Score A+ ON ATI RN Maternal Newborn Proctored Exam
2026/2027 instant pdf plus verified rationales
1. A pregnant client at 32 weeks of gestation reports painless, bright-red vaginal bleeding.
Which condition should the nurse suspect?
A. Abruptio placentae
B. Ectopic pregnancy
C. Placenta previa
D. Preterm labor
Answer: C. Placenta previa
Rationale: Placenta previa commonly presents with painless, bright-red vaginal bleeding during
the second or third trimester.
2. A pregnant client develops sudden severe abdominal pain, a rigid tender uterus, and
dark vaginal bleeding. Which complication is most likely?
A. Placenta previa
B. Abruptio placentae
C. Hyperemesis gravidarum
D. Gestational diabetes
Answer: B. Abruptio placentae
Rationale: Placental abruption typically causes painful vaginal bleeding, uterine tenderness, and
abdominal or back pain.
3. A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 9/min
and absent deep-tendon reflexes. What should the nurse do?
A. Increase the infusion
B. Continue the infusion
C. Stop the magnesium infusion and notify the healthcare provider immediately
D. Encourage ambulation
Answer: C. Stop the magnesium infusion and notify the healthcare provider immediately
Rationale: Respiratory depression and absent reflexes are signs of magnesium toxicity. The
infusion should be stopped and emergency management initiated according to protocol.
,4. Which medication should the nurse anticipate as an antidote for magnesium sulfate
toxicity?
A. Naloxone
B. Vitamin K
C. Calcium gluconate
D. Protamine sulfate
Answer: C. Calcium gluconate
Rationale: Calcium gluconate is the antidote used to counteract significant magnesium toxicity.
5. A postpartum client has heavy vaginal bleeding and a boggy uterus. What should the
nurse do first?
A. Place the client flat
B. Encourage oral fluids
C. Massage the uterine fundus
D. Encourage ambulation
Answer: C. Massage the uterine fundus
Rationale: A boggy uterus indicates uterine atony, a major cause of postpartum hemorrhage.
Fundal massage promotes uterine contraction.
6. A postpartum client has a firm uterus but continues to have heavy bright-red bleeding.
What should the nurse suspect?
A. Normal lochia
B. Genital tract laceration or another source of hemorrhage
C. Uterine atony
D. Urinary retention only
Answer: B. Genital tract laceration or another source of hemorrhage
Rationale: Persistent heavy bleeding despite a firm, contracted uterus suggests a source other
than uterine atony, such as trauma or laceration.
,7. A client with preeclampsia reports severe headache, blurred vision, and epigastric pain.
What is the priority nursing action?
A. Encourage ambulation
B. Dim the lights and discharge the client
C. Notify the healthcare provider promptly and continue close assessment
D. Encourage a high-sodium meal
Answer: C. Notify the healthcare provider promptly and continue close assessment
Rationale: Severe headache, visual disturbances, and epigastric/right-upper-quadrant pain are
warning signs of severe preeclampsia and possible complications.
8. A pregnant client with gestational diabetes asks why glucose control is important. What
is the best response?
A. “It prevents all pregnancy complications.”
B. “Good glucose control helps reduce maternal and fetal complications.”
C. “It eliminates the need for prenatal visits.”
D. “It guarantees the newborn will have normal glucose.”
Answer: B. “Good glucose control helps reduce maternal and fetal complications.”
Rationale: Appropriate glucose management reduces risks associated with hyperglycemia
during pregnancy, including fetal overgrowth and neonatal metabolic complications.
9. A newborn of a client with diabetes is at increased risk for which complication shortly
after birth?
A. Hyperglycemia
B. Hypoglycemia
C. Hypercalcemia
D. Hypertension
Answer: B. Hypoglycemia
Rationale: Infants of diabetic mothers may have increased insulin levels after birth, placing them
at risk for hypoglycemia.
, 10. A newborn's blood glucose is low and the newborn is symptomatic but able to feed.
What intervention should the nurse anticipate?
A. Delay feeding
B. Provide prompt feeding or prescribed glucose treatment and reassess glucose
C. Administer insulin
D. Restrict carbohydrates
Answer: B. Provide prompt feeding or prescribed glucose treatment and reassess glucose
Rationale: Symptomatic neonatal hypoglycemia requires prompt treatment according to the
newborn's condition and facility protocol.
11. A newborn develops jaundice within the first 24 hours after birth. How should the
nurse interpret this finding?
A. Expected physiologic jaundice
B. Normal feeding response
C. Potentially pathologic jaundice requiring evaluation
D. Evidence of adequate hydration
Answer: C. Potentially pathologic jaundice requiring evaluation
Rationale: Jaundice appearing during the first 24 hours is considered abnormal and requires
prompt evaluation.
12. A newborn receiving phototherapy has loose greenish stools. How should the nurse
interpret this finding?
A. Always evidence of infection
B. A possible expected effect of bilirubin elimination
C. Evidence of bowel obstruction
D. Severe dehydration in every case
Answer: B. A possible expected effect of bilirubin elimination
Rationale: Phototherapy increases bilirubin elimination, and loose stools can occur during
treatment.
