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Maternal ATI Practice Exam – 2025 Comprehensive
Study Questions, Detailed
Rationales, and Expert Answers for Nursing Success
Question: A nurse is caring for a newborn who has irregular respirations of 52/min with several periods of apnea lasting approximately 5 seconds. The newborn is pink with acrocyanosis. Which of the following actions should the nurse take? A. Administer oxygen B. Place the newborn in an isolette C. Continue to monitor the newborn routinely D. Assess the newborn's blood glucose Correct Answer: C Rationale: These are normal findings in a healthy newborn. Periodic breathing and acrocyanosis are common in the first few hours of life.
- A & B: No indication of respiratory distress requiring oxygen or isolette.
- D: No symptoms suggesting hypoglycemia. Question: A nurse is caring for a postpartum client who is having difficulty voiding. Which of the following actions should the nurse take first? A. Place the client's hands in warm water B. Administer an analgesic to the client C. Pour water from a squeeze bottle over the client's perineum D. Assist the client to the bathroom Correct Answer: D Rationale: Always assist with basic positioning first. Getting the client to the bathroom promotes natural voiding.
- A & C: Helpful non-invasive strategies but secondary.
- B: Pain control is important but not the first step for voiding assistance. Question: A nurse is planning care for a client at 35 weeks gestation. Which of the following laboratory tests should the nurse obtain? A. Rubella titer
B. Blood type C. Group B streptococcus ß-hemolytic D. 1 - hour glucose tolerance test Correct Answer: C Rationale: Group B strep testing is done at 35 – 37 weeks to plan for antibiotic prophylaxis during labor if needed.
- A & B: Done earlier in pregnancy. D: The glucose test is done around 24 – 28 weeks. Question: A nurse is performing an admission assessment of a client who has just arrived at the labor and delivery unit. Which of the following findings should the nurse identify as the priority? A. The client reports a pain level of 8 on a scale from 0 to 10 during contractions. B. The client's blood pressure is 148/92 mmHg. C. The client's temperature is 38.3°C (101°F). D. The fetal heart rate is 90/min. Correct Answer: D Rationale: A fetal heart rate of 90/min indicates bradycardia , which can result in fetal hypoxia or distress and requires immediate intervention.
- A: Pain is expected in labor and is managed but not an immediate threat.
- B: Elevated BP is concerning but not as urgent.
- C: Slight fever is worth monitoring but is less critical than fetal bradycardia. Question: A nurse is teaching a client who has active genital herpes simplex virus, type 2. Which of the following statements should the nurse include in the teaching? A. "You will have a cesarean birth prior to the onset of labor." B. "Your baby will receive erythromycin eye ointment after birth to treat the infection." C. "You should take oral metronidazole for 7 days prior to 37 weeks gestation." D. "You should schedule a cesarean birth after your water breaks." Correct Answer: A Rationale: Cesarean birth is recommended prior to the onset of labor to prevent transmission of herpes simplex virus during vaginal delivery.
- B: Erythromycin is used to prevent ophthalmia neonatorum due to gonorrhea, not herpes.
A. Hypertension B. Menorrhagia C. History of multiple gestations D. History of thromboembolic disease Correct Answer: B Rationale: An IUD may increase bleeding and is contraindicated in clients with menorrhagia.
- A & D: Not contraindications unless estrogen is involved.
- C: Multiple gestations are not a contraindication. 9. Naegele’s Rule - EDB Question: A nurse is using Naegele’s rule to determine the estimated date of birth (EDB) for a client whose first day of her last menstrual period was February 2, 2018. The nurse should identify which of the following as the client’s EDB? A. November 16, 2018 B. October 19, 2018 C. October 26, 2018 D. November 9, 2018 Correct Answer: D Rationale: Naegele’s Rule = LMP + 7 days - 3 months + 1 year Feb 2, 2018 → Nov 9, 2018
- Other options are incorrect due to miscalculated dates. A nurse is providing nutritional counseling for a client who is pregnant. Which nutrients should the nurse instruct the client to increase her daily diet? A. Iron B. Calcium C. Vitamin E D. Vitamin K - - correct ans- - a A nurse is caring for a client who is scheduled to receive a continuous IV infusion of oxytocin following a vaginal birth. Which of the following assessment findings should the nurse monitor to evaluate the effectiveness of the medication?
