ATI RN MATERNAL NEWBORN PROCTORED EXAM 2026 |
LEVEL 3 PRACTICE QUESTIONS AND ANSWERS WITH
RATIONALES
Core Domains
• Antepartum Assessment and Prenatal Care
• High-Risk Pregnancy Conditions (Preeclampsia, Gestational
Diabetes, Preterm Labor)
• Intrapartum Labor and Delivery Management
• Fetal Heart Rate Monitoring and Interpretation
• Postpartum Care and Complications
• Newborn Assessment and Immediate Care
• Medication Administration in Obstetric and Neonatal Care
• Breastfeeding and Lactation Support
• Patient Education and Evidence-Based Nursing Interventions
Introduction
This comprehensive practice examination prepares nursing students for
the ATI RN Maternal Newborn Proctored Exam, targeting Level 3
proficiency. It assesses clinical judgment, evidence-based practice, and
safe nursing care across the childbearing continuum. Questions
emphasize prioritization, fetal surveillance, maternal-fetal risk
identification, and timely intervention. The exam integrates Next
Generation NCLEX (NGN) item formats, including case studies and
clinical decision-making scenarios, to strengthen reasoning and
application. Successful completion demonstrates readiness to deliver
competent, patient-centered maternal-newborn nursing care.
,1. A nurse is assessing a client at 34 weeks of gestation receiving
magnesium sulfate for preeclampsia. Which finding should the
nurse report to the provider?
A. Deep tendon reflexes 2+
B. Urine output 20 mL/hr
C. Respiratory rate 14/min
D. Magnesium level 6 mEq/L
Correct answer: B. Urine output 20 mL/hr
RATIONALE: Urine output less than 30 mL/hr indicates
magnesium toxicity risk because magnesium is excreted renally. Deep
tendon reflexes 2+ and respiratory rate 14/min are within normal limits.
Magnesium level 6 mEq/L is therapeutic for seizure prophylaxis.
2. A nurse is caring for a client in the first stage of labor with an
internal fetal scalp electrode. Late decelerations appear on the
monitor. Which action should the nurse take first?
A. Increase the rate of the maintenance IV fluid
B. Change the client's position to a side-lying position
C. Administer oxygen via nonrebreather mask at 10 L/min
D. Notify the healthcare provider
Correct answer: B. Change the client's position to a side-lying
position
RATIONALE: According to the nursing process, the nurse should
first implement the least invasive intervention to improve placental
perfusion. Changing to a side-lying position alleviates pressure on the
,vena cava and improves blood flow to the placenta. Repositioning is the
immediate priority before oxygen or provider notification.
3. A nurse is providing discharge teaching to a postpartum client
with a prescription for rubella immunization. Which instruction
should the nurse include?
A. The vaccine should be repeated in 3 months
B. Do not breastfeed for 48 hours following the injection
C. Expect a low-grade fever for the next week
D. Avoid becoming pregnant for at least 28 days
Correct answer: D. Avoid becoming pregnant for at least 28 days
RATIONALE: The rubella vaccine is a live virus and is teratogenic.
Clients must avoid pregnancy for at least 4 weeks (28 days) post-
vaccination. Breastfeeding is not contraindicated, and repeat dosing is
not routinely required.
4. A nurse is assessing a newborn 1 hour after birth. Which findings
indicate respiratory distress? (Select All That Apply)
A. Nasal flaring
B. Acrocyanosis
C. Grunting
D. Chest retractions
E. Respiratory rate of 50/min
F. Abdominal breathing
Correct answer: A, C, D
, RATIONALE: Nasal flaring, grunting, and chest retractions are
classic signs of newborn respiratory distress indicating increased work
of breathing. Acrocyanosis is normal in the first 24-48 hours.
Respiratory rate of 50/min and abdominal breathing are normal newborn
findings.
5. A nurse is caring for a client at 38 weeks of gestation reporting
abdominal pain and vaginal bleeding. Which assessment is the
priority?
A. Check maternal blood pressure
B. Assess fetal heart rate
C. Determine the amount of vaginal bleeding
D. Perform a vaginal examination
Correct answer: B. Assess fetal heart rate
RATIONALE: In suspected abruptio placentae or placenta previa,
assessing fetal well-being is the primary concern to determine if
immediate delivery is necessary. Vaginal examinations are
contraindicated with unexplained vaginal bleeding until placenta previa
is ruled out.
6. A nurse is assessing a client at 32 weeks of gestation reporting
occasional mild contractions. Which finding indicates preterm
labor?
