ATI Maternal Newborn Proctored Exam V3
| 2026 Q&A with Rationale (ATI Maternal
Newborn Proctored Exam 2026)
1. A nurse is assessing a client who is at 34 weeks of gestation and is receiving magnesium
sulfate for preeclampsia. Which of the following findings 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
Rationale: A urine output of less than 30 mL/hr is a sign of magnesium toxicity as the
medication is excreted by the kidneys. Deep tendon reflexes of 2+ and a respiratory rate of
14/min are within normal limits for a client receiving this medication. A magnesium level
of 6 mEq/L is within the therapeutic range for seizure prophylaxis in preeclampsia.
2. 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 of the following
actions 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
Rationale: According to the nursing process, the nurse should first implement the least
invasive intervention to improve placental perfusion. Changing the client’s position to a
side-lying position helps alleviate pressure on the vena cava and improves blood flow to
the placenta. While oxygen administration and IV fluids are appropriate later steps,
repositioning is the immediate priority.
3. A nurse is providing discharge teaching to a client who is postpartum and has a prescription
for a rubella immunization. Which of the following instructions 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
Rationale: The rubella vaccine is a live virus and is teratogenic, meaning it can cause birth
defects if the client becomes pregnant shortly after receiving it. Clients are advised to avoid
pregnancy for at least 4 weeks (28 days) post-vaccination. Breastfeeding is not
,contraindicated with the rubella vaccine, and a repeat dose is generally not required unless
the client remains non-immune.
4. A nurse is assessing a newborn 1 hour after birth. Which of the following findings should
the nurse identify as a manifestation of 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 respiratory
distress in a newborn and indicate the infant is working harder to breathe. Acrocyanosis
(bluish hands and feet) is a normal finding in the first 24 to 48 hours of life due to
peripheral circulation adjustments. A respiratory rate of 50/min and abdominal breathing
are normal findings for a healthy newborn.
5. A nurse is caring for a client who is at 38 weeks of gestation and reports abdominal pain
and vaginal bleeding. Which of the following assessments 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
Rationale: In the event of suspected abruptio placentae or placenta previa, assessing fetal
well-being is the primary concern to determine if immediate delivery is necessary.
Checking maternal vitals and bleeding amounts are important but follow the assessment of
fetal heart tones. Vaginal examinations are contraindicated in the presence of unexplained
vaginal bleeding until placenta previa is ruled out.
6. A nurse is providing teaching about physiological changes during pregnancy to a client who
is at 10 weeks of gestation. Which of the following statements by the client indicates an
understanding of the teaching?
A. I will likely experience more frequent urination during this trimester.
B. It is normal to have a small amount of vaginal bleeding after intercourse.
C. I should expect to feel the baby move by next week.
D. My breasts will become less sensitive as the pregnancy progresses.
Correct Answer: A
Rationale: Frequent urination is a common symptom in the first trimester due to the
enlarging uterus placing pressure on the bladder. Quickening, or feeling the baby move,
| 2026 Q&A with Rationale (ATI Maternal
Newborn Proctored Exam 2026)
1. A nurse is assessing a client who is at 34 weeks of gestation and is receiving magnesium
sulfate for preeclampsia. Which of the following findings 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
Rationale: A urine output of less than 30 mL/hr is a sign of magnesium toxicity as the
medication is excreted by the kidneys. Deep tendon reflexes of 2+ and a respiratory rate of
14/min are within normal limits for a client receiving this medication. A magnesium level
of 6 mEq/L is within the therapeutic range for seizure prophylaxis in preeclampsia.
2. 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 of the following
actions 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
Rationale: According to the nursing process, the nurse should first implement the least
invasive intervention to improve placental perfusion. Changing the client’s position to a
side-lying position helps alleviate pressure on the vena cava and improves blood flow to
the placenta. While oxygen administration and IV fluids are appropriate later steps,
repositioning is the immediate priority.
3. A nurse is providing discharge teaching to a client who is postpartum and has a prescription
for a rubella immunization. Which of the following instructions 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
Rationale: The rubella vaccine is a live virus and is teratogenic, meaning it can cause birth
defects if the client becomes pregnant shortly after receiving it. Clients are advised to avoid
pregnancy for at least 4 weeks (28 days) post-vaccination. Breastfeeding is not
,contraindicated with the rubella vaccine, and a repeat dose is generally not required unless
the client remains non-immune.
4. A nurse is assessing a newborn 1 hour after birth. Which of the following findings should
the nurse identify as a manifestation of 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 respiratory
distress in a newborn and indicate the infant is working harder to breathe. Acrocyanosis
(bluish hands and feet) is a normal finding in the first 24 to 48 hours of life due to
peripheral circulation adjustments. A respiratory rate of 50/min and abdominal breathing
are normal findings for a healthy newborn.
5. A nurse is caring for a client who is at 38 weeks of gestation and reports abdominal pain
and vaginal bleeding. Which of the following assessments 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
Rationale: In the event of suspected abruptio placentae or placenta previa, assessing fetal
well-being is the primary concern to determine if immediate delivery is necessary.
Checking maternal vitals and bleeding amounts are important but follow the assessment of
fetal heart tones. Vaginal examinations are contraindicated in the presence of unexplained
vaginal bleeding until placenta previa is ruled out.
6. A nurse is providing teaching about physiological changes during pregnancy to a client who
is at 10 weeks of gestation. Which of the following statements by the client indicates an
understanding of the teaching?
A. I will likely experience more frequent urination during this trimester.
B. It is normal to have a small amount of vaginal bleeding after intercourse.
C. I should expect to feel the baby move by next week.
D. My breasts will become less sensitive as the pregnancy progresses.
Correct Answer: A
Rationale: Frequent urination is a common symptom in the first trimester due to the
enlarging uterus placing pressure on the bladder. Quickening, or feeling the baby move,