A. Urinary output B. Blood pressure C. Fundal consistency D. Pulse rate - - correct ans- - c; Oxytocin is a smooth muscle relaxant that causes contraction of the uterus. The nurse should palpate the uterine fundus to determine consistency or tone to determine if the medication is effective. A nurse in the labor and delivery suite is planning care for a group of 4 clients. Which of the following clients should the nurse see first? A. A client who is in active labor and has late decelerations on the fetal heart monitor strip B. A client who is in transition and screaming and disturbing other clients C. A client who has epidural analgesia and is reporting breakthrough pain D. A client who has received an oxytocin infusion and is experiencing contractions every 2 minutes lasting 60 sec - - correct ans- - a; Late decelerations are nonreassuring patterns that reflect impaired placental exchange or placental insufficiency. Because late decelerations indicate fetal hypoxia, the nurse should assess and intervene immediately by changing the client's position, administering oxygen, increasing IV fluids, and preparing for the possibility of an immediate cesarean birth. A nurse is teaching a client with pre-eclampsia who is scheduled to receive magnesium sulfate via continuous IV infusion about expected adverse effects. Which of the following adverse effects should the nurse include in the teaching? A. Elevated blood pressure B. Feeling of warmth C. Hyperactivity D. Generalized pruritus - - correct ans- - b; The nurse should tell the client to expect a feeling of warmth all over her body while the magnesium sulfate is infusing.
D. "If I notice periodic numbness and tingling in my fingers, I should call my provider." - - correct ans- - b A nurse is preparing to perform a heel stick on a newborn. Which of the following actions should the nurse take? A. Don sterile gloves prior to puncturing the newborn's heel B. Puncture the center aspect of the newborn's heel C. Elevate the newborn's heel prior to the procedure. D. Warm the heel with a warm washcloth prior to the procedure. - - correct ans- - d; The nurse should warm the heel with a warm washcloth for 5 to 10 minutes prior to the procedure to enhance blood flow to the heel. A nurse on the antepartum unit is caring for a client who is at 28 weeks gestation and reports dizziness when lying on her back. Into which of the following positions should the nurse assist the client? A. Lateral B. Lithotomy C. Trendelenburg D. Prone - - correct ans- - a; A lateral or side-lying position promotes uteroplacental blood flow and helps relieve the symptoms of supine hypotension, including faintness, dizziness, and breathlessness. A nurse is caring for a client in the latent phase of labor who is receiving oxytocin via continuous IV infusion. The client has contractions every 2 min that last 100 to 110 sec, and the fetal heart rate (FHR) is reassuring. Which of the following actions should the nurse take? A. Decrease the infusion rate of the maintenance IV fluid B. Administer oxygen via a nonrebreather mask C. Decrease the dose of oxytocin by half.
