ATI MATERNAL NEWBORN PROCTORED EXAM
ATI Maternal Newborn Proctored Exam
2025/2026 Edition
70 NGN-Style Questions with Verified Rationales
EXAM INSTRUCTIONS
1. Time Limit: 70 minutes (1 minute per question, recommended).
2. Scoring: Partial credit for select NGN items.
3. Rationales: Provided after each question.
4. Simulate NCLEX: Answer without external resources first; then review rationales.
Candidate Name: _________________________
Date: _________________________
Start Time: _________________________
End Time: _________________________
Total Score: ________ / 70
Apply clinical judgment and maternal-newborn safety principles.
\
, ATI MATERNAL NEWBORN PROCTORED EXAM
QUESTIONS
Section 1: Antepartum (Questions 1–20)
1. A nurse is assessing a client at 36 weeks of gestation. Which finding should the nurse
report to the provider immediately?
1. Blood pressure 110/70 mm Hg
2. +1 proteinuria
3. Mild ankle edema
4. Fundal height 35 cm
Answer: 2. +1 proteinuria
Rationale: Proteinuria after 20 weeks of gestation may indicate preeclampsia, especially when
accompanied by hypertension. A single +1 proteinuria requires further evaluation. Normal BP,
mild edema, and fundal height within 1 cm of gestational age are expected.
2. A client at 28 weeks of gestation has a positive one-hour glucose challenge test (GCT) of
155 mg/dL. Which of the following should the nurse anticipate next?
1. Repeat the one-hour GCT in 2 weeks
2. Perform a three-hour oral glucose tolerance test (OGTT)
3. Begin insulin therapy
4. Advise a low-carbohydrate diet
Answer: 2. Perform a three-hour oral glucose tolerance test (OGTT)
Rationale: A positive one-hour GCT (≥130-140 mg/dL depending on facility) is followed by a
diagnostic three-hour OGTT to confirm gestational diabetes. Insulin or diet changes are not
initiated without a confirmed diagnosis.
3. A nurse is providing teaching to a client with hyperemesis gravidarum. Which of the
following statements by the client indicates understanding?
1. “I will eat three large meals per day.”
2. “I will drink fluids between meals rather than with meals.”
3. “I will lie down immediately after eating.”
4. “I will increase my intake of fried foods.”
Answer: 2. “I will drink fluids between meals rather than with meals.”
Rationale: Separating fluids from solids helps reduce gastric distention and nausea. Small,
frequent meals, avoiding fatty/spicy foods, and sitting upright after meals are recommended.
4. A nurse is caring for a client with placenta previa. Which of the following interventions is
the priority?
1. Assess fetal heart rate every 4 hours
2. Prepare for immediate cesarean section
, ATI MATERNAL NEWBORN PROCTORED EXAM
3. Avoid vaginal examinations
4. Administer betamethasone
Answer: 3. Avoid vaginal examinations
Rationale: Digital vaginal examinations can disrupt the placental attachment and cause
catastrophic hemorrhage. Monitoring FHR, preparing for possible C-section, and
corticosteroids for fetal lung maturity are important but not the immediate priority over
avoiding vaginal exams.
5. A client at 32 weeks of gestation reports regular uterine contractions every 10 minutes,
low back pain, and pelvic pressure. Cervical examination reveals 2 cm dilation and 50%
effacement. Which of the following is the priority nursing action?
1. Administer tocolytics as prescribed
2. Place the client in Trendelenburg position
3. Obtain a specimen for fetal fibronectin
4. Encourage oral hydration
Answer: 1. Administer tocolytics as prescribed
Rationale: The client is in preterm labor (cervical changes before 37 weeks). Tocolytics are
used to delay delivery to allow for corticosteroids. Hydration may help with false labor but not
with true preterm labor. Trendelenburg is not recommended. fFN may be obtained but not the
priority.
6. A nurse is reviewing laboratory results for a client at 10 weeks of gestation. Which of the
following findings requires immediate follow-up?
1. Hemoglobin 11.2 g/dL
2. Rubella titer 0.8 IU/mL (equivocal)
3. White blood cell count 12,000/mm³
4. Platelet count 180,000/mm³
Answer: 2. Rubella titer 0.8 IU/mL (equivocal)
Rationale: A rubella titer <1:10 (or equivocal) indicates lack of immunity. The client should be
vaccinated postpartum. Hemoglobin of 11.2 is normal in pregnancy. WBC up to 15,000 is
normal. Platelet count is normal.
7. A nurse is performing a non-stress test (NST) on a client at 34 weeks. The fetal heart rate
tracing shows two accelerations of 15 bpm lasting 15 seconds each within 20 minutes. How
should the nurse interpret this result?
1. Reactive NST
2. Non-reactive NST
3. Positive contraction stress test
4. Equivocal NST
Answer: 1. Reactive NST
Rationale: A reactive NST at ≥32 weeks is defined as two or more accelerations of at least 15
bpm lasting at least 15 seconds within 20 minutes. This indicates fetal well-being.
