ATI RN Maternal Newborn OB Proctored
Complete Package 2026 Version. 2023
Versions RN ATI Maternal Newborn
Proctored Exam
Antepartum Care
Question 1: A nurse is teaching a client who is at 8 weeks of gestation about common
discomforts of pregnancy. Which statement by the client indicates an understanding of
the teaching?
A) "Nausea and vomiting usually last throughout the entire pregnancy."
B) "I may have increased vaginal discharge that is clear or white."
C) "I should expect to have episodes of dizziness when lying on my back."
D) "Breast tenderness indicates a problem with my pregnancy."
Rationale: Leukorrhea (increased white/clear vaginal discharge) is common in
pregnancy due to increased estrogen levels. Nausea typically resolves by 12–14 weeks.
Supine hypotension occurs when lying flat. Breast tenderness is a normal early sign of
pregnancy, not a problem.
Question 2: A nurse is assessing a client at 36 weeks of gestation. Which finding should
the nurse report to the provider immediately?
A) 1+ ankle edema
B) Blurred vision and headache
C) Braxton-Hicks contractions every 20 minutes
, D) Fetal heart rate of 140/min
Rationale: Blurred vision and headache are signs of preeclampsia/severe hypertension
and require immediate evaluation. Mild ankle edema is common. Braxton-Hicks are
irregular and painless. FHR of 140/min is normal (110–160 bpm).
Question 3: A nurse is calculating the estimated date of delivery for a client whose last
menstrual period began on April 1st. Using Naegele's rule, which of the following is the
estimated date of delivery?
A) January 8
B) January 15
C) February 8
D) February 15
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP, add 7 days,
and add 1 year. April 1st minus 3 months = January 1st; plus 7 days = January 8th of the
following year.
Question 4: A nurse is teaching a client who is at 12 weeks of gestation and has HIV.
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: Taking antiviral medication daily decreases the risk of transmission of HIV to
the newborn. Isolation is not required. HIV can be transmitted through breast milk, so
breastfeeding is not recommended.
, Question 5: 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
Rationale: Small, frequent meals prevent the stomach from becoming empty, which
exacerbates symptoms. Spicy foods may worsen nausea. Fluid avoidance risks
dehydration.
Intrapartum Care
Question 6: A client in active labor is dilated to 7 cm. The fetal heart rate shows late
decelerations. What is the priority nursing action?
A) Reposition the client to the left side
B) Administer oxygen via face mask
C) Prepare for immediate delivery
D) Increase IV fluid rate
Rationale: Late decelerations indicate uteroplacental insufficiency compromising fetal
oxygenation. The priority is maximizing oxygen delivery to the fetus by administering
100% oxygen via non-rebreather mask at 8–10 L/min.
Question 7: A nurse is caring for a client who is in the first stage of labor and has an
internal fetal scalp electrode. The nurse observes late decelerations 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
, 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.
Question 8: A nurse is caring for a client who is in active labor. The client reports lower
back pain. The nurse suspects this is related to a persistent occiput posterior fetal
position. Which nonpharmacological intervention should the nurse recommend?
A) Abdominal effleurage
B) Sacral counterpressure
C) Showering if not contraindicated
D) Back rub and massage
Rationale: Sacral counterpressure is specifically effective for the intense back pain
associated with occiput posterior positioning.
Question 9: A nurse is caring for a client following the administration of an epidural
block and is preparing to administer an IV fluid bolus. The client's partner asks about the
purpose of the IV fluid. Which is an appropriate response?
A) "It's needed to promote increased urinary output."
B) "It is needed to counteract respiratory depression."
C) "It is needed to counteract hypotension."
D) "It is needed to prevent oliguria."
Rationale: Epidural anesthesia causes sympathetic blockade leading to vasodilation and
hypotension. IV fluid bolus helps counteract this effect.
Question 10: A nurse is performing Leopold maneuvers prior to applying an external
fetal monitor. Which of the following is the purpose of this assessment?
