1
ATI RN Maternal Newborn
Proctored Exam 2025 –
Forms A | Updated Questions
with Rationales & 100%
Verified Answers
Form A: ATI RN Maternal Newborn Proctored Exam 2025
Fetal Monitoring
1. A nurse is assessing a fetal heart rate (FHR) tracing. Which finding indicates a
category I (normal) tracing?
a) FHR baseline of 180 bpm
b) Early decelerations with contractions
c) Absent variability with late decelerations
d) Variable decelerations with no recovery
Answer: b) Early decelerations with contractions
Rationale: A category I FHR tracing is normal, with a baseline of 110–160 bpm,
moderate variability, and no late or variable decelerations. Early decelerations, caused by
fetal head compression, are benign and expected during contractions.
2. A nurse observes variable decelerations on an FHR monitor. What is the priority
action?
a) Administer oxygen at 2 L/min
b) Reposition the client to her left side
c) Prepare for an emergency cesarean section
d) Increase the IV fluid rate
Answer: b) Reposition the client to her left side
Rationale: Variable decelerations indicate umbilical cord compression. Repositioning the
client to the left side relieves pressure on the cord, improving fetal oxygenation. Oxygen,
fluids, or surgery may be needed if repositioning fails.
3. Which FHR pattern is associated with uteroplacental insufficiency?
a) Early decelerations
b) Late decelerations
c) Variable decelerations
, 2
d) Accelerations
Answer: b) Late decelerations
Rationale: Late decelerations occur when FHR decreases after the peak of a contraction
and recovers after it ends, indicating reduced placental blood flow and fetal hypoxia.
Early decelerations reflect head compression, variable decelerations indicate cord
compression, and accelerations are normal.
4. A nurse is preparing to apply an external fetal monitor. What is the first step?
a) Calibrate the tocodynamometer
b) Palpate the fundus to locate the fetal back
c) Apply conductive gel to the client’s abdomen
d) Secure the ultrasound transducer
Answer: b) Palpate the fundus to locate the fetal back
Rationale: Palpating the fundus determines the fetal lie and position, ensuring the
ultrasound transducer is placed over the fetal back for accurate FHR monitoring. Other
steps follow.
5. A client at 38 weeks gestation has a positive contraction stress test. What does this
indicate?
a) Normal fetal response
b) Fetal distress with contractions
c) Inadequate cervical ripening
d) Preterm labor risk
Answer: b) Fetal distress with contractions
Rationale: A positive contraction stress test shows late decelerations with contractions,
indicating fetal intolerance to stress and possible uteroplacental insufficiency, requiring
further evaluation.
6. What is the normal FHR baseline range for a term fetus?
a) 90–130 bpm
b) 110–160 bpm
c) 160–200 bpm
d) 80–120 bpm
Answer: b) 110–160 bpm
Rationale: The normal FHR baseline for a term fetus is 110–160 bpm, reflecting a
healthy autonomic nervous system. Deviations suggest hypoxia or other complications.
7. A nurse notes a sinusoidal FHR pattern. What is the most likely cause?
a) Fetal head compression
b) Umbilical cord compression
c) Fetal anemia
d) Maternal hypertension
Answer: c) Fetal anemia
Rationale: A sinusoidal pattern, characterized by a smooth, wave-like FHR, is associated
with severe fetal anemia, often due to isoimmunization or hemorrhage, and requires
urgent intervention.
8. When monitoring FHR, which finding requires immediate provider notification?
a) Accelerations with fetal movement
b) Moderate variability
c) Prolonged decelerations lasting 3 minutes
, 3
d) Baseline FHR of 140 bpm
Answer: c) Prolonged decelerations lasting 3 minutes
Rationale: Prolonged decelerations (>2 minutes) indicate severe fetal hypoxia, requiring
immediate action to restore oxygenation, such as repositioning, oxygen administration, or
delivery.
9. A nurse is teaching a client about nonstress testing. What indicates a reactive result?
a) No FHR accelerations in 20 minutes
b) Two FHR accelerations of 15 bpm lasting 15 seconds in 20 minutes
c) FHR baseline of 180 bpm
d) Late decelerations with movement
Answer: b) Two FHR accelerations of 15 bpm lasting 15 seconds in 20 minutes
Rationale: A reactive nonstress test indicates fetal well-being, defined as at least two
accelerations of 15 bpm lasting 15 seconds within 20 minutes, associated with fetal
movement.
10. What is the purpose of a tocodynamometer during labor?
a) Monitor fetal heart rate
b) Assess cervical dilation
c) Measure uterine contraction strength and frequency
d) Detect fetal movement
Answer: c) Measure uterine contraction strength and frequency
Rationale: The tocodynamometer measures the frequency, duration, and intensity of
uterine contractions, aiding in labor progression assessment. FHR is monitored by
ultrasound transducers.
Labor Stages
11. A client is in the first stage of labor with contractions 5 minutes apart lasting 60
seconds. What is the nurse’s priority assessment?
a) Fetal heart rate
b) Maternal blood pressure
c) Cervical dilation
d) Pain level
Answer: a) Fetal heart rate
Rationale: Fetal heart rate is the priority to assess fetal well-being during labor.
Contractions may reduce placental perfusion, and FHR monitoring detects distress early.
