ATI Maternal Newborn Practice Questions 2026/2027
| ACTUAL-Style Questions & Answers, Maternity
Nursing, Pregnancy, Labor and Delivery, Postpartum
Care, Newborn Assessment, and Detailed Rationales
Question 1: A nurse is assessing a client who is at 34 weeks of gestation
and 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. Assess the fetal heart rate
C. Obtain a urine specimen
D. Prepare the client for an amniocentesis
CORRECT ANSWER: B. Assess the fetal heart rate
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess the fetal heart rate to ensure fetal well-
being and detect any cord prolapse, which is an obstetric emergency.
Sterile vaginal examination should be avoided until cord prolapse is ruled
out, and obtaining a urine specimen or preparing for amniocentesis is not
the immediate priority.
Question 2: A nurse is caring for a client who is in the first stage of labor
and has an epidural catheter in place. Which of the following findings
should the nurse report to the provider immediately?
A. Blood pressure 100/60 mm Hg
B. Fetal heart rate baseline of 140/min
C. Maternal temperature of 38.3°C (101°F)
D. Urinary output of 30 mL/hr
CORRECT ANSWER: C. Maternal temperature of 38.3°C (101°F)
Rationale: A maternal temperature of 38.3°C (101°F) or higher may indicate
chorioamnionitis, an intraamniotic infection that can be life-threatening for
both the mother and fetus. This finding requires immediate notification of
the provider. A blood pressure of 100/60 mm Hg, a fetal heart rate of
140/min, and urinary output of 30 mL/hr are within expected findings.
Question 3: A nurse is teaching a client who is at 12 weeks of gestation
about expected physiological changes during pregnancy. Which of the
following statements by the client indicates an understanding of the
teaching?
,A. "I should expect my blood pressure to increase significantly."
B. "I may experience nasal stuffiness due to increased blood flow."
C. "My hemoglobin level will increase during pregnancy."
D. "I will produce less vaginal discharge than before pregnancy."
CORRECT ANSWER: B. "I may experience nasal stuffiness due to
increased blood flow."
Rationale: Nasal stuffiness (rhinitis of pregnancy) is a common
physiological change caused by increased estrogen levels and blood flow
to the mucous membranes. Blood pressure typically remains stable or
decreases slightly, hemoglobin levels decrease due to hemodilution, and
vaginal discharge (leukorrhea) typically increases during pregnancy.
Question 4: A nurse is performing a newborn assessment. Which of the
following findings should the nurse identify as a sign of respiratory
distress?
A. Respiratory rate of 40/min
B. Acrocyanosis
C. Nasal flaring
D. Heart rate of 130/min
CORRECT ANSWER: C. Nasal flaring
Rationale: Nasal flaring is a sign of respiratory distress in a newborn,
indicating increased work of breathing. A respiratory rate of 40/min and a
heart rate of 130/min are within normal newborn ranges. Acrocyanosis
(bluish discoloration of the hands and feet) is a common and normal
finding in the first few hours after birth.
Question 5: A nurse is caring for a client who is 2 hours postpartum and
has a boggy uterus. Which of the following actions should the nurse
take first?
A. Administer methylergonovine
B. Perform fundal massage
C. Insert an indwelling urinary catheter
D. Obtain a hemoglobin level
CORRECT ANSWER: B. Perform fundal massage
,Rationale: A boggy uterus indicates uterine atony, which is the most
common cause of postpartum hemorrhage. The first action is to perform
fundal massage to stimulate uterine contractions and expel clots. If
massage is ineffective, then medications such as methylergonovine may
be administered. Inserting a catheter and obtaining a hemoglobin level are
secondary interventions.
Question 6: A nurse is assessing a client who is at 36 weeks of gestation
and has preeclampsia. Which of the following findings should the
nurse report to the provider immediately?
A. 1+ proteinuria
B. Blood pressure 150/90 mm Hg
C. Report of a severe headache
D. Dependent edema of the ankles
CORRECT ANSWER: C. Report of a severe headache
Rationale: A severe headache in a client with preeclampsia may indicate
worsening cerebral edema and impending seizures (eclampsia). This is a
neurologic sign of severe preeclampsia and requires immediate
intervention. Proteinuria, blood pressure of 150/90 mm Hg, and dependent
edema are expected findings in preeclampsia but are not immediately life-
threatening.
Question 7: A nurse is teaching a postpartum client about
breastfeeding. Which of the following instructions should the nurse
include?
