ATI Maternity Proctored Exam Practice Questions and Answers
Updated 2026 | Complete Maternal-Newborn Nursing Study Guide
with Verified Questions, Detailed Rationales, Antepartum Care,
Intrapartum Labor & Delivery, Postpartum Nursing, Newborn
Assessment, Fetal Monitoring, High-Risk Pregnancy, Obstetric
Complications & NGN NCLEX-RN/PN Exam Prep
Question 1: A nurse is assessing a client at 32 weeks of gestation who reports
frequent headaches and blurred vision. Which action should the nurse take first?
A. Administer acetaminophen as prescribed
B. Check the client's blood pressure
C. Encourage the client to rest in a darkened room
D. Document the findings in the medical record
CORRECT ANSWER: B. Check the client's blood pressure
Rationale: Headaches and blurred vision at 32 weeks gestation are potential signs of
preeclampsia. The nurse's priority is to assess blood pressure to evaluate for
hypertension, a key diagnostic criterion for preeclampsia. Early detection allows for
timely intervention to prevent complications such as eclampsia or placental abruption.
Question 2: A nurse is teaching a pregnant client about fetal development. At which
gestational age should the nurse inform the client that the fetus typically develops
audible heart tones via Doppler ultrasound?
A. 6 to 8 weeks
B. 10 to 12 weeks
C. 14 to 16 weeks
D. 18 to 20 weeks
CORRECT ANSWER: B. 10 to 12 weeks
Rationale: Fetal heart tones are typically detectable via Doppler ultrasound between 10
and 12 weeks of gestation. While the fetal heart begins beating around 6 weeks, it is not
reliably audible with a handheld Doppler until 10–12 weeks. This knowledge helps set
realistic expectations for prenatal monitoring.
Question 3: A nurse is caring for a client in active labor who suddenly reports
intense, constant abdominal pain and exhibits a board-like uterus. Which
complication should the nurse suspect?
A. Placenta previa
B. Uterine rupture
C. Placental abruption
D. Preterm labor
CORRECT ANSWER: C. Placental abruption
,Rationale: A board-like uterus with constant, severe abdominal pain is a classic sign of
placental abruption, where the placenta separates prematurely from the uterine wall.
This is an obstetric emergency requiring immediate intervention to prevent fetal demise
and maternal hemorrhage. Placenta previa typically presents with painless bleeding,
while uterine rupture often includes loss of fetal station and maternal tachycardia.
Question 4: A nurse is providing discharge teaching to a postpartum client about
lochia. Which statement by the client indicates understanding of normal lochia
progression?
A. "My lochia should be bright red for the first 2 weeks."
B. "Lochia alba typically lasts for 10 days after delivery."
C. "I should expect lochia serosa to appear around day 4 postpartum."
D. "Lochia should have a foul odor during the first week."
CORRECT ANSWER: C. "I should expect lochia serosa to appear around day 4
postpartum."
Rationale: Normal lochia progression includes lochia rubra (days 1–3, bright red), lochia
serosa (days 4–10, pinkish-brown), and lochia alba (days 11–21, yellowish-white).
Lochia should not have a foul odor, which suggests infection. Understanding this
timeline helps the client recognize abnormal findings requiring medical evaluation.
Question 5: A nurse is assessing a newborn 1 hour after birth. Which finding
requires immediate intervention?
A. Acrocyanosis
B. Respiratory rate of 58 breaths/min
C. Central cyanosis
D. Heart rate of 130 beats/min
CORRECT ANSWER: C. Central cyanosis
Rationale: Central cyanosis (bluish discoloration of the trunk, lips, or mucous
membranes) indicates inadequate oxygenation and requires immediate assessment
and intervention. Acrocyanosis (blue hands and feet) is normal in the first 24–48 hours
due to immature peripheral circulation. A respiratory rate of 58/min and heart rate of
130/min are within normal newborn ranges (30–60 breaths/min; 110–160 beats/min).
Question 6: A nurse is preparing to administer Rho(D) immune globulin to a
postpartum client. Which assessment finding is a prerequisite for administration?
A. Mother is Rh-negative, infant is Rh-positive
B. Mother is Rh-positive, infant is Rh-negative
C. Mother has a positive indirect Coombs test
D. Infant has a positive direct Coombs test
CORRECT ANSWER: A. Mother is Rh-negative, infant is Rh-positive
,Rationale: Rho(D) immune globulin is administered to Rh-negative mothers after
delivery of an Rh-positive infant to prevent maternal sensitization and hemolytic
disease in future pregnancies. It is not indicated if the mother is Rh-positive or if the
infant is Rh-negative. A positive indirect Coombs test indicates existing sensitization,
making RhoGAM ineffective.
