ATI RN MATERNAL NEWBORN 2023 PROCTORED EXAM Questions with 100% Correct
Answers | Verified | Latest Update
1. A nurse is teaching a client who is at 8 weeks of gestation about nutrition. Which of the following
statements by the client indicates an understanding of the teaching?
- A) "I will take a folic acid supplement of 100 mcg daily."
- B) "I need to increase my calcium intake to 1,000 mg per day during pregnancy."
- C) "I can continue to drink alcohol as long as I limit it to one glass of wine per week."
- D) "It is safe to eat deli meats and soft cheeses as long as they are refrigerated properly."
Correct Answer: B
Rationale: During pregnancy, the recommended daily intake of calcium is 1,000 mg (1,300 mg for
adolescents) to support fetal bone development. Folic acid recommendation is 400-800 mcg daily (A).
Alcohol should be avoided entirely during pregnancy (C). Deli meats and soft cheeses pose a risk of
listeriosis and should be heated until steaming hot or avoided (D).
2. A client at 39 weeks of gestation is admitted for induction of labor. Which medication does the nurse
anticipate administering first to ripen the cervix?
- A) Oxytocin (Pitocin)
- B) Misoprostol (Cytotec)
- C) Methylergonovine (Methergine)
- D) Terbutaline (Brethine)
Correct Answer: B
Rationale: Misoprostol is a prostaglandin E1 analogue used for cervical ripening and labor induction.
Oxytocin is used for augmentation or induction once the cervix is favorable. Methylergonovine is used to
treat postpartum hemorrhage. Terbutaline is a tocolytic used to stop preterm labor.
,3. A nurse is caring for a client who has a new diagnosis of gestational diabetes mellitus (GDM). Which of
the following is an expected finding?
- A) Glycosuria
- B) Hypoglycemia
- C) Weight loss
- D) Hypotension
Correct Answer: A
Rationale: Glycosuria is common in GDM because the renal threshold for glucose is lowered during
pregnancy and blood glucose levels exceed the threshold. Polyuria, polydipsia, and polyphagia may also
occur. Hypoglycemia is not typical; hyperglycemia is the hallmark. Weight gain is expected; weight loss
would be concerning.
4. A nurse is performing a nonstress test (NST) on a client at 34 weeks of gestation. Which of the
following findings indicates a reactive NST?
- A) Two fetal heart rate accelerations of 20 bpm above baseline lasting at least 20 seconds within a 20-
minute period.
- B) No fetal heart rate accelerations after 40 minutes of monitoring.
- C) Late decelerations following two uterine contractions.
- D) Baseline fetal heart rate of 100 bpm with minimal variability.
Correct Answer: A
Rationale: A reactive NST requires at least two accelerations of FHR ≥15 bpm (≥20 bpm before 32 weeks)
lasting ≥15 seconds (≥20 seconds before 32 weeks) within a 20-minute window. No accelerations is
non‑reactive; late decelerations are non‑reassuring; bradycardia with minimal variability is also
concerning.
5. A nurse is assessing a client who is 24 hours postpartum. The client’s fundus is firm, midline, and at
the level of the umbilicus. Lochia rubra is moderate. What is the priority nursing action?
- A) Massage the fundus vigorously.
,- B) Notify the provider immediately.
- C) Document the findings as normal.
- D) Administer oxytocin as prescribed.
Correct Answer: C
Rationale: One day postpartum, the fundus is expected to be at the umbilicus, firm, and midline. Lochia
rubra should be moderate (soaking less than one pad per hour). These are normal findings and should
be documented. Massage is only needed if the fundus is boggy. No intervention is required.
6. A newborn is delivered via vacuum extraction due to maternal exhaustion. Two hours after birth, the
nurse notes a fluctuating anterior fontanel and episodes of apnea. Which complication should the nurse
suspect?
- A) Cephalohematoma
- B) Subgaleal hemorrhage
- C) Caput succedaneum
- D) Molding
Correct Answer: B
Rationale: Subgaleal hemorrhage (bleeding into the potential space between the periosteum and the
galea aponeurotica) can occur after vacuum‑assisted delivery. Signs include fluctuant swelling that
crosses suture lines, pallor, tachycardia, hypotension, and respiratory distress (apnea). It is a medical
emergency. Cephalohematoma does not cross suture lines. Caput succedaneum is edema that crosses
suture lines but is not fluctuant.
