ATI RN MATERNAL NEWBORN PROCTORED
EXAM 2026 | PRACTICE QUESTIONS &
DETAILED RATIONALES | COMPLETE STUDY
GUIDE
ATI RN MATERNAL NEWBORN PROCTORED EXAM 2026
PRACTICE QUESTIONS & DETAILED RATIONALES | COMPLETE STUDY GUIDE
DOCUMENT OVERVIEW
• This comprehensive study guide contains practice questions designed to prepare
you for the ATI RN Maternal Newborn Proctored Exam, covering all essential topics
in maternal-neonatal nursing with detailed rationales for deeper understanding
• Study strategy: Work through questions systematically by topic, review rationales
for all answers (not just incorrect ones), and use this guide to identify knowledge
gaps before your proctored exam
QUESTIONS
QUESTION 1
A primigravida client at 32 weeks gestation presents to the clinic with a blood
pressure of 150/95 mmHg, proteinuria of 2+, and complaints of severe
headache and epigastric pain. Which of the following is the priority nursing
intervention?
A) Schedule a non-stress test for fetal assessment
B) Educate the client about dietary sodium restriction
C) Obtain stat laboratory tests including liver enzymes and platelet count
D) Refer the client to a support group for high-risk pregnancies
E) Provide the client with a list of relaxation techniques
,✓ CORRECT ANSWER: C) Obtain stat laboratory tests including liver enzymes
and platelet count
RATIONALE: The client is presenting with classic signs of severe
preeclampsia/HELLP syndrome (Hypertension, Elevated Liver enzymes, Low
Platelets): elevated BP, proteinuria, severe headache, and epigastric pain. These
symptoms suggest possible organ involvement and hemolysis. Stat laboratory work
is the priority to assess for HELLP syndrome and guide immediate treatment
decisions. Platelet count, liver enzymes, and LDH are critical for determining
disease severity. While fetal assessment is important, maternal stabilization and
diagnosis take priority in this life-threatening condition.
QUESTION 2
A client in active labor at 5 cm dilation is using epidural anesthesia. The nurse
notes fetal heart rate decelerations with each contraction lasting 30 seconds.
The client's blood pressure is 92/58 mmHg. What is the most appropriate
nursing action?
A) Continue monitoring as this is a normal finding with epidural use
B) Immediately prepare for emergency cesarean delivery
C) Turn the client to the left lateral position and administer IV fluids
D) Increase oxytocin infusion to shorten labor
E) Apply oxygen and prepare for instrumental delivery
✓ CORRECT ANSWER: C) Turn the client to the left lateral position and
administer IV fluids
RATIONALE: The clinical presentation indicates umbilical cord compression causing
early or variable decelerations with each contraction. Hypotension is a common
side effect of epidural anesthesia that can reduce placental perfusion. The most
,appropriate interventions are: 1) Position the client on the left lateral side to relieve
cord compression and improve placental perfusion, 2) Administer IV fluids to
counteract epidural-induced hypotension and improve maternal hemodynamics.
These non-invasive interventions often resolve fetal heart rate decelerations. If
decelerations persist despite these measures, then more aggressive interventions
would be considered.
QUESTION 3
A postpartum client on day 3 after vaginal delivery reports saturating one
perineal pad per hour with bright red blood, passage of a large clot, and
reports feeling dizzy when standing. Vital signs: BP 110/60 lying, 98/50
standing; HR 110. Which nursing diagnosis takes priority?
A) Risk for infection related to perineal laceration
B) Acute pain related to perineal trauma
C) Risk for decreased cardiac output related to excessive blood loss
D) Deficient knowledge related to postpartum self-care
E) Impaired tissue integrity related to episiotomy
✓ CORRECT ANSWER: C) Risk for decreased cardiac output related to excessive
blood loss
RATIONALE: This client is experiencing postpartum hemorrhage with signs of
hypovolemic shock: saturation of one pad per hour is excessive bleeding,
orthostatic vital signs (significant drop when standing), tachycardia (HR 110), and
dizziness upon standing indicating decreased cerebral perfusion. These findings
represent inadequate cardiac output secondary to blood loss. This is a life-
threatening complication requiring immediate intervention such as uterine
massage, IV fluid administration, oxytocic medications, and possible transfusion.