13. A newborn is receiving phototherapy. Which nursing intervention is appropriate?
2026/2027 instant pdf plus verified rationales
1. A pregnant client at 32 weeks of gestation reports painless, bright-red vaginal bleeding.
Which condition should the nurse suspect?
A. Abruptio placentae
B. Ectopic pregnancy
C. Placenta previa
D. Preterm labor
Answer: C. Placenta previa
Rationale: Placenta previa commonly presents with painless, bright-red vaginal bleeding during
the second or third trimester.
2. A pregnant client develops sudden severe abdominal pain, a rigid tender uterus, and
dark vaginal bleeding. Which complication is most likely?
A. Placenta previa
B. Abruptio placentae
C. Hyperemesis gravidarum
D. Gestational diabetes
Answer: B. Abruptio placentae
Rationale: Placental abruption typically causes painful vaginal bleeding, uterine tenderness, and
abdominal or back pain.
3. A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 9/min
and absent deep-tendon reflexes. What should the nurse do?
A. Increase the infusion
B. Continue the infusion
C. Stop the magnesium infusion and notify the healthcare provider immediately
D. Encourage ambulation
Answer: C. Stop the magnesium infusion and notify the healthcare provider immediately
Rationale: Respiratory depression and absent reflexes are signs of magnesium toxicity. The
infusion should be stopped and emergency management initiated according to protocol.
,4. Which medication should the nurse anticipate as an antidote for magnesium sulfate
toxicity?
A. Naloxone
B. Vitamin K
C. Calcium gluconate
D. Protamine sulfate
Answer: C. Calcium gluconate
Rationale: Calcium gluconate is the antidote used to counteract significant magnesium toxicity.
5. A postpartum client has heavy vaginal bleeding and a boggy uterus. What should the
nurse do first?
A. Place the client flat
B. Encourage oral fluids
C. Massage the uterine fundus
D. Encourage ambulation
Answer: C. Massage the uterine fundus
Rationale: A boggy uterus indicates uterine atony, a major cause of postpartum hemorrhage.
Fundal massage promotes uterine contraction.
6. A postpartum client has a firm uterus but continues to have heavy bright-red bleeding.
What should the nurse suspect?
A. Normal lochia
B. Genital tract laceration or another source of hemorrhage
C. Uterine atony
D. Urinary retention only
Answer: B. Genital tract laceration or another source of hemorrhage
Rationale: Persistent heavy bleeding despite a firm, contracted uterus suggests a source other
than uterine atony, such as trauma or laceration.
,7. A client with preeclampsia reports severe headache, blurred vision, and epigastric pain.
What is the priority nursing action?
A. Encourage ambulation
B. Dim the lights and discharge the client
C. Notify the healthcare provider promptly and continue close assessment
D. Encourage a high-sodium meal
Answer: C. Notify the healthcare provider promptly and continue close assessment
Rationale: Severe headache, visual disturbances, and epigastric/right-upper-quadrant pain are
warning signs of severe preeclampsia and possible complications.
8. A pregnant client with gestational diabetes asks why glucose control is important. What
is the best response?
A. “It prevents all pregnancy complications.”
B. “Good glucose control helps reduce maternal and fetal complications.”
C. “It eliminates the need for prenatal visits.”
D. “It guarantees the newborn will have normal glucose.”
Answer: B. “Good glucose control helps reduce maternal and fetal complications.”
Rationale: Appropriate glucose management reduces risks associated with hyperglycemia
during pregnancy, including fetal overgrowth and neonatal metabolic complications.
9. A newborn of a client with diabetes is at increased risk for which complication shortly
after birth?
A. Hyperglycemia
B. Hypoglycemia
C. Hypercalcemia
D. Hypertension
Answer: B. Hypoglycemia
Rationale: Infants of diabetic mothers may have increased insulin levels after birth, placing them
at risk for hypoglycemia.
, 10. A newborn's blood glucose is low and the newborn is symptomatic but able to feed.
What intervention should the nurse anticipate?
A. Delay feeding
B. Provide prompt feeding or prescribed glucose treatment and reassess glucose
C. Administer insulin
D. Restrict carbohydrates
Answer: B. Provide prompt feeding or prescribed glucose treatment and reassess glucose
Rationale: Symptomatic neonatal hypoglycemia requires prompt treatment according to the
newborn's condition and facility protocol.
11. A newborn develops jaundice within the first 24 hours after birth. How should the
nurse interpret this finding?
A. Expected physiologic jaundice
B. Normal feeding response
C. Potentially pathologic jaundice requiring evaluation
D. Evidence of adequate hydration
Answer: C. Potentially pathologic jaundice requiring evaluation
Rationale: Jaundice appearing during the first 24 hours is considered abnormal and requires
prompt evaluation.
12. A newborn receiving phototherapy has loose greenish stools. How should the nurse
interpret this finding?
A. Always evidence of infection
B. A possible expected effect of bilirubin elimination
C. Evidence of bowel obstruction
D. Severe dehydration in every case
Answer: B. A possible expected effect of bilirubin elimination
Rationale: Phototherapy increases bilirubin elimination, and loose stools can occur during
treatment.
13. A newborn is receiving phototherapy. Which nursing intervention is appropriate?
