ATI RN Maternal Newborn Proctor Exam 2026 70 Questions
ATI RN Maternal Newborn Proctor
Examination 2026
70 Questions with Answers and
Rationales
Instructions: Read each question carefully. For standard multiple-choice questions,
select the single best answer. For questions marked "Select all that apply," choose all
options that apply. Each question includes the correct answer and a detailed
rationale.
1. A nurse is assessing a client who is at 8 weeks of gestation and reports severe
nausea and vomiting. The client's weight has decreased by 3 lb since the last
visit. Which finding should the nurse identify as the priority to report?
A. Urine specific gravity 1.030
B. Ketones present in urine
C. Blood pressure 100/62 mm Hg
D. Fasting blood glucose 92 mg/dL
Correct Answer B. Ketones present in urine
Ketones in urine indicate the client is breaking down fat for energy due to
inadequate caloric intake and dehydration from excessive vomiting, suggesting
hyperemesis gravidarum, which can lead to metabolic acidosis requiring IV fluids and
antiemetics. Urine specific gravity 1.030 shows dehydration but ketones indicate a
more serious metabolic disturbance. BP 100/62 and glucose 92 mg/dL are within
normal limits.
2. A
nurse is teaching a client at 12 weeks of gestation with a positive
hepatitis B surface antigen (HBsAg). Which statement indicates
Practice Exam Page 1
,ATI RN Maternal Newborn Proctor Exam 2026 70 Questions
understanding?
A. "I will need a cesarean birth to prevent transmission."
B. "My baby will receive the hepatitis B vaccine and immune globulin after birth."
C. "I should stop breastfeeding to avoid passing the virus."
D. "The hepatitis B virus cannot cross the placenta."
Correct Answer B. "My baby will receive the hepatitis B vaccine and immune
globulin after birth."
The recommended management includes both hepatitis B vaccine and HBIG within
12 hours of birth, providing passive and active immunity and reducing transmission
risk by 85-95%. Cesarean is not routinely recommended for hepatitis B.
Breastfeeding is not contraindicated with prophylaxis. The virus can cross the
placenta, though perinatal transmission during
Practice Exam Page 2
,ATI RN Maternal Newborn Proctor Exam 2026 70 Questions
delivery is most common.
3. Anurse is reviewing lab results of a client at 28 weeks of gestation. Which
finding should be reported immediately?
A. Hemoglobin 10.2 g/dL
B. WBC count 12,000/mm3
C. Platelet count 95,000/mm3
D. Fasting blood glucose 110 mg/dL
Correct Answer C. Platelet count 95,000/mm3
A platelet count of 95,000/mm3 is below normal (150,000-400,000/mm3) and
indicates thrombocytopenia, a possible early sign of preeclampsia with severe
features or HELLP syndrome requiring urgent evaluation. Hgb 10.2 reflects
physiologic anemia of pregnancy. WBC 12,000 is normal for pregnancy. Glucose
110 may need further screening but is not an emergency.
4. Anurse is caring for a client in the first trimester with occasional light spotting.
Vital signs are stable and fetal heart rate is 140 bpm. Which action should the
nurse take?
A. Prepare the client for an immediate ultrasound
B. Instruct the client to avoid sexual activity
C. Document and reassure that light spotting can be normal
D. Administer terbutaline to prevent miscarriage
Correct Answer C. Document and reassure that light spotting can be normal
Light spotting affects 20-30% of first-trimester pregnancies, often from implantation
bleeding or cervical changes. With stable vitals and normal FHR, there is no
indication of imminent loss. Document, assess for other symptoms, and reassure.
Terbutaline is for preterm labor, not first-trimester spotting.
5. A
nurse is teaching a client at 16 weeks about pregnancy discomforts.
Which statement indicates understanding?
A. "I should lie on my back to relieve back pain."
B. "I can apply a warm compress to my lower back."
Practice Exam Page 3
, ATI RN Maternal Newborn Proctor Exam 2026 70 Questions
C. "Ishould reduce fluid intake to prevent frequent urination."
D. "Nausea in the second trimester means something is wrong."
Correct Answer B. "I can apply a warm compress to my lower back."
Backache from shifting center of gravity is managed with warm compresses, pelvic
tilt exercises, and proper body mechanics. Supine lying should be avoided after the
first trimester due to aortocaval compression. Reducing fluids is inappropriate in
pregnancy. Some nausea can persist into the second trimester without indicating a
problem.
6. Anurse assesses a client at 32 weeks reporting decreased fetal movement for
24 hours. Which action should the nurse take first?
