Ati Rn Maternal Newborn Proctored Exam 2026 | Study Guide, Practice Q&A & Detailed Rationales

ATI RN MATERNAL NEWBORN PROCTORED
EXAM 2026 | STUDY GUIDE, PRACTICE Q&A &
DETAILED RATIONALES

ATI RN MATERNAL NEWBORN PROCTORED EXAM 2026 | STUDY GUIDE,
PRACTICE Q&A & DETAILED RATIONALES

OVERVIEW

• This comprehensive study guide contains carefully constructed multiple-choice
questions designed to assess critical thinking and clinical knowledge across all
major maternal-newborn nursing topics tested on the ATI proctored exam.

• Study this material by reviewing questions systematically by topic area, analyzing
rationales for both correct and incorrect options, and using this resource for self-
assessment and remediation in weak areas before your proctored examination.




QUESTION 1

A primigravida at 28 weeks gestation presents to the clinic reporting sudden
onset of severe headache, visual disturbances, and right upper quadrant pain.
Her blood pressure is 165/110 mmHg. What is the priority nursing action?

A) Obtain a urinalysis for protein and send her home with instructions to rest

B) Administer antihypertensive medication and schedule a follow-up appointment
in 1 week

C) Notify the healthcare provider immediately and prepare for transfer to a labor
and delivery unit

D) Perform a nonstress test and document findings in the client's record

E) Instruct the client to monitor her blood pressure at home and call if symptoms
worsen

CORRECT ANSWER: C) Notify the healthcare provider immediately and
prepare for transfer to a labor and delivery unit

,RATIONALE: The clinical presentation described—severe headache, visual
disturbances, right upper quadrant pain, and elevated blood pressure (165/110
mmHg)—are classic signs of severe preeclampsia or HELLP syndrome, both of
which are obstetric emergencies. These symptoms indicate significant risk for
eclamptic seizures, placental abruption, hepatic rupture, or fetal compromise. The
priority action is immediate notification of the healthcare provider and transfer to a
facility equipped for emergency obstetric care. Options A and B delay critical
intervention. Option D, while appropriate, is secondary to the emergency
notification. Option E fails to recognize the severity and urgency of the situation.



QUESTION 2

A client at 36 weeks gestation is diagnosed with gestational diabetes mellitus
(GDM). Which statement by the client indicates a need for further teaching
regarding fetal complications?

A) "My baby might be larger than average because of high blood sugar levels"

B) "High blood sugar in pregnancy can cause my baby to have permanent kidney
damage after birth"

C) "My baby might have low blood sugar after delivery if my diabetes wasn't well
controlled"

D) "My baby could have respiratory distress syndrome because of immature lungs"

E) "My baby might develop low calcium levels after birth"

CORRECT ANSWER: B) "High blood sugar in pregnancy can cause my baby
to have permanent kidney damage after birth"

RATIONALE: While GDM can have multiple fetal effects, permanent kidney damage
is not a recognized complication of maternal GDM. Actual complications include
macrosomia (option A), neonatal hypoglycemia (option C), respiratory distress
syndrome related to surfactant deficiency (option D), and hypocalcemia (option E).
The statement about permanent kidney damage is inaccurate and indicates the
client has misunderstood the teaching about realistic fetal risks. This response

,requires clarification and corrected education to ensure the client understands
actual rather than imagined complications.



QUESTION 3

During a postpartum assessment at 2 hours after vaginal delivery, a client
expels a large clot vaginally. Which nursing action is most appropriate?

A) Call the healthcare provider immediately and keep the client on strict bed rest

B) Massage the fundus firmly and assess the clot for size and presence of tissue

C) Administer IV fluids and prepare the client for an emergency dilation and
curettage

D) Document the finding and reassess vital signs in 30 minutes

E) Apply a perineal heat lamp and encourage the client to void

CORRECT ANSWER: B) Massage the fundus firmly and assess the clot for
size and presence of tissue

RATIONALE: Expulsion of clots in the early postpartum period is expected and does
not necessarily indicate a complication. The appropriate response is to assess the
fundus for firmness and tone through fundal massage, and to evaluate the clot—
noting its size and whether it contains tissue. If the clot is larger than a golf ball or
contains tissue, this may warrant further investigation. However, a single clot
passage in the early postpartum period with adequate uterine firmness is a normal
finding. Options A and C represent overreactions to a normal phenomenon. Option
D is too passive. Option E, while acceptable postpartum care, does not address the
immediate assessment needed.



QUESTION 4

A client in active labor at 5 cm dilation suddenly experiences uterine tetany
with the use of intravenous oxytocin. What is the nurse's first action?

A) Increase the oxytocin infusion rate to contract the uterus more effectively

, B) Discontinue the oxytocin infusion immediately and notify the healthcare provider

C) Position the client supine and apply oxygen at 10 L/minute

D) Insert a urinary catheter and monitor urine output

E) Administer magnesium sulfate intravenously to stop contractions

CORRECT ANSWER: B) Discontinue the oxytocin infusion immediately and
notify the healthcare provider

RATIONALE: Uterine tetany (sustained contraction lasting more than 90 seconds
with less than 30 seconds between contractions) is a serious adverse effect of
oxytocin that compromises placental perfusion and increases risk of uterine
rupture. The immediate action is to stop the oxytocin infusion and notify the
provider. Option A is dangerous and would worsen the complication. Option C,
while appropriate, is secondary. Options D and E do not address the primary
problem. Discontinuing the medication is the priority intervention to restore
normal contraction patterns and prevent fetal hypoxia and maternal injury.



QUESTION 5

A client at 32 weeks gestation reports sudden vaginal bleeding and severe
abdominal pain. Ultrasound confirms placental abruption. Which assessment
finding would the nurse expect?

A) Painless vaginal bleeding with a soft, boggy fundus

B) Rigid, tender abdomen with concealed hemorrhage and signs of shock

C) Gradual onset of bleeding over several hours with minimal pain

D) Vaginal bleeding with cervical dilation and effacement

E) Spotting with intact amniotic membranes and Braxton-Hicks contractions

CORRECT ANSWER: B) Rigid, tender abdomen with concealed hemorrhage
and signs of shock

RATIONALE: Placental abruption presents with sudden vaginal bleeding, severe
abdominal pain, and a rigid, tender uterus due to irritation from blood in the