Fall Semester 2026–2027 ATI230 – ATI Maternal-
Newborn Proctored Updated 2026 | 190+ Questions
and Answers | ATI230 Maternal-Newborn
Comprehensive Study Guide, Practice Exam, Exam
Prep Test Bank, Antepartum Care, Intrapartum
Nursing, Labor & Delivery, Postpartum Care, Newborn
Assessment, Neonatal Nursing, High-Risk Pregnancy,
Obstetric Emergencies, Breastfeeding, Clinical
Judgment, Next Generation NCLEX (NGN), Detailed
Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who is 36 weeks gestation and reports
a sudden onset of severe abdominal pain with vaginal bleeding. The client's
uterus is firm and rigid on palpation. Which of the following actions should the
nurse take first?
A. Prepare the client for a vaginal examination
B. Administer an oral analgesic for pain relief
C. Position the client in a left lateral position
D. Apply an external fetal monitor
CORRECT ANSWER: D. Apply an external fetal monitor
Rationale: The presentation of sudden severe abdominal pain, vaginal bleeding, and a
rigid uterus is highly suggestive of placental abruption. The priority nursing action is to
apply an external fetal monitor to assess the fetal heart rate and pattern, which is crucial
for determining fetal well-being and guiding immediate management. Vaginal
examinations are contraindicated with bleeding of unknown origin until placenta previa
is ruled out. While left lateral positioning improves placental perfusion, monitoring the
fetus is the priority.
Question 2: A nurse is providing teaching to a new parent about newborn
screening tests. Which of the following statements indicates an understanding
of the purpose of the test for phenylketonuria (PKU)?
A. "This test checks for a deficiency in the enzyme that breaks down phenylalanine."
B. "This test measures the level of thyroid hormones in my baby's blood."
C. "A positive result means my baby has an infection that needs immediate antibiotics."
D. "This screening is only performed if there is a family history of metabolic disorders."
CORRECT ANSWER: A. "This test checks for a deficiency in the enzyme that
breaks down phenylalanine."
Rationale: PKU is a metabolic disorder caused by a deficiency of the enzyme
phenylalanine hydroxylase, which is needed to convert phenylalanine to tyrosine. If
untreated, high levels of phenylalanine can lead to severe intellectual disability. The
newborn screening test detects elevated phenylalanine levels. Options B, C, and D are
,incorrect as the test does not measure thyroid hormones, is not for infection, and is
universally performed regardless of family history.
Question 3: A nurse is assessing a client who is 12 hours postpartum following
a vaginal delivery. The client has saturated two perineal pads in the last hour
and reports feeling dizzy. Which of the following actions should the nurse
take?
A. Instruct the client to ambulate to the bathroom to void
B. Increase the rate of the intravenous infusion
C. Massage the uterine fundus
D. Administer an oral analgesic
CORRECT ANSWER: C. Massage the uterine fundus
Rationale: Saturation of two perineal pads in one hour accompanied by dizziness is a
sign of postpartum hemorrhage. The most common cause is uterine atony, and the
immediate nursing action is to massage the uterine fundus to stimulate contractions and
control bleeding. Increasing IV fluids, while appropriate, is secondary to the immediate
mechanical intervention of fundal massage.
Question 4: A nurse is teaching a prenatal class about physiological changes
during pregnancy. Which of the following findings should the nurse include as
an expected cardiovascular change?
A. Decreased heart rate
B. Decreased cardiac output
C. Increased blood pressure in the second trimester
D. Increased plasma volume
CORRECT ANSWER: D. Increased plasma volume
Rationale: During pregnancy, there is a significant increase in plasma volume (up to 40-
50%) to support the increased metabolic needs of the mother and fetus, and to
compensate for blood loss during delivery. Heart rate increases, not decreases, and
cardiac output also increases. Blood pressure typically decreases in the second trimester
due to peripheral vasodilation.
Question 5: A nurse is reviewing a client's prenatal record and notes a positive
"ballottement" sign. This finding is indicative of which of the following?
A. Fetal movement felt by the examiner
B. The presence of fetal heart tones
C. Passive movement of the fetus when the cervix is palpated
D. A positive pregnancy test
CORRECT ANSWER: C. Passive movement of the fetus when the cervix is
palpated
,Rationale: Ballottement is a physical examination sign that indicates the presence of a
fetus. It is elicited by palpating the cervix; the fetus floats upward in the amniotic fluid
and then rebounds, tapping against the examiner's finger. It is a sign of pregnancy,
typically observed around 16-20 weeks.
