ATI Maternal Newborn Nursing Scenarios 2026/2027 | ACTUAL-
Style Practice Questions & Answers, ATI RN Maternal Newborn
Exam Prep, Labor and Delivery Case Studies, High-Risk
Pregnancy, Fetal Heart Rate Interpretation, Postpartum
Complications, Newborn Assessment, Clinical Judgment, and
Detailed Rationales
Question 1: A nurse is caring for a client who is in the transition phase
of labor. Which of the following actions should the nurse take?
A. Encourage the client to use a pant-blow breathing pattern
B. Administer an epidural anesthetic immediately
C. Instruct the client to push with each contraction
D. Restrict the client from changing positions
CORRECT ANSWER: A. Encourage the client to use a pant-blow
breathing pattern
Rationale: The transition phase is the most intense part of the first stage of
labor, typically lasting from 7 to 10 cm dilation. Clients often feel a strong
urge to bear down. A pant-blow breathing pattern helps the client avoid
pushing before full dilation is achieved, preventing cervical edema and
exhaustion. Epidurals are not given this late in labor typically, pushing is
contraindicated until full dilation, and position changes are encouraged for
comfort and fetal descent.
Question 2: A nurse is assessing a newborn who was born vaginally
with vacuum extractor assistance. The nurse notes swelling over the
newborn's head that crosses the suture line. The nurse should identify
the swelling as which of the following findings?
A. Cephalohematoma
B. Caput succedaneum
C. Subgaleal hemorrhage
D. Molding
CORRECT ANSWER: B. Caput succedaneum
Rationale: Caput succedaneum is edema of the scalp that crosses suture
lines and is caused by pressure during delivery, commonly with vacuum
extraction. Cephalohematoma is a collection of blood between the skull
and periosteum that does not cross suture lines. Subgaleal hemorrhage is
,a serious condition involving bleeding between the galea aponeurotica and
periosteum. Molding refers to the overlapping of skull bones.
Question 3: A nurse is caring for a postpartum client who is
breastfeeding and reports sore, cracked nipples. Which of the following
instructions should the nurse provide?
A. Apply colostrum to the nipples after feeding
B. Wash the nipples with soap and water before each feeding
C. Limit breastfeeding to 5 minutes per breast
D. Use a nipple shield for every feeding
CORRECT ANSWER: A. Apply colostrum to the nipples after feeding
Rationale: Colostrum has healing properties and antibacterial effects.
Expressing a small amount onto the nipples after feeding and allowing
them to air dry promotes healing. Soap should be avoided as it removes
natural oils. Limiting feeding time does not address latch issues. Nipple
shields should not be used routinely as they can reduce milk transfer.
Question 4: A nurse is assessing a newborn whose mother had
gestational diabetes. Which of the following findings should the nurse
identify as a manifestation of hypoglycemia?
A. Hypertonia
B. Jitteriness
C. Increased urine output
D. Polycythemia
CORRECT ANSWER: B. Jitteriness
Rationale: Infants of diabetic mothers are at risk for hypoglycemia due to
fetal hyperinsulinism. Manifestations of neonatal hypoglycemia include
jitteriness, tremors, lethargy, poor feeding, and seizures. Hypertonia is not
typical; infants may be hypotonic. Polycythemia is associated with
maternal diabetes but is not a manifestation of hypoglycemia itself.
Question 5: A nurse is providing teaching to a client who is at 36 weeks
of gestation and is scheduled for a nonstress test. Which of the
following statements should the nurse include?
A. "You will need to drink 2 liters of water before the test."
B. "You will be offered orange juice to drink during the test."
,C. "The test will take approximately 5 minutes."
D. "You should avoid eating for 6 hours before the test."
CORRECT ANSWER: B. "You will be offered orange juice to drink during
the test."
Rationale: The nonstress test evaluates fetal heart rate accelerations in
response to fetal movement. If the fetus is not reactive, the nurse may offer
the client orange juice to stimulate fetal activity. The test typically takes 20
to 40 minutes, not 5 minutes. Fasting is not required, and water intake is
not a specific preparation.
Question 6: A nurse is caring for a client who is in labor and has a
prescription for an amniotomy. Which of the following assessments
should the nurse identify as the priority after the procedure?
A. Maternal blood pressure
B. Fetal heart rate
C. Contraction intensity
D. Urine output
CORRECT ANSWER: B. Fetal heart rate
Rationale: After amniotomy, the priority assessment is fetal heart rate to
rule out cord prolapse, which is a life-threatening emergency. Cord
prolapse occurs when the umbilical cord descends through the cervix
ahead of the presenting part, compromising fetal oxygenation. Maternal
vital signs and contraction patterns are important but not the immediate
priority.
