ATI Maternal Newborn Retake Proctored Exam 2026
2027 | Complete Q&A
Section 1: Questions 1–100
1. A client at 32 weeks of gestation reports sudden, severe abdominal pain and
vaginal bleeding. The nurse notes a rigid, board-like abdomen. Which action
should the nurse take first?
A. Administer IV fluids
B. Prepare for immediate cesarean delivery
C. Assess fetal heart rate and maternal vital signs
D. Perform a vaginal examination
Rationale: These findings suggest placental abruption. The priority is rapid assessment
of maternal hemodynamic stability and fetal well-being before interventions. Vaginal
examination is contraindicated until placenta previa is ruled out. While cesarean may
be needed, assessment comes first .
2. During labor, a client's fetal heart rate tracing shows late decelerations with
minimal variability. Which action should the nurse take first?
A. Administer oxygen via non-rebreather mask
B. Reposition the client to left lateral position
C. Increase IV fluid rate
D. Notify the provider immediately
Rationale: Late decelerations indicate uteroplacental insufficiency. Left lateral position
improves placental perfusion and is the first corrective action. Oxygen and fluids may
follow. Notification is necessary but after initiating corrective measures .
3. A postpartum client 2 hours after vaginal delivery has a boggy uterus
deviated to the right and moderate lochia rubra. Which action should the nurse
take first?
A. Massage the fundus
B. Assist the client to void
C. Administer methylergonovine
D. Increase IV oxytocin
,Rationale: A deviated, boggy fundus suggests a full bladder displacing the uterus and
impairing contraction. Bladder emptying is the first step. Massaging over a full bladder
can cause uterine inversion .
4. A newborn delivered at 38 weeks weighs 2,200 g. The nurse identifies this
newborn as:
A. Appropriate for gestational age (AGA)
B. Small for gestational age (SGA)
C. Large for gestational age (LGA)
D. Extremely low birth weight
Rationale: At 38 weeks, average birth weight is approximately 3,200–3,400 g. A weight
below the 10th percentile (approximately 2,700 g) is SGA. The infant is term but
growth-restricted, requiring monitoring for hypoglycemia and polycythemia .
5. A client in active labor requests epidural analgesia. Before administration,
the nurse should ensure:
A. The client has signed informed consent
B. IV access is established and fluid bolus given
C. Fetal heart rate is reassuring
D. All of the above
Rationale: All three are essential prerequisites for epidural placement: informed
consent, IV access with fluid preload to prevent hypotension, and reassuring fetal status
.
6. A client at 28 weeks of gestation has a fundal height of 26 cm. Which action
should the nurse take?
A. Document the finding as expected
B. Report the finding to the provider immediately
C. Request an ultrasound to evaluate fetal growth
D. Assess the client for gestational diabetes
Rationale: At 28 weeks, fundal height should approximate gestational age ±2 cm. A
measurement of 26 cm falls within the expected range (26–30 cm). Documentation is
appropriate .
7. A client at 12 weeks of gestation asks why she needs folic acid supplements.
Which response by the nurse is correct?
A. "Folic acid prevents iron-deficiency anemia during pregnancy."
B. "Folic acid reduces the risk of neural tube defects in the fetus."
,C. "Folic acid promotes adequate calcium absorption for fetal bone development."
D. "Folic acid prevents gestational hypertension."
Rationale: Folic acid supplementation of at least 400 mcg daily before and during early
pregnancy reduces the risk of neural tube defects. The neural tube closes by the fourth
week of gestation .
8. A client at 16 weeks of gestation reports frequent headaches and visual
changes. Blood pressure is 148/92 mm Hg. Which action should the nurse take
first?
A. Instruct the client to lie on her left side
B. Obtain a urine specimen for protein analysis
C. Administer acetaminophen for headache relief
D. Document the findings in the client's chart
Rationale: These findings suggest possible preeclampsia. Proteinuria is a required
criterion for diagnosis. Obtaining a urine specimen gathers essential assessment data
before interventions .
9. A client at 10 weeks of gestation has a rubella titer less than 1:8. Which
action should the nurse take?
A. Document the finding as normal
B. Report the finding to the provider
C. Administer the rubella vaccine immediately
D. Recheck the titer in 4 weeks
Rationale: A rubella titer less than 1:8 indicates susceptibility to rubella. The provider
should be notified. The vaccine is contraindicated during pregnancy and should be
administered postpartum .
10. A nurse is providing teaching to a client at 8 weeks of gestation about
manifestations to report. Which finding should the nurse include?