Question 6: A nurse is caring for a client who is receiving magnesium sulfate
for preeclampsia. Which of the following findings indicates magnesium
toxicity?
A. Respiratory rate of 14/min
B. Urine output of 40 mL/hr
C. Deep tendon reflexes 2+
D. Serum magnesium level of 9 mEq/L
CORRECT ANSWER: D. Serum magnesium level of 9 mEq/L
Rationale: The therapeutic range for magnesium sulfate is 4-7 mEq/L. A serum level of
9 mEq/L is in the toxic range. Signs of toxicity include loss of deep tendon reflexes
(areflexia), respiratory depression (less than 12/min), and oliguria (less than 30 mL/hr).
A respiratory rate of 14/min, urine output of 40 mL/hr, and 2+ reflexes are all within
normal or acceptable parameters.
Question 7: A nurse is providing discharge teaching to a postpartum client
who is breastfeeding. Which of the following statements by the client indicates
a need for further teaching?
A. "I will apply lanolin cream to my nipples after each feeding."
B. "I should wash my nipples with soap and water before each feeding."
C. "I need to ensure my baby is latched on correctly."
D. "I will feed my baby on demand, about every 2 to 3 hours."
CORRECT ANSWER: B. "I should wash my nipples with soap and water before
each feeding."
Rationale: Washing the nipples with soap and water can remove natural oils, leading to
dryness and cracking, which increases the risk of infection. The client should wash her
hands before feeding and may rinse the nipples with water, but soap is not
recommended. The other options are appropriate breastfeeding practices.
Question 8: A nurse is assessing a newborn 1 minute after birth. The newborn
has a heart rate of 130/min, respiratory effort with a weak cry, some flexion of
extremities, a grimace in response to suctioning, and a pink body with blue
extremities. What is the newborn's Apgar score?
A. 6
B. 7
C. 8
D. 9
CORRECT ANSWER: C. 8
, Rationale: The Apgar score is calculated at 1 and 5 minutes. The components are heart
rate (2 points for >100), respiratory effort (1 point for weak cry), muscle tone (1 point for
some flexion), reflex irritability (1 point for grimace), and color (1 point for pink
body/blue extremities, acrocyanosis). Total score is 2+1+1+1+1 = 8. This indicates the
infant is in good condition.
Question 9: A nurse is caring for a client in active labor who is dilated to 6 cm.
The client's amniotic membranes rupture spontaneously. Which of the
following actions should the nurse take first?
A. Assess the fetal heart rate
B. Check the pH of the fluid
C. Prepare for immediate delivery
D. Turn the client to the left side
CORRECT ANSWER: A. Assess the fetal heart rate
Rationale: After the rupture of membranes, the priority is to assess the fetal heart rate
immediately to detect any signs of cord compression or prolapse. While checking the
pH of the fluid (to confirm amniotic fluid) and turning the client to the left side (to
improve perfusion) are important, the first action is always to evaluate the fetal status.
Question 10: A nurse is providing education to a client at 28 weeks gestation
about signs of preterm labor. Which of the following symptoms should the
nurse include in the teaching?
A. Decreased fetal movement
B. A constant, dull backache
C. A sudden gush of clear fluid
D. Contractions that are irregular and painless
CORRECT ANSWER: B. A constant, dull backache
Rationale: A constant, dull backache is a common sign of preterm labor. Other signs
include regular, painful contractions, pelvic pressure, and a change in vaginal discharge
(bloody or watery). Decreased fetal movement is a sign of fetal distress, not specifically
preterm labor. A sudden gush of fluid suggests rupture of membranes. Painless, irregular
contractions are usually Braxton-Hicks contractions.
Question 11: A nurse is assessing a client at 24 weeks gestation who is at risk
for gestational diabetes. Which of the following laboratory values should the
nurse report to the provider?
