ATI RN MATERNAL NEWBORN
COMPREHENSIVE EXAM QUESTIONS WITH
RATIONALES 2025/2026
A pregnant client at 32 weeks gestation reports sudden leakage of clear fluid
from the vagina. What is the nurse’s priority action?
A. Encourage ambulation
B. Assess for rupture of membranes (CORRECT)
C. Instruct the client to empty her bladder
D. Obtain a urine specimen
Rationale: Sudden leakage may indicate premature rupture of membranes (PROM).
Confirming ROM is the priority to prevent infection and assess fetal risk.
A client at 28 weeks gestation has a BP of 150/95 mmHg, 3+ proteinuria, and
reports headaches. Which complication is most likely?
A. Gestational diabetes
B. Preeclampsia (CORRECT)
C. Hyperemesis gravidarum
D. Placenta previa
Rationale: Elevated BP, proteinuria, and headaches are classic signs of preeclampsia, a
A client in labor has a fetal heart rate of 180 bpm. What is the most appropriate
nursing action?
A. Document and continue monitoring
B. Administer oxygen and notify provider (CORRECT)
C. Encourage maternal ambulation
D. Initiate oxytocin infusion
Rationale: Fetal tachycardia (>160 bpm) may indicate maternal infection, fetal hypoxia, or
stress. Interventions include maternal oxygen, assessment, and notifying the provider.
A newborn is 2 hours old and has a temperature of 35.5°C. What is the nurse’s
priority intervention?
A. Place the newborn under a radiant warmer (CORRECT)
B. Feed the newborn immediately
C. Document the finding
D. Measure blood glucose
,ATI RN MATERNAL NEWBORN
COMPREHENSIVE EXAM QUESTIONS WITH
RATIONALES 2025/2026
Rationale: Hypothermia in a neonate (<36.5°C) can lead to metabolic complications.
Immediate warming is essential.
A postpartum client has a fundus that is soft, boggy, and located above the
umbilicus. What should the nurse do first?
A. Massage the fundus (CORRECT)
B. Increase IV fluid rate
C. Encourage urination
D. Assess vital signs
Rationale: A boggy uterus indicates uterine atony, a leading cause of postpartum hemorrhage.
Massage promotes contraction and reduces bleeding.
A client at 34 weeks gestation is diagnosed with gestational diabetes. Which
dietary instruction is most appropriate?
A. Consume high-carbohydrate meals
B. Limit carbohydrates and monitor glucose (CORRECT)
C. Avoid all sugars
D. Eat only two meals per day
Rationale: Gestational diabetes management includes a balanced diet with controlled
carbohydrate intake and frequent glucose monitoring.
A client at 36 weeks gestation reports painless bright red vaginal bleeding. What
is the likely cause?
A. Placenta previa (CORRECT)
B. Abruptio placentae
C. Uterine rupture
D. Preterm labor
Rationale: Painless, bright red bleeding in late pregnancy is a hallmark of placenta previa.
Abruptio usually presents with pain and dark bleeding.
During labor, a client’s contractions are 2 minutes apart and strong. Fetal heart
rate shows variable decelerations. What should the nurse do first?
A. Administer oxytocin
B. Reposition the client (CORRECT)
C. Encourage Valsalva maneuver
D. Apply fetal scalp electrode
,ATI RN MATERNAL NEWBORN
COMPREHENSIVE EXAM QUESTIONS WITH
RATIONALES 2025/2026
Rationale: Variable decelerations often indicate cord compression. Repositioning can relieve
pressure and improve fetal oxygenation.
A newborn is 12 hours old and has a glucose level of 32 mg/dL. What is the
nurse’s priority action?
A. Feed the newborn (CORRECT)
B. Document the result
C. Place the newborn under a warmer
D. Notify the provider
Rationale: Hypoglycemia (<40 mg/dL in neonates) requires immediate feeding to stabilize
glucose levels.
A client is 8 hours postpartum and reports feeling dizzy and faint. Vital signs: BP
80/50 mmHg, HR 120 bpm. What is the most likely cause?
A. Infection
B. Postpartum hemorrhage (CORRECT)
C. Normal postpartum changes
D. Preeclampsia
Rationale: Hypotension, tachycardia, and dizziness postpartum suggest early signs of
hemorrhage. Prompt assessment and intervention are required.
