ATI RN Maternal Newborn Proctored 2026/2027 Exam verified with correct
answers plus rationales
1. A nurse is caring for a client at 34 weeks of gestation who reports a sudden onset of
painless, bright-red vaginal bleeding. Which condition should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Preterm labor
D. Uterine rupture
Answer: B. Placenta previa.
Rationale: Placenta previa classically presents with painless, bright-red vaginal bleeding during
the second or third trimester. A vaginal examination should be avoided until placenta previa has
been excluded because it can cause severe hemorrhage.
2. A client at 32 weeks of gestation has a blood pressure of 168/112 mm Hg and reports a
severe headache and blurred vision. What is the nurse's priority action?
A. Encourage oral fluids
B. Place the client in a supine position
C. Notify the provider immediately
D. Encourage ambulation
Answer: C. Notify the provider immediately.
Rationale: Severe hypertension accompanied by neurologic symptoms indicates preeclampsia
with severe features and requires immediate intervention to prevent complications such as
stroke, seizures, and placental complications.
3. A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 10/min
and absent deep-tendon reflexes. Which medication should the nurse prepare to
administer?
A. Oxytocin
B. Calcium gluconate
C. Terbutaline
D. Methylergonovine
,Answer: B. Calcium gluconate.
Rationale: Respiratory depression and absent reflexes are signs of magnesium toxicity. Calcium
gluconate is the antidote.
4. Which finding in a newborn requires immediate nursing intervention?
A. Acrocyanosis shortly after birth
B. Respiratory rate of 44/min
C. Nasal flaring and grunting
D. Heart rate of 140/min
Answer: C. Nasal flaring and grunting.
Rationale: Nasal flaring and grunting indicate increased respiratory effort and possible
respiratory distress. Acrocyanosis can be expected during early transition.
5. A nurse is assessing a client 1 hour after vaginal birth. The fundus is boggy and
displaced to the right. What should the nurse do first?
A. Administer oxytocin
B. Massage the fundus
C. Prepare the client for surgery
D. Apply an ice pack to the perineum
Answer: B. Massage the fundus.
Rationale: A boggy uterus indicates uterine atony, a major cause of postpartum hemorrhage.
Fundal massage promotes uterine contraction. A displaced fundus can also indicate bladder
distention, which should subsequently be assessed.
6. Which finding is expected during the first 24 hours after birth?
A. Lochia alba
B. Lochia rubra
C. Complete absence of vaginal discharge
D. Purulent vaginal discharge
Answer: B. Lochia rubra.
,Rationale: Lochia rubra is the normal reddish postpartum discharge occurring during the first
several days after birth.
7. A newborn has an Apgar score of 8 at 1 minute and 9 at 5 minutes. How should the
nurse interpret these findings?
A. Severe neonatal depression
B. Moderate neonatal depression
C. Normal transition to extrauterine life
D. Need for immediate chest compressions
Answer: C. Normal transition to extrauterine life.
Rationale: Apgar scores of 7–10 generally indicate that the newborn is adapting well and
usually requires routine care and observation.
8. Which intervention is appropriate immediately after delivery to reduce neonatal heat
loss?
A. Bathe the newborn immediately
B. Place the newborn under a fan
C. Dry the newborn thoroughly and provide skin-to-skin contact
D. Leave the newborn uncovered for assessment
Answer: C. Dry the newborn thoroughly and provide skin-to-skin contact.
Rationale: Drying removes evaporative heat loss, while skin-to-skin contact provides warmth
and promotes physiologic stabilization.
9. A client receiving oxytocin has contractions occurring every 1 minute and lasting 90
seconds. What is the nurse's priority action?
A. Increase the oxytocin infusion
B. Stop the oxytocin infusion
C. Encourage the client to ambulate
D. Administer another dose of oxytocin
Answer: B. Stop the oxytocin infusion.
, Rationale: Excessive uterine activity can reduce uteroplacental perfusion and compromise the
fetus. Oxytocin should be stopped and fetal/maternal status assessed.
10. A fetal monitor shows recurrent late decelerations. Which intervention should the nurse
implement first?
A. Place the client in a lateral position
B. Encourage pushing
C. Increase oxytocin
D. Place the client supine
Answer: A. Place the client in a lateral position.
Rationale: Recurrent late decelerations suggest uteroplacental insufficiency. Maternal
repositioning improves uterine blood flow and is an immediate nursing intervention.
11. Which fetal heart-rate pattern is most concerning for umbilical cord compression?
A. Early decelerations
B. Variable decelerations
C. Moderate variability
D. Accelerations
Answer: B. Variable decelerations.
Rationale: Variable decelerations are caused by intermittent umbilical cord compression and
require assessment and appropriate intrauterine resuscitation measures.
12. A client at 30 weeks of gestation reports painless vaginal bleeding. Which action should
the nurse avoid?
A. Monitoring fetal heart rate
B. Assessing maternal vital signs
C. Performing a digital vaginal examination
D. Assessing the amount of bleeding
Answer: C. Performing a digital vaginal examination.
