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 practice
test featuring verified questions, correct answers, and detailed rationales. This study guide covers
essential maternal-newborn nursing concepts including antepartum care, labor and delivery,
postpartum assessment, newborn care, fetal monitoring, high-risk pregnancy complications,
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.
Q1. A nurse is assessing a pregnant client at 34 weeks of gestation who is
receiving intravenous magnesium sulfate for severe preeclampsia. Which of the
following findings is the priority indicator of magnesium toxicity?
A) Urinary output of 40 mL/hr over the last 2 hours
B) Respiratory rate of 10 breaths per minute
C) Soft, elicitable 1+ deep tendon reflexes
D) Maternal heart rate of 92 beats per minute
Answer: B) Respiratory rate of 10 breaths per minute
Rationale: Magnesium sulfate is a central nervous system depressant. Respiratory
depression (less than 12 breaths per minute) is a critical sign of toxicity that can
precede cardiac arrest. The infusion must be stopped immediately and the antidote
administered.
Q2. A nurse is caring for a client who is receiving a magnesium sulfate infusion.
The nurse identifies that the client is exhibiting signs of magnesium toxicity.
Which of the following medications should the nurse prepare to administer?
A) Protamine sulfate
B) Naloxone
C) Calcium gluconate
D) Terbutaline
Answer: C) Calcium gluconate
,Rationale: Calcium gluconate is the specific antidote for magnesium sulfate toxicity. It
counteracts the neuromuscular blocking effects of magnesium, restoring respiratory
drive and deep tendon reflexes.
Q3. A nurse is calculating the obstetric history for a client using the GTPAL
system. The client is currently pregnant at 12 weeks. She has a 5-year-old child
born at 39 weeks, a 3-year-old child born at 34 weeks, and had a spontaneous
abortion at 10 weeks of gestation. Which of the following represents the correct
GTPAL?
A) G4, T1, P1, A1, L2
B) G3, T2, P0, A1, L2
C) G4, T2, P1, A0, L2
D) G3, T1, P1, A1, L3
Answer: A) G4, T1, P1, A1, L2
Rationale: G (Gravida) = 4 total pregnancies (current, 5-year-old, 3-year-old,
spontaneous abortion). T (Term) = 1 birth at 37+ weeks (the 5-year-old). P (Preterm) =
1 birth between 20-36 weeks (the 3-year-old). A (Abortion) = 1 pregnancy ending before
20 weeks. L (Living) = 2 living children.
Q4. A nurse is assessing a client who is at 38 weeks of gestation and notes late
decelerations on the fetal heart rate monitor. Which of the following actions
should the nurse take first?
A) Increase the rate of the oxytocin infusion
B) Assist the client into a lateral position
C) Administer oxygen via a nasal cannula at 2 L/min
D) Notify the provider immediately
Answer: B) Assist the client into a lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency. Turning the client to
a side-lying position is the immediate priority to relieve vena cava compression,
maximize uterine blood flow, and improve fetal oxygenation.
Q5. A nurse is assessing a postpartum client 2 hours after a vaginal delivery. The
nurse notes that the fundus is boggy and displaced to the right of the midline.
Which of the following interventions should the nurse perform first?
,A) Massage the fundus continuously for 30 minutes
B) Administer a dose of methylergonovine intramuscularly
C) Assist the client to empty her bladder
D) Obtain a stat hemoglobin and hematocrit
Answer: C) Assist the client to empty her bladder
Rationale: A fundus that is displaced to the right and boggy is a classic sign of bladder
distention. A full bladder pushes the uterus out of place and prevents it from contracting
effectively, leading to uterine atony and increased bleeding. Emptying the bladder
resolves the displacement.
Q6. A nurse is using Naegele’s rule to calculate the estimated date of delivery
(EDD) for a client. The client reports that the first day of her last menstrual period
was October 10, 2025. Which of the following is the correct EDD?
A) July 17, 2026
B) July 3, 2026
C) January 17, 2026
D) July 10, 2026
Answer: A) July 17, 2026
Rationale: Naegele’s rule is calculated by taking the first day of the last menstrual
period (October 10), subtracting 3 months (July 10), adding 7 days (July 17), and
advancing the year if necessary (2026).