Question 7: A nurse is teaching a client who has active genital herpes
simplex virus type 2 about the plan of care. Which of the following
statements should the nurse include?
A. "You will have a cesarean birth prior to the onset of labor."
B. "Your baby will receive erythromycin eye ointment after birth to treat the
infection."
C. "You should take oral metronidazole for 7 days prior to 37 weeks of
gestation."
D. "You should schedule a cesarean birth after your water breaks."
CORRECT ANSWER: A. "You will have a cesarean birth prior to the onset
of labor."
, Rationale: Active genital herpes at the time of labor is an indication for
cesarean birth to prevent vertical transmission to the newborn. The
cesarean should be performed before rupture of membranes to minimize
exposure. Erythromycin eye ointment is for gonococcal ophthalmia, not
herpes. Metronidazole is not the treatment for herpes.
Question 8: A nurse is assessing a client who is at 36 weeks of gestation
and reports painless, bright red vaginal bleeding. Which of the
following conditions should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Vasa previa
CORRECT ANSWER: A. Placenta previa
Rationale: Placenta previa presents with painless, bright red vaginal
bleeding in the third trimester. The placenta implants in the lower uterine
segment, covering or near the cervical os. Abruptio placentae typically
presents with painful, dark red bleeding and a rigid, tender uterus. Uterine
rupture is associated with severe abdominal pain and fetal distress.
Question 9: A nurse is preparing to administer betamethasone to a
client who is at 33 weeks of gestation. Which of the following findings
should the nurse identify as an adverse effect of this medication?
A. Maternal hyperglycemia
B. Maternal bradycardia
C. Fetal tachycardia
D. Maternal hypotension
CORRECT ANSWER: A. Maternal hyperglycemia
Rationale: Betamethasone is a corticosteroid administered to stimulate
fetal lung maturity. A known adverse effect is maternal hyperglycemia,
which can predispose the newborn to hypoglycemia after birth. Maternal
bradycardia, fetal tachycardia, and maternal hypotension are not typical
adverse effects of betamethasone.
Question 10: A nurse is caring for a newborn who is 12 hours old and
has a blood glucose level of 45 mg/dL. Which of the following actions
should the nurse take?
Style Practice Questions & Answers, ATI RN Maternal Newborn
Exam Prep, Labor and Delivery Case Studies, High-Risk
Pregnancy, Fetal Heart Rate Interpretation, Postpartum
Complications, Newborn Assessment, Clinical Judgment, and
Detailed Rationales
Question 1: A nurse is caring for a client who is in the transition phase
of labor. Which of the following actions should the nurse take?
A. Encourage the client to use a pant-blow breathing pattern
B. Administer an epidural anesthetic immediately
C. Instruct the client to push with each contraction
D. Restrict the client from changing positions
CORRECT ANSWER: A. Encourage the client to use a pant-blow
breathing pattern
Rationale: The transition phase is the most intense part of the first stage of
labor, typically lasting from 7 to 10 cm dilation. Clients often feel a strong
urge to bear down. A pant-blow breathing pattern helps the client avoid
pushing before full dilation is achieved, preventing cervical edema and
exhaustion. Epidurals are not given this late in labor typically, pushing is
contraindicated until full dilation, and position changes are encouraged for
comfort and fetal descent.
Question 2: A nurse is assessing a newborn who was born vaginally
with vacuum extractor assistance. The nurse notes swelling over the
newborn's head that crosses the suture line. The nurse should identify
the swelling as which of the following findings?
A. Cephalohematoma
B. Caput succedaneum
C. Subgaleal hemorrhage
D. Molding
CORRECT ANSWER: B. Caput succedaneum
Rationale: Caput succedaneum is edema of the scalp that crosses suture
lines and is caused by pressure during delivery, commonly with vacuum
extraction. Cephalohematoma is a collection of blood between the skull
and periosteum that does not cross suture lines. Subgaleal hemorrhage is
,a serious condition involving bleeding between the galea aponeurotica and
periosteum. Molding refers to the overlapping of skull bones.
Question 3: A nurse is caring for a postpartum client who is
breastfeeding and reports sore, cracked nipples. Which of the following
instructions should the nurse provide?
A. Apply colostrum to the nipples after feeding
B. Wash the nipples with soap and water before each feeding
C. Limit breastfeeding to 5 minutes per breast
D. Use a nipple shield for every feeding
CORRECT ANSWER: A. Apply colostrum to the nipples after feeding
Rationale: Colostrum has healing properties and antibacterial effects.