A. Nausea upon awakening
B. Blurred or double vision
C. Increase in white vaginal discharge
D. Leg cramps when sleeping
Rationale: Blurred or double vision can indicate preeclampsia or gestational
hypertension and should be reported immediately. Nausea, leukorrhea, and leg cramps
are common normal findings .
11. A nurse is teaching a client about signs of preterm labor. Which finding
should the client report immediately?
, A. Painless bleeding
B. Severe abdominal pain and uterine tenderness
C. No bleeding
D. Increased fetal movement
Rationale: Placental abruption causes painful bleeding with a firm, tender uterus.
Painless bleeding is characteristic of placenta previa. Both require immediate
evaluation, but painful bleeding with tenderness suggests abruption, a maternal-fetal
emergency .
12. A nurse is performing a non-stress test on a client at 34 weeks of gestation.
Which finding indicates a reactive NST?
A. Two fetal heart rate accelerations of 15 bpm above baseline lasting 15
seconds within 20 minutes
B. No accelerations after 40 minutes
C. Late decelerations following contractions
D. Baseline fetal heart rate of 110 bpm with minimal variability
Rationale: A reactive NST is defined as two or more FHR accelerations of at least 15
bpm above baseline lasting at least 15 seconds within a 20-minute period. This
indicates fetal well-being .
13. A client at 12 weeks of gestation with HIV asks about transmission
prevention. Which statement should the nurse include?
A. "You will be in isolation after delivery."
B. "Abstain from sexual intercourse throughout pregnancy."
C. "Breastfeed your newborn to provide passive immunity."
D. "You should continue to take zidovudine throughout the pregnancy."
Rationale: Daily antiviral medication decreases the risk of perinatal HIV transmission.
Isolation is not required. Breastfeeding is contraindicated with HIV when safe formula
is available .
14. A nurse is caring for a client at 32 weeks of gestation experiencing preterm
labor. Which medication should the nurse anticipate administering?
A. Misoprostol
B. Betamethasone
C. Carboprost
D. Methylergonovine
Rationale: Betamethasone is administered to promote fetal lung maturity in preterm
labor. Misoprostol and carboprost are used for other obstetric indications.
Methylergonovine is used for postpartum hemorrhage .
2027 | Complete Q&A
Section 1: Questions 1–100
1. A client at 32 weeks of gestation reports sudden, severe abdominal pain and
vaginal bleeding. The nurse notes a rigid, board-like abdomen. Which action
should the nurse take first?
A. Administer IV fluids
B. Prepare for immediate cesarean delivery
C. Assess fetal heart rate and maternal vital signs
D. Perform a vaginal examination
Rationale: These findings suggest placental abruption. The priority is rapid assessment
of maternal hemodynamic stability and fetal well-being before interventions. Vaginal
examination is contraindicated until placenta previa is ruled out. While cesarean may
be needed, assessment comes first .
2. During labor, a client's fetal heart rate tracing shows late decelerations with
minimal variability. Which action should the nurse take first?
A. Administer oxygen via non-rebreather mask
B. Reposition the client to left lateral position
C. Increase IV fluid rate
D. Notify the provider immediately
Rationale: Late decelerations indicate uteroplacental insufficiency. Left lateral position
improves placental perfusion and is the first corrective action. Oxygen and fluids may
follow. Notification is necessary but after initiating corrective measures .
3. A postpartum client 2 hours after vaginal delivery has a boggy uterus
deviated to the right and moderate lochia rubra. Which action should the nurse
take first?
A. Massage the fundus
B. Assist the client to void
C. Administer methylergonovine
D. Increase IV oxytocin
,Rationale: A deviated, boggy fundus suggests a full bladder displacing the uterus and
impairing contraction. Bladder emptying is the first step. Massaging over a full bladder
can cause uterine inversion .
4. A newborn delivered at 38 weeks weighs 2,200 g. The nurse identifies this
newborn as:
A. Appropriate for gestational age (AGA)
B. Small for gestational age (SGA)
C. Large for gestational age (LGA)
D. Extremely low birth weight
Rationale: At 38 weeks, average birth weight is approximately 3,200–3,400 g. A weight
below the 10th percentile (approximately 2,700 g) is SGA. The infant is term but
growth-restricted, requiring monitoring for hypoglycemia and polycythemia .
