ATI RN Maternal-Newborn Proctored Exam 2026–2027 | Practice
Test Questions & Answers | Complete Study Guide
Prepare for the ATI RN Maternal-Newborn Proctored Exam with this comprehensive study
guide featuring practice questions, verified answers, and detailed rationales. This resource covers
essential maternal-newborn nursing concepts including antepartum care, labor and delivery,
postpartum management, newborn assessment, high-risk pregnancy complications, fetal
monitoring, breastfeeding, and patient education. Designed to reinforce critical clinical
knowledge and improve exam readiness, the material reflects the key content areas commonly
assessed on the ATI RN Maternal-Newborn Proctored Examination. Ideal for nursing students
seeking a reliable resource to strengthen their understanding, build confidence, and achieve
success on exam day.
Section 1: Antepartum Care and Fetal Development
1. A nurse is assessing a pregnant client at 12 weeks of gestation. Which of the
following findings should the nurse report to the provider immediately?
A. Persistent leukorrhea that is thin and white.
B. Unilateral lower quadrant abdominal pain with spotting.
C. Urinary frequency without painful urination.
D. Fatigue and nausea in the early morning.
B. Unilateral lower quadrant abdominal pain with spotting.
Rationale: Unilateral lower quadrant abdominal pain accompanied by spotting in the first
trimester is a classic sign of an ectopic pregnancy. This is a medical emergency due to
the risk of tubal rupture and hemorrhage. Leukorrhea, urinary frequency, and morning
sickness are expected presumptive signs of early pregnancy.
2. A nurse is reviewing the prenatal chart of a client who is at 16 weeks of gestation
and has an elevated maternal serum alpha-fetoprotein (MSAFP) level. The nurse
should understand that this test screens for which of the following conditions?
A. Gestational diabetes mellitus.
B. Neural tube defects.
C. Down syndrome.
D. Fetal hemolytic disease.
B. Neural tube defects.
Rationale: High levels of maternal serum alpha-fetoprotein (MSAFP) at 16 to 18 weeks
of gestation are strongly associated with open neural tube defects, such as spina bifida
or anencephaly. Low MSAFP levels are conversely associated with Down syndrome
(Trisomy 21).
, 3. A nurse is teaching a client who is at 20 weeks of gestation about a scheduled
nonstress test (NST). Which of the following statements should the nurse include
in the teaching?
A. "You will need to remain completely fasting for 6 hours prior to the test."
B. "The test will evaluate the baby's heart rate acceleration in response to fetal
movement."
C. "A medication called oxytocin will be given to cause mild contractions."
D. "The test requires a small sample of fluid taken from your amniotic sac."
B. "The test will evaluate the baby's heart rate acceleration in response to fetal
movement."
Rationale: A nonstress test (NST) monitors the response of the fetal heart rate to fetal
movement. A reactive (normal) NST requires at least two fetal heart rate accelerations
of at least 15 beats per minute above baseline, lasting for at least 15 seconds, within a
20-minute monitoring window.
4. A nurse is assessing a client using Naegele's rule to calculate the estimated date
of delivery (EDD). The client reports that her last menstrual period (LMP) began
on November 8, 2025. Which of the following dates is the correct EDD?
A. August 15, 2026
B. August 11, 2026
C. August 1, 2026
D. July 15, 2026
A. August 15, 2026
Rationale: According to Naegele's rule, the estimated date of delivery is calculated by
taking the first day of the last menstrual period (November 8, 2025), subtracting 3
calendar months (August 8), and adding 7 days (August 15), then adjusting the year if
necessary.
5. A nurse is caring for a client who is pregnant and has a prescription for an iron
supplement. Which of the following dietary instructions should the nurse provide
to optimize absorption?
A. "Take the iron supplement with a glass of whole milk."
B. "Drink a glass of orange juice when taking your iron pill."
C. "Take the supplement directly with your morning coffee."
D. "Avoid taking vitamin C during iron therapy."
B. "Drink a glass of orange juice when taking your iron pill."
,Rationale: Vitamin C (ascorbic acid) significantly enhances the gastrointestinal
absorption of non-heme iron. Calcium in milk and polyphenols/tannins in coffee or tea
inhibit iron absorption and should be avoided at the time of administration.
6. A nurse is recording obstetric history using the GTPAL system. The client has
one living child born at 39 weeks, twins born at 34 weeks, and had one
miscarriage at 10 weeks. She is currently pregnant. What is her GTPAL?
A. G4, T1, P1, A1, L3
B. G3, T2, P1, A1, L2
C. G4, T2, P2, A1, L3
D. G3, T1, P2, A0, L3
A. G4, T1, P1, A1, L3
Rationale: Gravida (G) is 4 (current pregnancy, miscarriage, twins, full-term child). Term
(T) is 1 (the child born at 39 weeks). Preterm (P) is 1 (the twin delivery at 34 weeks
counts as one preterm event). Abortion (A) is 1 (the miscarriage at 10 weeks). Living (L)
is 3 (the full-term child plus the two twins).
