ATI PN Maternal Newborn Exam
2025 – Verified Questions and Correct
Answers with Expert Rationales
Question 1
Scenario: A pregnant client at 32 weeks gestation reports decreased fetal movement over the
past 24 hours.
Question: What is the nurse’s priority action?
A) Encourage the client to drink more fluids.
B) Instruct the client to contact the healthcare provider.
C) Advise the client to rest in a supine position.
D) Monitor the client’s temperature.
Answer: B) Instruct the client to contact the healthcare provider.
Rationale: Decreased fetal movement may indicate fetal distress, requiring immediate
evaluation by the healthcare provider. Increasing fluids (A) is not specific, supine positioning (C)
may reduce placental perfusion, and monitoring temperature (D) is unrelated to the issue.
Question 2
Scenario: A client in labor at 39 weeks gestation has a fetal heart rate (FHR) of 100 bpm with
minimal variability.
Question: What is the nurse’s best action?
A) Continue routine monitoring.
B) Reposition the client and notify the provider.
C) Administer a tocolytic medication.
D) Encourage ambulation.
Answer: B) Reposition the client and notify the provider.
Rationale: An FHR of 100 bpm with minimal variability suggests fetal distress, requiring
immediate interventions like repositioning to improve placental perfusion and provider
notification. Routine monitoring (A) is inadequate, tocolytics (C) are inappropriate, and
ambulation (D) may worsen the situation.
,Question 3
Scenario: A postpartum client reports heavy vaginal bleeding and a boggy uterus 2 hours after
delivery.
Question: What is the nurse’s priority action?
A) Administer oxytocin as prescribed.
B) Massage the fundus and notify the provider.
C) Encourage increased fluid intake.
D) Monitor vital signs every 4 hours.
Answer: B) Massage the fundus and notify the provider.
Rationale: A boggy uterus and heavy bleeding suggest uterine atony, a leading cause of
postpartum hemorrhage, requiring fundal massage to stimulate contraction and provider
notification. Oxytocin (A) may be needed but requires a prescription, fluids (C) are secondary,
and monitoring every 4 hours (D) is too infrequent.
Question 4
Scenario: A newborn at 1 hour of age has a respiratory rate of 70 breaths/min and nasal flaring.
Question: What is the nurse’s best action?
A) Place the newborn in a prone position.
B) Notify the healthcare provider immediately.
C) Suction the newborn’s mouth gently.
D) Monitor the newborn for 1 hour.
Answer: B) Notify the healthcare provider immediately.
Rationale: A respiratory rate of 70 breaths/min and nasal flaring indicate respiratory distress in a
newborn, requiring immediate provider notification. Prone positioning (A) is unsafe, suctioning
(C) may not address the cause, and monitoring (D) delays intervention.
Question 5
Scenario: A client at 28 weeks gestation reports swelling in the hands and face.
Question: What is the nurse’s priority action?
A) Advise the client to elevate her legs.
B) Assess for signs of preeclampsia.
,C) Encourage a low-sodium diet.
D) Monitor weight gain daily.
Answer: B) Assess for signs of preeclampsia.
Rationale: Swelling in the hands and face may indicate preeclampsia, a serious condition
requiring assessment for hypertension, proteinuria, and other symptoms. Leg elevation (A) or
diet changes (C) are secondary, and monitoring weight (D) is not the priority.
Question 6
Scenario: A client in active labor requests pain relief. The nurse notes the client is 4 cm dilated
with regular contractions.
Question: What is the most appropriate pain management option?
A) Administer meperidine IV.
B) Offer nonpharmacologic methods like breathing techniques.
C) Prepare for an epidural anesthesia.
D) Administer morphine IM.
Answer: B) Offer nonpharmacologic methods like breathing techniques.
Rationale: At 4 cm dilation in early labor, nonpharmacologic pain relief like breathing
techniques is appropriate to avoid slowing labor. Meperidine (A) and morphine (D) may depress
fetal respiration, and epidural (C) is typically offered in active labor (6 cm or more).
Question 7
Scenario: A postpartum client at 24 hours post-delivery reports a fever of 100.8°F (38.2°C).
Question: What is the nurse’s best action?