D. Administer terbutaline 0.25 mg subcutaneously - - correct ans- - c; The nurse should decrease the dose of oxytocin by half because the client is experiencing uterine tachysystole. An adolescent reports abdominal cramping due to dysmenorrhea. Which of the following analgesics should the nurse expect the provider to prescribe? A. Fentanyl B. Acetaminophen and oxycodone C. Acetaminophen and hydrocodone D. Ibuprofen - - correct ans- - d; To treat dysmenorrhea, providers prescribe NSAIDs such as ibuprofen and naproxen. Providers also recommend exercise and dietary changes such as reducing salt and sugar intake and following a low-fat, vegetarian diet. A nurse is providing education for the parent of a premature infant on interventions to promote optimal development. Which of the following actions should the nurse instruct the parent to perform? A. Maintain bright lighting to enable close observation of the infant at all times B. Place the infant in a prone position with arms and legs extended C. Rouse the infant every 1-2 hr to provide auditory and visual stimulation D. Provide kangaroo care for the infant - - correct ans- - d A nurse is caring for a client in active labor whose membranes have ruptured. The fetal monitor tracing reveals late decelerations. Which of the following actions should the nurse take first? A. Turn the client onto her left side B. Palpate the client's uterus C. Administer oxygen to the client
d - Craniofacial anomalies are a manifestation of fetal alcohol syndrome, not neonatal abstinence syndrome due to maternal heroin use., A nurse is reviewing risk factors for postpartum depression with a newly licensed nurse. Which of the following risk factors should the nurse include? A. Gestational diabetes B. Planned pregnancy C. Being married D. Post-term birth - - correct ans- - a A nurse is assessing a client at 37 weeks gestation who has a suspected pelvic fracture due to blunt abdominal trauma. Which of the following findings should the nurse expect? A. Bradycardia B. Uterine contractions C. Seizures D. Bradypnea - - correct ans- - b; The nurse should expect the client to be experiencing uterine contractions due to abdominal trauma. A nurse is caring for a newborn who is experiencing opioid withdrawal. Which of the following manifestations should the nurse expect and report to the provider? A. Weak cry B. Absent Moro reflex C. Constipation D. Tremors - - correct ans- - d A nurse is providing teaching for a client who is pregnant and has type 1 diabetes mellitus. Which of the following statements should the nurse include in the teaching?
A. "You should expect to increase your insulin dosage during the first trimester of pregnancy." B. "You should expect to decrease your insulin dosage during the second and third trimesters of pregnancy." C. "You should expect to decrease your insulin dosage immediately after you deliver your baby." D. "You must increase your insulin dosage if breastfeeding." - - correct ans- - c A nurse is teaching new parents about newborn reflexes. Which of the following reflexes facilitates infant feeding? A. Stepping B. Moro C. Rooting D. Babinski - - correct ans- - c; The rooting reflex is elicited when the cheek is stroked and the newborn turns the head while making sucking motions with the mouth. This reflex supports effective sucking. A labor and delivery unit nurse is caring for a client in the second stage of labor. Which of the following actions should the nurse take? A. Encourage the client to change positions frequently. B. Instruct the client to take breaths and hold them for 10 seconds while pushing C. Assess maternal vital signs every 1 hour D. Assist the client to the restroom - - correct ans- - a; During the second stage, frequent position changes can promote the descent of the fetus through the birth canal. The nurse should assist the client in finding optimal positions of comfort which allow the client to rest between contractions but also enhances expulsive efforts.
A. Severe hypotension B. Proteinuria C. Elevated platelet count D. Seizures - - correct ans- - b; The nurse should expect a client with preeclampsia to have proteinuria and impaired kidney function. A nurse is reviewing the medical record of a client at 33 weeks gestation who has placenta previa and bleeding. Which of the following prescriptions should the nurse clarify with the provider? A. Perform a vaginal examination B. Perform continuous external fetal monitoring C. Insert a large-bore IV catheter D. Obtain a blood sample for laboratory testing - - correct ans- - a; When a client has a placenta previa, the placenta implants in the lower part of the uterus and obstructs the cervical os (the opening to the vagina). The nurse should clarify this prescription because any manipulation can cause tearing of the placenta and increased bleeding. A nurse is teaching a client about breastfeeding. Which of the following client statements indicates an understanding of the teaching? A. "I should consume about 700 extra calories a day while breastfeeding." B. "I will introduce bottle feeding of pumped breast milk when my baby is 2 weeks old." C. "I may notice increased cramping when I am feeding my baby." D. "I will place my baby on a strict feeding schedule to help establish a good feeding pattern." - - correct ans- - c; The client may notice an increase in uterine cramping while breastfeeding due to the release of oxytocin, which causes uterine muscle contraction. A nurse is caring for a client who had a precipitous delivery. Which of the following assessments is the priority during the fourth stage of labor?
