ATI Maternal Newborn Application 2026/2027 | ACTUAL-Style
Practice Questions & Answers, ATI RN Maternal Newborn Exam
Prep, Application-Based Nursing Questions, Clinical Judgment
Scenarios, Labor and Delivery, Pregnancy Complications, Fetal
Heart Rate Monitoring, Postpartum Care, Newborn Assessment,
and Detailed Rationales
Question 1: A nurse is caring for a client in the active phase of labor
who is experiencing uterine tachysystole with oxytocin infusing. Which
of the following actions should the nurse take FIRST?
A. Administer an IV fluid bolus of 500 mL lactated Ringer's
B. Discontinue the oxytocin infusion
C. Place the client in a left lateral position
D. Notify the provider of the contraction pattern
CORRECT ANSWER: B. Discontinue the oxytocin infusion
Rationale: When uterine tachysystole occurs with oxytocin infusing, the
FIRST action is to stop the medication causing the problem. This directly
addresses the root cause of excessive uterine activity. While IV fluids,
position changes, and provider notification are appropriate interventions,
stopping the oxytocin takes immediate priority to prevent fetal hypoxia and
uterine rupture. After discontinuing the infusion, the nurse should then
implement intrauterine resuscitation measures including position changes
and fluid administration.
Question 2: A nurse is assessing a postpartum client who delivered 2
hours ago and notes a boggy uterus with heavy vaginal bleeding. Which
action should the nurse take FIRST?
A. Notify the provider immediately
B. Administer methylergonovine as prescribed
C. Perform fundal massage
D. Insert an indwelling urinary catheter
CORRECT ANSWER: C. Perform fundal massage
Rationale: A boggy uterus indicates uterine atony, the most common cause
of postpartum hemorrhage. The FIRST intervention is to perform fundal
massage to stimulate uterine contraction and expel clots. This is a nursing
intervention that can be performed immediately without a prescription. If
massage does not firm the uterus and stop bleeding, then medications,
catheterization, and provider notification follow.
,Question 3: A nurse is reviewing the electronic fetal monitoring strip
and notes a baseline of 150 bpm with absent variability, no
accelerations, and recurrent late decelerations. Which of the following
is the priority nursing action?
A. Continue monitoring and document findings
B. Reposition the client to a left lateral position
C. Increase the oxytocin infusion rate
D. Administer oxygen at 2 L/min via nasal cannula
CORRECT ANSWER: B. Reposition the client to a left lateral position
Rationale: The fetal heart tracing shows Category III patterns indicating
fetal acidosis. Repositioning to a left lateral position is the first intrauterine
resuscitation measure. It improves uteroplacental perfusion by relieving
compression of the inferior vena cava and aorta. This intervention takes
immediate priority. Increasing oxytocin would worsen the pattern, and
oxygen should be administered at 8-10 L/min via nonrebreather mask if
needed.
Question 4: A nurse is caring for a client at 34 weeks gestation with
severe preeclampsia receiving magnesium sulfate. Which assessment
finding indicates magnesium toxicity requiring immediate intervention?
A. Blood pressure of 148/92 mm Hg
B. Respiratory rate of 11/min
C. Deep tendon reflexes of 2+
D. Urine output of 45 mL/hr
CORRECT ANSWER: B. Respiratory rate of 11/min
Rationale: Magnesium sulfate toxicity manifests as central nervous system
depression. A respiratory rate below 12/min indicates respiratory
depression requiring immediate intervention. The antidote is calcium
gluconate 1 g IV. Deep tendon reflexes should be assessed frequently; loss
of reflexes (not 2+) is an earlier sign of toxicity. Urine output of at least 30
mL/hr is required for magnesium clearance, so 45 mL/hr is acceptable.
Question 5: A newborn is delivered at 39 weeks via vacuum-assisted
vaginal delivery. The nurse notes a cephalohematoma over the right
parietal region. Which of the following statements by the nurse is
accurate?
,A. The swelling crosses suture lines and resolves within 24 hours
B. The swelling does not cross suture lines and may contribute to jaundice
C. This finding indicates an underlying skull fracture requiring immediate
imaging
D. The hematoma requires aspiration to prevent infection
CORRECT ANSWER: B. The swelling does not cross suture lines and
may contribute to jaundice
Rationale: Cephalohematoma is a subperiosteal hemorrhage that does
NOT cross suture lines. It results from trauma during delivery and resolves
over weeks. The breakdown of red blood cells in the hematoma can
contribute to hyperbilirubinemia and jaundice. Caput succedaneum
crosses suture lines and resolves within 24-48 hours. Skull fracture may
accompany cephalohematoma but is not always present, and aspiration is
contraindicated due to infection risk.
Question 6: A nurse is providing discharge teaching to a postpartum
client who is breastfeeding. Which statement indicates the client
understands proper breastfeeding technique?
