal development. At
which gestational age does the fetal heart begin to beat?
A. 2 weeks
B. 4 weeks
C. 8 weeks
D. 12 weeks
CORRECT ANSWER: B. 4 weeks
Rationale: The fetal heart begins to beat at approximately 4 weeks (22–28
days) of gestation. By 8 weeks, all major organs are formed, and the heart
has four chambers. Twelve weeks marks the beginning of the second
trimester, and 2 weeks is too early for cardiac development.
Question 3: A client in the first trimester reports nausea and vomiting.
Which instruction should the nurse provide?
A. Eat three large meals daily
B. Drink fluids with meals
,C. Eat dry crackers before rising
D. Avoid protein-rich foods
CORRECT ANSWER: C. Eat dry crackers before rising
Rationale: Eating dry crackers before rising helps reduce morning nausea
because it prevents an empty stomach, which can trigger nausea. Small
frequent meals are recommended rather than three large meals. Fluids
should be taken between meals, not with meals, to reduce stomach
distention. Protein-rich foods are encouraged, not avoided.
Question 4: A nurse is assessing a client at 36 weeks gestation. Which
finding should the nurse report immediately?
A. Braxton Hicks contractions
B. Visual disturbances and epigastric pain
C. Mild ankle edema
D. Urinary frequency
CORRECT ANSWER: B. Visual disturbances and epigastric pain
Rationale: Visual disturbances and epigastric pain are classic warning
signs of preeclampsia with severe features, indicating possible hepatic
involvement and impending seizures. Braxton Hicks contractions, mild
ankle edema, and urinary frequency are common expected discomforts of
late pregnancy.
Question 5: A client is receiving magnesium sulfate for preeclampsia.
Which assessment finding indicates magnesium toxicity?
A. Blood pressure 138/88 mm Hg
B. Respiratory rate 10/min
C. Deep tendon reflexes 2+
D. Urine output 40 mL/hr
CORRECT ANSWER: B. Respiratory rate 10/min
Rationale: A respiratory rate below 12/min is an early sign of magnesium
sulfate toxicity, which can progress to respiratory depression and cardiac
arrest. Deep tendon reflexes should be monitored; loss of reflexes
precedes respiratory depression. Urine output must remain at least 30
mL/hr to prevent accumulation. Blood pressure of 138/88 is not indicative
of toxicity.
,Question 6: A nurse is caring for a client in active labor. The fetal heart
rate tracing shows late decelerations. Which action should the nurse
take first?
A. Increase the oxytocin infusion rate
B. Reposition the client to the left lateral position
C. Prepare for immediate delivery
D. Document the finding and continue monitoring
CORRECT ANSWER: B. Reposition the client to the left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency. The
first nursing action is to reposition the client to the left lateral position to
improve uteroplacental blood flow. Increasing oxytocin would worsen the
condition. Preparing for delivery may be necessary if the pattern persists,
but repositioning is the immediate first action. Documentation is important
but not the priority.
Question 7: A postpartum client is at risk for hemorrhage. Which
medication should the nurse anticipate administering to prevent
uterine atony?
A. Methylergonovine
B. Oxytocin
C. Magnesium sulfate
D. Betamethasone
CORRECT ANSWER: B. Oxytocin
Rationale: Oxytocin is the first-line medication for prevention and
treatment of uterine atony, which is the most common cause of
postpartum hemorrhage. Methylergonovine is also used but is
contraindicated in hypertension. Magnesium sulfate is used for
preeclampsia, not hemorrhage. Betamethasone is a corticosteroid used for
fetal lung maturity.
Question 8: A nurse is assessing a newborn immediately after delivery.
Which finding requires immediate intervention?
A. Heart rate 130/min
B. Respiratory rate 50/min
C. Acrocyanosis
D. Grunting and nasal flaring
, CORRECT ANSWER: D. Grunting and nasal flaring
Rationale: Grunting and nasal flaring are signs of respiratory distress in the
newborn and require immediate intervention, such as suctioning and
oxygen administration. A heart rate of 130/min and respiratory rate of
50/min are within normal limits. Acrocyanosis (bluish hands and feet) is a
normal finding in the first few hours after birth.
