ATI RN Maternal-Newborn Proctored Exam 2026–2028 | 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.
Question 1
A nurse is caring for a patient who is at 34 weeks of gestation and presents with a
sudden onset of severe, continuous abdominal pain, uterine tenderness, and dark
vaginal bleeding. The nurse notes that the patient's abdomen feels board-like and rigid
on palpation. Which condition should the nurse suspect?
A) Placenta previa.
B) B) Abruptio placentae.
C) Cervical insufficiency.
D) Hydatidiform mole.
Rationale: Abruptio placentae is the premature separation of the placenta from the
uterine wall. It is characterized by acute, painful uterine contractions, a rigid or board-
like abdomen, and dark vaginal bleeding. In contrast, placenta previa presents as
painless, bright red vaginal bleeding.
Question 2
A nurse is assessing a newborn 15 minutes after birth. Which of the following clinical
findings should the nurse identify as a manifestation of respiratory distress requiring
immediate intervention?
A) Acrocyanosis.
B) Synchronized chest and abdominal movements.
,C) A respiratory rate of 52 breaths per minute.
D) D) Nasal flaring, intercostal retractions, and expiratory grunting.
Rationale: Nasal flaring, chest wall retractions, and expiratory grunting are classic signs
of newborn respiratory distress syndrome. A respiratory rate between 30 and 60
breaths/min is normal, and acrocyanosis (blueness of the hands and feet) is an
expected finding in the first 24 to 48 hours.
Question 3
A nurse is preparing to administer intramuscular Phytonadione (Vitamin K) to a
newborn. Which of the following muscle sites should the nurse select for the injection?
A) Deltoid muscle.
B) Dorsogluteal muscle.
C) C) Vastus lateralis.
D) Ventrogluteal muscle.
Rationale: The vastus lateralis (anterolateral thigh) is the preferred and safest muscle
site for intramuscular injections in newborns and infants because it is the most
developed muscle group and avoids injury to major blood vessels or the sciatic nerve.
Question 4
A nurse is reviewing the laboratory results of a patient who is at 12 weeks of gestation.
The patient's blood type is A-negative. Which of the following interventions should the
nurse plan to implement?
A) Administer Rho(D) immune globulin immediately.
B) Schedule a continuous amniocentesis series every 2 weeks.
C) C) Administer Rho(D) immune globulin at 28 weeks of gestation and within 72
hours of delivery if the newborn is Rh-positive.
D) Prepare the patient for a total blood exchange transfusion.
Rationale: For Rh-negative individuals, Rho(D) immune globulin is routinely
administered prophylactically at 28 weeks of pregnancy. A second dose is given within
72 hours of delivery only if the newborn's blood type is confirmed to be Rh-positive.
,Question 5
A nurse is caring for a patient who is in active labor at 39 weeks of gestation and is
receiving a continuous intravenous infusion of Oxytocin. The nurse notes a pattern of
late decelerations on the electronic fetal monitor. Which of the following actions must
the nurse perform first?
A) Increase the rate of the oxytocin infusion to accelerate delivery.
B) B) Discontinue the oxytocin infusion immediately.
C) Perform an immediate sterile vaginal examination.
D) Place the patient in a flat supine position.
Rationale: Late decelerations indicate uteroplacental insufficiency. Oxytocin stimulates
uterine contractions, which further decreases placental perfusion. The priority action is
to immediately stop the oxytocin to relieve uterine stress, followed by turning the patient
onto their side and applying oxygen.
Question 6
A nurse is monitoring a postpartum patient 2 hours after a vaginal delivery. Upon
palpation, the nurse notes that the uterine fundus is boggy, soft, and displaced upwards
and to the right of the midline. Which of the following interventions should the nurse
perform first?
A) Administer a prescription for methylergonovine intramuscularly.
B) B) Assist the patient to the bathroom to empty their bladder.
