ATI Maternal Newborn Nursing Exam 2026/2027 |
ACTUAL-Style Practice Questions & Answers, Obstetric
Nursing, Pregnancy Complications, Labor and Delivery,
Postpartum Care, Newborn Assessment, and Detailed
Rationales
Question 1: A nurse is calculating the estimated date of delivery for
a client whose last menstrual period began on March 10. Using
Naegele's rule, which of the following is the estimated date of
delivery?
A. December 3
B. December 17
C. January 3
D. January 17
CORRECT ANSWER: B. December 17
Rationale: Naegele's rule calculates the EDD by subtracting 3 months from
the first day of the last menstrual period and adding 7 days plus 1 year.
March 10 minus 3 months equals December 10; adding 7 days equals
December 17 of the same year.
Question 2: 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
B. Check the fetal heart rate
C. Obtain a specimen for nitrazine testing
D. Place the client in a supine position
CORRECT ANSWER: B. Check the fetal heart rate
Rationale: When spontaneous 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.
A sterile vaginal examination is contraindicated until cord prolapse is ruled
out.
Question 3: A nurse is caring for a client at 10 weeks of gestation
who reports nasal stuffiness. Which of the following statements by
the client indicates understanding of this finding?
,A. "This means I am developing a respiratory infection."
B. "This is caused by increased blood flow to my mucous membranes."
C. "I should take a decongestant every day."
D. "This indicates I have pregnancy-induced hypertension."
CORRECT ANSWER: B. "This is caused by increased blood flow to
my mucous membranes."
Rationale: During pregnancy, increased estrogen levels and vascular
congestion cause nasal mucosa swelling, leading to nasal stuffiness and
epistaxis. This is a normal physiological change and does not indicate
infection or hypertension.
Question 4: 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.
Question 5: A nurse is caring for a client in the first stage of labor
who 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.
,Question 6: 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
Rationale: Placenta previa increases the risk of postpartum hemorrhage
due to abnormal placental implantation and potential uterine atony.
Previous vaginal delivery, maternal age of 25, and singleton pregnancy are
not significant risk factors.
Question 7: A nurse is teaching a postpartum client about
breastfeeding. Which of the following statements indicates a need
for further teaching?
A. "I should feed my baby every 2 to 3 hours."
B. "I will ensure a deep latch to prevent nipple pain."
C. "I should supplement with formula to ensure adequate intake."
D. "I will wake my baby if they sleep longer than 4 hours."
CORRECT ANSWER: C. "I should supplement with formula to
ensure adequate intake."
Rationale: Routine formula supplementation is not recommended for
breastfeeding newborns unless medically indicated. Frequent feeding every
2-3 hours, ensuring a deep latch, and waking a sleepy newborn are
appropriate breastfeeding practices.
Question 8: A nurse is caring for a client at 32 weeks of gestation
who is experiencing preterm labor. Which of the following
medications should the nurse plan to administer to promote fetal
lung maturity?
A. Misoprostol
B. Betamethasone
C. Methylergonovine
D. Poractant alfa
CORRECT ANSWER: B. Betamethasone
, Rationale: Betamethasone is a glucocorticoid administered to clients
between 24 and 34 weeks of gestation who are at risk for preterm delivery.
It stimulates fetal lung maturity and reduces the risk of respiratory distress
syndrome.
Question 9: 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 10: 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 increases.
Question 11: 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?
ACTUAL-Style Practice Questions & Answers, Obstetric
Nursing, Pregnancy Complications, Labor and Delivery,
Postpartum Care, Newborn Assessment, and Detailed
Rationales
Question 1: A nurse is calculating the estimated date of delivery for
a client whose last menstrual period began on March 10. Using
Naegele's rule, which of the following is the estimated date of
delivery?
A. December 3
B. December 17
C. January 3
D. January 17
CORRECT ANSWER: B. December 17
Rationale: Naegele's rule calculates the EDD by subtracting 3 months from
the first day of the last menstrual period and adding 7 days plus 1 year.
March 10 minus 3 months equals December 10; adding 7 days equals
December 17 of the same year.
Question 2: 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
B. Check the fetal heart rate
C. Obtain a specimen for nitrazine testing
D. Place the client in a supine position
CORRECT ANSWER: B. Check the fetal heart rate
Rationale: When spontaneous 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.
A sterile vaginal examination is contraindicated until cord prolapse is ruled
out.
Question 3: A nurse is caring for a client at 10 weeks of gestation
who reports nasal stuffiness. Which of the following statements by
the client indicates understanding of this finding?
,A. "This means I am developing a respiratory infection."
B. "This is caused by increased blood flow to my mucous membranes."
C. "I should take a decongestant every day."
D. "This indicates I have pregnancy-induced hypertension."
CORRECT ANSWER: B. "This is caused by increased blood flow to
my mucous membranes."
Rationale: During pregnancy, increased estrogen levels and vascular
congestion cause nasal mucosa swelling, leading to nasal stuffiness and
epistaxis. This is a normal physiological change and does not indicate
infection or hypertension.
Question 4: 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.
Question 5: A nurse is caring for a client in the first stage of labor
who 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.
,Question 6: 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
Rationale: Placenta previa increases the risk of postpartum hemorrhage
due to abnormal placental implantation and potential uterine atony.
Previous vaginal delivery, maternal age of 25, and singleton pregnancy are
not significant risk factors.
Question 7: A nurse is teaching a postpartum client about
breastfeeding. Which of the following statements indicates a need
for further teaching?
A. "I should feed my baby every 2 to 3 hours."
B. "I will ensure a deep latch to prevent nipple pain."
C. "I should supplement with formula to ensure adequate intake."
D. "I will wake my baby if they sleep longer than 4 hours."
CORRECT ANSWER: C. "I should supplement with formula to
ensure adequate intake."
Rationale: Routine formula supplementation is not recommended for
breastfeeding newborns unless medically indicated. Frequent feeding every
2-3 hours, ensuring a deep latch, and waking a sleepy newborn are
appropriate breastfeeding practices.
Question 8: A nurse is caring for a client at 32 weeks of gestation
who is experiencing preterm labor. Which of the following
medications should the nurse plan to administer to promote fetal
lung maturity?
A. Misoprostol
B. Betamethasone
C. Methylergonovine
D. Poractant alfa
CORRECT ANSWER: B. Betamethasone
, Rationale: Betamethasone is a glucocorticoid administered to clients
between 24 and 34 weeks of gestation who are at risk for preterm delivery.
It stimulates fetal lung maturity and reduces the risk of respiratory distress
syndrome.
Question 9: 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 10: 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 increases.
Question 11: 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?
