ATI MATERNAL(NEWBORN) EXAM COMPREHENSIVE
GUIDE 2026/27 EDITION
1 A client at 38 weeks’ gestation has a reactive nonstress test
(NST). Which statement best explains the significance of a
reactive NST?
A. It indicates fetal acidemia is present.
B. It confirms the fetus is in breech presentation.
,C. It demonstrates adequate fetal oxygenation and autonomic
function.
D. It predicts the exact time of labor onset.
Correct Answer: C
Explanation: A reactive NST (two or more accelerations within
20 minutes) indicates adequate fetal oxygenation and intact
autonomic function; it does not diagnose acidemia, presentation,
or predict labor timing.
2 A postpartum client who delivered 4 hours ago has boggy
fundus and saturated peripad in 15 minutes. What is the nurse’s
first action?
A. Notify the provider and prepare for surgery.
B. Massage the fundus firmly and reassess bleeding.
C. Administer ordered oxytocin without assessment.
D. Place the client in Trendelenburg position.
Correct Answer: B
Explanation: Uterine atony is the most common cause of early
postpartum hemorrhage; fundal massage is the immediate first-
line nursing intervention to stimulate contraction and decrease
bleeding—other options are secondary or inappropriate initial
actions.
3 A neonate born at 35 weeks is jittery and has a temperature of
35.8°C. Which intervention is highest priority?
A. Offer oral glucose water.
B. Place the infant in a radiant warmer and recheck temperature.
C. Obtain blood cultures and start antibiotics.
D. Begin phototherapy.
,Correct Answer: B
Explanation: Preterm neonates are at high risk for hypothermia
which can cause jitteriness and metabolic instability; rewarming
under a radiant warmer is priority—glucose or antibiotics may
be indicated later after assessment.
4 A pregnant client with preeclampsia is receiving magnesium
sulfate IV. Which finding requires immediate action?
A. Deep tendon reflexes 2+ bilaterally.
B. Respiratory rate 8 breaths per minute.
C. Urine output of 50 mL/hr.
D. Blood pressure decreased from 160/100 to 140/88 mm Hg.
Correct Answer: B
Explanation: Respiratory depression (RR <12, often <10) is a
sign of magnesium toxicity and requires immediate cessation of
magnesium and administration of calcium gluconate; DTRs 2+
and urine output 50 mL/hr are acceptable, and BP reduction is
therapeutic.
5 A client complains of severe unilateral pelvic pain and vaginal
spotting at 7 weeks gestation. Which finding most strongly
suggests ectopic pregnancy?
A. Positive urine hCG.
B. Lower abdominal cramping.
C. Shoulder pain and dizziness.
D. Fundal height larger than expected.
Correct Answer: C
Explanation: Shoulder pain and dizziness may indicate
intraperitoneal bleeding irritating the diaphragm from a
, ruptured ectopic—positive hCG and cramping are nonspecific;
fundal height is irrelevant early in ectopic.
6 A nurse assesses a newborn with a two-vessel umbilical cord.
Which associated risk should the nurse anticipate?
A. Polyhydramnios only.
B. Increased risk of congenital anomalies and growth restriction.
C. No clinical significance—normal variant.
D. Maternal hyperglycemia.
Correct Answer: B
Explanation: A single umbilical artery (two-vessel cord) is
associated with increased risk of congenital anomalies and
intrauterine growth restriction; it is not simply benign and not
directly linked to maternal hyperglycemia or polyhydramnios
alone.
7 During second stage of labor, a fetal heart rate tracing shows
variable decelerations with moderate variability. Which
intervention is most appropriate initially?
A. Prepare for immediate cesarean delivery.
B. Change maternal position to left lateral and assess for cord
compression.
C. Administer terbutaline to slow contractions.
D. Start continuous oxytocin infusion.
Correct Answer: B
Explanation: Variable decelerations often indicate cord
compression; initial interventions include maternal
repositioning (left lateral, knee-chest), oxygen, and assessing for
GUIDE 2026/27 EDITION
1 A client at 38 weeks’ gestation has a reactive nonstress test
(NST). Which statement best explains the significance of a
reactive NST?