7. A nurse is performing an assessment on a client at 28 weeks of gestation. The
nurse measures the fundal height in centimeters. Which of the following
measurements is expected for this gestational age?
A. 22 cm
B. 28 cm
C. 34 cm
D. 40 cm
B. 28 cm
Rationale: From 18 to 32 weeks of gestation, the fundal height measured in centimeters
from the symphysis pubis to the top of the uterine fundus should approximately equal
the number of weeks of gestation, plus or minus 2 cm.
8. A nurse is teaching a client about performing fetal movement counts (kick
counts) during the third trimester. Which of the following instructions should the
nurse give?
A. "Count the movements once every three days in the morning."
B. "Notify your provider immediately if you count fewer than 10 movements within
2 hours."
C. "Expect the baby to move continuously without pausing for sleep."
D. "Lie flat on your back while counting fetal movements."
B. "Notify your provider immediately if you count fewer than 10 movements within
2 hours."
, Rationale: A reduction in fetal movement is a warning sign of potential fetal
compromise. Clients should be instructed to sit or lie on their side and count
movements. Fewer than 10 movements in a 2-hour window warrants further clinical
evaluation, such as an NST.
9. A nurse is assessing a pregnant client at 8 weeks of gestation and observes a
bluish-purple discoloration of the cervix and vaginal mucosa. The nurse should
document this finding as which of the following signs?
A. Goodell's sign
B. Hegar's sign
C. Chadwick's sign
D. Ballottement
C. Chadwick's sign
Rationale: Chadwick's sign is a bluish-purple discoloration of the mucosa of the cervix
and vagina caused by increased vascularity during pregnancy. Goodell's sign is the
softening of the cervical tip, and Hegar's sign is the softening of the lower uterine
segment.
10. A nurse is caring for a client who is at 35 weeks of gestation and is scheduled for
a Group B Streptococcus (GBS) screening. Which of the following actions should
the nurse anticipate?
A. Collecting a clean-catch urine specimen.
B. Obtaining a blood sample via venipuncture.
C. Obtaining a vaginal and rectal swab from the client.
D. Performing an ultrasound of the fetal kidneys.
C. Obtaining a vaginal and rectal swab from the client.
Rationale: Screening for Group B Streptococcus (GBS) is recommended for all
pregnant clients between 35 and 37 weeks of gestation. It involves collecting a swab
from the lower vagina and rectum to determine the need for intrapartum prophylactic
antibiotics.
Section 2: Antepartum Complications
Test Questions & Answers | Complete Study Guide
Prepare for the ATI RN Maternal-Newborn Proctored Exam with this comprehensive study
guide featuring practice questions, verified answers, and detailed rationales. This resource covers
essential maternal-newborn nursing concepts including antepartum care, labor and delivery,
postpartum management, newborn assessment, high-risk pregnancy complications, fetal
monitoring, breastfeeding, and patient education. Designed to reinforce critical clinical
knowledge and improve exam readiness, the material reflects the key content areas commonly
assessed on the ATI RN Maternal-Newborn Proctored Examination. Ideal for nursing students
seeking a reliable resource to strengthen their understanding, build confidence, and achieve
success on exam day.
Section 1: Antepartum Care and Fetal Development
1. A nurse is assessing a pregnant client at 12 weeks of gestation. Which of the
following findings should the nurse report to the provider immediately?
A. Persistent leukorrhea that is thin and white.
B. Unilateral lower quadrant abdominal pain with spotting.
C. Urinary frequency without painful urination.
D. Fatigue and nausea in the early morning.
B. Unilateral lower quadrant abdominal pain with spotting.
Rationale: Unilateral lower quadrant abdominal pain accompanied by spotting in the first
trimester is a classic sign of an ectopic pregnancy. This is a medical emergency due to
the risk of tubal rupture and hemorrhage. Leukorrhea, urinary frequency, and morning
sickness are expected presumptive signs of early pregnancy.
2. A nurse is reviewing the prenatal chart of a client who is at 16 weeks of gestation
and has an elevated maternal serum alpha-fetoprotein (MSAFP) level. The nurse
should understand that this test screens for which of the following conditions?
A. Gestational diabetes mellitus.
B. Neural tube defects.
C. Down syndrome.
D. Fetal hemolytic disease.
B. Neural tube defects.
Rationale: High levels of maternal serum alpha-fetoprotein (MSAFP) at 16 to 18 weeks
of gestation are strongly associated with open neural tube defects, such as spina bifida
or anencephaly. Low MSAFP levels are conversely associated with Down syndrome
(Trisomy 21).
, 3. A nurse is teaching a client who is at 20 weeks of gestation about a scheduled
nonstress test (NST). Which of the following statements should the nurse include
in the teaching?
A. "You will need to remain completely fasting for 6 hours prior to the test."
B. "The test will evaluate the baby's heart rate acceleration in response to fetal
movement."