A. Obtaining the client's temperature B. Inspecting the client's perineum C. Palpating the client's fundus D. Checking the client for hemorrhoids - - correct ans- - c; The nurse should apply the safety and risk-reduction priority-setting framework, which assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. A postpartum nurse is caring for a client who is 4 hours postpartum and has a painful third- degree perineal laceration. Which of the following interventions should the nurse take? A. Prepare to initiate a warm water sitz bath for the client's perineum. B. Encourage the client to sit on a soft pillow C. Apply ice packs to the client's perineum D. Administer an acetaminophen suppository rectally - - correct ans- - c A nurse is providing discharge instructions for a client who had a cesarean birth 4 days ago. The client's hemoglobin level is 9.2 g/dL, and the provider has prescribed an iron supplement. Which foods should the nurse recommend to help increase the client's iron intake? A. Spinach B. Citrus fruit C. Milk D. Whole-grain bread - - correct ans- - b; Foods with a high vitamin C content help increase iron absorption. These foods include citrus fruits, strawberries, melons, and tomatoes. A nurse is assessing a client who is postpartum following a vacuum-assisted birth. For which of the following findings should the nurse monitor to identify a cervical laceration? A. Continuous lochia flow and a flaccid uterus
B. 400 mg C. 1,000 mg D. 2,000 mg - - correct ans- - c; The nurse should instruct the client that 1,000 mg of calcium is recommended for women age 19 and older and those who are lactating. This amount of calcium is sufficient to meet the client's and the infant's needs because additional calcium is absorbed from the intestines during this time. A nurse is caring for a client who is pregnant with a male child and expresses concern to the nurse about the possibility of the child having hemophilia. The client is a carrier of the gene mutation for this condition. Which of the following percentages represents the child's chance of having this disorder? A. 25% B. 50% C. 75% D. 100% - - correct ans- - b; Hemophilia A is an X-linked recessive inheritance disorder, which means that female clients who are carriers have a 50% chance of passing the gene mutation to their children. If the child is female, she will be a carrier. If the child is male, he will have the disorder. This is because male children inherit an X chromosome from their biological mothers and a Y chromosome from their biological fathers. If the male child has the gene mutation on 1 of his X chromosomes, it will cause the disorder even though it is on a copy of the gene. A nurse is providing nutritional teaching for a pregnant client who had a prepregnancy body mass index (BMI) of 38. Which of the following statements by the client demonstrate an understanding of the teaching about her recommended weight gain during pregnancy? A. "I should plan to gain 12.7 to 18.1 kg during my pregnancy." B. "I should plan to gain 11.3 to 15.9 kg during my pregnancy." C. "I should plan to gain 6.8 to 11.3 kg during my pregnancy." D. "I should plan to gain 5 to 9.1 kg during my pregnancy." - - correct ans- - d; Clients with a prepregnancy BMI of greater than 30 are considered to be obese and should plan to limit their weight gain to 5 to 9.1 kg (11 to 20 lb) during pregnancy.
