ATI Maternal Newborn Review 2026/2027 | ACTUAL-
Style Practice Questions & Answers, ATI RN Exam
Prep, Pregnancy, Labor and Delivery, Postpartum
Nursing, Newborn Assessment, and Detailed Rationales
180 Original ATI Maternal Newborn Review Exam Questions
Question 1: A nurse is assessing a client at 34 weeks of gestation who
reports a persistent headache unrelieved by acetaminophen and notes
visual changes. The client's blood pressure is 158/102 mm Hg, and
urine protein is 3+. Which of the following actions should the nurse
take FIRST?
A. Administer prescribed hydralazine for hypertension
B. Initiate prescribed magnesium sulfate infusion
C. Prepare the client for immediate cesarean delivery
D. Obtain a serum uric acid level
CORRECT ANSWER: B. Initiate prescribed magnesium sulfate infusion
Rationale: The client is demonstrating manifestations of severe
preeclampsia with severe features (persistent headache, visual changes,
BP ≥160/110, proteinuria). Magnesium sulfate is the standard of care to
prevent seizures (eclampsia). While antihypertensive medication may be
indicated, initiating seizure prophylaxis is the priority because seizures
pose the greatest immediate threat to maternal and fetal well-being.
Immediate cesarean delivery is not warranted without fetal indications, and
serum uric acid is not a priority diagnostic for acute management.
Question 2: A nurse is caring for a postpartum client at 12 hours after a
spontaneous vaginal delivery. The client reports a gush of dark red
blood when she stands to ambulate. The fundus is firm at the
umbilicus. Which of the following explanations should the nurse
provide?
A. "You may have retained placental fragments causing this bleeding."
B. "This is normal because blood pools in the vagina while you are lying
down."
C. "This indicates a uterine infection and requires antibiotics."
D. "Your uterus has become relaxed and needs massage."
,CORRECT ANSWER: B. "This is normal because blood pools in the
vagina while you are lying down."
Rationale: In the early postpartum period, lochia accumulates in the vagina
when the client is recumbent. Upon standing, gravity causes a gush of
blood to be expelled. A firm fundus at the umbilicus indicates adequate
uterine tone, ruling out uterine atony. Retained placental fragments
typically present with continued bleeding and a boggy fundus. There are no
signs of infection such as fever or foul-smelling discharge.
Question 3: A nurse is assessing a newborn 1 hour after birth and notes
jaundice of the sclera and skin. Which of the following actions should
the nurse take?
A. Document the finding as a normal variation
B. Encourage increased breastfeeding frequency
C. Report the finding to the provider immediately
D. Place the newborn under phototherapy lights
CORRECT ANSWER: C. Report the finding to the provider immediately
Rationale: Jaundice appearing within the first 24 hours of life is considered
pathologic jaundice and requires immediate provider notification.
Pathologic jaundice can result from hemolytic disease, infection, or other
serious conditions that may cause kernicterus if left untreated. Physiologic
jaundice typically appears after 24 hours of life. Phototherapy may be
indicated but requires a provider order and serum bilirubin evaluation first.
Question 4: A nurse is providing discharge teaching to a client who is
not breastfeeding and is experiencing breast engorgement. Which of
the following instructions should the nurse include?
A. "Apply warm compresses to your breasts several times daily."
B. "Place ice packs on your breasts for 15 minutes on and 45 minutes off."
C. "Massage your breasts firmly to express milk."
D. "Wear a loose-fitting bra to promote milk flow."
CORRECT ANSWER: B. "Place ice packs on your breasts for 15 minutes
on and 45 minutes off."
,Rationale: For the non-breastfeeding client, ice packs help decrease
swelling and suppress milk production. A 15-minute on, 45-minute off
schedule prevents rebound vasodilation. Warm compresses and massage
stimulate milk production and should be avoided. A supportive, snug bra
(not loose) provides comfort and support.
Question 5: A nurse is testing a newborn's reflexes and quickly turns
the newborn's head to one side while the infant is lying supine. The
newborn extends the arm and leg on the side to which the head was
turned, while the opposite arm and leg flex. Which reflex is the nurse
assessing?
A. Moro reflex
B. Palmar grasp reflex
C. Tonic neck reflex
D. Babinski reflex
CORRECT ANSWER: C. Tonic neck reflex
Rationale: The tonic neck reflex (fencing reflex) is elicited by turning the
newborn's head to one side. The arm and leg on the side to which the head
is turned extend, while the opposite extremities flex. This reflex typically
disappears by 3 to 4 months of age. The Moro reflex is elicited by a sudden
movement or noise. The palmar grasp is elicited by placing a finger in the
newborn's palm. The Babinski reflex is elicited by stroking the sole of the
foot.