A) To determine cervical dilation
Complete Package 2026 Version. 2023
Versions RN ATI Maternal Newborn
Proctored Exam
Antepartum Care
Question 1: A nurse is teaching a client who is at 8 weeks of gestation about common
discomforts of pregnancy. Which statement by the client indicates an understanding of
the teaching?
A) "Nausea and vomiting usually last throughout the entire pregnancy."
B) "I may have increased vaginal discharge that is clear or white."
C) "I should expect to have episodes of dizziness when lying on my back."
D) "Breast tenderness indicates a problem with my pregnancy."
Rationale: Leukorrhea (increased white/clear vaginal discharge) is common in
pregnancy due to increased estrogen levels. Nausea typically resolves by 12–14 weeks.
Supine hypotension occurs when lying flat. Breast tenderness is a normal early sign of
pregnancy, not a problem.
Question 2: A nurse is assessing a client at 36 weeks of gestation. Which finding should
the nurse report to the provider immediately?
A) 1+ ankle edema
B) Blurred vision and headache
C) Braxton-Hicks contractions every 20 minutes
, D) Fetal heart rate of 140/min
Rationale: Blurred vision and headache are signs of preeclampsia/severe hypertension
and require immediate evaluation. Mild ankle edema is common. Braxton-Hicks are
irregular and painless. FHR of 140/min is normal (110–160 bpm).
Question 3: A nurse is calculating the estimated date of delivery for a client whose last
menstrual period began on April 1st. Using Naegele's rule, which of the following is the
estimated date of delivery?
A) January 8
B) January 15
C) February 8
D) February 15
Rationale: Naegele's rule: subtract 3 months from the first day of the LMP, add 7 days,
and add 1 year. April 1st minus 3 months = January 1st; plus 7 days = January 8th of the
following year.
Question 4: A nurse is teaching a client who is at 12 weeks of gestation and has HIV.
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: Taking antiviral medication daily decreases the risk of transmission of HIV to
the newborn. Isolation is not required. HIV can be transmitted through breast milk, so
breastfeeding is not recommended.
, Question 5: 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
Rationale: Small, frequent meals prevent the stomach from becoming empty, which
exacerbates symptoms. Spicy foods may worsen nausea. Fluid avoidance risks
dehydration.
Intrapartum Care
Question 6: A client in active labor is dilated to 7 cm. The fetal heart rate shows late
decelerations. What is the priority nursing action?
A) Reposition the client to the left side
B) Administer oxygen via face mask
C) Prepare for immediate delivery
D) Increase IV fluid rate
Rationale: Late decelerations indicate uteroplacental insufficiency compromising fetal
oxygenation. The priority is maximizing oxygen delivery to the fetus by administering
100% oxygen via non-rebreather mask at 8–10 L/min.
Question 7: A nurse is caring for a client who is in the first stage of labor and has an
internal fetal scalp electrode. The nurse observes late decelerations 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
, 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.
Question 8: A nurse is caring for a client who is in active labor. The client reports lower
back pain. The nurse suspects this is related to a persistent occiput posterior fetal
position. Which nonpharmacological intervention should the nurse recommend?
A) Abdominal effleurage
B) Sacral counterpressure
C) Showering if not contraindicated
D) Back rub and massage
Rationale: Sacral counterpressure is specifically effective for the intense back pain
associated with occiput posterior positioning.
Question 9: A nurse is caring for a client following the administration of an epidural
block and is preparing to administer an IV fluid bolus. The client's partner asks about the
purpose of the IV fluid. Which is an appropriate response?
A) "It's needed to promote increased urinary output."
B) "It is needed to counteract respiratory depression."
C) "It is needed to counteract hypotension."
D) "It is needed to prevent oliguria."
Rationale: Epidural anesthesia causes sympathetic blockade leading to vasodilation and
hypotension. IV fluid bolus helps counteract this effect.
Question 10: A nurse is performing Leopold maneuvers prior to applying an external
fetal monitor. Which of the following is the purpose of this assessment?
A) To determine cervical dilation