A. "You should feed your newborn every 4 to 5 hours."
B. "You should wake your newborn if they sleep longer than 3 hours."
C. "You should offer only one breast per feeding session."
D. "You should pump and discard your milk for the first 3 days."
CORRECT ANSWER: B. "You should wake your newborn if they sleep
longer than 3 hours."
Rationale: Newborns should breastfeed every 2 to 3 hours, which means
waking them if they sleep longer than 3 hours to ensure adequate intake
and stimulate milk production. Feeding every 4 to 5 hours is too infrequent.
Both breasts should be offered at each feeding to promote milk supply.
Colostrum should not be discarded as it is rich in antibodies and nutrients.
, Question 8: A nurse is reviewing the laboratory results of a client who is
at 28 weeks of gestation. Which of the following findings should the
nurse report to the provider?
A. Hemoglobin 11.5 g/dL
B. Platelet count 150,000/mm³
C. Fasting blood glucose 105 mg/dL
D. Hematocrit 34%
CORRECT ANSWER: C. Fasting blood glucose 105 mg/dL
Rationale: A fasting blood glucose of 105 mg/dL is above the expected
reference range (less than 95 mg/dL) and may indicate gestational
diabetes. This finding requires further evaluation. Hemoglobin of 11.5 g/dL,
platelet count of 150,000/mm³, and hematocrit of 34% are within expected
ranges for pregnancy.
Question 9: A nurse is caring for a newborn immediately after birth.
Which of the following actions should the nurse take first?
A. Administer vitamin K injection
B. Dry the newborn with a warm blanket
C. Obtain a blood glucose level
D. Apply erythromycin ointment to the eyes
CORRECT ANSWER: B. Dry the newborn with a warm blanket
Rationale: The first priority after birth is to dry the newborn to prevent heat
loss and stimulate breathing. Newborns are at high risk for hypothermia
due to their large body surface area relative to weight and lack of
subcutaneous fat. Administering vitamin K, obtaining blood glucose, and
applying eye ointment are important but secondary to thermoregulation
and respiratory support.
Question 10: A nurse is assessing a client who is 24 hours postpartum
and reports pain at the site of a third-degree perineal laceration. Which
of the following interventions should the nurse recommend?
A. Apply a warm compress to the perineum
B. Perform sitz baths three times daily
C. Use a doughnut-shaped cushion when sitting
D. Avoid taking stool softeners
| ACTUAL-Style Questions & Answers, Maternity
Nursing, Pregnancy, Labor and Delivery, Postpartum
Care, Newborn Assessment, and Detailed Rationales
Question 1: A nurse is assessing a client who is at 34 weeks of gestation
and 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. Assess the fetal heart rate
C. Obtain a urine specimen
D. Prepare the client for an amniocentesis
CORRECT ANSWER: B. Assess the fetal heart rate
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess the fetal heart rate to ensure fetal well-
being and detect any cord prolapse, which is an obstetric emergency.
Sterile vaginal examination should be avoided until cord prolapse is ruled
out, and obtaining a urine specimen or preparing for amniocentesis is not
the immediate priority.
Question 2: A nurse is caring for a client who is in the first stage of labor
and has an epidural catheter in place. Which of the following findings
should the nurse report to the provider immediately?
A. Blood pressure 100/60 mm Hg
B. Fetal heart rate baseline of 140/min
C. Maternal temperature of 38.3°C (101°F)
D. Urinary output of 30 mL/hr
CORRECT ANSWER: C. Maternal temperature of 38.3°C (101°F)
Rationale: A maternal temperature of 38.3°C (101°F) or higher may indicate
chorioamnionitis, an intraamniotic infection that can be life-threatening for
both the mother and fetus. This finding requires immediate notification of
the provider. A blood pressure of 100/60 mm Hg, a fetal heart rate of
140/min, and urinary output of 30 mL/hr are within expected findings.
Question 3: A nurse is teaching a client who is at 12 weeks of gestation
about expected physiological changes during pregnancy. Which of the
following statements by the client indicates an understanding of the
teaching?
,A. "I should expect my blood pressure to increase significantly."
B. "I may experience nasal stuffiness due to increased blood flow."
C. "My hemoglobin level will increase during pregnancy."
D. "I will produce less vaginal discharge than before pregnancy."
CORRECT ANSWER: B. "I may experience nasal stuffiness due to
increased blood flow."
Rationale: Nasal stuffiness (rhinitis of pregnancy) is a common
physiological change caused by increased estrogen levels and blood flow
to the mucous membranes. Blood pressure typically remains stable or
decreases slightly, hemoglobin levels decrease due to hemodilution, and
vaginal discharge (leukorrhea) typically increases during pregnancy.