Question 6: A nurse is caring for a client receiving magnesium sulfate
for preeclampsia. Which of the following assessment findings
indicates magnesium toxicity requiring immediate intervention?
A. Blood pressure of 148/92 mm Hg
B. Respiratory rate of 10 breaths/min
C. Urinary output of 35 mL/hr
D. Deep tendon reflexes of 2+
CORRECT ANSWER: B. Respiratory rate of 10 breaths/min
, Rationale: Magnesium sulfate toxicity manifests as respiratory depression
(RR <12/min), loss of deep tendon reflexes, and oliguria. A respiratory rate
of 10 breaths/min indicates impending toxicity and requires immediate
discontinuation of the infusion and possible administration of calcium
gluconate. Urinary output should be maintained at ≥30 mL/hr. Deep tendon
reflexes of 2+ are normal. Blood pressure elevation is expected with
preeclampsia.
Question 7: A nurse is assessing a newborn born at 39 weeks of
gestation. Which of the following physical findings should the nurse
expect?
A. Abundant lanugo covering the back
B. Symmetric rib cage
C. Few heel creases on the feet
D. Flat, soft pinnae that fold easily
CORRECT ANSWER: B. Symmetric rib cage
Rationale: A full-term newborn (37-42 weeks) should have a symmetric rib
cage, moderate lanugo (especially on shoulders), heel creases covering
most of the sole, and firm, well-curved pinnae with instant recoil. Abundant
lanugo, few heel creases, and flat pinnae are characteristic of preterm
newborns.
Question 8: A nurse is providing teaching to a client at 10 weeks of
gestation about expected physiological changes. Which of the
following statements by the client indicates understanding?
A. "My blood pressure will increase significantly during pregnancy."
B. "I may experience nasal stuffiness due to increased blood flow."
C. "My heart rate will decrease as my pregnancy progresses."
D. "My hemoglobin level will increase above my pre-pregnancy level."
CORRECT ANSWER: B. "I may experience nasal stuffiness due to
increased blood flow."
Rationale: Increased estrogen levels and vascular congestion during
pregnancy cause swelling of the nasal mucosa, leading to nasal stuffiness
Style Practice Questions & Answers, ATI RN Exam
Prep, Pregnancy, Labor and Delivery, Postpartum
Nursing, Newborn Assessment, and Detailed Rationales
180 Original ATI Maternal Newborn Review Exam Questions
Question 1: A nurse is assessing a client at 34 weeks of gestation who
reports a persistent headache unrelieved by acetaminophen and notes
visual changes. The client's blood pressure is 158/102 mm Hg, and
urine protein is 3+. Which of the following actions should the nurse
take FIRST?
A. Administer prescribed hydralazine for hypertension
B. Initiate prescribed magnesium sulfate infusion
C. Prepare the client for immediate cesarean delivery
D. Obtain a serum uric acid level
CORRECT ANSWER: B. Initiate prescribed magnesium sulfate infusion
Rationale: The client is demonstrating manifestations of severe
preeclampsia with severe features (persistent headache, visual changes,
BP ≥160/110, proteinuria). Magnesium sulfate is the standard of care to
prevent seizures (eclampsia). While antihypertensive medication may be
indicated, initiating seizure prophylaxis is the priority because seizures
pose the greatest immediate threat to maternal and fetal well-being.
Immediate cesarean delivery is not warranted without fetal indications, and
serum uric acid is not a priority diagnostic for acute management.
Question 2: A nurse is caring for a postpartum client at 12 hours after a
spontaneous vaginal delivery. The client reports a gush of dark red
blood when she stands to ambulate. The fundus is firm at the
umbilicus. Which of the following explanations should the nurse
provide?
A. "You may have retained placental fragments causing this bleeding."
B. "This is normal because blood pools in the vagina while you are lying
down."
C. "This indicates a uterine infection and requires antibiotics."
D. "Your uterus has become relaxed and needs massage."
,CORRECT ANSWER: B. "This is normal because blood pools in the
vagina while you are lying down."
Rationale: In the early postpartum period, lochia accumulates in the vagina
when the client is recumbent. Upon standing, gravity causes a gush of
blood to be expelled. A firm fundus at the umbilicus indicates adequate
uterine tone, ruling out uterine atony. Retained placental fragments
typically present with continued bleeding and a boggy fundus. There are no
signs of infection such as fever or foul-smelling discharge.