Question 7: A nurse is teaching a client about nonpharmacological pain
management during labor. Which technique should the nurse recommend for the
latent phase of labor?
A. Epidural analgesia
B. Patterned breathing
C. Pudendal block
D. General anesthesia
CORRECT ANSWER: B. Patterned breathing
Rationale: Patterned breathing is a nonpharmacological technique appropriate for the
latent phase of labor to promote relaxation and coping. Epidural analgesia, pudendal
block, and general anesthesia are pharmacological interventions typically reserved for
active labor or delivery. Nonpharmacological methods empower clients and reduce
reliance on medications early in labor.
Question 8: A nurse is caring for a client receiving magnesium sulfate for
preeclampsia. Which assessment finding indicates magnesium toxicity?
A. Deep tendon reflexes of 2+
B. Urine output of 40 mL/hr
C. Respiratory rate of 10 breaths/min
D. Blood pressure of 148/92 mm Hg
CORRECT ANSWER: C. Respiratory rate of 10 breaths/min
Rationale: Magnesium sulfate depresses the central nervous system; respiratory
depression (<12 breaths/min) is a critical sign of toxicity. Other indicators include
absent deep tendon reflexes, urine output <30 mL/hr, and lethargy. Therapeutic
monitoring includes assessing reflexes, respirations, and renal function. Calcium
gluconate is the antidote for magnesium toxicity.
Question 9: A nurse is assessing a postpartum client 24 hours after cesarean birth.
Which finding suggests a potential complication?
A. Lochia rubra with small clots
B. Incisional pain rated 4/10 with movement
C. Temperature of 38.2°C (100.8°F)
D. Absence of flatus
CORRECT ANSWER: C. Temperature of 38.2°C (100.8°F)
, Rationale: A temperature ≥38°C (100.4°F) after the first 24 hours postpartum may
indicate infection, such as endometritis or wound infection. Lochia rubra with small
clots, mild incisional pain, and absence of flatus are expected findings within 24 hours
after cesarean birth. Persistent fever requires further assessment and intervention.
Question 10: A nurse is providing newborn care education to a group of parents.
Which statement about newborn sleep safety should the nurse include?
A. "Place your baby on their stomach to sleep to prevent choking."
B. "Use soft bedding and stuffed animals to comfort your baby."
C. "Share a bed with your baby for easier breastfeeding."
D. "Place your baby on their back on a firm mattress with no loose items."
CORRECT ANSWER: D. "Place your baby on their back on a firm mattress with no
loose items."
Rationale: The American Academy of Pediatrics recommends placing infants on their
back on a firm sleep surface without loose bedding, pillows, or toys to reduce the risk of
Sudden Infant Death Syndrome (SIDS). Prone sleeping, soft bedding, and bed-sharing
increase SIDS risk. Safe sleep practices are critical newborn education topics.
Question 11: A nurse is caring for a client at 39 weeks gestation with a diagnosis of
placenta previa. Which intervention should the nurse anticipate?
A. Digital vaginal examination
B. Amniotomy to induce labor
C. Scheduled cesarean birth
D. Oxytocin infusion for augmentation
CORRECT ANSWER: C. Scheduled cesarean birth
Rationale: Placenta previa, where the placenta covers the cervical os, contraindicates
vaginal examination and vaginal delivery due to risk of catastrophic hemorrhage.
Cesarean birth is the standard management. Amniotomy and oxytocin are avoided as
they can provoke bleeding. Management focuses on monitoring and planned surgical
delivery.
Question 12: A nurse is assessing a newborn for jaundice. Which finding indicates
pathological jaundice requiring intervention?