ATI Maternal Newborn Proctored Exam
2025/2026 Edition
70 NGN-Style Questions with Verified Rationales
EXAM INSTRUCTIONS
1. Time Limit: 70 minutes (1 minute per question, recommended).
2. Scoring: Partial credit for select NGN items.
3. Rationales: Provided after each question.
4. Simulate NCLEX: Answer without external resources first; then review rationales.
Candidate Name: _________________________
Date: _________________________
Start Time: _________________________
End Time: _________________________
Total Score: ________ / 70
Apply clinical judgment and maternal-newborn safety principles.
\
, ATI MATERNAL NEWBORN PROCTORED EXAM
QUESTIONS
Section 1: Antepartum (Questions 1–20)
1. A nurse is assessing a client at 36 weeks of gestation. Which finding should the nurse
report to the provider immediately?
1. Blood pressure 110/70 mm Hg
2. +1 proteinuria
3. Mild ankle edema
4. Fundal height 35 cm
Answer: 2. +1 proteinuria
Rationale: Proteinuria after 20 weeks of gestation may indicate preeclampsia, especially when
accompanied by hypertension. A single +1 proteinuria requires further evaluation. Normal BP,
mild edema, and fundal height within 1 cm of gestational age are expected.
2. A client at 28 weeks of gestation has a positive one-hour glucose challenge test (GCT) of
155 mg/dL. Which of the following should the nurse anticipate next?
1. Repeat the one-hour GCT in 2 weeks
2. Perform a three-hour oral glucose tolerance test (OGTT)
3. Begin insulin therapy
4. Advise a low-carbohydrate diet
Answer: 2. Perform a three-hour oral glucose tolerance test (OGTT)
Rationale: A positive one-hour GCT (≥130-140 mg/dL depending on facility) is followed by a
diagnostic three-hour OGTT to confirm gestational diabetes. Insulin or diet changes are not
initiated without a confirmed diagnosis.
3. A nurse is providing teaching to a client with hyperemesis gravidarum. Which of the
following statements by the client indicates understanding?
1. “I will eat three large meals per day.”
2. “I will drink fluids between meals rather than with meals.”
3. “I will lie down immediately after eating.”
4. “I will increase my intake of fried foods.”
Answer: 2. “I will drink fluids between meals rather than with meals.”
Rationale: Separating fluids from solids helps reduce gastric distention and nausea. Small,
frequent meals, avoiding fatty/spicy foods, and sitting upright after meals are recommended.
4. A nurse is caring for a client with placenta previa. Which of the following interventions is
the priority?
1. Assess fetal heart rate every 4 hours
2. Prepare for immediate cesarean section
, ATI MATERNAL NEWBORN PROCTORED EXAM
3. Avoid vaginal examinations
4. Administer betamethasone
Answer: 3. Avoid vaginal examinations
Rationale: Digital vaginal examinations can disrupt the placental attachment and cause
catastrophic hemorrhage. Monitoring FHR, preparing for possible C-section, and
corticosteroids for fetal lung maturity are important but not the immediate priority over
avoiding vaginal exams.
5. A client at 32 weeks of gestation reports regular uterine contractions every 10 minutes,
low back pain, and pelvic pressure. Cervical examination reveals 2 cm dilation and 50%
effacement. Which of the following is the priority nursing action?
1. Administer tocolytics as prescribed
2. Place the client in Trendelenburg position
3. Obtain a specimen for fetal fibronectin
4. Encourage oral hydration
Answer: 1. Administer tocolytics as prescribed
Rationale: The client is in preterm labor (cervical changes before 37 weeks). Tocolytics are
used to delay delivery to allow for corticosteroids. Hydration may help with false labor but not
with true preterm labor. Trendelenburg is not recommended. fFN may be obtained but not the
priority.
6. A nurse is reviewing laboratory results for a client at 10 weeks of gestation. Which of the
following findings requires immediate follow-up?
1. Hemoglobin 11.2 g/dL
2. Rubella titer 0.8 IU/mL (equivocal)
3. White blood cell count 12,000/mm³
4. Platelet count 180,000/mm³
Answer: 2. Rubella titer 0.8 IU/mL (equivocal)
Rationale: A rubella titer <1:10 (or equivocal) indicates lack of immunity. The client should be
vaccinated postpartum. Hemoglobin of 11.2 is normal in pregnancy. WBC up to 15,000 is
normal. Platelet count is normal.
7. A nurse is performing a non-stress test (NST) on a client at 34 weeks. The fetal heart rate
tracing shows two accelerations of 15 bpm lasting 15 seconds each within 20 minutes. How
should the nurse interpret this result?
1. Reactive NST
2. Non-reactive NST
3. Positive contraction stress test
4. Equivocal NST
Answer: 1. Reactive NST
Rationale: A reactive NST at ≥32 weeks is defined as two or more accelerations of at least 15
bpm lasting at least 15 seconds within 20 minutes. This indicates fetal well-being.