7. A nurse is caring for a client with preeclampsia who is receiving magnesium sulfate IV. Which finding
indicates magnesium toxicity?
- A) Respiratory rate of 14/min
- B) Urine output of 40 mL/hr
- C) Deep tendon reflexes 1+
- D) Blood pressure 130/80 mm Hg
, Correct Answer: C
Rationale: Magnesium toxicity causes decreased deep tendon reflexes (DTRs) (1+ or absent), respiratory
depression (<12/min), and decreased urine output (<30 mL/hr). DTRs 2+ are normal; 1+ indicates early
toxicity. The nurse should stop the infusion and have calcium gluconate (antidote) available. Option B is
borderline but not critical; option A is normal; option D is well controlled.
8. A client is receiving oxytocin for induction of labor. She is having contractions every 2 minutes lasting
90 seconds, and the fetal heart rate shows late decelerations. What should the nurse do first?
- A) Increase the oxytocin infusion rate.
- B) Discontinue the oxytocin infusion.
- C) Reposition the client to her right side.
- D) Administer oxygen via face mask at 2 L/min.
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency and are a non‑reassuring FHR pattern.
The first action is to discontinue oxytocin to reduce uterine activity. Next, reposition the client (left
lateral), administer oxygen (8-10 L/min), increase IV fluids, and notify the provider. Increasing oxytocin
would worsen the pattern.
9. A nurse is assessing a newborn who is 12 hours old. The newborn’s blood glucose level is 40 mg/dL.
Which of the following actions should the nurse take?
- A) Feed the newborn formula or breast milk.
- B) Administer IV dextrose 10% bolus.
- C) Notify the provider immediately.
- D) Document the finding as normal.
Correct Answer: A
Rationale: The normal newborn blood glucose level is >40-45 mg/dL. A level of 40 mg/dL is borderline
low. The nurse should feed the newborn early and frequently (breast milk or formula). Recheck glucose
Answers | Verified | Latest Update
1. A nurse is teaching a client who is at 8 weeks of gestation about nutrition. Which of the following
statements by the client indicates an understanding of the teaching?
- A) "I will take a folic acid supplement of 100 mcg daily."
- B) "I need to increase my calcium intake to 1,000 mg per day during pregnancy."
- C) "I can continue to drink alcohol as long as I limit it to one glass of wine per week."
- D) "It is safe to eat deli meats and soft cheeses as long as they are refrigerated properly."
Correct Answer: B
Rationale: During pregnancy, the recommended daily intake of calcium is 1,000 mg (1,300 mg for
adolescents) to support fetal bone development. Folic acid recommendation is 400-800 mcg daily (A).
Alcohol should be avoided entirely during pregnancy (C). Deli meats and soft cheeses pose a risk of
listeriosis and should be heated until steaming hot or avoided (D).
2. A client at 39 weeks of gestation is admitted for induction of labor. Which medication does the nurse
anticipate administering first to ripen the cervix?
- A) Oxytocin (Pitocin)
- B) Misoprostol (Cytotec)
- C) Methylergonovine (Methergine)
- D) Terbutaline (Brethine)
Correct Answer: B
Rationale: Misoprostol is a prostaglandin E1 analogue used for cervical ripening and labor induction.
Oxytocin is used for augmentation or induction once the cervix is favorable. Methylergonovine is used to
treat postpartum hemorrhage. Terbutaline is a tocolytic used to stop preterm labor.
,3. A nurse is caring for a client who has a new diagnosis of gestational diabetes mellitus (GDM). Which of
the following is an expected finding?
- A) Glycosuria
- B) Hypoglycemia
- C) Weight loss
- D) Hypotension
Correct Answer: A
Rationale: Glycosuria is common in GDM because the renal threshold for glucose is lowered during
pregnancy and blood glucose levels exceed the threshold. Polyuria, polydipsia, and polyphagia may also
occur. Hypoglycemia is not typical; hyperglycemia is the hallmark. Weight gain is expected; weight loss
would be concerning.