A. It indicates fetal acidemia is present.
B. It confirms the fetus is in breech presentation.
,C. It demonstrates adequate fetal oxygenation and autonomic
function.
D. It predicts the exact time of labor onset.
Correct Answer: C
Explanation: A reactive NST (two or more accelerations within
20 minutes) indicates adequate fetal oxygenation and intact
autonomic function; it does not diagnose acidemia, presentation,
or predict labor timing.
2 A postpartum client who delivered 4 hours ago has boggy
fundus and saturated peripad in 15 minutes. What is the nurse’s
first action?
A. Notify the provider and prepare for surgery.
B. Massage the fundus firmly and reassess bleeding.
C. Administer ordered oxytocin without assessment.
D. Place the client in Trendelenburg position.
Correct Answer: B
Explanation: Uterine atony is the most common cause of early
postpartum hemorrhage; fundal massage is the immediate first-
line nursing intervention to stimulate contraction and decrease
bleeding—other options are secondary or inappropriate initial
actions.
3 A neonate born at 35 weeks is jittery and has a temperature of
35.8°C. Which intervention is highest priority?
A. Offer oral glucose water.
B. Place the infant in a radiant warmer and recheck temperature.
C. Obtain blood cultures and start antibiotics.
D. Begin phototherapy.
,Correct Answer: B
Explanation: Preterm neonates are at high risk for hypothermia
which can cause jitteriness and metabolic instability; rewarming
under a radiant warmer is priority—glucose or antibiotics may
be indicated later after assessment.
4 A pregnant client with preeclampsia is receiving magnesium
sulfate IV. Which finding requires immediate action?
A. Deep tendon reflexes 2+ bilaterally.
B. Respiratory rate 8 breaths per minute.
C. Urine output of 50 mL/hr.
D. Blood pressure decreased from 160/100 to 140/88 mm Hg.
Correct Answer: B
Explanation: Respiratory depression (RR <12, often <10) is a
sign of magnesium toxicity and requires immediate cessation of
magnesium and administration of calcium gluconate; DTRs 2+
and urine output 50 mL/hr are acceptable, and BP reduction is
therapeutic.
5 A client complains of severe unilateral pelvic pain and vaginal
spotting at 7 weeks gestation. Which finding most strongly
suggests ectopic pregnancy?
A. Positive urine hCG.
B. Lower abdominal cramping.
C. Shoulder pain and dizziness.
D. Fundal height larger than expected.
Correct Answer: C
Explanation: Shoulder pain and dizziness may indicate
intraperitoneal bleeding irritating the diaphragm from a
, ruptured ectopic—positive hCG and cramping are nonspecific;
fundal height is irrelevant early in ectopic.
6 A nurse assesses a newborn with a two-vessel umbilical cord.
Which associated risk should the nurse anticipate?
A. Polyhydramnios only.
B. Increased risk of congenital anomalies and growth restriction.
C. No clinical significance—normal variant.
D. Maternal hyperglycemia.
Correct Answer: B
Explanation: A single umbilical artery (two-vessel cord) is
associated with increased risk of congenital anomalies and
intrauterine growth restriction; it is not simply benign and not
directly linked to maternal hyperglycemia or polyhydramnios
alone.
7 During second stage of labor, a fetal heart rate tracing shows
variable decelerations with moderate variability. Which
intervention is most appropriate initially?
A. Prepare for immediate cesarean delivery.
B. Change maternal position to left lateral and assess for cord
compression.
C. Administer terbutaline to slow contractions.
D. Start continuous oxytocin infusion.
Correct Answer: B
Explanation: Variable decelerations often indicate cord
compression; initial interventions include maternal
repositioning (left lateral, knee-chest), oxygen, and assessing for
