ATI Maternal Newborn Nursing 2026/2027 | ATI RN
Maternal Newborn Proctored Assessment Study Guide &
Practice Questions | ATI Maternal Newborn Nursing Exam
Prep, Pregnancy & Fetal Development, Antepartum Care,
High-Risk Pregnancy, Complications of Pregnancy,
Hypertensive & Hemorrhagic Disorders, Labor & Delivery,
Intrapartum Nursing, Pain Management, Postpartum Care,
Postpartum Complications, Newborn Assessment &
Adaptation, Newborn Complications, Medications, Nutrition,
Patient Education, Clinical Judgment, Prioritization, NGN-
Style Case Studies & Detailed Rationales
Question 1: A nurse is assessing a client who is at 36 weeks of gestation
and reports a sudden gush of fluid from the vagina. Which of the
following actions should the nurse take first?
A. Perform a sterile vaginal examination
B. Check the fetal heart rate
C. Obtain a specimen for nitrazine testing
D. Place the client in a supine position
CORRECT ANSWER: B. Check the fetal heart rate
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being by checking the fetal
heart rate for signs of distress, such as variable decelerations from cord
compression. A sterile vaginal examination is contraindicated until cord
prolapse is ruled out, and nitrazine testing is performed after fetal status is
confirmed. Placing the client supine is not the first priority and may worsen
supine hypotensive syndrome.
Question 2: A nurse is caring for a client in the first stage of labor who is
experiencing contractions every 2 minutes, lasting 60 seconds, and
reports intense pain. Which of the following findings should the nurse
identify as the priority?
A. Respiratory rate of 22/min
B. Fetal heart rate of 110/min with late decelerations
C. Maternal heart rate of 100/min
D. Blood pressure of 130/80 mm Hg
CORRECT ANSWER: B. Fetal heart rate of 110/min with late
decelerations
,Rationale: Late decelerations indicate uteroplacental insufficiency and are
a nonreassuring fetal heart rate pattern requiring immediate intervention.
The nurse should reposition the client, administer oxygen, increase IV
fluids, and notify the provider. Maternal vital signs are important but do not
take priority over signs of fetal compromise.
Question 3: A nurse is teaching a client who is at 12 weeks of gestation
about expected physiological changes. Which of the following
statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "I may notice my gums bleeding when I brush my teeth."
C. "My hemoglobin level will increase during pregnancy."
D. "I will have less vaginal discharge than before pregnancy."
CORRECT ANSWER: B. "I may notice my gums bleeding when I brush
my teeth."
Rationale: Gingival hyperemia and bleeding are common during pregnancy
due to increased estrogen and blood flow to mucous membranes. Blood
pressure typically decreases slightly in the second trimester, hemoglobin
levels decrease due to hemodilution, and vaginal discharge (leukorrhea)
increases during pregnancy.
Question 4: A nurse is caring for a client who is 2 hours postpartum and
has a boggy uterus with heavy lochia. Which of the following actions
should the nurse take first?
A. Administer methylergonovine
B. Perform fundal massage
C. Increase the IV oxytocin rate
D. Notify the provider
CORRECT ANSWER: B. Perform fundal massage
Rationale: A boggy uterus indicates uterine atony, the most common cause
of postpartum hemorrhage. The first action is to massage the fundus to
stimulate uterine contraction. If massage is ineffective, then medications
such as oxytocin or methylergonovine may be administered, and the
provider notified.
Question 5: A nurse is assessing a newborn 1 minute after birth. The
newborn has a heart rate of 110/min, a weak cry, some flexion of
,extremities, a grimace when stimulated, and a blue body with pink
extremities. What Apgar score should the nurse assign?
A. 4
B. 5
C. 6
D. 7
CORRECT ANSWER: C. 6
Rationale: Apgar scoring: Heart rate 110 = 2 points; weak cry = 1 point;
some flexion = 1 point; grimace = 1 point; blue body with pink extremities
(acrocyanosis) = 1 point. Total = 6. This indicates moderate depression
requiring stimulation and monitoring.
Question 6: A nurse is reviewing the medical record of a client who is at
28 weeks of gestation and has gestational diabetes. Which of the
following findings should the nurse report to the provider?
A. Fasting blood glucose of 90 mg/dL
B. 1-hour glucose tolerance test of 150 mg/dL
C. Fetal heart rate of 140/min
D. Blood pressure of 118/76 mm Hg
CORRECT ANSWER: B. 1-hour glucose tolerance test of 150 mg/dL
Rationale: A 1-hour glucose tolerance test result of 150 mg/dL is above the
normal threshold of 140 mg/dL, indicating possible gestational diabetes
and requiring further evaluation. Fasting glucose of 90 mg/dL is within
normal limits, and the other findings are unremarkable.
