Maternity 2026 ATI

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Sample questions from Maternity 2026 ATI

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 28-year-old G1P0 at 34 weeks is admitted to labor and delivery with a persistent headache, blurred vision, and right upper quadrant pain. Blood pressure is 168/112 mm Hg, respiratory rate is 18/min, and platelets are 88,000/mm3. Which action should the nurse take first?

   • A.Obtain a 24-hour urine collection before initiating treatment
   • B.Activate the severe hypertension protocol and notify the obstetric provider
   • C.Encourage oral fluids and reassess the blood pressure in 1 hour
   • D.Prepare the client for discharge with daily fetal movement monitoring

   Rationale: Severe hypertension with neurologic symptoms, right upper quadrant pain, and thrombocytopenia requires immediate escalation for preeclampsia with severe features. A 24-hour urine collection must not delay treatment, and oral hydration with delayed reassessment does not address the risk of stroke or seizure. Discharge is unsafe with these findings. The exam takeaway is to prioritize maternal stabilization when severe features are present.

2. 2.A 31-year-old client receiving IV magnesium sulfate for preeclampsia is being monitored in labor and delivery. The nurse finds a respiratory rate of 9/min, absent patellar reflexes, and urine output of 20 mL during the past hour. Which action is the priority?

   • A.Increase the maintenance IV fluid rate and reassess in 30 minutes
   • B.Continue magnesium sulfate because reduced reflexes are expected
   • C.Stop magnesium sulfate and initiate urgent assessment and respiratory support
   • D.Administer the scheduled oral antihypertensive before intervening

   Rationale: Respiratory depression, absent reflexes, and oliguria suggest magnesium toxicity, requiring immediate discontinuation and respiratory support. Increasing fluids alone does not stop magnesium exposure, and continuing the infusion could worsen toxicity. An oral antihypertensive does not treat respiratory depression and must not delay emergency care. The nurse should anticipate calcium gluconate under an emergency order or protocol.

3. 3.A 24-year-old at 32 weeks arrives at obstetric triage after a sudden gush of bright red vaginal blood without pain. The uterus is soft, fetal heart rate is 145/min, and maternal blood pressure is 110/70 mm Hg. Which action should the nurse avoid until placental location is established?

   • A.Applying external fetal monitoring
   • B.Establishing peripheral IV access
   • C.Preparing for transabdominal ultrasonography
   • D.Performing a digital cervical examination

   Rationale: Painless, bright red bleeding suggests placenta previa, and a digital cervical examination can trigger severe hemorrhage. External fetal monitoring helps assess fetal status without disturbing the placenta. IV access supports rapid treatment if bleeding increases, while ultrasonography helps identify placental location. The exam takeaway is to avoid digital examination when placenta previa has not been excluded.

4. 4.A 35-year-old at 36 weeks presents to the emergency department after a motor vehicle collision. The client reports constant abdominal pain; the uterus is rigid, blood pressure is 92/58 mm Hg, pulse is 124/min, and the fetal tracing shows recurrent late decelerations. Only a small amount of vaginal blood is visible. Which interpretation should guide immediate care?

   • A.Concealed placental abruption with maternal and fetal compromise
   • B.Placenta previa with reassuring maternal adaptation
   • C.Normal cervical change associated with early labor
   • D.Supine hypotension that will resolve without further evaluation

   Answer and rationale are in the full material.

5. 5.A 22-year-old at approximately 7 weeks arrives at the emergency department with unilateral pelvic pain, shoulder pain, and dizziness. Blood pressure is 82/46 mm Hg, pulse is 132/min, and a urine pregnancy test is positive. Which intervention has the highest priority?

   • A.Teach the client about outpatient methotrexate therapy
   • B.Collect a clean-catch urine specimen before further evaluation
   • C.Initiate emergency hemorrhage care and prepare for urgent surgical evaluation
   • D.Schedule repeat serum hCG testing in 48 hours

   Answer and rationale are in the full material.