Question 9: A client at 32 weeks gestation is diagnosed with placenta
previa. Which nursing intervention is appropriate?
A. Perform vaginal examinations every 4 hours
B. Encourage ambulation
C. Monitor for painless vaginal bleeding
D. Administer oxytocin
CORRECT ANSWER: C. Monitor for painless vaginal bleeding
Rationale: Placenta previa typically presents with painless, bright red
vaginal bleeding in the third trimester. Vaginal examinations are
contraindicated because they can cause severe hemorrhage. Ambulation
is restricted, and oxytocin is contraindicated. Monitoring for bleeding is the
priority nursing intervention.
Question 10: A nurse is teaching a client about breastfeeding. Which
statement indicates the client understands the teaching?
A. "I should feed my baby every 4 hours."
B. "I should wake my baby if he sleeps longer than 3 hours."
C. "I should give my baby water between feedings."
D. "I should limit feedings to 10 minutes per breast."
CORRECT ANSWER: B. "I should wake my baby if he sleeps longer than
3 hours."
Rationale: Newborns should breastfeed every 2–3 hours, and if they sleep
longer than 3 hours, they should be awakened to feed to prevent
hypoglycemia and ensure adequate intake. Feeding every 4 hours is too
infrequent. Water supplementation is not recommended for breastfed
newborns. Feedings should not be limited by time; the baby should feed
until satisfied.
| ACTUAL-Style Practice Questions & Answers, ATI RN Exam Prep,
Prenatal Care, Pregnancy Complications, Labor and Delivery, Fetal
Monitoring, Postpartum Nursing, Newborn Care, and Detailed
Rationales
Question 1: A client at 38 weeks gestation reports a sudden gush of
fluid from the vagina. Which assessment should the nurse perform
first?
A. Check the fetal heart rate
B. Perform a sterile vaginal examination
C. Assess the color and odor of the fluid
D. Obtain a maternal blood pressure
CORRECT ANSWER: A. Check the fetal heart rate
Rationale: When rupture of membranes occurs, the priority nursing action
is to assess fetal well-being by checking the fetal heart rate for signs of
distress, such as variable decelerations from cord compression. Vaginal
examination is contraindicated until placenta previa is ruled out and
should not be the first action. Assessing fluid characteristics and maternal
vital signs are important but secondary to fetal assessment.
Question 2: A nurse is teaching a client about fetal development. At
which gestational age does the fetal heart begin to beat?
A. 2 weeks
B. 4 weeks
C. 8 weeks
D. 12 weeks
CORRECT ANSWER: B. 4 weeks
Rationale: The fetal heart begins to beat at approximately 4 weeks (22–28
days) of gestation. By 8 weeks, all major organs are formed, and the heart
has four chambers. Twelve weeks marks the beginning of the second
trimester, and 2 weeks is too early for cardiac development.
Question 3: A client in the first trimester reports nausea and vomiting.
Which instruction should the nurse provide?
A. Eat three large meals daily
B. Drink fluids with meals
,C. Eat dry crackers before rising
D. Avoid protein-rich foods
CORRECT ANSWER: C. Eat dry crackers before rising
Rationale: Eating dry crackers before rising helps reduce morning nausea
because it prevents an empty stomach, which can trigger nausea. Small
frequent meals are recommended rather than three large meals. Fluids
should be taken between meals, not with meals, to reduce stomach
distention. Protein-rich foods are encouraged, not avoided.
Question 4: A nurse is assessing a client at 36 weeks gestation. Which
finding should the nurse report immediately?
A. Braxton Hicks contractions
B. Visual disturbances and epigastric pain
C. Mild ankle edema
D. Urinary frequency
CORRECT ANSWER: B. Visual disturbances and epigastric pain
Rationale: Visual disturbances and epigastric pain are classic warning
signs of preeclampsia with severe features, indicating possible hepatic
involvement and impending seizures. Braxton Hicks contractions, mild
ankle edema, and urinary frequency are common expected discomforts of
late pregnancy.