A nurse in a clinic is teaching a client who is at 37 weeks of gestation and is scheduled for an external cephalic version. Which of the following statements should the nurse make? A. "Your provider will insert a hand into your uterus and turn your baby around." B. "You will receive medication to relax your uterus prior to the procedure." C. "This procedure will be performed in the clinic at your next visit." D. "Your baby's heartbeat will be monitored occasionally throughout the procedure." - - correct ans- - b; A client who is scheduled to undergo an external cephalic version often receives a tocolytic prior to the procedure to allow the uterus to relax. A relaxed uterus allows the provider to provide an easier version. A nurse is teaching a parent how to care for his newborn's circumcision site. Which of the following client statements indicates an understanding of the teaching? A. "I should clean the circumcision site with half-strength hydrogen peroxide twice a day." B. "I should apply the diaper loosely until the circumcision site is healed." C. "I should notify the doctor if yellow discharge forms on the head of the penis." D. "Newborns typically do not experience any pain from this procedure." - - correct ans- - b A nurse is providing care for a pregnant adolescent who is at 12 weeks gestation and verbalizes a fear of gaining weight during pregnancy. Which of the following actions should the nurse take? A. Have the client watch a fetal growth and development video during pregnancy. B. Supply pamphlets that discuss the importance of nutrition during pregnancy. C. Explain how poor nutrition can prevent the baby from growing properly. D. Provide examples of how eating well will help maintain a healthy weight during pregnancy. - - correct ans- - d; Adolescents are typically preoccupied with self and lack the ability to understand outcomes that will occur in the future. Effective teaching for this age group should mainly focus on benefits to the client and positive outcomes that will occur in the near future.
A. Assist the client to the bathroom to empty her bladder B. Increase the rate of the primary IV infusion C. Position the client in a semi-Fowler's position D. Provide glucose via oral hydration or IV - - correct ans- - b; Late decelerations can be caused by uteroplacental insufficiency. The fetal heart tracing shows a gradual decrease in fetal heart rate with a return to baseline on uterine contractions. This could be related to maternal hypotension, which can be corrected with increased IV fluids to increase maternal blood volume. This improves uterine and cardiac perfusion as well. A nurse is caring for several clients. Which of the following clients should the nurse identify as a candidate for oral contraceptives? A. A client who smokes 2 packs of cigarettes per week B. A client who is breastfeeding a 7-month-old infant C. A client who is taking an anticonvulsant medication D. A client who is taking anti-HIV protease inhibitors - - correct ans- - b; A client can begin using oral contraceptives 4 weeks after childbirth; therefore, this client is a candidate for oral contraceptive therapy. A nurse teaches a client about using the Lamaze method to manage pain during labor. Which of the following pieces of information should the nurse include? A. "Learning about childbirth will reduce any fear you might have, which will help you focus more on abdominal breathing during contractions." B. "You will learn how to prevent pain during labor by focusing your mind to control your breathing." C. "During labor, you will be encouraged to disassociate by using an internal focal point." D. "During labor, you will use conscious relaxation and levels of progressive breathing." -
A nurse is preparing to administer meperidine hydrochloride to a client who is in labor. Which of the following statements should the nurse make to the client? A. "This medication can cause your blood pressure to rise." B. "This medication can cause dry mouth." C. "This medication can cause you to urinate excessively." D. "This medication can make you sleepy." - - correct ans- - d; Meperidine hydrochloride is an opioid analgesic used for moderate to severe pain during labor. It binds to the brain's opioid receptors and alters the client's response to pain. The client should be informed of the possible adverse effects of this medication, such as hypotension, confusion, sedation, headaches, respiratory depression, constipation, and urinary retention. A nurse is caring for a client who is 24 years old and at 13 weeks of gestation. The client's history includes a BMI of 31 prior to pregnancy, a prior post-term delivery, and a newborn birth weight of 4,167.38 g (9 lb 3 oz). Which of the following laboratory values should the nurse expect to collect? A. Maternal serum alpha-fetoprotein B. Pregnancy-associated plasma protein A C. Chorionic villus sampling D. HbA1c - - correct ans- - d; HbA1c measures average plasma glucose concentration over the 12 weeks preceding the test. A female client whose BMI is >30 and who has a history of delivering a baby weighing over 4,082.33 grams (9 lb) is at risk for impaired glucose metabolism and should be screened at the end of the first trimester. A nurse is assessing a client who is pregnant, and reports increased nasal stuffiness. The nurse should inform the client which of the following hormones is responsible for this discomfort? A. Relaxin B. Estrogen C. Progesterone