A) Encourage increased fluid intake.
B) Assess for signs of infection.
C) Administer acetaminophen PRN.
D) Monitor the temperature every 8 hours.
Answer: B) Assess for signs of infection.
Rationale: A fever above 100.4°F post-delivery suggests possible infection (e.g., endometritis),
requiring assessment for symptoms like foul lochia or uterine tenderness. Fluids (A) are
secondary, acetaminophen (C) treats symptoms but not the cause, and monitoring (D) is too
infrequent.
, Question 8
Scenario: A newborn at 12 hours of age has a bilirubin level of 12 mg/dL.
Question: What is the nurse’s best action?
A) Encourage early discharge.
B) Notify the healthcare provider.
C) Increase formula feedings.
D) Monitor the newborn’s skin color.
Answer: B) Notify the healthcare provider.
Rationale: A bilirubin level of 12 mg/dL at 12 hours indicates hyperbilirubinemia, requiring
provider evaluation for possible phototherapy. Early discharge (A) is unsafe, feedings (C) are
secondary, and monitoring (D) delays intervention.
Question 9
Scenario: A client at 36 weeks gestation reports a sudden gush of clear fluid from the vagina.
Question: What is the nurse’s priority action?
A) Encourage ambulation to promote labor.
B) Perform a sterile speculum exam to confirm rupture of membranes.
C) Administer a tocolytic medication.
D) Monitor fetal heart rate every 4 hours.
Answer: B) Perform a sterile speculum exam to confirm rupture of membranes.
Rationale: A sudden gush of fluid suggests premature rupture of membranes (PROM), requiring
confirmation with a sterile speculum exam and tests like nitrazine or ferning. Ambulation (A)
risks cord prolapse, tocolytics (C) are inappropriate, and monitoring every 4 hours (D) is
inadequate.
Question 10
Scenario: A postpartum client is breastfeeding and reports nipple soreness.
Question: What should the nurse teach the client?
A) Discontinue breastfeeding temporarily.
B) Ensure proper latch and apply lanolin cream.
C) Clean nipples with soap before feeding.
D) Limit breastfeeding to 5 minutes per session.
2025 – Verified Questions and Correct
Answers with Expert Rationales
Question 1
Scenario: A pregnant client at 32 weeks gestation reports decreased fetal movement over the
past 24 hours.
Question: What is the nurse’s priority action?
A) Encourage the client to drink more fluids.
B) Instruct the client to contact the healthcare provider.
C) Advise the client to rest in a supine position.
D) Monitor the client’s temperature.
Answer: B) Instruct the client to contact the healthcare provider.
Rationale: Decreased fetal movement may indicate fetal distress, requiring immediate
evaluation by the healthcare provider. Increasing fluids (A) is not specific, supine positioning (C)
may reduce placental perfusion, and monitoring temperature (D) is unrelated to the issue.
Question 2
Scenario: A client in labor at 39 weeks gestation has a fetal heart rate (FHR) of 100 bpm with
minimal variability.
Question: What is the nurse’s best action?
A) Continue routine monitoring.
B) Reposition the client and notify the provider.
C) Administer a tocolytic medication.
D) Encourage ambulation.
Answer: B) Reposition the client and notify the provider.
Rationale: An FHR of 100 bpm with minimal variability suggests fetal distress, requiring
immediate interventions like repositioning to improve placental perfusion and provider
notification. Routine monitoring (A) is inadequate, tocolytics (C) are inappropriate, and
ambulation (D) may worsen the situation.
,Question 3
Scenario: A postpartum client reports heavy vaginal bleeding and a boggy uterus 2 hours after
delivery.
Question: What is the nurse’s priority action?
A) Administer oxytocin as prescribed.
B) Massage the fundus and notify the provider.
C) Encourage increased fluid intake.
D) Monitor vital signs every 4 hours.
Answer: B) Massage the fundus and notify the provider.
Rationale: A boggy uterus and heavy bleeding suggest uterine atony, a leading cause of
postpartum hemorrhage, requiring fundal massage to stimulate contraction and provider
notification. Oxytocin (A) may be needed but requires a prescription, fluids (C) are secondary,
and monitoring every 4 hours (D) is too infrequent.
