ATI Maternal Newborn Proctored Exam 2026–2027 | 200+ Practice
Questions & Detailed Rationales | ATI RN Maternal-Newborn Study
Guide & Exam Prep | Antepartum, Intrapartum, Postpartum, Newborn
Care, High-Risk Pregnancy, Fetal Monitoring & Pharmacology
SECTION 1: ANTEPARTUM ASSESSMENT & PRENATAL CARE
Questions 1–25
Question 1
A nurse is caring for a client at 38 weeks' gestation who reports a sudden gush of fluid from the
vagina. Which of the following actions should the nurse take first?
A. Prepare the client for an immediate cesarean birth
B. Assess the fetal heart rate and characteristics of the fluid
C. Obtain a urine specimen for culture
D. Administer oxytocin intravenously
Correct Answer: B
Rationale: When a client reports spontaneous rupture of membranes, the priority nursing
action is to assess fetal well-being by monitoring the fetal heart rate and evaluating the fluid for
color, amount, and odor. This helps detect complications such as cord prolapse or meconium
staining. Immediate cesarean birth and oxytocin administration are not first-line actions without
further assessment .
Question 2
A nurse is teaching a client at 10 weeks' gestation about expected physiological changes during
pregnancy. Which of the following statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
Correct Answer: C
Rationale: During pregnancy, increased estrogen levels and vascular congestion cause nasal
mucosa swelling, leading to nasal stuffiness and epistaxis. Blood pressure typically remains
,stable or slightly decreases, heart rate increases, and hemoglobin levels decrease due to
hemodilution .
Question 3
A nurse is calculating the estimated date of birth using Naegele's rule for a client whose last
menstrual period began on June 21. Which is the estimated date of delivery?
A. March 14
B. March 28
C. April 14
D. April 28
Correct Answer: B
Rationale: Naegele's rule is calculated by subtracting 3 months from the first day of the LMP
and adding 7 days. June 21 minus 3 months = March 21; March 21 plus 7 days = March 28 .
Question 4
A nurse is reviewing laboratory results for a client at 28 weeks of gestation. Hemoglobin is 10.2
g/dL and hematocrit is 31%. These values most likely represent:
A. Iron-deficiency anemia needing immediate ferrous sulfate
B. Physiologic anemia from plasma volume expansion exceeding red-cell mass
C. Acute blood loss from undetected abruption
D. Folic-acid deficiency
Correct Answer: B
Rationale: Plasma volume expands 40–50% while red-cell mass rises only 20–30%,
producing expected dilutional anemia. These values are consistent with physiologic anemia of
pregnancy .
Question 5
A nurse is assessing a client at 26 weeks of gestation who reports an episode of dizziness after
lying on her back on the couch. Which of the following actions should the nurse take?
A. Request a prescription for preeclampsia laboratory studies
B. Advise the client to lie on her side
,C. Request an ultrasound to evaluate fetal well-being
D. Advise the client to add a calcium supplement to her diet
Correct Answer: B
Rationale: Supine hypotensive syndrome occurs when the gravid uterus compresses the
inferior vena cava, reducing venous return and cardiac output. Advising the client to lie on her
side relieves this compression .
Question 6
A nurse is teaching a client at 12 weeks of gestation about cardiovascular changes. Which
statement indicates correct understanding?
A. "My blood pressure will gradually decrease during the first trimester."
B. "I should expect my heart rate to decrease by about 10 beats per minute."
C. "My cardiac output will increase significantly to support the pregnancy."
D. "Blood volume will remain relatively stable throughout my pregnancy."
Correct Answer: C
Rationale: Cardiac output increases by 30–50% during pregnancy to meet fetal and
placental metabolic demands. Heart rate increases by 10–15 bpm, not decreases. Blood volume
increases by 40–50%, not remains stable .
Question 7
A nurse is caring for a client at 12 weeks of gestation who reports nausea and vomiting. Which
intervention should the nurse recommend?
A. Eat small, frequent meals throughout the day
B. Increase intake of spicy foods
C. Consume large meals at bedtime
D. Avoid all fluids until symptoms subside
Correct Answer: A
Rationale: Nausea and vomiting in early pregnancy is best managed by eating small,
frequent meals to prevent the stomach from becoming empty, which exacerbates symptoms.
Spicy foods may worsen nausea, large bedtime meals increase discomfort, and fluid avoidance
risks dehydration .
, Question 8
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 for signs of distress
C. Place the client in a supine position
D. Obtain a specimen for nitrazine testing
Correct Answer: B
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 .
Question 9
A nurse is providing teaching to a client who is at 8 weeks of gestation about manifestations to
report to the provider. Which of the following findings should the nurse include?
A. Nausea upon awakening
B. Blurred or double vision
C. Increase in white vaginal discharge
D. Leg cramps when sleeping
Correct Answer: B
Rationale: Blurred or double vision can indicate preeclampsia or gestational hypertension
and should be reported immediately. Nausea upon awakening is a common manifestation of
early pregnancy. Increased white vaginal discharge (leukorrhea) is normal. Leg cramps are
common due to changes in circulation .
Question 10
A nurse is teaching a client about signs of preterm labor. Which finding should the client report
immediately?