A. "I should feel a sharp pain throughout the entire feeding"
B. "The baby's chin should touch my breast during feeding"
C. "I should limit feedings to 5 minutes on each breast"
D. "I need to wash my nipples with soap before each feeding"
CORRECT ANSWER: B. "The baby's chin should touch my breast during
feeding"
Rationale: Proper latch technique includes the baby's chin touching the
breast and the nose close to but not touching the breast. This ensures
adequate mouthful of breast tissue. Sharp pain throughout feeding
indicates poor latch. Feedings should not be time-limited but should
continue until the baby is satisfied. Soap should be avoided on nipples as it
removes natural protective oils.
Question 7: A nurse is assessing a client at 36 weeks gestation who
reports painless, bright red vaginal bleeding. Which of the following
findings is most concerning for placenta previa?
A. Uterine tenderness on palpation
B. Soft, nontender uterus
, C. Fetal heart rate baseline of 130 bpm
D. Ruptured membranes with clear fluid
CORRECT ANSWER: B. Soft, nontender uterus
Rationale: Placenta previa classically presents with painless, bright red
vaginal bleeding and a soft, nontender uterus. Uterine tenderness suggests
abruptio placentae. A normal fetal heart rate and clear fluid do not
differentiate the condition. The soft, nontender uterus is the most specific
finding for placenta previa. Vaginal examination is contraindicated when
placenta previa is suspected.
Question 8: A nurse is teaching a client who is at 12 weeks gestation
about expected physiological changes. Which statement indicates the
client understands the teaching?
A. "I should expect my blood pressure to increase significantly"
B. "My heart rate will decrease during pregnancy"
C. "I may experience nasal stuffiness due to increased blood flow"
D. "My blood glucose levels should remain unchanged"
CORRECT ANSWER: C. "I may experience nasal stuffiness due to
increased blood flow"
Rationale: Pregnancy causes increased estrogen levels leading to
hyperemia and edema of mucous membranes, resulting in nasal stuffiness
and epistaxis. Blood pressure typically remains the same or decreases
slightly due to peripheral vasodilation. Heart rate increases by 10-15 bpm.
Blood glucose is affected by placental hormones causing insulin
resistance.
Question 9: A nurse is caring for a client who is 1 day postpartum and
reports abdominal cramping during breastfeeding. Which response by
the nurse is appropriate?
A. "This is abnormal and may indicate infection"
B. "These are afterpains caused by oxytocin release during breastfeeding"
C. "You should stop breastfeeding to prevent further cramping"
D. "This indicates your uterus is not contracting properly"
CORRECT ANSWER: B. "These are afterpains caused by oxytocin
release during breastfeeding"
Practice Questions & Answers, ATI RN Maternal Newborn Exam
Prep, Application-Based Nursing Questions, Clinical Judgment
Scenarios, Labor and Delivery, Pregnancy Complications, Fetal
Heart Rate Monitoring, Postpartum Care, Newborn Assessment,
and Detailed Rationales
Question 1: A nurse is caring for a client in the active phase of labor
who is experiencing uterine tachysystole with oxytocin infusing. Which
of the following actions should the nurse take FIRST?
A. Administer an IV fluid bolus of 500 mL lactated Ringer's
B. Discontinue the oxytocin infusion
C. Place the client in a left lateral position
D. Notify the provider of the contraction pattern
CORRECT ANSWER: B. Discontinue the oxytocin infusion
Rationale: When uterine tachysystole occurs with oxytocin infusing, the
FIRST action is to stop the medication causing the problem. This directly
addresses the root cause of excessive uterine activity. While IV fluids,
position changes, and provider notification are appropriate interventions,
stopping the oxytocin takes immediate priority to prevent fetal hypoxia and
uterine rupture. After discontinuing the infusion, the nurse should then
implement intrauterine resuscitation measures including position changes
and fluid administration.
Question 2: A nurse is assessing a postpartum client who delivered 2
hours ago and notes a boggy uterus with heavy vaginal bleeding. Which
action should the nurse take FIRST?
A. Notify the provider immediately
B. Administer methylergonovine as prescribed
C. Perform fundal massage
D. Insert an indwelling urinary catheter
CORRECT ANSWER: C. Perform fundal massage
Rationale: A boggy uterus indicates uterine atony, the most common cause
of postpartum hemorrhage. The FIRST intervention is to perform fundal
massage to stimulate uterine contraction and expel clots. This is a nursing
intervention that can be performed immediately without a prescription. If
massage does not firm the uterus and stop bleeding, then medications,
catheterization, and provider notification follow.
,Question 3: A nurse is reviewing the electronic fetal monitoring strip
and notes a baseline of 150 bpm with absent variability, no
accelerations, and recurrent late decelerations. Which of the following
is the priority nursing action?
