ATI MATERNAL PROCTORED EXAM LATEST 2026/2027
Maternal-Newborn Nursing (ATI Proctored Focus) | Key Domains: Antepartum Care &
Complications, Intrapartum Care & Pain Management, Postpartum Care & Complications, Newborn
Assessment & Immediate Care, Newborn Nutrition & Common Disorders, and Family Education &
Health Promotion | Expert-Aligned Structure | Proctored Exam Format
Introduction
This structured ATI Maternal Proctored Exam for 2026/2027 provides a comprehensive set of
exam-style questions with correct answers and rationales. It is designed to simulate the rigor and
content of the ATI Maternal Newborn proctored exam, emphasizing critical thinking, prioritization,
and the application of evidence-based maternity nursing principles.
Exam Structure:
• Proctored Exam Simulation: (70 COMPLEX SCENARIO QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the underlying pathophysiology of a maternal/newborn complication, the priority
nursing action based on assessment data (e.g., abnormal fetal heart rate pattern, signs of
postpartum hemorrhage), the correct interpretation of diagnostic findings, the key patient
education point, and why alternative options are incorrect, contraindicated, or not the highest
priority according to ATI standards.
1. A client at 32 weeks of gestation reports sudden, severe abdominal pain and vaginal bleeding.
The nurse notes a rigid, board-like abdomen. What is the priority nursing action?
A. Administer IV fluids
B. Prepare for immediate cesarean delivery
C. Assess fetal heart rate and maternal vital signs
, D. Perform a vaginal examination
C. Assess fetal heart rate and maternal vital signs
These findings suggest placental abruption. The priority is rapid assessment of maternal
hemodynamic stability and fetal well-being before interventions. Vaginal exam (D) is
contraindicated until placenta previa is ruled out. While cesarean (B) may be needed, assessment
comes first per ATI prioritization.
2. During labor, a client’s fetal heart rate tracing shows late decelerations with minimal variability.
What is the most appropriate initial nursing intervention?
A. Administer oxygen via non-rebreather mask
B. Reposition the client to left lateral position
C. Increase IV fluid rate
D. Notify the provider immediately
B. Reposition the client to left lateral position
Late decelerations indicate uteroplacental insufficiency. Left lateral position improves placental
perfusion and is the first corrective action per ATI guidelines. Oxygen (A) and fluids (C) may follow.
Notification (D) is necessary but after initiating corrective measures.
3. A postpartum client 2 hours after vaginal delivery has a boggy uterus deviated to the right and
moderate lochia rubra. What should the nurse do first?
A. Massage the fundus
B. Assist the client to void
C. Administer methylergonovine
D. Increase IV oxytocin
B. Assist the client to void
, A deviated, boggy fundus suggests a full bladder displacing the uterus, impairing contraction.
Bladder emptying is the first step before uterine massage or medications. Massaging over a full
bladder can cause uterine inversion, which is contraindicated.
4. A newborn delivered at 38 weeks weighs 2,200 g (4 lb 13 oz). The nurse identifies this as:
A. Appropriate for gestational age (AGA)
B. Small for gestational age (SGA)
C. Large for gestational age (LGA)
D. Preterm
B. Small for gestational age (SGA)
At 38 weeks, average birth weight is ~3,200–3,400 g. A weight <10th percentile (~2,700 g) is SGA.
The infant is term (not D) but growth-restricted, requiring monitoring for hypoglycemia and
polycythemia.
5. A client in active labor requests epidural analgesia. Before administration, the nurse should
ensure:
A. The client has signed informed consent
B. IV access is established and fluid bolus given
C. Fetal heart rate is reassuring
D. All of the above
D. All of the above
Epidural requires informed consent (A), IV access with 500–1000 mL fluid bolus to prevent
hypotension (B), and reassuring fetal status (C) to avoid masking distress. ATI emphasizes all three
safety steps prior to procedure.
6. A newborn exhibits jitteriness, poor feeding, and a blood glucose of 30 mg/dL at 2 hours of life.
What is the priority action?