A. Increased Braxton Hicks contractions
B. Low back pain that comes and goes
Questions & Detailed Rationales | ATI RN Maternal-Newborn Study
Guide & Exam Prep | Antepartum, Intrapartum, Postpartum, Newborn
Care, High-Risk Pregnancy, Fetal Monitoring & Pharmacology
SECTION 1: ANTEPARTUM ASSESSMENT & PRENATAL CARE
Questions 1–25
Question 1
A nurse is caring for a client at 38 weeks' gestation who reports a sudden gush of fluid from the
vagina. Which of the following actions should the nurse take first?
A. Prepare the client for an immediate cesarean birth
B. Assess the fetal heart rate and characteristics of the fluid
C. Obtain a urine specimen for culture
D. Administer oxytocin intravenously
Correct Answer: B
Rationale: When a client reports spontaneous rupture of membranes, the priority nursing
action is to assess fetal well-being by monitoring the fetal heart rate and evaluating the fluid for
color, amount, and odor. This helps detect complications such as cord prolapse or meconium
staining. Immediate cesarean birth and oxytocin administration are not first-line actions without
further assessment .
Question 2
A nurse is teaching a client at 10 weeks' gestation about expected physiological changes during
pregnancy. Which of the following statements by the client indicates understanding?
A. "I should expect my blood pressure to increase significantly."
B. "My heart rate will decrease as my pregnancy progresses."
C. "I may experience nasal stuffiness due to increased blood flow."
D. "My hemoglobin level will rise above my pre-pregnancy level."
Correct Answer: C
Rationale: During pregnancy, increased estrogen levels and vascular congestion cause nasal
mucosa swelling, leading to nasal stuffiness and epistaxis. Blood pressure typically remains
,stable or slightly decreases, heart rate increases, and hemoglobin levels decrease due to
hemodilution .
Question 3
A nurse is calculating the estimated date of birth using Naegele's rule for a client whose last
menstrual period began on June 21. Which is the estimated date of delivery?
A. March 14
B. March 28
C. April 14
D. April 28
Correct Answer: B
Rationale: Naegele's rule is calculated by subtracting 3 months from the first day of the LMP
and adding 7 days. June 21 minus 3 months = March 21; March 21 plus 7 days = March 28 .
Question 4
A nurse is reviewing laboratory results for a client at 28 weeks of gestation. Hemoglobin is 10.2
g/dL and hematocrit is 31%. These values most likely represent:
A. Iron-deficiency anemia needing immediate ferrous sulfate
B. Physiologic anemia from plasma volume expansion exceeding red-cell mass
C. Acute blood loss from undetected abruption
D. Folic-acid deficiency
Correct Answer: B
Rationale: Plasma volume expands 40–50% while red-cell mass rises only 20–30%,
producing expected dilutional anemia. These values are consistent with physiologic anemia of
pregnancy .
Question 5
A nurse is assessing a client at 26 weeks of gestation who reports an episode of dizziness after
lying on her back on the couch. Which of the following actions should the nurse take?
A. Request a prescription for preeclampsia laboratory studies
B. Advise the client to lie on her side
,C. Request an ultrasound to evaluate fetal well-being
D. Advise the client to add a calcium supplement to her diet
Correct Answer: B
Rationale: Supine hypotensive syndrome occurs when the gravid uterus compresses the
inferior vena cava, reducing venous return and cardiac output. Advising the client to lie on her
side relieves this compression .
Question 6
A nurse is teaching a client at 12 weeks of gestation about cardiovascular changes. Which
statement indicates correct understanding?
A. "My blood pressure will gradually decrease during the first trimester."
B. "I should expect my heart rate to decrease by about 10 beats per minute."
C. "My cardiac output will increase significantly to support the pregnancy."
D. "Blood volume will remain relatively stable throughout my pregnancy."
Correct Answer: C
Rationale: Cardiac output increases by 30–50% during pregnancy to meet fetal and
placental metabolic demands. Heart rate increases by 10–15 bpm, not decreases. Blood volume
increases by 40–50%, not remains stable .
Question 7
A nurse is caring for a client at 12 weeks of gestation who reports nausea and vomiting. Which
intervention should the nurse recommend?
A. Eat small, frequent meals throughout the day
B. Increase intake of spicy foods
C. Consume large meals at bedtime
D. Avoid all fluids until symptoms subside
Correct Answer: A
Rationale: Nausea and vomiting in early pregnancy is best managed by eating small,
frequent meals to prevent the stomach from becoming empty, which exacerbates symptoms.
Spicy foods may worsen nausea, large bedtime meals increase discomfort, and fluid avoidance
risks dehydration .
, Question 8
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 for signs of distress
C. Place the client in a supine position
D. Obtain a specimen for nitrazine testing
Correct Answer: B
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 .
Question 9
A nurse is providing teaching to a client who is at 8 weeks of gestation about manifestations to
report to the provider. Which of the following findings should the nurse include?
A. Nausea upon awakening
B. Blurred or double vision
C. Increase in white vaginal discharge
D. Leg cramps when sleeping
Correct Answer: B
Rationale: Blurred or double vision can indicate preeclampsia or gestational hypertension
and should be reported immediately. Nausea upon awakening is a common manifestation of
early pregnancy. Increased white vaginal discharge (leukorrhea) is normal. Leg cramps are
common due to changes in circulation .
Question 10
A nurse is teaching a client about signs of preterm labor. Which finding should the client report
immediately?
A. Increased Braxton Hicks contractions
B. Low back pain that comes and goes