A. Irregular contractions that subside with rest
B. Cervical dilation of 2 cm with 50% effacement
C. Fetal heart rate baseline of 140/min with moderate variability
LEVEL 3 PRACTICE QUESTIONS AND ANSWERS WITH
RATIONALES
Core Domains
• Antepartum Assessment and Prenatal Care
• High-Risk Pregnancy Conditions (Preeclampsia, Gestational
Diabetes, Preterm Labor)
• Intrapartum Labor and Delivery Management
• Fetal Heart Rate Monitoring and Interpretation
• Postpartum Care and Complications
• Newborn Assessment and Immediate Care
• Medication Administration in Obstetric and Neonatal Care
• Breastfeeding and Lactation Support
• Patient Education and Evidence-Based Nursing Interventions
Introduction
This comprehensive practice examination prepares nursing students for
the ATI RN Maternal Newborn Proctored Exam, targeting Level 3
proficiency. It assesses clinical judgment, evidence-based practice, and
safe nursing care across the childbearing continuum. Questions
emphasize prioritization, fetal surveillance, maternal-fetal risk
identification, and timely intervention. The exam integrates Next
Generation NCLEX (NGN) item formats, including case studies and
clinical decision-making scenarios, to strengthen reasoning and
application. Successful completion demonstrates readiness to deliver
competent, patient-centered maternal-newborn nursing care.
,1. A nurse is assessing a client at 34 weeks of gestation receiving
magnesium sulfate for preeclampsia. Which finding should the
nurse report to the provider?
A. Deep tendon reflexes 2+
B. Urine output 20 mL/hr
C. Respiratory rate 14/min
D. Magnesium level 6 mEq/L
Correct answer: B. Urine output 20 mL/hr
RATIONALE: Urine output less than 30 mL/hr indicates
magnesium toxicity risk because magnesium is excreted renally. Deep
tendon reflexes 2+ and respiratory rate 14/min are within normal limits.
Magnesium level 6 mEq/L is therapeutic for seizure prophylaxis.
2. A nurse is caring for a client in the first stage of labor with an
internal fetal scalp electrode. Late decelerations appear on the
monitor. Which action should the nurse take first?
A. Increase the rate of the maintenance IV fluid
B. Change the client's position to a side-lying position
C. Administer oxygen via nonrebreather mask at 10 L/min
D. Notify the healthcare provider
Correct answer: B. Change the client's position to a side-lying
position
RATIONALE: According to the nursing process, the nurse should
first implement the least invasive intervention to improve placental
perfusion. Changing to a side-lying position alleviates pressure on the
,vena cava and improves blood flow to the placenta. Repositioning is the
immediate priority before oxygen or provider notification.
3. A nurse is providing discharge teaching to a postpartum client
with a prescription for rubella immunization. Which instruction
should the nurse include?
A. The vaccine should be repeated in 3 months
B. Do not breastfeed for 48 hours following the injection
C. Expect a low-grade fever for the next week
D. Avoid becoming pregnant for at least 28 days
Correct answer: D. Avoid becoming pregnant for at least 28 days
RATIONALE: The rubella vaccine is a live virus and is teratogenic.
Clients must avoid pregnancy for at least 4 weeks (28 days) post-
vaccination. Breastfeeding is not contraindicated, and repeat dosing is
not routinely required.
4. A nurse is assessing a newborn 1 hour after birth. Which findings
indicate respiratory distress? (Select All That Apply)
A. Nasal flaring
B. Acrocyanosis
C. Grunting
D. Chest retractions
E. Respiratory rate of 50/min
F. Abdominal breathing
Correct answer: A, C, D
, RATIONALE: Nasal flaring, grunting, and chest retractions are
classic signs of newborn respiratory distress indicating increased work
of breathing. Acrocyanosis is normal in the first 24-48 hours.
Respiratory rate of 50/min and abdominal breathing are normal newborn
findings.
5. A nurse is caring for a client at 38 weeks of gestation reporting
abdominal pain and vaginal bleeding. Which assessment is the
priority?
A. Check maternal blood pressure
B. Assess fetal heart rate
C. Determine the amount of vaginal bleeding
D. Perform a vaginal examination
Correct answer: B. Assess fetal heart rate
RATIONALE: In suspected abruptio placentae or placenta previa,
assessing fetal well-being is the primary concern to determine if
immediate delivery is necessary. Vaginal examinations are
contraindicated with unexplained vaginal bleeding until placenta previa
is ruled out.
6. A nurse is assessing a client at 32 weeks of gestation reporting
occasional mild contractions. Which finding indicates preterm
labor?
A. Irregular contractions that subside with rest
B. Cervical dilation of 2 cm with 50% effacement
C. Fetal heart rate baseline of 140/min with moderate variability