Rationale: Painless bleeding suggests placenta previa. Vaginal examination can disrupt the
placenta and cause severe hemorrhage.
answers plus rationales
1. A nurse is caring for a client at 34 weeks of gestation who reports a sudden onset of
painless, bright-red vaginal bleeding. Which condition should the nurse suspect?
A. Abruptio placentae
B. Placenta previa
C. Preterm labor
D. Uterine rupture
Answer: B. Placenta previa.
Rationale: Placenta previa classically presents with painless, bright-red vaginal bleeding during
the second or third trimester. A vaginal examination should be avoided until placenta previa has
been excluded because it can cause severe hemorrhage.
2. A client at 32 weeks of gestation has a blood pressure of 168/112 mm Hg and reports a
severe headache and blurred vision. What is the nurse's priority action?
A. Encourage oral fluids
B. Place the client in a supine position
C. Notify the provider immediately
D. Encourage ambulation
Answer: C. Notify the provider immediately.
Rationale: Severe hypertension accompanied by neurologic symptoms indicates preeclampsia
with severe features and requires immediate intervention to prevent complications such as
stroke, seizures, and placental complications.
3. A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 10/min
and absent deep-tendon reflexes. Which medication should the nurse prepare to
administer?
A. Oxytocin
B. Calcium gluconate
C. Terbutaline
D. Methylergonovine
,Answer: B. Calcium gluconate.
Rationale: Respiratory depression and absent reflexes are signs of magnesium toxicity. Calcium
gluconate is the antidote.
4. Which finding in a newborn requires immediate nursing intervention?
A. Acrocyanosis shortly after birth
B. Respiratory rate of 44/min
C. Nasal flaring and grunting
D. Heart rate of 140/min
Answer: C. Nasal flaring and grunting.
Rationale: Nasal flaring and grunting indicate increased respiratory effort and possible
respiratory distress. Acrocyanosis can be expected during early transition.
5. A nurse is assessing a client 1 hour after vaginal birth. The fundus is boggy and
displaced to the right. What should the nurse do first?
A. Administer oxytocin
B. Massage the fundus
C. Prepare the client for surgery
D. Apply an ice pack to the perineum
Answer: B. Massage the fundus.
Rationale: A boggy uterus indicates uterine atony, a major cause of postpartum hemorrhage.
Fundal massage promotes uterine contraction. A displaced fundus can also indicate bladder
distention, which should subsequently be assessed.
6. Which finding is expected during the first 24 hours after birth?
A. Lochia alba
B. Lochia rubra
C. Complete absence of vaginal discharge
D. Purulent vaginal discharge
Answer: B. Lochia rubra.
,Rationale: Lochia rubra is the normal reddish postpartum discharge occurring during the first
several days after birth.
7. A newborn has an Apgar score of 8 at 1 minute and 9 at 5 minutes. How should the
nurse interpret these findings?
A. Severe neonatal depression
B. Moderate neonatal depression
C. Normal transition to extrauterine life
D. Need for immediate chest compressions
Answer: C. Normal transition to extrauterine life.
Rationale: Apgar scores of 7–10 generally indicate that the newborn is adapting well and
usually requires routine care and observation.
8. Which intervention is appropriate immediately after delivery to reduce neonatal heat
loss?
A. Bathe the newborn immediately
B. Place the newborn under a fan
C. Dry the newborn thoroughly and provide skin-to-skin contact
D. Leave the newborn uncovered for assessment
Answer: C. Dry the newborn thoroughly and provide skin-to-skin contact.
Rationale: Drying removes evaporative heat loss, while skin-to-skin contact provides warmth
and promotes physiologic stabilization.
9. A client receiving oxytocin has contractions occurring every 1 minute and lasting 90
seconds. What is the nurse's priority action?
A. Increase the oxytocin infusion
B. Stop the oxytocin infusion
C. Encourage the client to ambulate
D. Administer another dose of oxytocin
Answer: B. Stop the oxytocin infusion.
, Rationale: Excessive uterine activity can reduce uteroplacental perfusion and compromise the
fetus. Oxytocin should be stopped and fetal/maternal status assessed.
10. A fetal monitor shows recurrent late decelerations. Which intervention should the nurse
implement first?
A. Place the client in a lateral position
B. Encourage pushing
C. Increase oxytocin
D. Place the client supine
Answer: A. Place the client in a lateral position.
Rationale: Recurrent late decelerations suggest uteroplacental insufficiency. Maternal
repositioning improves uterine blood flow and is an immediate nursing intervention.
11. Which fetal heart-rate pattern is most concerning for umbilical cord compression?
A. Early decelerations
B. Variable decelerations
C. Moderate variability
D. Accelerations
Answer: B. Variable decelerations.
Rationale: Variable decelerations are caused by intermittent umbilical cord compression and
require assessment and appropriate intrauterine resuscitation measures.
12. A client at 30 weeks of gestation reports painless vaginal bleeding. Which action should
the nurse avoid?
A. Monitoring fetal heart rate
B. Assessing maternal vital signs
C. Performing a digital vaginal examination
D. Assessing the amount of bleeding
Answer: C. Performing a digital vaginal examination.
Rationale: Painless bleeding suggests placenta previa. Vaginal examination can disrupt the
placenta and cause severe hemorrhage.