A. Fasting blood glucose of 70 mg/dL
B. 1-hour glucose tolerance test result of 135 mg/dL
C. 3-hour glucose tolerance test result with one elevated value
D. Hemoglobin A1c of 5.5%
CORRECT ANSWER: B. 1-hour glucose tolerance test result of 135 mg/dL
Newborn Proctored Updated 2026 | 190+ Questions
and Answers | ATI230 Maternal-Newborn
Comprehensive Study Guide, Practice Exam, Exam
Prep Test Bank, Antepartum Care, Intrapartum
Nursing, Labor & Delivery, Postpartum Care, Newborn
Assessment, Neonatal Nursing, High-Risk Pregnancy,
Obstetric Emergencies, Breastfeeding, Clinical
Judgment, Next Generation NCLEX (NGN), Detailed
Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who is 36 weeks gestation and reports
a sudden onset of severe abdominal pain with vaginal bleeding. The client's
uterus is firm and rigid on palpation. Which of the following actions should the
nurse take first?
A. Prepare the client for a vaginal examination
B. Administer an oral analgesic for pain relief
C. Position the client in a left lateral position
D. Apply an external fetal monitor
CORRECT ANSWER: D. Apply an external fetal monitor
Rationale: The presentation of sudden severe abdominal pain, vaginal bleeding, and a
rigid uterus is highly suggestive of placental abruption. The priority nursing action is to
apply an external fetal monitor to assess the fetal heart rate and pattern, which is crucial
for determining fetal well-being and guiding immediate management. Vaginal
examinations are contraindicated with bleeding of unknown origin until placenta previa
is ruled out. While left lateral positioning improves placental perfusion, monitoring the
fetus is the priority.
Question 2: A nurse is providing teaching to a new parent about newborn
screening tests. Which of the following statements indicates an understanding
of the purpose of the test for phenylketonuria (PKU)?
A. "This test checks for a deficiency in the enzyme that breaks down phenylalanine."
B. "This test measures the level of thyroid hormones in my baby's blood."
C. "A positive result means my baby has an infection that needs immediate antibiotics."
D. "This screening is only performed if there is a family history of metabolic disorders."
CORRECT ANSWER: A. "This test checks for a deficiency in the enzyme that
breaks down phenylalanine."
Rationale: PKU is a metabolic disorder caused by a deficiency of the enzyme
phenylalanine hydroxylase, which is needed to convert phenylalanine to tyrosine. If
untreated, high levels of phenylalanine can lead to severe intellectual disability. The
newborn screening test detects elevated phenylalanine levels. Options B, C, and D are
,incorrect as the test does not measure thyroid hormones, is not for infection, and is
universally performed regardless of family history.
Question 3: A nurse is assessing a client who is 12 hours postpartum following
a vaginal delivery. The client has saturated two perineal pads in the last hour
and reports feeling dizzy. Which of the following actions should the nurse
take?
A. Instruct the client to ambulate to the bathroom to void
B. Increase the rate of the intravenous infusion
C. Massage the uterine fundus
D. Administer an oral analgesic
CORRECT ANSWER: C. Massage the uterine fundus
Rationale: Saturation of two perineal pads in one hour accompanied by dizziness is a
sign of postpartum hemorrhage. The most common cause is uterine atony, and the
immediate nursing action is to massage the uterine fundus to stimulate contractions and
control bleeding. Increasing IV fluids, while appropriate, is secondary to the immediate
mechanical intervention of fundal massage.
Question 4: A nurse is teaching a prenatal class about physiological changes
during pregnancy. Which of the following findings should the nurse include as
an expected cardiovascular change?
A. Decreased heart rate
B. Decreased cardiac output
C. Increased blood pressure in the second trimester
D. Increased plasma volume
CORRECT ANSWER: D. Increased plasma volume
Rationale: During pregnancy, there is a significant increase in plasma volume (up to 40-
50%) to support the increased metabolic needs of the mother and fetus, and to
compensate for blood loss during delivery. Heart rate increases, not decreases, and
cardiac output also increases. Blood pressure typically decreases in the second trimester
due to peripheral vasodilation.
Question 5: A nurse is reviewing a client's prenatal record and notes a positive
"ballottement" sign. This finding is indicative of which of the following?
A. Fetal movement felt by the examiner
B. The presence of fetal heart tones
C. Passive movement of the fetus when the cervix is palpated
D. A positive pregnancy test
CORRECT ANSWER: C. Passive movement of the fetus when the cervix is
palpated
,Rationale: Ballottement is a physical examination sign that indicates the presence of a
fetus. It is elicited by palpating the cervix; the fetus floats upward in the amniotic fluid
and then rebounds, tapping against the examiner's finger. It is a sign of pregnancy,
typically observed around 16-20 weeks.