Question 4: A nurse is performing a newborn assessment. Which of the
following findings should the nurse identify as a sign of respiratory
distress?
A. Respiratory rate of 40/min
B. Acrocyanosis
C. Nasal flaring
D. Heart rate of 130/min
CORRECT ANSWER: C. Nasal flaring
Rationale: Nasal flaring is a sign of respiratory distress in a newborn,
indicating increased work of breathing. A respiratory rate of 40/min and a
heart rate of 130/min are within normal newborn ranges. Acrocyanosis
(bluish discoloration of the hands and feet) is a common and normal
finding in the first few hours after birth.
Question 5: A nurse is caring for a client who is 2 hours postpartum and
has a boggy uterus. Which of the following actions should the nurse
take first?
A. Administer methylergonovine
B. Perform fundal massage
C. Insert an indwelling urinary catheter
D. Obtain a hemoglobin level
CORRECT ANSWER: B. Perform fundal massage
,Rationale: A boggy uterus indicates uterine atony, which is the most
common cause of postpartum hemorrhage. The first action is to perform
fundal massage to stimulate uterine contractions and expel clots. If
massage is ineffective, then medications such as methylergonovine may
be administered. Inserting a catheter and obtaining a hemoglobin level are
secondary interventions.
Question 6: A nurse is assessing a client who is at 36 weeks of gestation
and has preeclampsia. Which of the following findings should the
nurse report to the provider immediately?
A. 1+ proteinuria
B. Blood pressure 150/90 mm Hg
C. Report of a severe headache
D. Dependent edema of the ankles
CORRECT ANSWER: C. Report of a severe headache
Rationale: A severe headache in a client with preeclampsia may indicate
worsening cerebral edema and impending seizures (eclampsia). This is a
neurologic sign of severe preeclampsia and requires immediate
intervention. Proteinuria, blood pressure of 150/90 mm Hg, and dependent
edema are expected findings in preeclampsia but are not immediately life-
threatening.
Question 7: A nurse is teaching a postpartum client about
breastfeeding. Which of the following instructions should the nurse
include?
A. "You should feed your newborn every 4 to 5 hours."
B. "You should wake your newborn if they sleep longer than 3 hours."
C. "You should offer only one breast per feeding session."
D. "You should pump and discard your milk for the first 3 days."
CORRECT ANSWER: B. "You should wake your newborn if they sleep
longer than 3 hours."
Rationale: Newborns should breastfeed every 2 to 3 hours, which means
waking them if they sleep longer than 3 hours to ensure adequate intake
and stimulate milk production. Feeding every 4 to 5 hours is too infrequent.
Both breasts should be offered at each feeding to promote milk supply.
Colostrum should not be discarded as it is rich in antibodies and nutrients.
, Question 8: A nurse is reviewing the laboratory results of a client who is
at 28 weeks of gestation. Which of the following findings should the
nurse report to the provider?
A. Hemoglobin 11.5 g/dL
B. Platelet count 150,000/mm³
C. Fasting blood glucose 105 mg/dL
D. Hematocrit 34%
CORRECT ANSWER: C. Fasting blood glucose 105 mg/dL
Rationale: A fasting blood glucose of 105 mg/dL is above the expected
reference range (less than 95 mg/dL) and may indicate gestational
diabetes. This finding requires further evaluation. Hemoglobin of 11.5 g/dL,
platelet count of 150,000/mm³, and hematocrit of 34% are within expected
ranges for pregnancy.
Question 9: A nurse is caring for a newborn immediately after birth.
Which of the following actions should the nurse take first?
A. Administer vitamin K injection
B. Dry the newborn with a warm blanket
C. Obtain a blood glucose level
D. Apply erythromycin ointment to the eyes
CORRECT ANSWER: B. Dry the newborn with a warm blanket
Rationale: The first priority after birth is to dry the newborn to prevent heat
loss and stimulate breathing. Newborns are at high risk for hypothermia
due to their large body surface area relative to weight and lack of
subcutaneous fat. Administering vitamin K, obtaining blood glucose, and
applying eye ointment are important but secondary to thermoregulation
and respiratory support.
Question 10: A nurse is assessing a client who is 24 hours postpartum
and reports pain at the site of a third-degree perineal laceration. Which
of the following interventions should the nurse recommend?
A. Apply a warm compress to the perineum
B. Perform sitz baths three times daily
C. Use a doughnut-shaped cushion when sitting
D. Avoid taking stool softeners
