2025 Maternity ATI Exam: Comprehensive Practice QuestionsOFFICIAL STUDY RESOURCE: FULL TEST BANK WITH RATIONALES 2026 COMPLETE EXAM SOLUTION - MULTIPLE VERSIONS INCLUDED complete Review Guide with Practice Questions, RationaleCs, and Expert Strat

A nurse is caring for a client who delivered by cesarean birth 6 hours ago. The nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage. Which of the following actions should the nurse take? • A. Apply an ice pack to the incision site • B. Replace the surgical dressing • C. Administer 500 mL lactated Ringer's IV bolus • D. Evaluate urinary output Rationale: A distended bladder displaces the uterus upward and to the side (usually the right), which prevents the uterine muscle from contracting down tightly (uterine atony). This lack of contraction allows the intramyometrial blood vessels to bleed freely, manifesting as a steady trickle of lochia. Evaluating output or assessing for a full bladder is the vital first step. 2. Nonpharmacological Relief for Breast Engorgement A nurse is providing discharge instructions to a client who is postpartum and has engorged breasts. Which of the following nonpharmacological comfort measures should the nurse include in the teaching? • A. Wear nipple shields during feeding • B. Use plastic-lined breast pads • C. Use a breast binder for 2 days D. Apply cabbage leaves after feedings Rationale: Fresh, clean cabbage leaves contain natural phytoestrogens and anti-inflammatory properties that cause local vasoconstriction when applied to the breasts. This reduces tissue edema and vascular engorgement, providing cooling relief. (They should be used sparingly after feedings to avoid accidentally tanking the milk supply). 3. Calculating Estimated Date of Birth (EDB) A nurse is calculating the estimated date of birth using Naegele’s rule for a client whose last menstrual cycle started on June 21. What is the estimated delivery date in the next year? • A. March 14 • B. March 28 • C. April 4 • D. April 11 Rationale: Naegele’s Rule states: $text{First day of LMP} - 3text{ months} + 7text{ days} + 1text{ year}$. • June 21 minus 3 months = March 21. • March 21 plus 7 days = March 28. 4. Supporting Parents Through Perinatal Loss A nurse is caring for a client immediately following the delivery of a stillborn fetus. Which of the following actions should the nurse take? • A. Inform the client that the law requires her to name the fetus • B. Limit the amount of time the fetus is in the client’s room • C. Instruct the client that an autopsy should be performed within 24 hours • D. Prepare the client for what to expect the fetus to look like Rationale: Seeing and holding their stillborn infant helps parents process the reality of the loss and aids the grieving process. Before bringing the infant to the room, the nurse must gently prepare the parents for what to expect visually (e.g., skin maceration, discoloration, cold temperature) to alleviate shock and emotional distress. 5. Educational Interventions for Adolescent Mothers A nurse is observing an adolescent client who is offering her newborn a bottle while he is lying in the bassinet. When the nurse offers to pick the newborn up and place him in the client's arms, the mother states, "No, the baby is too tired to be held." Which of the following actions should the nurse take? • A. Demonstrate how to hold the newborn and allow the client to practice • B. Persuade the client to breastfeed the newborn to promote bonding • C. Offer to take the newborn to the nursery to finish his feeding • D. Insist that the mother pick up the newborn to feed him Rationale: Adolescent mothers may lack confidence or knowledge regarding newborn care and bonding techniques (such as eye-to-eye contact during feeding). Modeling the behavior through a supportive demonstration reduces anxiety, prevents a defensive reaction, and empowers the mother to practice holding her infant safely. 6. Recognizing Transition Phase Signs A nurse is caring for a client who is in labor. Which of the following findings should prompt the nurse to reassess the client? • A. Intense contractions lasting 45-60 seconds • B. An urge to have a bowel movement during contractions • C. A sense of excitement and warm, flushed skin • D. Progressive sacral discomfort during contractions Rationale: While a sudden urge to push or a bowel movement indicates the second stage, a dramatic shift in maternal behavior—such as sudden extreme anxiety, irritability, excitement, or flushed skin from hormonal surges—strongly signals that the client has entered the transition phase of labor ($8text{ to }10text{ cm}$ dilation). This finding requires an immediate assessment of labor progression. 