Maternal-Newborn Nursing (ATI Proctored Focus) | Key Domains: Antepartum Care &
Complications, Intrapartum Care & Pain Management, Postpartum Care & Complications, Newborn
Assessment & Immediate Care, Newborn Nutrition & Common Disorders, and Family Education &
Health Promotion | Expert-Aligned Structure | Proctored Exam Format
Introduction
This structured ATI Maternal Proctored Exam for 2026/2027 provides a comprehensive set of
exam-style questions with correct answers and rationales. It is designed to simulate the rigor and
content of the ATI Maternal Newborn proctored exam, emphasizing critical thinking, prioritization,
and the application of evidence-based maternity nursing principles.
Exam Structure:
• Proctored Exam Simulation: (70 COMPLEX SCENARIO QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the underlying pathophysiology of a maternal/newborn complication, the priority
nursing action based on assessment data (e.g., abnormal fetal heart rate pattern, signs of
postpartum hemorrhage), the correct interpretation of diagnostic findings, the key patient
education point, and why alternative options are incorrect, contraindicated, or not the highest
priority according to ATI standards.
1. A client at 32 weeks of gestation reports sudden, severe abdominal pain and vaginal bleeding.
The nurse notes a rigid, board-like abdomen. What is the priority nursing action?
A. Administer IV fluids
B. Prepare for immediate cesarean delivery
C. Assess fetal heart rate and maternal vital signs
, D. Perform a vaginal examination
C. Assess fetal heart rate and maternal vital signs
These findings suggest placental abruption. The priority is rapid assessment of maternal
hemodynamic stability and fetal well-being before interventions. Vaginal exam (D) is
contraindicated until placenta previa is ruled out. While cesarean (B) may be needed, assessment
comes first per ATI prioritization.
2. During labor, a client’s fetal heart rate tracing shows late decelerations with minimal variability.
What is the most appropriate initial nursing intervention?
A. Administer oxygen via non-rebreather mask
B. Reposition the client to left lateral position
C. Increase IV fluid rate
D. Notify the provider immediately
B. Reposition the client to left lateral position
Late decelerations indicate uteroplacental insufficiency. Left lateral position improves placental
perfusion and is the first corrective action per ATI guidelines. Oxygen (A) and fluids (C) may follow.
Notification (D) is necessary but after initiating corrective measures.
3. A postpartum client 2 hours after vaginal delivery has a boggy uterus deviated to the right and
moderate lochia rubra. What should the nurse do first?
A. Massage the fundus
B. Assist the client to void
C. Administer methylergonovine
D. Increase IV oxytocin
B. Assist the client to void
, A deviated, boggy fundus suggests a full bladder displacing the uterus, impairing contraction.
Bladder emptying is the first step before uterine massage or medications. Massaging over a full
bladder can cause uterine inversion, which is contraindicated.
4. A newborn delivered at 38 weeks weighs 2,200 g (4 lb 13 oz). The nurse identifies this as:
A. Appropriate for gestational age (AGA)
B. Small for gestational age (SGA)
C. Large for gestational age (LGA)
D. Preterm
B. Small for gestational age (SGA)
At 38 weeks, average birth weight is ~3,200–3,400 g. A weight <10th percentile (~2,700 g) is SGA.
The infant is term (not D) but growth-restricted, requiring monitoring for hypoglycemia and
polycythemia.
5. A client in active labor requests epidural analgesia. Before administration, the nurse should
ensure:
A. The client has signed informed consent
B. IV access is established and fluid bolus given
C. Fetal heart rate is reassuring
D. All of the above
D. All of the above
Epidural requires informed consent (A), IV access with 500–1000 mL fluid bolus to prevent
hypotension (B), and reassuring fetal status (C) to avoid masking distress. ATI emphasizes all three
safety steps prior to procedure.
6. A newborn exhibits jitteriness, poor feeding, and a blood glucose of 30 mg/dL at 2 hours of life.
What is the priority action?