C) Perform vigorous fundal massage for 45 continuous minutes.
D) Increase the maintenance rate of the intravenous fluids.
Rationale: A fundus that is displaced upward and to the right is a classic sign of uterine
atony secondary to urinary bladder distension. A full bladder blocks the uterus from
contracting firmly. Assisting the patient to void will allow the uterus to return to the
midline and contract.
Question 7
, A nurse is providing discharge teaching to the parents of a male newborn who has just
undergone a plastic bell (Plastibell) circumcision. Which of the following instructions
should the nurse include?
A) Apply a thick layer of petroleum jelly to the penis with every diaper change.
B) B) Avoid applying petroleum jelly to the penis, and expect the plastic rim to fall
off within 8 days.
C) Cleanse the area vigorously using alcohol swabs twice daily.
D) Pull the plastic ring downward firmly if it does not detach within 48 hours.
Rationale: When a Plastibell device is used for circumcision, petroleum jelly is avoided
because it can cause the plastic ring to slip off prematurely. The ring is designed to
remain in place and naturally detach within 5 to 8 days.
Question 8
A nurse is assessing a postpartum patient who delivered 3 days ago. The nurse notes
that the patient's vaginal discharge is pinkish-brown in color and contains no large clots.
How should the nurse document this finding?
A) Lochia rubra.
B) B) Lochia serosa.
C) Lochia alba.
D) Lochia purulenta.
Rationale: Lochia serosa is the pinkish-brown vaginal discharge that typically occurs
from postpartum day 4 through day 10. Lochia rubra is bright red and lasts for the first 1
to 3 days, while lochia alba is a yellowish-white discharge that occurs from day 11 up to
several weeks.
Question 9
A nurse is providing dietary teaching to a pregnant client who has a new diagnosis of
gestational diabetes mellitus. Which of the following statements by the client indicates
an accurate understanding of the instructions?
A) "I should avoid all carbohydrates and eat only proteins."
B) "I will skip breakfast so my blood sugar doesn't spike in the morning."
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.
Question 1
A nurse is caring for a patient who is at 34 weeks of gestation and presents with a
sudden onset of severe, continuous abdominal pain, uterine tenderness, and dark
vaginal bleeding. The nurse notes that the patient's abdomen feels board-like and rigid
on palpation. Which condition should the nurse suspect?
A) Placenta previa.
B) B) Abruptio placentae.
C) Cervical insufficiency.
D) Hydatidiform mole.
Rationale: Abruptio placentae is the premature separation of the placenta from the
uterine wall. It is characterized by acute, painful uterine contractions, a rigid or board-
like abdomen, and dark vaginal bleeding. In contrast, placenta previa presents as
painless, bright red vaginal bleeding.
Question 2
A nurse is assessing a newborn 15 minutes after birth. Which of the following clinical
findings should the nurse identify as a manifestation of respiratory distress requiring
immediate intervention?
A) Acrocyanosis.
B) Synchronized chest and abdominal movements.
,C) A respiratory rate of 52 breaths per minute.
D) D) Nasal flaring, intercostal retractions, and expiratory grunting.
Rationale: Nasal flaring, chest wall retractions, and expiratory grunting are classic signs
of newborn respiratory distress syndrome. A respiratory rate between 30 and 60
breaths/min is normal, and acrocyanosis (blueness of the hands and feet) is an
expected finding in the first 24 to 48 hours.
Question 3
A nurse is preparing to administer intramuscular Phytonadione (Vitamin K) to a
newborn. Which of the following muscle sites should the nurse select for the injection?
A) Deltoid muscle.
B) Dorsogluteal muscle.
C) C) Vastus lateralis.
D) Ventrogluteal muscle.
Rationale: The vastus lateralis (anterolateral thigh) is the preferred and safest muscle
site for intramuscular injections in newborns and infants because it is the most
developed muscle group and avoids injury to major blood vessels or the sciatic nerve.