Question 7: A nurse is caring for a client who is in active labor and
requests epidural analgesia. Which of the following actions should the
nurse take prior to the procedure?
A. Administer a bolus of IV fluids
B. Place the client in a supine position
C. Insert an indwelling urinary catheter
D. Perform a vaginal examination
CORRECT ANSWER: A. Administer a bolus of IV fluids
Rationale: Before epidural placement, a fluid bolus (typically 500–1000 mL
of lactated Ringer's) is administered to prevent maternal hypotension from
, sympathetic blockade. A vaginal examination may be done to assess labor
progress but is not the priority pre-procedure action. Supine positioning is
avoided due to supine hypotensive syndrome.
Question 8: A nurse is assessing a client who is 24 hours postpartum
and reports pain at the episiotomy site. Which of the following
interventions should the nurse recommend?
A. Apply a warm compress to the perineum
B. Perform Kegel exercises frequently
C. Use a sitz bath several times a day
D. Sit directly on the episiotomy site
CORRECT ANSWER: C. Use a sitz bath several times a day
Rationale: Sitz baths promote perineal healing, increase circulation, and
reduce pain and edema. Warm compresses are used before birth, not
postpartum. Kegel exercises are beneficial but do not directly relieve acute
episiotomy pain. Sitting directly on the episiotomy site increases pressure
and discomfort.
Question 9: A nurse is teaching a pregnant client about nutrition. Which
of the following foods should the nurse recommend as the best source
of iron?
A. Whole milk
B. Lean red meat
C. White bread
D. Apples
CORRECT ANSWER: B. Lean red meat
Rationale: Lean red meat is an excellent source of heme iron, which is
more readily absorbed than non-heme iron. Whole milk is low in iron, white
bread is fortified but less bioavailable, and apples contain negligible iron.
Question 10: A nurse is caring for a client who is 32 weeks of gestation
and reports leaking clear fluid from the vagina. Which of the following
tests should the nurse anticipate to confirm rupture of membranes?
A. Contraction stress test
B. Fern test
Maternal Newborn Proctored Assessment Study Guide &
Practice Questions | ATI Maternal Newborn Nursing Exam
Prep, Pregnancy & Fetal Development, Antepartum Care,
High-Risk Pregnancy, Complications of Pregnancy,
Hypertensive & Hemorrhagic Disorders, Labor & Delivery,
Intrapartum Nursing, Pain Management, Postpartum Care,
Postpartum Complications, Newborn Assessment &
Adaptation, Newborn Complications, Medications, Nutrition,
Patient Education, Clinical Judgment, Prioritization, NGN-
Style Case Studies & Detailed Rationales
Question 1: A nurse is assessing a client who is at 36 weeks of gestation
and reports a sudden gush of fluid from the vagina. Which of the
following actions should the nurse take first?
A. Perform a sterile vaginal examination
B. Check the fetal heart rate
C. Obtain a specimen for nitrazine testing
D. Place the client in a supine position
CORRECT ANSWER: B. Check the fetal heart rate
Rationale: When a client reports spontaneous rupture of membranes, the
priority nursing action is to assess fetal well-being by checking the fetal
heart rate for signs of distress, such as variable decelerations from cord
compression. A sterile vaginal examination is contraindicated until cord
prolapse is ruled out, and nitrazine testing is performed after fetal status is
confirmed. Placing the client supine is not the first priority and may worsen
supine hypotensive syndrome.
Question 2: A nurse is caring for a client in the first stage of labor who is
experiencing contractions every 2 minutes, lasting 60 seconds, and
reports intense pain. Which of the following findings should the nurse
identify as the priority?
A. Respiratory rate of 22/min
B. Fetal heart rate of 110/min with late decelerations
C. Maternal heart rate of 100/min
D. Blood pressure of 130/80 mm Hg
CORRECT ANSWER: B. Fetal heart rate of 110/min with late
decelerations
,Rationale: Late decelerations indicate uteroplacental insufficiency and are
a nonreassuring fetal heart rate pattern requiring immediate intervention.
The nurse should reposition the client, administer oxygen, increase IV
fluids, and notify the provider. Maternal vital signs are important but do not
take priority over signs of fetal compromise.
Question 3: A nurse is teaching a client who is at 12 weeks of gestation
about expected physiological changes. Which of the following
statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "I may notice my gums bleeding when I brush my teeth."
