ATI Maternal Newborn Test Bank 2026/2027 |
ACTUAL-Style Practice Questions & Answers, ATI RN
Maternal Newborn Nursing Exam Prep, Pregnancy and
Prenatal Care, Labor and Delivery, Postpartum
Nursing, Newborn Assessment, High-Risk Pregnancy,
Obstetric Complications, Fetal Monitoring, and
Detailed Rationales
Question 1: 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
this finding as which of the following?
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 commonly associated with vacuum-assisted delivery.
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 overlapping of cranial bones.
Question 2: A nurse is caring for a client who is at 35 weeks of gestation
and has a prescription for terbutaline for preterm labor. Which of the
following statements by the client should the nurse identify as the
priority finding?
A. "My ankles are swollen at the end of the day."
B. "I can feel the baby kicking my ribs, and it is very uncomfortable."
C. "I'm growing more and more worried every day."
D. "My heart feels as if it is racing."
CORRECT ANSWER: D. "My heart feels as if it is racing."
Rationale: Terbutaline is a beta-2 adrenergic agonist that can cause
maternal tachycardia as an adverse effect. A heart rate greater than
130/min requires holding the medication and notifying the provider. While
,anxiety and discomfort are important, tachycardia is a physiological safety
concern.
Question 3: A nurse is planning care for a newborn who requires
phototherapy for hyperbilirubinemia. Which of the following actions
should the nurse include in the plan of care?
A. Swaddle the newborn in a receiving blanket during treatment.
B. Maintain NPO status until the newborn's bilirubin is within the expected
reference range.
C. Ensure the newborn's eyes are closed before applying the eye shield.
D. Apply lotion to the newborn's skin twice per day.
CORRECT ANSWER: C. Ensure the newborn's eyes are closed before
applying the eye shield.
Rationale: Overexposure to phototherapy lights can damage the newborn's
corneas and retinas. The nurse must gently close the newborn's eyes prior
to applying the eye shield. The newborn should be undressed except for a
diaper to maximize skin exposure. Feeding should continue to promote
bilirubin excretion.
Question 4: A nurse is caring for a client who is at 32 weeks of gestation
and reports a sudden gush of fluid. Which of the following actions
should the nurse take first?
A. Perform a sterile vaginal exam.
B. Assess fetal heart rate and check for cord prolapse.
C. Obtain a urine specimen.
D. Place the client in Trendelenburg position.
CORRECT ANSWER: B. Assess fetal heart rate and check for cord
prolapse.
Rationale: After rupture of membranes, the priority is assessing fetal well-
being and ruling out cord prolapse. The nurse should immediately assess
the fetal heart rate. Sterile vaginal exams are limited due to infection risk.
Trendelenburg position is used if cord prolapse is suspected but is not the
first action.
Question 5: A nurse is assessing a client who is in labor and observes
late decelerations on the fetal monitor tracing. Which of the following
,conditions should the nurse identify as the cause of late
decelerations?
A. Head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Fetal sleep cycle
CORRECT ANSWER: C. Uteroplacental insufficiency
Rationale: Late decelerations are caused by uteroplacental insufficiency,
which reduces blood flow and oxygen delivery to the fetus during
contractions. Early decelerations are caused by head compression.
Variable decelerations are caused by umbilical cord compression. Fetal
sleep cycles may cause minimal variability.
Question 6: A nurse is caring for a newborn who has a blood glucose
level of 45 mg/dL. Which of the following actions should the nurse
take?
A. Administer IV dextrose.
B. Encourage the mother to breastfeed the newborn.
C. Prepare for phototherapy.
D. Obtain a serum bilirubin level.
CORRECT ANSWER: B. Encourage the mother to breastfeed the
newborn.
Rationale: A blood glucose level of 45 mg/dL is within the expected
reference range for a newborn (greater than 40 mg/dL). The nurse should
encourage breastfeeding to maintain glucose levels. IV dextrose is reserved
for hypoglycemia. Phototherapy is unrelated to glucose management.
