ATI PN Maternal Newborn
Comprehensive Exam| 2025\2026
QUESTIONS AND ANSWERS |Accurate
Answers |Graded A+
A nurse is caring for a client who is in labor and observes late decelerations on the electronic
fetal monitor. Which of the following is the first action the nurse should take?
A. Assist the client into the left-lateral position
B. Apply a fetal scalp electrode
C. Insert an IV catheter
D. Perform a vaginal exam - AnswerA. Late decelerations is indicative of placental insufficiency
so primary action would be to rotate mother laterally
A nurse is performing Leopold maneuver on a client who is in labor. Which of the following
techniques should the nurse use to identify fetal lie [position of fetus in relation to maternal
spine; transverse or longitudinal]?
A. Apply palms of both hands to the sides of the uterus
B. Palpate the fundus of the uterus
C. Grasp lower uterine segment between thumb and fingers
D. Stand facing the client's feet with fingertips outlining cephalic prominence - AnswerB.
Palpating the fundus identifies the fetal part that is presenting, including whether the fetus is
traverse (perpendicular to mother's spine) or longitudinal (parallel to mother's spine)
A nurse is caring for a client and her partner during the second stage of labor. The client's partner
asks the nurse to explain how he will know when crowning occurs. Which of the following is an
appropriate response by the nurse?
A. "The placenta will protrude from the vagina"
B. "Your partner will report a decrease in the intensity of contractions"
C. "The vaginal area will bulge as the baby's head appears"
,D. "your partner will report less rectal pain" - AnswerC. crowning is the appearance of the fetal
head
A nurse is caring for a client in the third stage of labor. Which of the following findings indicate
that placental separation has occurred? (select all that apply)
A. Lengthening of the umbilical cord
B. Swift gush of clear amniotic fluid
C. Softening of the lower uterine segment
D. Appearance of dark blood from the vagina
E. Fundus is firm upon palpation - AnswerA, D, E
A nurse is caring for a client who is in the transition phase of labor and reports that she need to
have a bowel movement with the peak of contractions. Which of the following is an appropriate
nursing intervention?
A. assist the client to the bathroom
B. Prepare for an impending delivery
C. Prepare to remove a fecal impaction
D. Encourage the client to take deep, cleansing breaths - AnswerB. Urge to have a bowel
movement in this stage indicates fetal descent and complete dilation
A nurse in L&D is planning care for a newly admitted client who reports she is in labor and has
been having vaginal bleeding for 2 weeks. Which of the following should the nurse include in the
plan of care?
A. Inspect the introitus for a prolapsed cord
B. Perform a test to identify the ferning pattern
C. Monitor station of the presenting part
D. Defer vaginal examinations - AnswerD. Vaginal exams should not be performed until
placental abnormalities are ruled out as source of bleeding
A nurse is caring for a client who is in the first stage of labor and encourages the client to void
every 2 hr. The nurse explains that a...
A. full bladder increases the risk for fetal trauma
B. full bladder increases the risk of bladder infections
C. distended bladder will be traumatized by frequent pelvic exams
,D. distended bladder reduces pelvic space needed for birth - AnswerD. reduces pelvic space,
impedes fetal descent, and places the bladder at risk for trauma during labor process
A nurse is caring for a client who is at 42 wks gestation and is admitted to the l&D unit. During
an ultrasound, it is noted that the fetus is large for gestational age. The nurse reviews the
prescription from the provider to begin an amnioinfusion. The nurse should know that an
amnioinfusion is indicated for which of the following reasons? (select all that apply)
A. oligohydramnios
B. hydramnios
C. Fetal cord compression
D. hydration
E. Fetal immaturity - AnswerA, C
Oligohydramnios: a condition of pregnancy characterized by a deficiency of amniotic fluid
which can result in cord compression
A nurse is caring for a client who has been in labor for 12 hrs, and her membranes are intact. The
provider has decided to perform an amniotomy in an effort to facilitate the progress of labor. The
nurse performs a vaginal exam to ensure which of the following prior to the performance of the
amniotomy?