Expressing a small amount onto the nipples after feeding and allowing
them to air dry promotes healing. Soap should be avoided as it removes
natural oils. Limiting feeding time does not address latch issues. Nipple
shields should not be used routinely as they can reduce milk transfer.
Question 4: A nurse is assessing a newborn whose mother had
gestational diabetes. Which of the following findings should the nurse
identify as a manifestation of hypoglycemia?
A. Hypertonia
B. Jitteriness
C. Increased urine output
D. Polycythemia
CORRECT ANSWER: B. Jitteriness
Rationale: Infants of diabetic mothers are at risk for hypoglycemia due to
fetal hyperinsulinism. Manifestations of neonatal hypoglycemia include
jitteriness, tremors, lethargy, poor feeding, and seizures. Hypertonia is not
typical; infants may be hypotonic. Polycythemia is associated with
maternal diabetes but is not a manifestation of hypoglycemia itself.
Question 5: A nurse is providing teaching to a client who is at 36 weeks
of gestation and is scheduled for a nonstress test. Which of the
following statements should the nurse include?
A. "You will need to drink 2 liters of water before the test."
B. "You will be offered orange juice to drink during the test."
,C. "The test will take approximately 5 minutes."
D. "You should avoid eating for 6 hours before the test."
CORRECT ANSWER: B. "You will be offered orange juice to drink during
the test."
Rationale: The nonstress test evaluates fetal heart rate accelerations in
response to fetal movement. If the fetus is not reactive, the nurse may offer
the client orange juice to stimulate fetal activity. The test typically takes 20
to 40 minutes, not 5 minutes. Fasting is not required, and water intake is
not a specific preparation.
Question 6: A nurse is caring for a client who is in labor and has a
prescription for an amniotomy. Which of the following assessments
should the nurse identify as the priority after the procedure?
A. Maternal blood pressure
B. Fetal heart rate
C. Contraction intensity
D. Urine output
CORRECT ANSWER: B. Fetal heart rate
Rationale: After amniotomy, the priority assessment is fetal heart rate to
rule out cord prolapse, which is a life-threatening emergency. Cord
prolapse occurs when the umbilical cord descends through the cervix
ahead of the presenting part, compromising fetal oxygenation. Maternal
vital signs and contraction patterns are important but not the immediate
priority.
Question 7: A nurse is teaching a client who has active genital herpes
simplex virus type 2 about the plan of care. Which of the following
statements should the nurse include?
A. "You will have a cesarean birth prior to the onset of labor."
B. "Your baby will receive erythromycin eye ointment after birth to treat the
infection."
C. "You should take oral metronidazole for 7 days prior to 37 weeks of
gestation."
D. "You should schedule a cesarean birth after your water breaks."
CORRECT ANSWER: A. "You will have a cesarean birth prior to the onset
of labor."
, Rationale: Active genital herpes at the time of labor is an indication for
cesarean birth to prevent vertical transmission to the newborn. The
cesarean should be performed before rupture of membranes to minimize
exposure. Erythromycin eye ointment is for gonococcal ophthalmia, not
herpes. Metronidazole is not the treatment for herpes.
Question 8: A nurse is assessing a client who is at 36 weeks of gestation
and reports painless, bright red vaginal bleeding. Which of the
following conditions should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Vasa previa
CORRECT ANSWER: A. Placenta previa
Rationale: Placenta previa presents with painless, bright red vaginal
bleeding in the third trimester. The placenta implants in the lower uterine
segment, covering or near the cervical os. Abruptio placentae typically
presents with painful, dark red bleeding and a rigid, tender uterus. Uterine
rupture is associated with severe abdominal pain and fetal distress.
Question 9: A nurse is preparing to administer betamethasone to a
client who is at 33 weeks of gestation. Which of the following findings
should the nurse identify as an adverse effect of this medication?
A. Maternal hyperglycemia
B. Maternal bradycardia
C. Fetal tachycardia
D. Maternal hypotension
CORRECT ANSWER: A. Maternal hyperglycemia
Rationale: Betamethasone is a corticosteroid administered to stimulate
fetal lung maturity. A known adverse effect is maternal hyperglycemia,
which can predispose the newborn to hypoglycemia after birth. Maternal
bradycardia, fetal tachycardia, and maternal hypotension are not typical
adverse effects of betamethasone.
Question 10: A nurse is caring for a newborn who is 12 hours old and
has a blood glucose level of 45 mg/dL. Which of the following actions
should the nurse take?