A. Jaundice appearing at 48 hours of life
B. Total serum bilirubin of 8 mg/dL at 24 hours
C. Jaundice limited to the face and upper chest
D. Bilirubin rising by 2 mg/dL per day after day 3
CORRECT ANSWER: B. Total serum bilirubin of 8 mg/dL at 24 hours
Rationale: Jaundice appearing within the first 24 hours of life is always pathological and
requires immediate evaluation. A bilirubin level of 8 mg/dL at 24 hours exceeds the 95th
Updated 2026 | Complete Maternal-Newborn Nursing Study Guide
with Verified Questions, Detailed Rationales, Antepartum Care,
Intrapartum Labor & Delivery, Postpartum Nursing, Newborn
Assessment, Fetal Monitoring, High-Risk Pregnancy, Obstetric
Complications & NGN NCLEX-RN/PN Exam Prep
Question 1: A nurse is assessing a client at 32 weeks of gestation who reports
frequent headaches and blurred vision. Which action should the nurse take first?
A. Administer acetaminophen as prescribed
B. Check the client's blood pressure
C. Encourage the client to rest in a darkened room
D. Document the findings in the medical record
CORRECT ANSWER: B. Check the client's blood pressure
Rationale: Headaches and blurred vision at 32 weeks gestation are potential signs of
preeclampsia. The nurse's priority is to assess blood pressure to evaluate for
hypertension, a key diagnostic criterion for preeclampsia. Early detection allows for
timely intervention to prevent complications such as eclampsia or placental abruption.
Question 2: A nurse is teaching a pregnant client about fetal development. At which
gestational age should the nurse inform the client that the fetus typically develops
audible heart tones via Doppler ultrasound?
A. 6 to 8 weeks
B. 10 to 12 weeks
C. 14 to 16 weeks
D. 18 to 20 weeks
CORRECT ANSWER: B. 10 to 12 weeks
Rationale: Fetal heart tones are typically detectable via Doppler ultrasound between 10
and 12 weeks of gestation. While the fetal heart begins beating around 6 weeks, it is not
reliably audible with a handheld Doppler until 10–12 weeks. This knowledge helps set
realistic expectations for prenatal monitoring.
Question 3: A nurse is caring for a client in active labor who suddenly reports
intense, constant abdominal pain and exhibits a board-like uterus. Which
complication should the nurse suspect?
A. Placenta previa
B. Uterine rupture
C. Placental abruption
D. Preterm labor
CORRECT ANSWER: C. Placental abruption
,Rationale: A board-like uterus with constant, severe abdominal pain is a classic sign of
placental abruption, where the placenta separates prematurely from the uterine wall.
This is an obstetric emergency requiring immediate intervention to prevent fetal demise
and maternal hemorrhage. Placenta previa typically presents with painless bleeding,
while uterine rupture often includes loss of fetal station and maternal tachycardia.
Question 4: A nurse is providing discharge teaching to a postpartum client about
lochia. Which statement by the client indicates understanding of normal lochia
progression?
A. "My lochia should be bright red for the first 2 weeks."
B. "Lochia alba typically lasts for 10 days after delivery."
C. "I should expect lochia serosa to appear around day 4 postpartum."
D. "Lochia should have a foul odor during the first week."
CORRECT ANSWER: C. "I should expect lochia serosa to appear around day 4
postpartum."
Rationale: Normal lochia progression includes lochia rubra (days 1–3, bright red), lochia
serosa (days 4–10, pinkish-brown), and lochia alba (days 11–21, yellowish-white).
Lochia should not have a foul odor, which suggests infection. Understanding this
timeline helps the client recognize abnormal findings requiring medical evaluation.
Question 5: A nurse is assessing a newborn 1 hour after birth. Which finding
requires immediate intervention?
A. Acrocyanosis
B. Respiratory rate of 58 breaths/min
C. Central cyanosis
D. Heart rate of 130 beats/min
CORRECT ANSWER: C. Central cyanosis
Rationale: Central cyanosis (bluish discoloration of the trunk, lips, or mucous
membranes) indicates inadequate oxygenation and requires immediate assessment
and intervention. Acrocyanosis (blue hands and feet) is normal in the first 24–48 hours
due to immature peripheral circulation. A respiratory rate of 58/min and heart rate of
130/min are within normal newborn ranges (30–60 breaths/min; 110–160 beats/min).
Question 6: A nurse is preparing to administer Rho(D) immune globulin to a
postpartum client. Which assessment finding is a prerequisite for administration?
A. Mother is Rh-negative, infant is Rh-positive
B. Mother is Rh-positive, infant is Rh-negative
C. Mother has a positive indirect Coombs test
D. Infant has a positive direct Coombs test
CORRECT ANSWER: A. Mother is Rh-negative, infant is Rh-positive
,Rationale: Rho(D) immune globulin is administered to Rh-negative mothers after
delivery of an Rh-positive infant to prevent maternal sensitization and hemolytic
disease in future pregnancies. It is not indicated if the mother is Rh-positive or if the
infant is Rh-negative. A positive indirect Coombs test indicates existing sensitization,
making RhoGAM ineffective.