C. "My hemoglobin level will increase during pregnancy."
D. "I will have less vaginal discharge than before pregnancy."
CORRECT ANSWER: B. "I may notice my gums bleeding when I brush
my teeth."
Rationale: Gingival hyperemia and bleeding are common during pregnancy
due to increased estrogen and blood flow to mucous membranes. Blood
pressure typically decreases slightly in the second trimester, hemoglobin
levels decrease due to hemodilution, and vaginal discharge (leukorrhea)
increases during pregnancy.
Question 4: A nurse is caring for a client who is 2 hours postpartum and
has a boggy uterus with heavy lochia. Which of the following actions
should the nurse take first?
A. Administer methylergonovine
B. Perform fundal massage
C. Increase the IV oxytocin rate
D. Notify the provider
CORRECT ANSWER: B. Perform fundal massage
Rationale: A boggy uterus indicates uterine atony, the most common cause
of postpartum hemorrhage. The first action is to massage the fundus to
stimulate uterine contraction. If massage is ineffective, then medications
such as oxytocin or methylergonovine may be administered, and the
provider notified.
Question 5: A nurse is assessing a newborn 1 minute after birth. The
newborn has a heart rate of 110/min, a weak cry, some flexion of
,extremities, a grimace when stimulated, and a blue body with pink
extremities. What Apgar score should the nurse assign?
A. 4
B. 5
C. 6
D. 7
CORRECT ANSWER: C. 6
Rationale: Apgar scoring: Heart rate 110 = 2 points; weak cry = 1 point;
some flexion = 1 point; grimace = 1 point; blue body with pink extremities
(acrocyanosis) = 1 point. Total = 6. This indicates moderate depression
requiring stimulation and monitoring.
Question 6: A nurse is reviewing the medical record of a client who is at
28 weeks of gestation and has gestational diabetes. Which of the
following findings should the nurse report to the provider?
A. Fasting blood glucose of 90 mg/dL
B. 1-hour glucose tolerance test of 150 mg/dL
C. Fetal heart rate of 140/min
D. Blood pressure of 118/76 mm Hg
CORRECT ANSWER: B. 1-hour glucose tolerance test of 150 mg/dL
Rationale: A 1-hour glucose tolerance test result of 150 mg/dL is above the
normal threshold of 140 mg/dL, indicating possible gestational diabetes
and requiring further evaluation. Fasting glucose of 90 mg/dL is within
normal limits, and the other findings are unremarkable.
Question 7: A nurse is caring for a client who is in active labor and
requests epidural analgesia. Which of the following actions should the
nurse take prior to the procedure?
A. Administer a bolus of IV fluids
B. Place the client in a supine position
C. Insert an indwelling urinary catheter
D. Perform a vaginal examination
CORRECT ANSWER: A. Administer a bolus of IV fluids
Rationale: Before epidural placement, a fluid bolus (typically 500–1000 mL
of lactated Ringer's) is administered to prevent maternal hypotension from
, sympathetic blockade. A vaginal examination may be done to assess labor
progress but is not the priority pre-procedure action. Supine positioning is
avoided due to supine hypotensive syndrome.
Question 8: A nurse is assessing a client who is 24 hours postpartum
and reports pain at the episiotomy site. Which of the following
interventions should the nurse recommend?
A. Apply a warm compress to the perineum
B. Perform Kegel exercises frequently
C. Use a sitz bath several times a day
D. Sit directly on the episiotomy site
CORRECT ANSWER: C. Use a sitz bath several times a day
Rationale: Sitz baths promote perineal healing, increase circulation, and
reduce pain and edema. Warm compresses are used before birth, not
postpartum. Kegel exercises are beneficial but do not directly relieve acute
episiotomy pain. Sitting directly on the episiotomy site increases pressure
and discomfort.
Question 9: A nurse is teaching a pregnant client about nutrition. Which
of the following foods should the nurse recommend as the best source
of iron?
A. Whole milk
B. Lean red meat
C. White bread
D. Apples
CORRECT ANSWER: B. Lean red meat
Rationale: Lean red meat is an excellent source of heme iron, which is
more readily absorbed than non-heme iron. Whole milk is low in iron, white
bread is fortified but less bioavailable, and apples contain negligible iron.
Question 10: A nurse is caring for a client who is 32 weeks of gestation
and reports leaking clear fluid from the vagina. Which of the following
tests should the nurse anticipate to confirm rupture of membranes?
A. Contraction stress test
B. Fern test