While other diagnoses are relevant, the immediate threat to maternal safety makes
decreased cardiac output the priority.
, QUESTION 4
A client with gestational diabetes mellitus is discussing birth plan options at
38 weeks gestation. Which statement by the nurse is most appropriate?
A) "Gestational diabetes means you will automatically have a cesarean delivery to
protect your baby."
B) "With gestational diabetes, your baby is at high risk for respiratory distress
syndrome at term."
C) "Vaginal delivery is possible, but you'll need close glucose monitoring during
labor and your baby will need newborn screening for hypoglycemia."
D) "You should plan to breastfeed exclusively since formula feeding increases your
baby's blood sugar problems."
E) "Gestational diabetes only affects your pregnancy and won't impact your baby
after birth."
✓ CORRECT ANSWER: C) Vaginal delivery is possible, but you'll need close
glucose monitoring during labor and your baby will need newborn screening
for hypoglycemia.
RATIONALE: Gestational diabetes does not contraindicate vaginal delivery; vaginal
delivery is the goal with good glycemic control. Key management points include:
maintaining euglycemia during labor (the metabolic stress of labor increases
glucose needs and can cause maternal hypoglycemia), continuous monitoring of
maternal blood glucose, and assessing the newborn for hypoglycemia within the
first 1-2 hours of life. Babies born to mothers with GDM are at risk for hypoglycemia
due to fetal hyperinsulinemia in response to maternal hyperglycemia. Option B is
incorrect because respiratory distress syndrome risk is actually lower at term.
Option E is partially incorrect because GDM increases the child's future risk of type
2 diabetes.
EXAM 2026 | PRACTICE QUESTIONS &
DETAILED RATIONALES | COMPLETE STUDY
GUIDE
ATI RN MATERNAL NEWBORN PROCTORED EXAM 2026
PRACTICE QUESTIONS & DETAILED RATIONALES | COMPLETE STUDY GUIDE
DOCUMENT OVERVIEW
• This comprehensive study guide contains practice questions designed to prepare
you for the ATI RN Maternal Newborn Proctored Exam, covering all essential topics
in maternal-neonatal nursing with detailed rationales for deeper understanding
• Study strategy: Work through questions systematically by topic, review rationales
for all answers (not just incorrect ones), and use this guide to identify knowledge
gaps before your proctored exam
QUESTIONS
QUESTION 1
A primigravida client at 32 weeks gestation presents to the clinic with a blood
pressure of 150/95 mmHg, proteinuria of 2+, and complaints of severe
headache and epigastric pain. Which of the following is the priority nursing
intervention?
A) Schedule a non-stress test for fetal assessment
B) Educate the client about dietary sodium restriction
C) Obtain stat laboratory tests including liver enzymes and platelet count
D) Refer the client to a support group for high-risk pregnancies
E) Provide the client with a list of relaxation techniques
,✓ CORRECT ANSWER: C) Obtain stat laboratory tests including liver enzymes
and platelet count
RATIONALE: The client is presenting with classic signs of severe
preeclampsia/HELLP syndrome (Hypertension, Elevated Liver enzymes, Low
Platelets): elevated BP, proteinuria, severe headache, and epigastric pain. These
symptoms suggest possible organ involvement and hemolysis. Stat laboratory work
is the priority to assess for HELLP syndrome and guide immediate treatment
decisions. Platelet count, liver enzymes, and LDH are critical for determining
disease severity. While fetal assessment is important, maternal stabilization and
diagnosis take priority in this life-threatening condition.