Question 7: A nurse is assessing a newborn who is 48 hours old and has
a maternal history of methadone use during pregnancy. Which of the
following manifestations should the nurse identify as an indication of
neonatal abstinence syndrome?
A. Lethargy and poor feeding
B. Excessive high-pitched cry
C. Decreased muscle tone
D. Respiratory depression
, CORRECT ANSWER: B. Excessive high-pitched cry
Rationale: Neonatal abstinence syndrome (NAS) manifests with central
nervous system hyperirritability, including excessive high-pitched crying,
tremors, and increased muscle tone. Lethargy, poor feeding, and
respiratory depression are more consistent with opioid toxicity rather than
withdrawal.
Question 8: A nurse is caring for a client who is at 34 weeks of gestation
and has placenta previa. Which of the following actions should the
nurse take?
A. Perform a vaginal exam to assess cervical dilation.
B. Initiate continuous external fetal monitoring.
C. Encourage the client to ambulate frequently.
D. Administer a cleansing enema.
CORRECT ANSWER: B. Initiate continuous external fetal monitoring.
Rationale: Placenta previa can cause painless bright red vaginal bleeding
and necessitates continuous fetal monitoring to assess fetal well-being.
Vaginal exams are contraindicated due to the risk of provoking severe
hemorrhage. Ambulation and enemas are not appropriate for this client.
Question 9: A nurse is providing discharge teaching to a client following
the removal of a hydatidiform mole. Which of the following statements
should the nurse include in the teaching?
A. "You should not become pregnant for at least 1 year."
B. "You should seek genetic counseling prior to getting pregnant again."
C. "You should have an hCG level drawn in 6 weeks."
D. "You should have your blood pressure checked weekly for the next
month."
CORRECT ANSWER: A. "You should not become pregnant for at least 1
year."
Rationale: Hydatidiform moles carry an increased risk of choriocarcinoma.
Pregnancy must be avoided for at least 1 year to allow for close monitoring
of hCG levels and to detect malignancy. Genetic counseling is not
indicated. hCG levels are monitored more frequently than every 6 weeks.
ACTUAL-Style Practice Questions & Answers, ATI RN
Maternal Newborn Nursing Exam Prep, Pregnancy and
Prenatal Care, Labor and Delivery, Postpartum
Nursing, Newborn Assessment, High-Risk Pregnancy,
Obstetric Complications, Fetal Monitoring, and
Detailed Rationales
Question 1: 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
this finding as which of the following?
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 commonly associated with vacuum-assisted delivery.
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 overlapping of cranial bones.
Question 2: A nurse is caring for a client who is at 35 weeks of gestation
and has a prescription for terbutaline for preterm labor. Which of the
following statements by the client should the nurse identify as the
priority finding?
A. "My ankles are swollen at the end of the day."
B. "I can feel the baby kicking my ribs, and it is very uncomfortable."
C. "I'm growing more and more worried every day."
D. "My heart feels as if it is racing."
CORRECT ANSWER: D. "My heart feels as if it is racing."
Rationale: Terbutaline is a beta-2 adrenergic agonist that can cause
maternal tachycardia as an adverse effect. A heart rate greater than
130/min requires holding the medication and notifying the provider. While
,anxiety and discomfort are important, tachycardia is a physiological safety
concern.
Question 3: A nurse is planning care for a newborn who requires
phototherapy for hyperbilirubinemia. Which of the following actions
should the nurse include in the plan of care?
A. Swaddle the newborn in a receiving blanket during treatment.
B. Maintain NPO status until the newborn's bilirubin is within the expected
reference range.
C. Ensure the newborn's eyes are closed before applying the eye shield.
D. Apply lotion to the newborn's skin twice per day.
CORRECT ANSWER: C. Ensure the newborn's eyes are closed before
applying the eye shield.
Rationale: Overexposure to phototherapy lights can damage the newborn's
corneas and retinas. The nurse must gently close the newborn's eyes prior
to applying the eye shield. The newborn should be undressed except for a
diaper to maximize skin exposure. Feeding should continue to promote
bilirubin excretion.