7. Assessing Lab Value Trends in Severe Preeclampsia A nurse is assessing a client at 27 weeks of gestation who has preeclampsia. Which of the following findings should the nurse report to the provider? • A. Hemoglobin 14.8 g/dL • B. Urine protein concentration 200 mg/24 hr • C. Platelet count 60,000/mm³ D. White blood cell count 11,000/mm³ Rationale: A normal platelet count ranges from $150,000text{ to }400,000/text{mm}^3$. A drop below $100,000/text{mm}^3$ indicates thrombocytopenia, a critical sign of worsening preeclampsia or the development of HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets), which carries a severe risk of maternal hemorrhage. 8. Landmark Technique for Fundal Height A nurse in a clinic is preparing to measure the fundal height of a client who is pregnant. Which of the following actions should the nurse take? • A. Lay the tape measure horizontally over the middle of the client’s abdomen • B. Place the client in a left-lateral position to obtain the measurement • C. Ensure that the client has a full bladder before taking the measurement • D. Measure from the upper border of the pubis to the upper border of the fundus Rationale: Fundal height is measured vertically from the superior border of the symphysis pubis to the top of the uterine fundus using a flexible tape measure. The client must empty her bladder beforehand because a full bladder can push the uterus upward, falsely exaggerating the measurement by several centimeters. 9. Hydration Therapy for Gestational Constipation A nurse is caring for a client who is at 20 weeks of gestation and reports constipation. Which of the following recommendations should the nurse make to help relieve this common discomfort of pregnancy? • A. Include 18 g of fiber in the diet each day • B. Drink 2-3 L of water each day • C. Add 30 mL of mineral oil to each meal • D. Take 60 mL of magnesium hydroxide once daily Rationale: Increased progesterone levels during pregnancy cause generalized smooth muscle relaxation, which slows intestinal transit time (peristalsis) and permits higher water reabsorption from the colon. Consuming $2text{ to }3text{ L}$ of fluids daily softens feces and helps restore physiological bowel patterns. (Fiber intake should ideally be higher, around $25text{ to }28text{ g}$ daily). 10. Documenting Umbilical Cord Sounds A nurse is assessing the fetal heart rate for a client who is at 38 weeks of gestation. When using an ultrasound device, the nurse hears blood rushing through the umbilical vessels in synchronization with the fetal heart beat. Which of the following terms should the nurse use to document this finding? • A. Goodell's sign • B. Funic souffle • C. Quickening • D. Hegar's sign Rationale: A funic souffle is a soft, blowing murmur heard synchronously with the fetal heart rate, produced by blood rushing through the umbilical arteries. A uterine souffle is a sound synchronous with the maternal pulse caused by blood flow through the large uterine vessels. Goodell’s and Hegar’s signs are structural signs of early pregnancy. 11. Nursery Infection Control Parameters A nurse manager in a newborn nursery is reviewing infection control procedures with a group of newly hired nurses. Which of the following instructions should the nurse manager include in the teaching? • A. Allow parents to enter the nursery if they are wearing a mask • B. Place newborn bassinets at least 3 feet apart • C. Place the newborn's foot on a sterile field during a heelstick • D. Maintain airborne precautions in the nursery Rationale: To minimize the risk of droplet transmission and cross-contamination between highly vulnerable neonates, standard nursery infection guidelines dictate maintaining a minimum space of $3text{ feet}$ between all infant bassinets. Standard precautions, rather than airborne or sterile fields for heel sticks, are utilized. 12. Reversing Magnesium Sulfate Toxicity A nurse is caring for a client who is receiving magnesium sulfate by continuous IV infusion. The nurse notes a respiratory rate of 8/min and absent deep-tendon reflexes. Which of the following medications should the nurse administer? • A. Phytonadione • B. Acetylcysteine C. Protamine sulfate • D. Calcium gluconate Rationale: Respiratory depression ($ 12/text{min}$) and loss of deep tendon reflexes (DTRs) are classic indicators of severe magnesium sulfate toxicity. Calcium gluconate ($1text{ g}$ IV pushed slowly over several minutes) acts as the direct antidote by displacing magnesium ions from neuromuscular junctions. 13. Comfort Measures for Postpartum Urinary Retention A nurse is caring for a client who is 8 hours postpartum following a vaginal delivery and is unable to void. Which of the following interventions should the nurse use to promote voiding? • A. Apply suprapubic pressure • B. Administer a diuretic to the client • C. Insert an indwelling urinary catheter • D. Encourage the client to void in the shower Rationale: Postpartum urinary retention can occur due to periurethral edema or temporary bladder desensitization from local birth trauma. Non-invasive nursing methods like letting the warm water of a shower run over the client's perineum promote relaxation of the pelvic floor and internal urinary sphincters, facilitating spontaneous voiding before jumping to catheterization.