5. A client in active labor requests epidural analgesia. Before administration,
the nurse should ensure:
A. The client has signed informed consent
B. IV access is established and fluid bolus given
C. Fetal heart rate is reassuring
D. All of the above
Rationale: All three are essential prerequisites for epidural placement: informed
consent, IV access with fluid preload to prevent hypotension, and reassuring fetal status
.
6. A client at 28 weeks of gestation has a fundal height of 26 cm. Which action
should the nurse take?
A. Document the finding as expected
B. Report the finding to the provider immediately
C. Request an ultrasound to evaluate fetal growth
D. Assess the client for gestational diabetes
Rationale: At 28 weeks, fundal height should approximate gestational age ±2 cm. A
measurement of 26 cm falls within the expected range (26–30 cm). Documentation is
appropriate .
7. A client at 12 weeks of gestation asks why she needs folic acid supplements.
Which response by the nurse is correct?
A. "Folic acid prevents iron-deficiency anemia during pregnancy."
B. "Folic acid reduces the risk of neural tube defects in the fetus."
,C. "Folic acid promotes adequate calcium absorption for fetal bone development."
D. "Folic acid prevents gestational hypertension."
Rationale: Folic acid supplementation of at least 400 mcg daily before and during early
pregnancy reduces the risk of neural tube defects. The neural tube closes by the fourth
week of gestation .
8. A client at 16 weeks of gestation reports frequent headaches and visual
changes. Blood pressure is 148/92 mm Hg. Which action should the nurse take
first?
A. Instruct the client to lie on her left side
B. Obtain a urine specimen for protein analysis
C. Administer acetaminophen for headache relief
D. Document the findings in the client's chart
Rationale: These findings suggest possible preeclampsia. Proteinuria is a required
criterion for diagnosis. Obtaining a urine specimen gathers essential assessment data
before interventions .
9. A client at 10 weeks of gestation has a rubella titer less than 1:8. Which
action should the nurse take?
A. Document the finding as normal
B. Report the finding to the provider
C. Administer the rubella vaccine immediately
D. Recheck the titer in 4 weeks
Rationale: A rubella titer less than 1:8 indicates susceptibility to rubella. The provider
should be notified. The vaccine is contraindicated during pregnancy and should be
administered postpartum .
10. A nurse is providing teaching to a client at 8 weeks of gestation about
manifestations to report. Which finding should the nurse include?
A. Nausea upon awakening
B. Blurred or double vision
C. Increase in white vaginal discharge
D. Leg cramps when sleeping
Rationale: Blurred or double vision can indicate preeclampsia or gestational
hypertension and should be reported immediately. Nausea, leukorrhea, and leg cramps
are common normal findings .
11. A nurse is teaching a client about signs of preterm labor. Which finding
should the client report immediately?
, A. Painless bleeding
B. Severe abdominal pain and uterine tenderness
C. No bleeding
D. Increased fetal movement
Rationale: Placental abruption causes painful bleeding with a firm, tender uterus.
Painless bleeding is characteristic of placenta previa. Both require immediate
evaluation, but painful bleeding with tenderness suggests abruption, a maternal-fetal
emergency .
12. A nurse is performing a non-stress test on a client at 34 weeks of gestation.
Which finding indicates a reactive NST?
A. Two fetal heart rate accelerations of 15 bpm above baseline lasting 15
seconds within 20 minutes
B. No accelerations after 40 minutes
C. Late decelerations following contractions
D. Baseline fetal heart rate of 110 bpm with minimal variability
Rationale: A reactive NST is defined as two or more FHR accelerations of at least 15
bpm above baseline lasting at least 15 seconds within a 20-minute period. This
indicates fetal well-being .
13. A client at 12 weeks of gestation with HIV asks about transmission
prevention. Which statement should the nurse include?
A. "You will be in isolation after delivery."
B. "Abstain from sexual intercourse throughout pregnancy."
C. "Breastfeed your newborn to provide passive immunity."
D. "You should continue to take zidovudine throughout the pregnancy."
Rationale: Daily antiviral medication decreases the risk of perinatal HIV transmission.
Isolation is not required. Breastfeeding is contraindicated with HIV when safe formula
is available .
14. A nurse is caring for a client at 32 weeks of gestation experiencing preterm
labor. Which medication should the nurse anticipate administering?
A. Misoprostol
B. Betamethasone
C. Carboprost
D. Methylergonovine
Rationale: Betamethasone is administered to promote fetal lung maturity in preterm
labor. Misoprostol and carboprost are used for other obstetric indications.
Methylergonovine is used for postpartum hemorrhage .