12. A client is in the second stage of labor and reports an urge to push. What is the
nurse’s priority action?
a) Check cervical dilation
b) Administer an analgesic
c) Encourage pushing with contractions
d) Notify the provider
Answer: a) Check cervical dilation
Rationale: The urge to push typically indicates full cervical dilation (10 cm), signaling
ATI RN Maternal Newborn
Proctored Exam 2025 –
Forms A | Updated Questions
with Rationales & 100%
Verified Answers
Form A: ATI RN Maternal Newborn Proctored Exam 2025
Fetal Monitoring
1. A nurse is assessing a fetal heart rate (FHR) tracing. Which finding indicates a
category I (normal) tracing?
a) FHR baseline of 180 bpm
b) Early decelerations with contractions
c) Absent variability with late decelerations
d) Variable decelerations with no recovery
Answer: b) Early decelerations with contractions
Rationale: A category I FHR tracing is normal, with a baseline of 110–160 bpm,
moderate variability, and no late or variable decelerations. Early decelerations, caused by
fetal head compression, are benign and expected during contractions.
2. A nurse observes variable decelerations on an FHR monitor. What is the priority
action?
a) Administer oxygen at 2 L/min
b) Reposition the client to her left side
c) Prepare for an emergency cesarean section
d) Increase the IV fluid rate
Answer: b) Reposition the client to her left side
Rationale: Variable decelerations indicate umbilical cord compression. Repositioning the
client to the left side relieves pressure on the cord, improving fetal oxygenation. Oxygen,
fluids, or surgery may be needed if repositioning fails.
3. Which FHR pattern is associated with uteroplacental insufficiency?
a) Early decelerations
b) Late decelerations
c) Variable decelerations
, 2
d) Accelerations
Answer: b) Late decelerations
Rationale: Late decelerations occur when FHR decreases after the peak of a contraction
and recovers after it ends, indicating reduced placental blood flow and fetal hypoxia.
Early decelerations reflect head compression, variable decelerations indicate cord
compression, and accelerations are normal.
4. A nurse is preparing to apply an external fetal monitor. What is the first step?
a) Calibrate the tocodynamometer
b) Palpate the fundus to locate the fetal back
c) Apply conductive gel to the client’s abdomen
d) Secure the ultrasound transducer
Answer: b) Palpate the fundus to locate the fetal back
Rationale: Palpating the fundus determines the fetal lie and position, ensuring the
ultrasound transducer is placed over the fetal back for accurate FHR monitoring. Other
steps follow.
5. A client at 38 weeks gestation has a positive contraction stress test. What does this
indicate?
a) Normal fetal response
b) Fetal distress with contractions
c) Inadequate cervical ripening
d) Preterm labor risk
Answer: b) Fetal distress with contractions
Rationale: A positive contraction stress test shows late decelerations with contractions,
indicating fetal intolerance to stress and possible uteroplacental insufficiency, requiring
further evaluation.
6. What is the normal FHR baseline range for a term fetus?
a) 90–130 bpm
b) 110–160 bpm
c) 160–200 bpm
d) 80–120 bpm
Answer: b) 110–160 bpm
Rationale: The normal FHR baseline for a term fetus is 110–160 bpm, reflecting a
healthy autonomic nervous system. Deviations suggest hypoxia or other complications.
7. A nurse notes a sinusoidal FHR pattern. What is the most likely cause?
a) Fetal head compression
b) Umbilical cord compression
c) Fetal anemia
d) Maternal hypertension
Answer: c) Fetal anemia
Rationale: A sinusoidal pattern, characterized by a smooth, wave-like FHR, is associated
with severe fetal anemia, often due to isoimmunization or hemorrhage, and requires
urgent intervention.
8. When monitoring FHR, which finding requires immediate provider notification?
a) Accelerations with fetal movement
b) Moderate variability
c) Prolonged decelerations lasting 3 minutes
, 3
d) Baseline FHR of 140 bpm
Answer: c) Prolonged decelerations lasting 3 minutes
Rationale: Prolonged decelerations (>2 minutes) indicate severe fetal hypoxia, requiring
immediate action to restore oxygenation, such as repositioning, oxygen administration, or
delivery.
9. A nurse is teaching a client about nonstress testing. What indicates a reactive result?
a) No FHR accelerations in 20 minutes
b) Two FHR accelerations of 15 bpm lasting 15 seconds in 20 minutes
c) FHR baseline of 180 bpm
d) Late decelerations with movement
Answer: b) Two FHR accelerations of 15 bpm lasting 15 seconds in 20 minutes
Rationale: A reactive nonstress test indicates fetal well-being, defined as at least two
accelerations of 15 bpm lasting 15 seconds within 20 minutes, associated with fetal
movement.
10. What is the purpose of a tocodynamometer during labor?
a) Monitor fetal heart rate
b) Assess cervical dilation
c) Measure uterine contraction strength and frequency
d) Detect fetal movement
Answer: c) Measure uterine contraction strength and frequency
Rationale: The tocodynamometer measures the frequency, duration, and intensity of
uterine contractions, aiding in labor progression assessment. FHR is monitored by
ultrasound transducers.
Labor Stages
11. A client is in the first stage of labor with contractions 5 minutes apart lasting 60
seconds. What is the nurse’s priority assessment?
a) Fetal heart rate
b) Maternal blood pressure
c) Cervical dilation
d) Pain level
Answer: a) Fetal heart rate
Rationale: Fetal heart rate is the priority to assess fetal well-being during labor.
Contractions may reduce placental perfusion, and FHR monitoring detects distress early.
12. A client is in the second stage of labor and reports an urge to push. What is the
nurse’s priority action?
a) Check cervical dilation
b) Administer an analgesic
c) Encourage pushing with contractions
d) Notify the provider
Answer: a) Check cervical dilation
Rationale: The urge to push typically indicates full cervical dilation (10 cm), signaling