A. Fetal engagement
B. Fetal lie
C. Fetal attitude
D. Fetal position - AnswerA. This will prevent a cord prolapse
A nurse is caring for a client who has no prenatal care, is Rh- and will undergo an external
version at 37 weeks gestation. The nurse anticipates a prescription for which of the following
meds to be administered prior tot the version?
A. Prostaglandin gel (Cervidil)
B. Magnesium sulfate
C. Rho(D) immune globulin (RhoGAM)
D. Oxytocin (Pitocin) - AnswerC. Because of lack of prenatal care, RhoGAM is needed to
prevent isoimmunization due to procedure
, A nurse is caring for a client who is receiving oxytocin (Pitocin) for induction of labor and has an
intrauterine pressure catheter placed to monitor uterine contractions. For which of the following
contraction patterns should the nurse discontinue the infusion of oxytocin?
A. Frequency of every 2 min
B. Duration of 90-120 secs
C. Intensity of 60-90 mmHg
D. Resting tone of 15 mmHg - AnswerB. D/C if uterine hyperstimulation occurs. Contractions
longer than 90 secs deprive the fetus of oxygen for too long
A nurse educator in the L&D unit is reviewing the use of chemical agents to promote cervical
ripening with a group of newly hired nurses. Which of the following statements by a nurse
indicates understand of the teaching?
A. "They are administered in an oral form"
B. "The act by absorbing fluid from the tissues"
C. "They promote dilation of the os"
D. "They include an amniotomy" - AnswerA. Chemical agents are meds administered PO
A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxation
between hypertonic contractions. The nurse recognizes the adverse effects of the contraction
pattern is...
A. prolonged labor
B. reduced fetal oxygen supply
C. delayed cervical dilation
D. increased maternal stress - AnswerB. incomplete relaxation between contractions reduces the
amount of oxygen the fetus gets.
A nurse is caring for a client who is in active labor and reports severe back pain. During
assessment, the fetus is noted to be in the occiput posterior position. Which of the following
maternal positions should the nurse suggest to the client to facilitate normal labor progression?
A. Hands and knees
B. Lithotomy
C. Trendelenburg
Comprehensive Exam| 2025\2026
QUESTIONS AND ANSWERS |Accurate
Answers |Graded A+
A nurse is caring for a client who is in labor and observes late decelerations on the electronic
fetal monitor. Which of the following is the first action the nurse should take?
A. Assist the client into the left-lateral position
B. Apply a fetal scalp electrode
C. Insert an IV catheter
D. Perform a vaginal exam - AnswerA. Late decelerations is indicative of placental insufficiency
so primary action would be to rotate mother laterally
A nurse is performing Leopold maneuver on a client who is in labor. Which of the following
techniques should the nurse use to identify fetal lie [position of fetus in relation to maternal
spine; transverse or longitudinal]?
A. Apply palms of both hands to the sides of the uterus
B. Palpate the fundus of the uterus
C. Grasp lower uterine segment between thumb and fingers
D. Stand facing the client's feet with fingertips outlining cephalic prominence - AnswerB.
Palpating the fundus identifies the fetal part that is presenting, including whether the fetus is
traverse (perpendicular to mother's spine) or longitudinal (parallel to mother's spine)
A nurse is caring for a client and her partner during the second stage of labor. The client's partner
asks the nurse to explain how he will know when crowning occurs. Which of the following is an
appropriate response by the nurse?
A. "The placenta will protrude from the vagina"
B. "Your partner will report a decrease in the intensity of contractions"
C. "The vaginal area will bulge as the baby's head appears"
,D. "your partner will report less rectal pain" - AnswerC. crowning is the appearance of the fetal
head
A nurse is caring for a client in the third stage of labor. Which of the following findings indicate
that placental separation has occurred? (select all that apply)
A. Lengthening of the umbilical cord
B. Swift gush of clear amniotic fluid
C. Softening of the lower uterine segment
D. Appearance of dark blood from the vagina
E. Fundus is firm upon palpation - AnswerA, D, E
A nurse is caring for a client who is in the transition phase of labor and reports that she need to
have a bowel movement with the peak of contractions. Which of the following is an appropriate
nursing intervention?