A. Auscultate the fetal heart rate
B. Initiate continuous fetal monitoring
C. Instruct the client to drink cold water and lie on her left side
D. Notify the provider immediately
Practice Exam Page 4
ATI RN Maternal Newborn Proctor
Examination 2026
70 Questions with Answers and
Rationales
Instructions: Read each question carefully. For standard multiple-choice questions,
select the single best answer. For questions marked "Select all that apply," choose all
options that apply. Each question includes the correct answer and a detailed
rationale.
1. A nurse is assessing a client who is at 8 weeks of gestation and reports severe
nausea and vomiting. The client's weight has decreased by 3 lb since the last
visit. Which finding should the nurse identify as the priority to report?
A. Urine specific gravity 1.030
B. Ketones present in urine
C. Blood pressure 100/62 mm Hg
D. Fasting blood glucose 92 mg/dL
Correct Answer B. Ketones present in urine
Ketones in urine indicate the client is breaking down fat for energy due to
inadequate caloric intake and dehydration from excessive vomiting, suggesting
hyperemesis gravidarum, which can lead to metabolic acidosis requiring IV fluids and
antiemetics. Urine specific gravity 1.030 shows dehydration but ketones indicate a
more serious metabolic disturbance. BP 100/62 and glucose 92 mg/dL are within
normal limits.
2. A
nurse is teaching a client at 12 weeks of gestation with a positive
hepatitis B surface antigen (HBsAg). Which statement indicates
Practice Exam Page 1
,ATI RN Maternal Newborn Proctor Exam 2026 70 Questions
understanding?
A. "I will need a cesarean birth to prevent transmission."
B. "My baby will receive the hepatitis B vaccine and immune globulin after birth."
C. "I should stop breastfeeding to avoid passing the virus."
D. "The hepatitis B virus cannot cross the placenta."
Correct Answer B. "My baby will receive the hepatitis B vaccine and immune
globulin after birth."
The recommended management includes both hepatitis B vaccine and HBIG within
12 hours of birth, providing passive and active immunity and reducing transmission
risk by 85-95%. Cesarean is not routinely recommended for hepatitis B.
Breastfeeding is not contraindicated with prophylaxis. The virus can cross the
placenta, though perinatal transmission during
Practice Exam Page 2
,ATI RN Maternal Newborn Proctor Exam 2026 70 Questions
delivery is most common.
3. Anurse is reviewing lab results of a client at 28 weeks of gestation. Which
finding should be reported immediately?
A. Hemoglobin 10.2 g/dL
B. WBC count 12,000/mm3
C. Platelet count 95,000/mm3
D. Fasting blood glucose 110 mg/dL
Correct Answer C. Platelet count 95,000/mm3
A platelet count of 95,000/mm3 is below normal (150,000-400,000/mm3) and
indicates thrombocytopenia, a possible early sign of preeclampsia with severe
features or HELLP syndrome requiring urgent evaluation. Hgb 10.2 reflects
physiologic anemia of pregnancy. WBC 12,000 is normal for pregnancy. Glucose
110 may need further screening but is not an emergency.
4. Anurse is caring for a client in the first trimester with occasional light spotting.
Vital signs are stable and fetal heart rate is 140 bpm. Which action should the
nurse take?
A. Prepare the client for an immediate ultrasound
B. Instruct the client to avoid sexual activity
C. Document and reassure that light spotting can be normal
D. Administer terbutaline to prevent miscarriage
Correct Answer C. Document and reassure that light spotting can be normal
Light spotting affects 20-30% of first-trimester pregnancies, often from implantation
bleeding or cervical changes. With stable vitals and normal FHR, there is no
indication of imminent loss. Document, assess for other symptoms, and reassure.
Terbutaline is for preterm labor, not first-trimester spotting.
5. A
nurse is teaching a client at 16 weeks about pregnancy discomforts.
Which statement indicates understanding?
A. "I should lie on my back to relieve back pain."
B. "I can apply a warm compress to my lower back."
Practice Exam Page 3
, ATI RN Maternal Newborn Proctor Exam 2026 70 Questions
C. "Ishould reduce fluid intake to prevent frequent urination."
D. "Nausea in the second trimester means something is wrong."
Correct Answer B. "I can apply a warm compress to my lower back."
Backache from shifting center of gravity is managed with warm compresses, pelvic
tilt exercises, and proper body mechanics. Supine lying should be avoided after the
first trimester due to aortocaval compression. Reducing fluids is inappropriate in
pregnancy. Some nausea can persist into the second trimester without indicating a
problem.
6. Anurse assesses a client at 32 weeks reporting decreased fetal movement for
24 hours. Which action should the nurse take first?
A. Auscultate the fetal heart rate
B. Initiate continuous fetal monitoring
C. Instruct the client to drink cold water and lie on her left side
D. Notify the provider immediately
Practice Exam Page 4