C. "A medication called oxytocin will be given to cause mild contractions."
D. "The test requires a small sample of fluid taken from your amniotic sac."
B. "The test will evaluate the baby's heart rate acceleration in response to fetal
movement."
Rationale: A nonstress test (NST) monitors the response of the fetal heart rate to fetal
movement. A reactive (normal) NST requires at least two fetal heart rate accelerations
of at least 15 beats per minute above baseline, lasting for at least 15 seconds, within a
20-minute monitoring window.
4. A nurse is assessing a client using Naegele's rule to calculate the estimated date
of delivery (EDD). The client reports that her last menstrual period (LMP) began
on November 8, 2025. Which of the following dates is the correct EDD?
A. August 15, 2026
B. August 11, 2026
C. August 1, 2026
D. July 15, 2026
A. August 15, 2026
Rationale: According to Naegele's rule, the estimated date of delivery is calculated by
taking the first day of the last menstrual period (November 8, 2025), subtracting 3
calendar months (August 8), and adding 7 days (August 15), then adjusting the year if
necessary.
5. A nurse is caring for a client who is pregnant and has a prescription for an iron
supplement. Which of the following dietary instructions should the nurse provide
to optimize absorption?
A. "Take the iron supplement with a glass of whole milk."
B. "Drink a glass of orange juice when taking your iron pill."
C. "Take the supplement directly with your morning coffee."
D. "Avoid taking vitamin C during iron therapy."
B. "Drink a glass of orange juice when taking your iron pill."
,Rationale: Vitamin C (ascorbic acid) significantly enhances the gastrointestinal
absorption of non-heme iron. Calcium in milk and polyphenols/tannins in coffee or tea
inhibit iron absorption and should be avoided at the time of administration.
6. A nurse is recording obstetric history using the GTPAL system. The client has
one living child born at 39 weeks, twins born at 34 weeks, and had one
miscarriage at 10 weeks. She is currently pregnant. What is her GTPAL?
A. G4, T1, P1, A1, L3
B. G3, T2, P1, A1, L2
C. G4, T2, P2, A1, L3
D. G3, T1, P2, A0, L3
A. G4, T1, P1, A1, L3
Rationale: Gravida (G) is 4 (current pregnancy, miscarriage, twins, full-term child). Term
(T) is 1 (the child born at 39 weeks). Preterm (P) is 1 (the twin delivery at 34 weeks
counts as one preterm event). Abortion (A) is 1 (the miscarriage at 10 weeks). Living (L)
is 3 (the full-term child plus the two twins).
7. A nurse is performing an assessment on a client at 28 weeks of gestation. The
nurse measures the fundal height in centimeters. Which of the following
measurements is expected for this gestational age?
A. 22 cm
B. 28 cm
C. 34 cm
D. 40 cm
B. 28 cm
Rationale: From 18 to 32 weeks of gestation, the fundal height measured in centimeters
from the symphysis pubis to the top of the uterine fundus should approximately equal
the number of weeks of gestation, plus or minus 2 cm.
8. A nurse is teaching a client about performing fetal movement counts (kick
counts) during the third trimester. Which of the following instructions should the
nurse give?
A. "Count the movements once every three days in the morning."
B. "Notify your provider immediately if you count fewer than 10 movements within
2 hours."
C. "Expect the baby to move continuously without pausing for sleep."
D. "Lie flat on your back while counting fetal movements."
B. "Notify your provider immediately if you count fewer than 10 movements within
2 hours."
, Rationale: A reduction in fetal movement is a warning sign of potential fetal
compromise. Clients should be instructed to sit or lie on their side and count
movements. Fewer than 10 movements in a 2-hour window warrants further clinical
evaluation, such as an NST.
9. A nurse is assessing a pregnant client at 8 weeks of gestation and observes a
bluish-purple discoloration of the cervix and vaginal mucosa. The nurse should
document this finding as which of the following signs?
A. Goodell's sign
B. Hegar's sign
C. Chadwick's sign
D. Ballottement
C. Chadwick's sign
Rationale: Chadwick's sign is a bluish-purple discoloration of the mucosa of the cervix
and vagina caused by increased vascularity during pregnancy. Goodell's sign is the
softening of the cervical tip, and Hegar's sign is the softening of the lower uterine
segment.
10. A nurse is caring for a client who is at 35 weeks of gestation and is scheduled for
a Group B Streptococcus (GBS) screening. Which of the following actions should
the nurse anticipate?
A. Collecting a clean-catch urine specimen.
B. Obtaining a blood sample via venipuncture.
C. Obtaining a vaginal and rectal swab from the client.
D. Performing an ultrasound of the fetal kidneys.
C. Obtaining a vaginal and rectal swab from the client.
Rationale: Screening for Group B Streptococcus (GBS) is recommended for all
pregnant clients between 35 and 37 weeks of gestation. It involves collecting a swab
from the lower vagina and rectum to determine the need for intrapartum prophylactic
antibiotics.
Section 2: Antepartum Complications