Question 4
A nurse is reviewing the laboratory results of a patient who is at 12 weeks of gestation.
The patient's blood type is A-negative. Which of the following interventions should the
nurse plan to implement?
A) Administer Rho(D) immune globulin immediately.
B) Schedule a continuous amniocentesis series every 2 weeks.
C) C) Administer Rho(D) immune globulin at 28 weeks of gestation and within 72
hours of delivery if the newborn is Rh-positive.
D) Prepare the patient for a total blood exchange transfusion.
Rationale: For Rh-negative individuals, Rho(D) immune globulin is routinely
administered prophylactically at 28 weeks of pregnancy. A second dose is given within
72 hours of delivery only if the newborn's blood type is confirmed to be Rh-positive.
,Question 5
A nurse is caring for a patient who is in active labor at 39 weeks of gestation and is
receiving a continuous intravenous infusion of Oxytocin. The nurse notes a pattern of
late decelerations on the electronic fetal monitor. Which of the following actions must
the nurse perform first?
A) Increase the rate of the oxytocin infusion to accelerate delivery.
B) B) Discontinue the oxytocin infusion immediately.
C) Perform an immediate sterile vaginal examination.
D) Place the patient in a flat supine position.
Rationale: Late decelerations indicate uteroplacental insufficiency. Oxytocin stimulates
uterine contractions, which further decreases placental perfusion. The priority action is
to immediately stop the oxytocin to relieve uterine stress, followed by turning the patient
onto their side and applying oxygen.
Question 6
A nurse is monitoring a postpartum patient 2 hours after a vaginal delivery. Upon
palpation, the nurse notes that the uterine fundus is boggy, soft, and displaced upwards
and to the right of the midline. Which of the following interventions should the nurse
perform first?
A) Administer a prescription for methylergonovine intramuscularly.
B) B) Assist the patient to the bathroom to empty their bladder.
C) Perform vigorous fundal massage for 45 continuous minutes.
D) Increase the maintenance rate of the intravenous fluids.
Rationale: A fundus that is displaced upward and to the right is a classic sign of uterine
atony secondary to urinary bladder distension. A full bladder blocks the uterus from
contracting firmly. Assisting the patient to void will allow the uterus to return to the
midline and contract.
Question 7
, A nurse is providing discharge teaching to the parents of a male newborn who has just
undergone a plastic bell (Plastibell) circumcision. Which of the following instructions
should the nurse include?
A) Apply a thick layer of petroleum jelly to the penis with every diaper change.
B) B) Avoid applying petroleum jelly to the penis, and expect the plastic rim to fall
off within 8 days.
C) Cleanse the area vigorously using alcohol swabs twice daily.
D) Pull the plastic ring downward firmly if it does not detach within 48 hours.
Rationale: When a Plastibell device is used for circumcision, petroleum jelly is avoided
because it can cause the plastic ring to slip off prematurely. The ring is designed to
remain in place and naturally detach within 5 to 8 days.
Question 8
A nurse is assessing a postpartum patient who delivered 3 days ago. The nurse notes
that the patient's vaginal discharge is pinkish-brown in color and contains no large clots.
How should the nurse document this finding?
A) Lochia rubra.
B) B) Lochia serosa.
C) Lochia alba.
D) Lochia purulenta.
Rationale: Lochia serosa is the pinkish-brown vaginal discharge that typically occurs
from postpartum day 4 through day 10. Lochia rubra is bright red and lasts for the first 1
to 3 days, while lochia alba is a yellowish-white discharge that occurs from day 11 up to
several weeks.
Question 9
A nurse is providing dietary teaching to a pregnant client who has a new diagnosis of
gestational diabetes mellitus. Which of the following statements by the client indicates
an accurate understanding of the instructions?
A) "I should avoid all carbohydrates and eat only proteins."
B) "I will skip breakfast so my blood sugar doesn't spike in the morning."
