ATI Maternal Newborn Proctored Exam 2025 – 100 NCLEX-Style Practice Questions with Detailed Rationales

Question 1 A nurse is caring for a client who is at 10 weeks of gestation. The client reports nausea and vomiting. Which of the following instructions should the nurse include? A. Eat three large meals each day B. Drink a glass of water with meals C. Eat dry crackers before getting out of bed D. Take an iron supplement on an empty stomach Answer: C. Eat dry crackers before getting out of bed Rationale: Eating dry crackers before rising can help reduce nausea by stabilizing gastric acid. Small, frequent meals are recommended. Water should be consumed between meals, not with meals, to avoid overfilling the stomach. ________________________________________Question 2 A nurse is assessing a newborn who is 1 hour old. Which of the following findings should be reported to the provider? A. Heart rate 160 bpm B. Acrocyanosis C. Respiratory rate 70 breaths/min D. Positive Babinski reflex Answer: C. Respiratory rate 70 breaths/min Rationale: Normal newborn respiratory rate is 30–60 breaths/min. A rate of 70 may indicate respiratory distress and should be reported. Acrocyanosis and a positive Babinski reflex are normal in a newborn. ________________________________________Question 3 A nurse is providing discharge teaching to a postpartum client about preventing postpartum complications. Which of the following instructions should the nurse include? A. "You should report lochia that changes to dark red after 10 days." B. "You should report a temperature greater than 100.4°F (38°C)." C. "You should avoid walking to prevent bleeding." D. "You should expect breast engorgement to last 10–14 days." Answer: B. "You should report a temperature greater than 100.4°F (38°C)." Rationale: A postpartum temperature above 100.4°F may indicate infection. Lochia normally lightens in color over time. Early ambulation is encouraged, and breast engorgement typically resolves in 24–48 hours with appropriate care. ________________________________________Question 4 A nurse is caring for a client who is in labor and has a history of genital herpes simplex virus. Which of the following is an appropriate action? A. Allow vaginal birth if no lesions are present B. Administer acyclovir during labor C. Apply betadine to lesions D. Perform an episiotomy to prevent transmission Answer: A. Allow vaginal birth if no lesions are present Rationale: Vaginal birth is permissible in clients with herpes simplex virus only if no active lesions are present. Cesarean delivery is indicated if lesions are observed to reduce neonatal transmission risk. ________________________________________Question 5 A nurse is caring for a postpartum client who is bottle-feeding her newborn. The client reports breast engorgement. Which of the following actions should the nurse recommend? A. Apply warm compresses B. Wear a supportive bra continuously C. Massage the breasts D. Express small amounts of milk Answer: B. Wear a supportive bra continuously Rationale: For non-breastfeeding clients, a tight supportive bra helps relieve discomfort. Heat, massage, and milk expression stimulate milk production and are not recommended for mothers who are not breastfeeding. ________________________________________Question 6 A nurse is monitoring a client who is receiving oxytocin for labor induction. The nurse notes late decelerations on the fetal monitor. Which of the following actions should the nurse take first? A. Turn the client to a lateral position B. Administer oxygen by face mask C. Increase the IV fluid rate D. Stop the oxytocin infusion Answer: A. Turn the client to a lateral position Rationale: Late decelerations suggest uteroplacental insufficiency. The first action should be to improve placental perfusion by repositioning the client. Other interventions follow if the decelerations persist. ________________________________________ Question 7 A nurse is providing teaching to a client about danger signs of pregnancy. Which of the following findings should the client report immediately? A. Frequent urination B. Leg cramps C. Swelling of the face D. Breast tenderness Answer: C. Swelling of the face Rationale: Swelling of the face can indicate preeclampsia, which is a serious hypertensive disorder of pregnancy. Other options are common, non-dangerous discomforts of pregnancy. ________________________________________Question 8 A nurse is caring for a client at 38 weeks gestation who is scheduled for a nonstress test. Which of the following is a reassuring finding? A. Two accelerations of 15 bpm for 10 seconds each B. Absence of fetal movement C. Fetal heart rate of 130 bpm with no accelerations D. Two accelerations of 15 bpm for 15 seconds each in 20 minutes Answer: D. Two accelerations of 15 bpm for 15 seconds each in 20 minutes Rationale: This is a reactive (reassuring) nonstress test result. Accelerations demonstrate adequate fetal oxygenation and neurologic function. ________________________________________Question 9 A nurse is caring for a newborn immediately after birth. Which action should the nurse take first? A. Dry the newborn B. Administer vitamin K C. Apply the identification bands D. Assess the Apgar score Answer: A. Dry the newborn Rationale: According to the ABC priority framework, thermoregulation is essential. Drying the infant prevents heat loss and stimulates breathing. Other interventions follow once the airway and warmth are ensured. ________________________________________ Question 10 A nurse is assessing a client who is 12 hours postpartum and reports chills and fever. Which of the following actions should the nurse take first? A. Encourage fluid intake B. Check the client’s fundus C. Review the white blood cell count D. Obtain a temperature reading Answer: D. Obtain a temperature reading Rationale: The first action in this scenario is to assess and validate the client’s report by taking a temperature. Nursing process dictates assessment before intervention. ________________________________________Question 11 A nurse is providing discharge teaching to a client who is postpartum and plans to breastfeed. Which instruction should the nurse include? A. "Wash your nipples with soap and water before each feeding." B. "Breastfeed on a set schedule every 3 hours." C. "Let the baby nurse at least 15 minutes on each breast." D. "Limit fluid intake to reduce engorgement." Answer: C. "Let the baby nurse at least 15 minutes on each breast." Rationale: Allowing the infant to nurse for at least 15 minutes per breast ensures the baby receives the hindmilk, which is rich in fat and essential nutrients. Soap can dry the nipples, and feeding should be on demand rather than on a strict schedule.