Question 4
Scenario: A newborn at 1 hour of age has a respiratory rate of 70 breaths/min and nasal flaring.
Question: What is the nurse’s best action?
A) Place the newborn in a prone position.
B) Notify the healthcare provider immediately.
C) Suction the newborn’s mouth gently.
D) Monitor the newborn for 1 hour.
Answer: B) Notify the healthcare provider immediately.
Rationale: A respiratory rate of 70 breaths/min and nasal flaring indicate respiratory distress in a
newborn, requiring immediate provider notification. Prone positioning (A) is unsafe, suctioning
(C) may not address the cause, and monitoring (D) delays intervention.
Question 5
Scenario: A client at 28 weeks gestation reports swelling in the hands and face.
Question: What is the nurse’s priority action?
A) Advise the client to elevate her legs.
B) Assess for signs of preeclampsia.
,C) Encourage a low-sodium diet.
D) Monitor weight gain daily.
Answer: B) Assess for signs of preeclampsia.
Rationale: Swelling in the hands and face may indicate preeclampsia, a serious condition
requiring assessment for hypertension, proteinuria, and other symptoms. Leg elevation (A) or
diet changes (C) are secondary, and monitoring weight (D) is not the priority.
Question 6
Scenario: A client in active labor requests pain relief. The nurse notes the client is 4 cm dilated
with regular contractions.
Question: What is the most appropriate pain management option?
A) Administer meperidine IV.
B) Offer nonpharmacologic methods like breathing techniques.
C) Prepare for an epidural anesthesia.
D) Administer morphine IM.
Answer: B) Offer nonpharmacologic methods like breathing techniques.
Rationale: At 4 cm dilation in early labor, nonpharmacologic pain relief like breathing
techniques is appropriate to avoid slowing labor. Meperidine (A) and morphine (D) may depress
fetal respiration, and epidural (C) is typically offered in active labor (6 cm or more).
Question 7
Scenario: A postpartum client at 24 hours post-delivery reports a fever of 100.8°F (38.2°C).
Question: What is the nurse’s best action?
A) Encourage increased fluid intake.
B) Assess for signs of infection.
C) Administer acetaminophen PRN.
D) Monitor the temperature every 8 hours.
Answer: B) Assess for signs of infection.
Rationale: A fever above 100.4°F post-delivery suggests possible infection (e.g., endometritis),
requiring assessment for symptoms like foul lochia or uterine tenderness. Fluids (A) are
secondary, acetaminophen (C) treats symptoms but not the cause, and monitoring (D) is too
infrequent.
, Question 8
Scenario: A newborn at 12 hours of age has a bilirubin level of 12 mg/dL.
Question: What is the nurse’s best action?
A) Encourage early discharge.
B) Notify the healthcare provider.
C) Increase formula feedings.
D) Monitor the newborn’s skin color.
Answer: B) Notify the healthcare provider.
Rationale: A bilirubin level of 12 mg/dL at 12 hours indicates hyperbilirubinemia, requiring
provider evaluation for possible phototherapy. Early discharge (A) is unsafe, feedings (C) are
secondary, and monitoring (D) delays intervention.
Question 9
Scenario: A client at 36 weeks gestation reports a sudden gush of clear fluid from the vagina.
Question: What is the nurse’s priority action?
A) Encourage ambulation to promote labor.
B) Perform a sterile speculum exam to confirm rupture of membranes.
C) Administer a tocolytic medication.
D) Monitor fetal heart rate every 4 hours.
Answer: B) Perform a sterile speculum exam to confirm rupture of membranes.
Rationale: A sudden gush of fluid suggests premature rupture of membranes (PROM), requiring
confirmation with a sterile speculum exam and tests like nitrazine or ferning. Ambulation (A)
risks cord prolapse, tocolytics (C) are inappropriate, and monitoring every 4 hours (D) is
inadequate.
Question 10
Scenario: A postpartum client is breastfeeding and reports nipple soreness.
Question: What should the nurse teach the client?
A) Discontinue breastfeeding temporarily.
B) Ensure proper latch and apply lanolin cream.
C) Clean nipples with soap before feeding.
D) Limit breastfeeding to 5 minutes per session.