A client is at 40 weeks gestation, laboring, and the fetus is in occiput posterior
position. Which intervention helps facilitate labor?
A. Encourage maternal ambulation and position changes (CORRECT)
B. Apply oxytocin immediately
C. Prepare for cesarean birth
D. Administer epidural analgesia
Rationale: Maternal position changes can help rotate the fetus to an anterior position,
promoting labor progression.
A client at 20 weeks gestation reports severe right upper quadrant pain, nausea,
and vomiting. What condition should the nurse suspect?
A. Preeclampsia
B. HELLP syndrome (CORRECT)
C. Gestational diabetes
D. Hyperemesis gravidarum
, ATI RN MATERNAL NEWBORN
COMPREHENSIVE EXAM QUESTIONS WITH
RATIONALES 2025/2026
Rationale: HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) presents
with upper quadrant pain, nausea, and vomiting. Requires immediate evaluation.
A client in labor receives oxytocin. Fetal heart rate shows late decelerations.
What is the nurse’s first action?
A. Increase oxytocin
B. Reposition the client and provide oxygen (CORRECT)
C. Document findings
D. Prepare for discharge
Rationale: Late decelerations indicate uteroplacental insufficiency. Interventions include
repositioning, oxygen, and stopping oxytocin if indicated.
A newborn’s Apgar score at 1 minute is 6. What does this indicate?
A. Excellent condition
B. Moderate distress (CORRECT)
C. Severe distress
D. Normal range
Rationale: Apgar score 7–10 is normal; 4–6 indicates moderate distress, requiring stimulation
and monitoring.
A postpartum client reports soaking 1 pad per hour and passing clots the size of
a golf ball. What is the nurse’s priority action?
A. Document the findings
B. Assess fundus and vital signs (CORRECT)
C. Reassure the client
D. Encourage ambulation
Rationale: Excessive bleeding with large clots may indicate postpartum hemorrhage.
Immediate fundal massage and assessment are required.
A client with preterm labor is receiving magnesium sulfate. What is a priority
assessment?
A. Blood pressure
B. Respiratory rate (CORRECT)
C. Heart rate
D. Temperature
COMPREHENSIVE EXAM QUESTIONS WITH
RATIONALES 2025/2026
A pregnant client at 32 weeks gestation reports sudden leakage of clear fluid
from the vagina. What is the nurse’s priority action?
A. Encourage ambulation
B. Assess for rupture of membranes (CORRECT)
C. Instruct the client to empty her bladder
D. Obtain a urine specimen
Rationale: Sudden leakage may indicate premature rupture of membranes (PROM).
Confirming ROM is the priority to prevent infection and assess fetal risk.
A client at 28 weeks gestation has a BP of 150/95 mmHg, 3+ proteinuria, and
reports headaches. Which complication is most likely?
A. Gestational diabetes
B. Preeclampsia (CORRECT)
C. Hyperemesis gravidarum
D. Placenta previa
Rationale: Elevated BP, proteinuria, and headaches are classic signs of preeclampsia, a
A client in labor has a fetal heart rate of 180 bpm. What is the most appropriate
nursing action?
A. Document and continue monitoring
B. Administer oxygen and notify provider (CORRECT)
C. Encourage maternal ambulation
D. Initiate oxytocin infusion
Rationale: Fetal tachycardia (>160 bpm) may indicate maternal infection, fetal hypoxia, or
stress. Interventions include maternal oxygen, assessment, and notifying the provider.
A newborn is 2 hours old and has a temperature of 35.5°C. What is the nurse’s
priority intervention?
A. Place the newborn under a radiant warmer (CORRECT)
B. Feed the newborn immediately
C. Document the finding
D. Measure blood glucose
,ATI RN MATERNAL NEWBORN
COMPREHENSIVE EXAM QUESTIONS WITH
RATIONALES 2025/2026
Rationale: Hypothermia in a neonate (<36.5°C) can lead to metabolic complications.
Immediate warming is essential.
A postpartum client has a fundus that is soft, boggy, and located above the
umbilicus. What should the nurse do first?
A. Massage the fundus (CORRECT)
B. Increase IV fluid rate
C. Encourage urination
D. Assess vital signs
Rationale: A boggy uterus indicates uterine atony, a leading cause of postpartum hemorrhage.