Question 6: A nurse is caring for a client who is receiving magnesium sulfate
for preeclampsia. Which of the following findings indicates magnesium
toxicity?
A. Respiratory rate of 14/min
B. Urine output of 40 mL/hr
C. Deep tendon reflexes 2+
D. Serum magnesium level of 9 mEq/L
CORRECT ANSWER: D. Serum magnesium level of 9 mEq/L
Rationale: The therapeutic range for magnesium sulfate is 4-7 mEq/L. A serum level of
9 mEq/L is in the toxic range. Signs of toxicity include loss of deep tendon reflexes
(areflexia), respiratory depression (less than 12/min), and oliguria (less than 30 mL/hr).
A respiratory rate of 14/min, urine output of 40 mL/hr, and 2+ reflexes are all within
normal or acceptable parameters.
Question 7: A nurse is providing discharge teaching to a postpartum client
who is breastfeeding. Which of the following statements by the client indicates
a need for further teaching?
A. "I will apply lanolin cream to my nipples after each feeding."
B. "I should wash my nipples with soap and water before each feeding."
C. "I need to ensure my baby is latched on correctly."
D. "I will feed my baby on demand, about every 2 to 3 hours."
CORRECT ANSWER: B. "I should wash my nipples with soap and water before
each feeding."
Rationale: Washing the nipples with soap and water can remove natural oils, leading to
dryness and cracking, which increases the risk of infection. The client should wash her
hands before feeding and may rinse the nipples with water, but soap is not
recommended. The other options are appropriate breastfeeding practices.
Question 8: A nurse is assessing a newborn 1 minute after birth. The newborn
has a heart rate of 130/min, respiratory effort with a weak cry, some flexion of
extremities, a grimace in response to suctioning, and a pink body with blue
extremities. What is the newborn's Apgar score?
A. 6
B. 7
C. 8
D. 9
CORRECT ANSWER: C. 8
, Rationale: The Apgar score is calculated at 1 and 5 minutes. The components are heart
rate (2 points for >100), respiratory effort (1 point for weak cry), muscle tone (1 point for
some flexion), reflex irritability (1 point for grimace), and color (1 point for pink
body/blue extremities, acrocyanosis). Total score is 2+1+1+1+1 = 8. This indicates the
infant is in good condition.
Question 9: A nurse is caring for a client in active labor who is dilated to 6 cm.
The client's amniotic membranes rupture spontaneously. Which of the
following actions should the nurse take first?
A. Assess the fetal heart rate
B. Check the pH of the fluid
C. Prepare for immediate delivery
D. Turn the client to the left side
CORRECT ANSWER: A. Assess the fetal heart rate
Rationale: After the rupture of membranes, the priority is to assess the fetal heart rate
immediately to detect any signs of cord compression or prolapse. While checking the
pH of the fluid (to confirm amniotic fluid) and turning the client to the left side (to
improve perfusion) are important, the first action is always to evaluate the fetal status.
Question 10: A nurse is providing education to a client at 28 weeks gestation
about signs of preterm labor. Which of the following symptoms should the
nurse include in the teaching?
A. Decreased fetal movement
B. A constant, dull backache
C. A sudden gush of clear fluid
D. Contractions that are irregular and painless
CORRECT ANSWER: B. A constant, dull backache
Rationale: A constant, dull backache is a common sign of preterm labor. Other signs
include regular, painful contractions, pelvic pressure, and a change in vaginal discharge
(bloody or watery). Decreased fetal movement is a sign of fetal distress, not specifically
preterm labor. A sudden gush of fluid suggests rupture of membranes. Painless, irregular
contractions are usually Braxton-Hicks contractions.
Question 11: A nurse is assessing a client at 24 weeks gestation who is at risk
for gestational diabetes. Which of the following laboratory values should the
nurse report to the provider?
A. Fasting blood glucose of 70 mg/dL
B. 1-hour glucose tolerance test result of 135 mg/dL
C. 3-hour glucose tolerance test result with one elevated value
D. Hemoglobin A1c of 5.5%
CORRECT ANSWER: B. 1-hour glucose tolerance test result of 135 mg/dL