Question 5: A client is receiving magnesium sulfate for preeclampsia.
Which assessment finding indicates magnesium toxicity?
A. Blood pressure 138/88 mm Hg
B. Respiratory rate 10/min
C. Deep tendon reflexes 2+
D. Urine output 40 mL/hr
CORRECT ANSWER: B. Respiratory rate 10/min
Rationale: A respiratory rate below 12/min is an early sign of magnesium
sulfate toxicity, which can progress to respiratory depression and cardiac
arrest. Deep tendon reflexes should be monitored; loss of reflexes
precedes respiratory depression. Urine output must remain at least 30
mL/hr to prevent accumulation. Blood pressure of 138/88 is not indicative
of toxicity.
,Question 6: A nurse is caring for a client in active labor. The fetal heart
rate tracing shows late decelerations. Which action should the nurse
take first?
A. Increase the oxytocin infusion rate
B. Reposition the client to the left lateral position
C. Prepare for immediate delivery
D. Document the finding and continue monitoring
CORRECT ANSWER: B. Reposition the client to the left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency. The
first nursing action is to reposition the client to the left lateral position to
improve uteroplacental blood flow. Increasing oxytocin would worsen the
condition. Preparing for delivery may be necessary if the pattern persists,
but repositioning is the immediate first action. Documentation is important
but not the priority.
Question 7: A postpartum client is at risk for hemorrhage. Which
medication should the nurse anticipate administering to prevent
uterine atony?
A. Methylergonovine
B. Oxytocin
C. Magnesium sulfate
D. Betamethasone
CORRECT ANSWER: B. Oxytocin
Rationale: Oxytocin is the first-line medication for prevention and
treatment of uterine atony, which is the most common cause of
postpartum hemorrhage. Methylergonovine is also used but is
contraindicated in hypertension. Magnesium sulfate is used for
preeclampsia, not hemorrhage. Betamethasone is a corticosteroid used for
fetal lung maturity.
Question 8: A nurse is assessing a newborn immediately after delivery.
Which finding requires immediate intervention?
A. Heart rate 130/min
B. Respiratory rate 50/min
C. Acrocyanosis
D. Grunting and nasal flaring
, CORRECT ANSWER: D. Grunting and nasal flaring
Rationale: Grunting and nasal flaring are signs of respiratory distress in the
newborn and require immediate intervention, such as suctioning and
oxygen administration. A heart rate of 130/min and respiratory rate of
50/min are within normal limits. Acrocyanosis (bluish hands and feet) is a
normal finding in the first few hours after birth.
Question 9: A client at 32 weeks gestation is diagnosed with placenta
previa. Which nursing intervention is appropriate?
A. Perform vaginal examinations every 4 hours
B. Encourage ambulation
C. Monitor for painless vaginal bleeding
D. Administer oxytocin
CORRECT ANSWER: C. Monitor for painless vaginal bleeding
Rationale: Placenta previa typically presents with painless, bright red
vaginal bleeding in the third trimester. Vaginal examinations are
contraindicated because they can cause severe hemorrhage. Ambulation
is restricted, and oxytocin is contraindicated. Monitoring for bleeding is the
priority nursing intervention.
Question 10: A nurse is teaching a client about breastfeeding. Which
statement indicates the client understands the teaching?
A. "I should feed my baby every 4 hours."
B. "I should wake my baby if he sleeps longer than 3 hours."
C. "I should give my baby water between feedings."
D. "I should limit feedings to 10 minutes per breast."
CORRECT ANSWER: B. "I should wake my baby if he sleeps longer than
3 hours."
Rationale: Newborns should breastfeed every 2–3 hours, and if they sleep
longer than 3 hours, they should be awakened to feed to prevent
hypoglycemia and ensure adequate intake. Feeding every 4 hours is too
infrequent. Water supplementation is not recommended for breastfed
newborns. Feedings should not be limited by time; the baby should feed
until satisfied.