A. Continue monitoring and document findings
B. Reposition the client to a left lateral position
C. Increase the oxytocin infusion rate
D. Administer oxygen at 2 L/min via nasal cannula
CORRECT ANSWER: B. Reposition the client to a left lateral position
Rationale: The fetal heart tracing shows Category III patterns indicating
fetal acidosis. Repositioning to a left lateral position is the first intrauterine
resuscitation measure. It improves uteroplacental perfusion by relieving
compression of the inferior vena cava and aorta. This intervention takes
immediate priority. Increasing oxytocin would worsen the pattern, and
oxygen should be administered at 8-10 L/min via nonrebreather mask if
needed.
Question 4: A nurse is caring for a client at 34 weeks gestation with
severe preeclampsia receiving magnesium sulfate. Which assessment
finding indicates magnesium toxicity requiring immediate intervention?
A. Blood pressure of 148/92 mm Hg
B. Respiratory rate of 11/min
C. Deep tendon reflexes of 2+
D. Urine output of 45 mL/hr
CORRECT ANSWER: B. Respiratory rate of 11/min
Rationale: Magnesium sulfate toxicity manifests as central nervous system
depression. A respiratory rate below 12/min indicates respiratory
depression requiring immediate intervention. The antidote is calcium
gluconate 1 g IV. Deep tendon reflexes should be assessed frequently; loss
of reflexes (not 2+) is an earlier sign of toxicity. Urine output of at least 30
mL/hr is required for magnesium clearance, so 45 mL/hr is acceptable.
Question 5: A newborn is delivered at 39 weeks via vacuum-assisted
vaginal delivery. The nurse notes a cephalohematoma over the right
parietal region. Which of the following statements by the nurse is
accurate?
,A. The swelling crosses suture lines and resolves within 24 hours
B. The swelling does not cross suture lines and may contribute to jaundice
C. This finding indicates an underlying skull fracture requiring immediate
imaging
D. The hematoma requires aspiration to prevent infection
CORRECT ANSWER: B. The swelling does not cross suture lines and
may contribute to jaundice
Rationale: Cephalohematoma is a subperiosteal hemorrhage that does
NOT cross suture lines. It results from trauma during delivery and resolves
over weeks. The breakdown of red blood cells in the hematoma can
contribute to hyperbilirubinemia and jaundice. Caput succedaneum
crosses suture lines and resolves within 24-48 hours. Skull fracture may
accompany cephalohematoma but is not always present, and aspiration is
contraindicated due to infection risk.
Question 6: A nurse is providing discharge teaching to a postpartum
client who is breastfeeding. Which statement indicates the client
understands proper breastfeeding technique?
A. "I should feel a sharp pain throughout the entire feeding"
B. "The baby's chin should touch my breast during feeding"
C. "I should limit feedings to 5 minutes on each breast"
D. "I need to wash my nipples with soap before each feeding"
CORRECT ANSWER: B. "The baby's chin should touch my breast during
feeding"
Rationale: Proper latch technique includes the baby's chin touching the
breast and the nose close to but not touching the breast. This ensures
adequate mouthful of breast tissue. Sharp pain throughout feeding
indicates poor latch. Feedings should not be time-limited but should
continue until the baby is satisfied. Soap should be avoided on nipples as it
removes natural protective oils.
Question 7: A nurse is assessing a client at 36 weeks gestation who
reports painless, bright red vaginal bleeding. Which of the following
findings is most concerning for placenta previa?
A. Uterine tenderness on palpation
B. Soft, nontender uterus
, C. Fetal heart rate baseline of 130 bpm
D. Ruptured membranes with clear fluid
CORRECT ANSWER: B. Soft, nontender uterus
Rationale: Placenta previa classically presents with painless, bright red
vaginal bleeding and a soft, nontender uterus. Uterine tenderness suggests
abruptio placentae. A normal fetal heart rate and clear fluid do not
differentiate the condition. The soft, nontender uterus is the most specific
finding for placenta previa. Vaginal examination is contraindicated when
placenta previa is suspected.
Question 8: A nurse is teaching a client who is at 12 weeks gestation
about expected physiological changes. Which statement indicates the
client understands the teaching?
A. "I should expect my blood pressure to increase significantly"
B. "My heart rate will decrease during pregnancy"
C. "I may experience nasal stuffiness due to increased blood flow"
D. "My blood glucose levels should remain unchanged"
CORRECT ANSWER: C. "I may experience nasal stuffiness due to
increased blood flow"
Rationale: Pregnancy causes increased estrogen levels leading to
hyperemia and edema of mucous membranes, resulting in nasal stuffiness
and epistaxis. Blood pressure typically remains the same or decreases
slightly due to peripheral vasodilation. Heart rate increases by 10-15 bpm.
Blood glucose is affected by placental hormones causing insulin
resistance.
Question 9: A nurse is caring for a client who is 1 day postpartum and
reports abdominal cramping during breastfeeding. Which response by
the nurse is appropriate?
A. "This is abnormal and may indicate infection"
B. "These are afterpains caused by oxytocin release during breastfeeding"
C. "You should stop breastfeeding to prevent further cramping"
D. "This indicates your uterus is not contracting properly"
CORRECT ANSWER: B. "These are afterpains caused by oxytocin
release during breastfeeding"