Q7. A nurse is assessing a newborn 1 minute after birth and notes the following:
heart rate 130/min, slow and irregular respirations, active movement with well-
flexed extremities, grimace when the soles of the feet are flicked, and a pink body
with blue hands and feet. Which of the following is the correct APGAR score?
A) 6
B) 7
C) 8
D) 9
Answer: B) 7
Rationale: Heart rate >100 = 2 points. Respiratory effort (slow/irregular) = 1 point.
Muscle tone (active movement/flexed) = 2 points. Reflex irritability (grimace) = 1 point.
Appearance (body pink, extremities blue/acrocyanosis) = 1 point. Total score = 2 + 1 +
2 + 1 + 1 = 7.
, Q8. A nurse is reviewing the prenatal laboratory results of a client who is at 10
weeks of gestation. The results indicate the client is Rh-negative. Which of the
following statements should the nurse include in the client teaching?
A) "You will receive an injection of Rh(D) immune globulin at your next weekly
appointment."
B) "Rh(D) immune globulin will be administered around 28 weeks of gestation and again
within 72 hours after birth if your baby is Rh-positive."
C) "An Rh-negative status means you will require a cesarean birth to protect the baby."
D) "You will only need Rh(D) immune globulin if you experience abdominal trauma
during the first trimester."
Answer: B) "Rh(D) immune globulin will be administered around 28 weeks of
gestation and again within 72 hours after birth if your baby is Rh-positive."
Rationale: Rh(D) immune globulin (RhoGAM) is administered prophylactically at 28
weeks of gestation to Rh-negative clients to prevent isoimmunization, and a second
dose is given postnatally within 72 hours if the newborn is Rh-positive.
Q9. A nurse is assessing a client at 32 weeks of gestation who reports a sudden
gush of painless, bright red vaginal bleeding. The nurse should identify that these
findings are consistent with which of the following complications?
A) Abruptio placentae
B) Placenta previa
C) Cervical insufficiency
D) Preeclampsia
Answer: B) Placenta previa
Rationale: Painless, bright red vaginal bleeding during the second or third trimester is
the hallmark manifestation of placenta previa. In contrast, abruptio placentae causes
painful, dark red bleeding with a rigid, board-like abdomen.
Q10. A nurse is preparing to perform a sterile vaginal examination on a client who
is at 36 weeks of gestation and presents with active vaginal bleeding. Which of
the following actions is appropriate?
A) Perform the examination immediately using sterile gloves
B) Perform the examination only after checking the fetal station
Practice Test Questions & Answers | Complete Study Guide
Prepare for the ATI RN Maternal-Newborn Proctored Exam with this comprehensive practice
test featuring verified questions, correct answers, and detailed rationales. This study guide covers
essential maternal-newborn nursing concepts including antepartum care, labor and delivery,
postpartum assessment, newborn care, fetal monitoring, high-risk pregnancy complications,
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.
Q1. A nurse is assessing a pregnant client at 34 weeks of gestation who is
receiving intravenous magnesium sulfate for severe preeclampsia. Which of the
following findings is the priority indicator of magnesium toxicity?
A) Urinary output of 40 mL/hr over the last 2 hours
B) Respiratory rate of 10 breaths per minute
C) Soft, elicitable 1+ deep tendon reflexes
D) Maternal heart rate of 92 beats per minute
Answer: B) Respiratory rate of 10 breaths per minute
Rationale: Magnesium sulfate is a central nervous system depressant. Respiratory
depression (less than 12 breaths per minute) is a critical sign of toxicity that can
precede cardiac arrest. The infusion must be stopped immediately and the antidote
administered.
Q2. A nurse is caring for a client who is receiving a magnesium sulfate infusion.
The nurse identifies that the client is exhibiting signs of magnesium toxicity.
Which of the following medications should the nurse prepare to administer?
A) Protamine sulfate
B) Naloxone
C) Calcium gluconate
D) Terbutaline
Answer: C) Calcium gluconate
,Rationale: Calcium gluconate is the specific antidote for magnesium sulfate toxicity. It
counteracts the neuromuscular blocking effects of magnesium, restoring respiratory
drive and deep tendon reflexes.