Question 4: A nurse is caring for a client who is at 32 weeks of gestation
and reports a sudden gush of fluid. Which of the following actions
should the nurse take first?
A. Perform a sterile vaginal exam.
B. Assess fetal heart rate and check for cord prolapse.
C. Obtain a urine specimen.
D. Place the client in Trendelenburg position.
CORRECT ANSWER: B. Assess fetal heart rate and check for cord
prolapse.
Rationale: After rupture of membranes, the priority is assessing fetal well-
being and ruling out cord prolapse. The nurse should immediately assess
the fetal heart rate. Sterile vaginal exams are limited due to infection risk.
Trendelenburg position is used if cord prolapse is suspected but is not the
first action.
Question 5: A nurse is assessing a client who is in labor and observes
late decelerations on the fetal monitor tracing. Which of the following
,conditions should the nurse identify as the cause of late
decelerations?
A. Head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Fetal sleep cycle
CORRECT ANSWER: C. Uteroplacental insufficiency
Rationale: Late decelerations are caused by uteroplacental insufficiency,
which reduces blood flow and oxygen delivery to the fetus during
contractions. Early decelerations are caused by head compression.
Variable decelerations are caused by umbilical cord compression. Fetal
sleep cycles may cause minimal variability.
Question 6: A nurse is caring for a newborn who has a blood glucose
level of 45 mg/dL. Which of the following actions should the nurse
take?
A. Administer IV dextrose.
B. Encourage the mother to breastfeed the newborn.
C. Prepare for phototherapy.
D. Obtain a serum bilirubin level.
CORRECT ANSWER: B. Encourage the mother to breastfeed the
newborn.
Rationale: A blood glucose level of 45 mg/dL is within the expected
reference range for a newborn (greater than 40 mg/dL). The nurse should
encourage breastfeeding to maintain glucose levels. IV dextrose is reserved
for hypoglycemia. Phototherapy is unrelated to glucose management.
Question 7: A nurse is assessing a newborn who is 48 hours old and has
a maternal history of methadone use during pregnancy. Which of the
following manifestations should the nurse identify as an indication of
neonatal abstinence syndrome?
A. Lethargy and poor feeding
B. Excessive high-pitched cry
C. Decreased muscle tone
D. Respiratory depression
, CORRECT ANSWER: B. Excessive high-pitched cry
Rationale: Neonatal abstinence syndrome (NAS) manifests with central
nervous system hyperirritability, including excessive high-pitched crying,
tremors, and increased muscle tone. Lethargy, poor feeding, and
respiratory depression are more consistent with opioid toxicity rather than
withdrawal.
Question 8: A nurse is caring for a client who is at 34 weeks of gestation
and has placenta previa. Which of the following actions should the
nurse take?
A. Perform a vaginal exam to assess cervical dilation.
B. Initiate continuous external fetal monitoring.
C. Encourage the client to ambulate frequently.
D. Administer a cleansing enema.
CORRECT ANSWER: B. Initiate continuous external fetal monitoring.
Rationale: Placenta previa can cause painless bright red vaginal bleeding
and necessitates continuous fetal monitoring to assess fetal well-being.
Vaginal exams are contraindicated due to the risk of provoking severe
hemorrhage. Ambulation and enemas are not appropriate for this client.
Question 9: A nurse is providing discharge teaching to a client following
the removal of a hydatidiform mole. Which of the following statements
should the nurse include in the teaching?
A. "You should not become pregnant for at least 1 year."
B. "You should seek genetic counseling prior to getting pregnant again."
C. "You should have an hCG level drawn in 6 weeks."
D. "You should have your blood pressure checked weekly for the next
month."
CORRECT ANSWER: A. "You should not become pregnant for at least 1
year."
Rationale: Hydatidiform moles carry an increased risk of choriocarcinoma.
Pregnancy must be avoided for at least 1 year to allow for close monitoring
of hCG levels and to detect malignancy. Genetic counseling is not
indicated. hCG levels are monitored more frequently than every 6 weeks.