4. A nurse is performing a nonstress test (NST) on a client at 34 weeks of gestation. Which of the
following findings indicates a reactive NST?
- A) Two fetal heart rate accelerations of 20 bpm above baseline lasting at least 20 seconds within a 20-
minute period.
- B) No fetal heart rate accelerations after 40 minutes of monitoring.
- C) Late decelerations following two uterine contractions.
- D) Baseline fetal heart rate of 100 bpm with minimal variability.
Correct Answer: A
Rationale: A reactive NST requires at least two accelerations of FHR ≥15 bpm (≥20 bpm before 32 weeks)
lasting ≥15 seconds (≥20 seconds before 32 weeks) within a 20-minute window. No accelerations is
non‑reactive; late decelerations are non‑reassuring; bradycardia with minimal variability is also
concerning.
5. A nurse is assessing a client who is 24 hours postpartum. The client’s fundus is firm, midline, and at
the level of the umbilicus. Lochia rubra is moderate. What is the priority nursing action?
- A) Massage the fundus vigorously.
,- B) Notify the provider immediately.
- C) Document the findings as normal.
- D) Administer oxytocin as prescribed.
Correct Answer: C
Rationale: One day postpartum, the fundus is expected to be at the umbilicus, firm, and midline. Lochia
rubra should be moderate (soaking less than one pad per hour). These are normal findings and should
be documented. Massage is only needed if the fundus is boggy. No intervention is required.
6. A newborn is delivered via vacuum extraction due to maternal exhaustion. Two hours after birth, the
nurse notes a fluctuating anterior fontanel and episodes of apnea. Which complication should the nurse
suspect?
- A) Cephalohematoma
- B) Subgaleal hemorrhage
- C) Caput succedaneum
- D) Molding
Correct Answer: B
Rationale: Subgaleal hemorrhage (bleeding into the potential space between the periosteum and the
galea aponeurotica) can occur after vacuum‑assisted delivery. Signs include fluctuant swelling that
crosses suture lines, pallor, tachycardia, hypotension, and respiratory distress (apnea). It is a medical
emergency. Cephalohematoma does not cross suture lines. Caput succedaneum is edema that crosses
suture lines but is not fluctuant.
7. A nurse is caring for a client with preeclampsia who is receiving magnesium sulfate IV. Which finding
indicates magnesium toxicity?
- A) Respiratory rate of 14/min
- B) Urine output of 40 mL/hr
- C) Deep tendon reflexes 1+
- D) Blood pressure 130/80 mm Hg
, Correct Answer: C
Rationale: Magnesium toxicity causes decreased deep tendon reflexes (DTRs) (1+ or absent), respiratory
depression (<12/min), and decreased urine output (<30 mL/hr). DTRs 2+ are normal; 1+ indicates early
toxicity. The nurse should stop the infusion and have calcium gluconate (antidote) available. Option B is
borderline but not critical; option A is normal; option D is well controlled.
8. A client is receiving oxytocin for induction of labor. She is having contractions every 2 minutes lasting
90 seconds, and the fetal heart rate shows late decelerations. What should the nurse do first?
- A) Increase the oxytocin infusion rate.
- B) Discontinue the oxytocin infusion.
- C) Reposition the client to her right side.
- D) Administer oxygen via face mask at 2 L/min.
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency and are a non‑reassuring FHR pattern.
The first action is to discontinue oxytocin to reduce uterine activity. Next, reposition the client (left
lateral), administer oxygen (8-10 L/min), increase IV fluids, and notify the provider. Increasing oxytocin
would worsen the pattern.
9. A nurse is assessing a newborn who is 12 hours old. The newborn’s blood glucose level is 40 mg/dL.
Which of the following actions should the nurse take?
- A) Feed the newborn formula or breast milk.
- B) Administer IV dextrose 10% bolus.
- C) Notify the provider immediately.
- D) Document the finding as normal.
Correct Answer: A
Rationale: The normal newborn blood glucose level is >40-45 mg/dL. A level of 40 mg/dL is borderline
low. The nurse should feed the newborn early and frequently (breast milk or formula). Recheck glucose