QUESTION 2
A client in active labor at 5 cm dilation is using epidural anesthesia. The nurse
notes fetal heart rate decelerations with each contraction lasting 30 seconds.
The client's blood pressure is 92/58 mmHg. What is the most appropriate
nursing action?
A) Continue monitoring as this is a normal finding with epidural use
B) Immediately prepare for emergency cesarean delivery
C) Turn the client to the left lateral position and administer IV fluids
D) Increase oxytocin infusion to shorten labor
E) Apply oxygen and prepare for instrumental delivery
✓ CORRECT ANSWER: C) Turn the client to the left lateral position and
administer IV fluids
RATIONALE: The clinical presentation indicates umbilical cord compression causing
early or variable decelerations with each contraction. Hypotension is a common
side effect of epidural anesthesia that can reduce placental perfusion. The most
,appropriate interventions are: 1) Position the client on the left lateral side to relieve
cord compression and improve placental perfusion, 2) Administer IV fluids to
counteract epidural-induced hypotension and improve maternal hemodynamics.
These non-invasive interventions often resolve fetal heart rate decelerations. If
decelerations persist despite these measures, then more aggressive interventions
would be considered.
QUESTION 3
A postpartum client on day 3 after vaginal delivery reports saturating one
perineal pad per hour with bright red blood, passage of a large clot, and
reports feeling dizzy when standing. Vital signs: BP 110/60 lying, 98/50
standing; HR 110. Which nursing diagnosis takes priority?
A) Risk for infection related to perineal laceration
B) Acute pain related to perineal trauma
C) Risk for decreased cardiac output related to excessive blood loss
D) Deficient knowledge related to postpartum self-care
E) Impaired tissue integrity related to episiotomy
✓ CORRECT ANSWER: C) Risk for decreased cardiac output related to excessive
blood loss
RATIONALE: This client is experiencing postpartum hemorrhage with signs of
hypovolemic shock: saturation of one pad per hour is excessive bleeding,
orthostatic vital signs (significant drop when standing), tachycardia (HR 110), and
dizziness upon standing indicating decreased cerebral perfusion. These findings
represent inadequate cardiac output secondary to blood loss. This is a life-
threatening complication requiring immediate intervention such as uterine
massage, IV fluid administration, oxytocic medications, and possible transfusion.
While other diagnoses are relevant, the immediate threat to maternal safety makes
decreased cardiac output the priority.
, QUESTION 4
A client with gestational diabetes mellitus is discussing birth plan options at
38 weeks gestation. Which statement by the nurse is most appropriate?
A) "Gestational diabetes means you will automatically have a cesarean delivery to
protect your baby."
B) "With gestational diabetes, your baby is at high risk for respiratory distress
syndrome at term."
C) "Vaginal delivery is possible, but you'll need close glucose monitoring during
labor and your baby will need newborn screening for hypoglycemia."
D) "You should plan to breastfeed exclusively since formula feeding increases your
baby's blood sugar problems."
E) "Gestational diabetes only affects your pregnancy and won't impact your baby
after birth."
✓ CORRECT ANSWER: C) Vaginal delivery is possible, but you'll need close
glucose monitoring during labor and your baby will need newborn screening
for hypoglycemia.
RATIONALE: Gestational diabetes does not contraindicate vaginal delivery; vaginal
delivery is the goal with good glycemic control. Key management points include:
maintaining euglycemia during labor (the metabolic stress of labor increases
glucose needs and can cause maternal hypoglycemia), continuous monitoring of
maternal blood glucose, and assessing the newborn for hypoglycemia within the
first 1-2 hours of life. Babies born to mothers with GDM are at risk for hypoglycemia
due to fetal hyperinsulinemia in response to maternal hyperglycemia. Option B is
incorrect because respiratory distress syndrome risk is actually lower at term.
Option E is partially incorrect because GDM increases the child's future risk of type
2 diabetes.