A. assist the client to the bathroom
B. Prepare for an impending delivery
C. Prepare to remove a fecal impaction
D. Encourage the client to take deep, cleansing breaths - AnswerB. Urge to have a bowel
movement in this stage indicates fetal descent and complete dilation
A nurse in L&D is planning care for a newly admitted client who reports she is in labor and has
been having vaginal bleeding for 2 weeks. Which of the following should the nurse include in the
plan of care?
A. Inspect the introitus for a prolapsed cord
B. Perform a test to identify the ferning pattern
C. Monitor station of the presenting part
D. Defer vaginal examinations - AnswerD. Vaginal exams should not be performed until
placental abnormalities are ruled out as source of bleeding
A nurse is caring for a client who is in the first stage of labor and encourages the client to void
every 2 hr. The nurse explains that a...
A. full bladder increases the risk for fetal trauma
B. full bladder increases the risk of bladder infections
C. distended bladder will be traumatized by frequent pelvic exams
,D. distended bladder reduces pelvic space needed for birth - AnswerD. reduces pelvic space,
impedes fetal descent, and places the bladder at risk for trauma during labor process
A nurse is caring for a client who is at 42 wks gestation and is admitted to the l&D unit. During
an ultrasound, it is noted that the fetus is large for gestational age. The nurse reviews the
prescription from the provider to begin an amnioinfusion. The nurse should know that an
amnioinfusion is indicated for which of the following reasons? (select all that apply)
A. oligohydramnios
B. hydramnios
C. Fetal cord compression
D. hydration
E. Fetal immaturity - AnswerA, C
Oligohydramnios: a condition of pregnancy characterized by a deficiency of amniotic fluid
which can result in cord compression
A nurse is caring for a client who has been in labor for 12 hrs, and her membranes are intact. The
provider has decided to perform an amniotomy in an effort to facilitate the progress of labor. The
nurse performs a vaginal exam to ensure which of the following prior to the performance of the
amniotomy?
A. Fetal engagement
B. Fetal lie
C. Fetal attitude
D. Fetal position - AnswerA. This will prevent a cord prolapse
A nurse is caring for a client who has no prenatal care, is Rh- and will undergo an external
version at 37 weeks gestation. The nurse anticipates a prescription for which of the following
meds to be administered prior tot the version?
A. Prostaglandin gel (Cervidil)
B. Magnesium sulfate
C. Rho(D) immune globulin (RhoGAM)
D. Oxytocin (Pitocin) - AnswerC. Because of lack of prenatal care, RhoGAM is needed to
prevent isoimmunization due to procedure
, A nurse is caring for a client who is receiving oxytocin (Pitocin) for induction of labor and has an
intrauterine pressure catheter placed to monitor uterine contractions. For which of the following
contraction patterns should the nurse discontinue the infusion of oxytocin?
A. Frequency of every 2 min
B. Duration of 90-120 secs
C. Intensity of 60-90 mmHg
D. Resting tone of 15 mmHg - AnswerB. D/C if uterine hyperstimulation occurs. Contractions
longer than 90 secs deprive the fetus of oxygen for too long
A nurse educator in the L&D unit is reviewing the use of chemical agents to promote cervical
ripening with a group of newly hired nurses. Which of the following statements by a nurse
indicates understand of the teaching?
A. "They are administered in an oral form"
B. "The act by absorbing fluid from the tissues"
C. "They promote dilation of the os"
D. "They include an amniotomy" - AnswerA. Chemical agents are meds administered PO
A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxation
between hypertonic contractions. The nurse recognizes the adverse effects of the contraction
pattern is...
A. prolonged labor
B. reduced fetal oxygen supply
C. delayed cervical dilation
D. increased maternal stress - AnswerB. incomplete relaxation between contractions reduces the
amount of oxygen the fetus gets.
A nurse is caring for a client who is in active labor and reports severe back pain. During
assessment, the fetus is noted to be in the occiput posterior position. Which of the following
maternal positions should the nurse suggest to the client to facilitate normal labor progression?
A. Hands and knees
B. Lithotomy
C. Trendelenburg