Question 7: A nurse is teaching a client about nonpharmacological pain
management during labor. Which technique should the nurse recommend for the
latent phase of labor?
A. Epidural analgesia
B. Patterned breathing
C. Pudendal block
D. General anesthesia
CORRECT ANSWER: B. Patterned breathing
Rationale: Patterned breathing is a nonpharmacological technique appropriate for the
latent phase of labor to promote relaxation and coping. Epidural analgesia, pudendal
block, and general anesthesia are pharmacological interventions typically reserved for
active labor or delivery. Nonpharmacological methods empower clients and reduce
reliance on medications early in labor.
Question 8: A nurse is caring for a client receiving magnesium sulfate for
preeclampsia. Which assessment finding indicates magnesium toxicity?
A. Deep tendon reflexes of 2+
B. Urine output of 40 mL/hr
C. Respiratory rate of 10 breaths/min
D. Blood pressure of 148/92 mm Hg
CORRECT ANSWER: C. Respiratory rate of 10 breaths/min
Rationale: Magnesium sulfate depresses the central nervous system; respiratory
depression (<12 breaths/min) is a critical sign of toxicity. Other indicators include
absent deep tendon reflexes, urine output <30 mL/hr, and lethargy. Therapeutic
monitoring includes assessing reflexes, respirations, and renal function. Calcium
gluconate is the antidote for magnesium toxicity.
Question 9: A nurse is assessing a postpartum client 24 hours after cesarean birth.
Which finding suggests a potential complication?
A. Lochia rubra with small clots
B. Incisional pain rated 4/10 with movement
C. Temperature of 38.2°C (100.8°F)
D. Absence of flatus
CORRECT ANSWER: C. Temperature of 38.2°C (100.8°F)
, Rationale: A temperature ≥38°C (100.4°F) after the first 24 hours postpartum may
indicate infection, such as endometritis or wound infection. Lochia rubra with small
clots, mild incisional pain, and absence of flatus are expected findings within 24 hours
after cesarean birth. Persistent fever requires further assessment and intervention.
Question 10: A nurse is providing newborn care education to a group of parents.
Which statement about newborn sleep safety should the nurse include?
A. "Place your baby on their stomach to sleep to prevent choking."
B. "Use soft bedding and stuffed animals to comfort your baby."
C. "Share a bed with your baby for easier breastfeeding."
D. "Place your baby on their back on a firm mattress with no loose items."
CORRECT ANSWER: D. "Place your baby on their back on a firm mattress with no
loose items."
Rationale: The American Academy of Pediatrics recommends placing infants on their
back on a firm sleep surface without loose bedding, pillows, or toys to reduce the risk of
Sudden Infant Death Syndrome (SIDS). Prone sleeping, soft bedding, and bed-sharing
increase SIDS risk. Safe sleep practices are critical newborn education topics.
Question 11: A nurse is caring for a client at 39 weeks gestation with a diagnosis of
placenta previa. Which intervention should the nurse anticipate?
A. Digital vaginal examination
B. Amniotomy to induce labor
C. Scheduled cesarean birth
D. Oxytocin infusion for augmentation
CORRECT ANSWER: C. Scheduled cesarean birth
Rationale: Placenta previa, where the placenta covers the cervical os, contraindicates
vaginal examination and vaginal delivery due to risk of catastrophic hemorrhage.
Cesarean birth is the standard management. Amniotomy and oxytocin are avoided as
they can provoke bleeding. Management focuses on monitoring and planned surgical
delivery.
Question 12: A nurse is assessing a newborn for jaundice. Which finding indicates
pathological jaundice requiring intervention?
A. Jaundice appearing at 48 hours of life
B. Total serum bilirubin of 8 mg/dL at 24 hours
C. Jaundice limited to the face and upper chest
D. Bilirubin rising by 2 mg/dL per day after day 3
CORRECT ANSWER: B. Total serum bilirubin of 8 mg/dL at 24 hours
Rationale: Jaundice appearing within the first 24 hours of life is always pathological and
requires immediate evaluation. A bilirubin level of 8 mg/dL at 24 hours exceeds the 95th