Question 3: A nurse is assessing a newborn 1 hour after birth and notes
jaundice of the sclera and skin. Which of the following actions should
the nurse take?
A. Document the finding as a normal variation
B. Encourage increased breastfeeding frequency
C. Report the finding to the provider immediately
D. Place the newborn under phototherapy lights
CORRECT ANSWER: C. Report the finding to the provider immediately
Rationale: Jaundice appearing within the first 24 hours of life is considered
pathologic jaundice and requires immediate provider notification.
Pathologic jaundice can result from hemolytic disease, infection, or other
serious conditions that may cause kernicterus if left untreated. Physiologic
jaundice typically appears after 24 hours of life. Phototherapy may be
indicated but requires a provider order and serum bilirubin evaluation first.
Question 4: A nurse is providing discharge teaching to a client who is
not breastfeeding and is experiencing breast engorgement. Which of
the following instructions should the nurse include?
A. "Apply warm compresses to your breasts several times daily."
B. "Place ice packs on your breasts for 15 minutes on and 45 minutes off."
C. "Massage your breasts firmly to express milk."
D. "Wear a loose-fitting bra to promote milk flow."
CORRECT ANSWER: B. "Place ice packs on your breasts for 15 minutes
on and 45 minutes off."
,Rationale: For the non-breastfeeding client, ice packs help decrease
swelling and suppress milk production. A 15-minute on, 45-minute off
schedule prevents rebound vasodilation. Warm compresses and massage
stimulate milk production and should be avoided. A supportive, snug bra
(not loose) provides comfort and support.
Question 5: A nurse is testing a newborn's reflexes and quickly turns
the newborn's head to one side while the infant is lying supine. The
newborn extends the arm and leg on the side to which the head was
turned, while the opposite arm and leg flex. Which reflex is the nurse
assessing?
A. Moro reflex
B. Palmar grasp reflex
C. Tonic neck reflex
D. Babinski reflex
CORRECT ANSWER: C. Tonic neck reflex
Rationale: The tonic neck reflex (fencing reflex) is elicited by turning the
newborn's head to one side. The arm and leg on the side to which the head
is turned extend, while the opposite extremities flex. This reflex typically
disappears by 3 to 4 months of age. The Moro reflex is elicited by a sudden
movement or noise. The palmar grasp is elicited by placing a finger in the
newborn's palm. The Babinski reflex is elicited by stroking the sole of the
foot.
Question 6: A nurse is caring for a client receiving magnesium sulfate
for preeclampsia. Which of the following assessment findings
indicates magnesium toxicity requiring immediate intervention?
A. Blood pressure of 148/92 mm Hg
B. Respiratory rate of 10 breaths/min
C. Urinary output of 35 mL/hr
D. Deep tendon reflexes of 2+
CORRECT ANSWER: B. Respiratory rate of 10 breaths/min
, Rationale: Magnesium sulfate toxicity manifests as respiratory depression
(RR <12/min), loss of deep tendon reflexes, and oliguria. A respiratory rate
of 10 breaths/min indicates impending toxicity and requires immediate
discontinuation of the infusion and possible administration of calcium
gluconate. Urinary output should be maintained at ≥30 mL/hr. Deep tendon
reflexes of 2+ are normal. Blood pressure elevation is expected with
preeclampsia.
Question 7: A nurse is assessing a newborn born at 39 weeks of
gestation. Which of the following physical findings should the nurse
expect?
A. Abundant lanugo covering the back
B. Symmetric rib cage
C. Few heel creases on the feet
D. Flat, soft pinnae that fold easily
CORRECT ANSWER: B. Symmetric rib cage
Rationale: A full-term newborn (37-42 weeks) should have a symmetric rib
cage, moderate lanugo (especially on shoulders), heel creases covering
most of the sole, and firm, well-curved pinnae with instant recoil. Abundant
lanugo, few heel creases, and flat pinnae are characteristic of preterm
newborns.
Question 8: A nurse is providing teaching to a client at 10 weeks of
gestation about expected physiological changes. Which of the
following statements by the client indicates understanding?
A. "My blood pressure will increase significantly during pregnancy."
B. "I may experience nasal stuffiness due to increased blood flow."
C. "My heart rate will decrease as my pregnancy progresses."
D. "My hemoglobin level will increase above my pre-pregnancy level."
CORRECT ANSWER: B. "I may experience nasal stuffiness due to
increased blood flow."
Rationale: Increased estrogen levels and vascular congestion during
pregnancy cause swelling of the nasal mucosa, leading to nasal stuffiness