Massage promotes contraction and reduces bleeding.
A client at 34 weeks gestation is diagnosed with gestational diabetes. Which
dietary instruction is most appropriate?
A. Consume high-carbohydrate meals
B. Limit carbohydrates and monitor glucose (CORRECT)
C. Avoid all sugars
D. Eat only two meals per day
Rationale: Gestational diabetes management includes a balanced diet with controlled
carbohydrate intake and frequent glucose monitoring.
A client at 36 weeks gestation reports painless bright red vaginal bleeding. What
is the likely cause?
A. Placenta previa (CORRECT)
B. Abruptio placentae
C. Uterine rupture
D. Preterm labor
Rationale: Painless, bright red bleeding in late pregnancy is a hallmark of placenta previa.
Abruptio usually presents with pain and dark bleeding.
During labor, a client’s contractions are 2 minutes apart and strong. Fetal heart
rate shows variable decelerations. What should the nurse do first?
A. Administer oxytocin
B. Reposition the client (CORRECT)
C. Encourage Valsalva maneuver
D. Apply fetal scalp electrode
,ATI RN MATERNAL NEWBORN
COMPREHENSIVE EXAM QUESTIONS WITH
RATIONALES 2025/2026
Rationale: Variable decelerations often indicate cord compression. Repositioning can relieve
pressure and improve fetal oxygenation.
A newborn is 12 hours old and has a glucose level of 32 mg/dL. What is the
nurse’s priority action?
A. Feed the newborn (CORRECT)
B. Document the result
C. Place the newborn under a warmer
D. Notify the provider
Rationale: Hypoglycemia (<40 mg/dL in neonates) requires immediate feeding to stabilize
glucose levels.
A client is 8 hours postpartum and reports feeling dizzy and faint. Vital signs: BP
80/50 mmHg, HR 120 bpm. What is the most likely cause?
A. Infection
B. Postpartum hemorrhage (CORRECT)
C. Normal postpartum changes
D. Preeclampsia
Rationale: Hypotension, tachycardia, and dizziness postpartum suggest early signs of
hemorrhage. Prompt assessment and intervention are required.
A client is at 40 weeks gestation, laboring, and the fetus is in occiput posterior
position. Which intervention helps facilitate labor?
A. Encourage maternal ambulation and position changes (CORRECT)
B. Apply oxytocin immediately
C. Prepare for cesarean birth
D. Administer epidural analgesia
Rationale: Maternal position changes can help rotate the fetus to an anterior position,
promoting labor progression.
A client at 20 weeks gestation reports severe right upper quadrant pain, nausea,
and vomiting. What condition should the nurse suspect?
A. Preeclampsia
B. HELLP syndrome (CORRECT)
C. Gestational diabetes
D. Hyperemesis gravidarum
, ATI RN MATERNAL NEWBORN
COMPREHENSIVE EXAM QUESTIONS WITH
RATIONALES 2025/2026
Rationale: HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) presents
with upper quadrant pain, nausea, and vomiting. Requires immediate evaluation.
A client in labor receives oxytocin. Fetal heart rate shows late decelerations.
What is the nurse’s first action?
A. Increase oxytocin
B. Reposition the client and provide oxygen (CORRECT)
C. Document findings
D. Prepare for discharge
Rationale: Late decelerations indicate uteroplacental insufficiency. Interventions include
repositioning, oxygen, and stopping oxytocin if indicated.
A newborn’s Apgar score at 1 minute is 6. What does this indicate?
A. Excellent condition
B. Moderate distress (CORRECT)
C. Severe distress
D. Normal range
Rationale: Apgar score 7–10 is normal; 4–6 indicates moderate distress, requiring stimulation
and monitoring.
A postpartum client reports soaking 1 pad per hour and passing clots the size of
a golf ball. What is the nurse’s priority action?
A. Document the findings
B. Assess fundus and vital signs (CORRECT)
C. Reassure the client
D. Encourage ambulation
Rationale: Excessive bleeding with large clots may indicate postpartum hemorrhage.
Immediate fundal massage and assessment are required.
A client with preterm labor is receiving magnesium sulfate. What is a priority
assessment?
A. Blood pressure
B. Respiratory rate (CORRECT)
C. Heart rate
D. Temperature