Q3. A nurse is calculating the obstetric history for a client using the GTPAL
system. The client is currently pregnant at 12 weeks. She has a 5-year-old child
born at 39 weeks, a 3-year-old child born at 34 weeks, and had a spontaneous
abortion at 10 weeks of gestation. Which of the following represents the correct
GTPAL?
A) G4, T1, P1, A1, L2
B) G3, T2, P0, A1, L2
C) G4, T2, P1, A0, L2
D) G3, T1, P1, A1, L3
Answer: A) G4, T1, P1, A1, L2
Rationale: G (Gravida) = 4 total pregnancies (current, 5-year-old, 3-year-old,
spontaneous abortion). T (Term) = 1 birth at 37+ weeks (the 5-year-old). P (Preterm) =
1 birth between 20-36 weeks (the 3-year-old). A (Abortion) = 1 pregnancy ending before
20 weeks. L (Living) = 2 living children.
Q4. A nurse is assessing a client who is at 38 weeks of gestation and notes late
decelerations on the fetal heart rate monitor. Which of the following actions
should the nurse take first?
A) Increase the rate of the oxytocin infusion
B) Assist the client into a lateral position
C) Administer oxygen via a nasal cannula at 2 L/min
D) Notify the provider immediately
Answer: B) Assist the client into a lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency. Turning the client to
a side-lying position is the immediate priority to relieve vena cava compression,
maximize uterine blood flow, and improve fetal oxygenation.
Q5. A nurse is assessing a postpartum client 2 hours after a vaginal delivery. The
nurse notes that the fundus is boggy and displaced to the right of the midline.
Which of the following interventions should the nurse perform first?
,A) Massage the fundus continuously for 30 minutes
B) Administer a dose of methylergonovine intramuscularly
C) Assist the client to empty her bladder
D) Obtain a stat hemoglobin and hematocrit
Answer: C) Assist the client to empty her bladder
Rationale: A fundus that is displaced to the right and boggy is a classic sign of bladder
distention. A full bladder pushes the uterus out of place and prevents it from contracting
effectively, leading to uterine atony and increased bleeding. Emptying the bladder
resolves the displacement.
Q6. A nurse is using Naegele’s rule to calculate the estimated date of delivery
(EDD) for a client. The client reports that the first day of her last menstrual period
was October 10, 2025. Which of the following is the correct EDD?
A) July 17, 2026
B) July 3, 2026
C) January 17, 2026
D) July 10, 2026
Answer: A) July 17, 2026
Rationale: Naegele’s rule is calculated by taking the first day of the last menstrual
period (October 10), subtracting 3 months (July 10), adding 7 days (July 17), and
advancing the year if necessary (2026).
Q7. A nurse is assessing a newborn 1 minute after birth and notes the following:
heart rate 130/min, slow and irregular respirations, active movement with well-
flexed extremities, grimace when the soles of the feet are flicked, and a pink body
with blue hands and feet. Which of the following is the correct APGAR score?
A) 6
B) 7
C) 8
D) 9
Answer: B) 7
Rationale: Heart rate >100 = 2 points. Respiratory effort (slow/irregular) = 1 point.
Muscle tone (active movement/flexed) = 2 points. Reflex irritability (grimace) = 1 point.
Appearance (body pink, extremities blue/acrocyanosis) = 1 point. Total score = 2 + 1 +
2 + 1 + 1 = 7.
, Q8. A nurse is reviewing the prenatal laboratory results of a client who is at 10
weeks of gestation. The results indicate the client is Rh-negative. Which of the
following statements should the nurse include in the client teaching?
A) "You will receive an injection of Rh(D) immune globulin at your next weekly
appointment."
B) "Rh(D) immune globulin will be administered around 28 weeks of gestation and again
within 72 hours after birth if your baby is Rh-positive."
C) "An Rh-negative status means you will require a cesarean birth to protect the baby."
D) "You will only need Rh(D) immune globulin if you experience abdominal trauma
during the first trimester."
Answer: B) "Rh(D) immune globulin will be administered around 28 weeks of
gestation and again within 72 hours after birth if your baby is Rh-positive."
Rationale: Rh(D) immune globulin (RhoGAM) is administered prophylactically at 28
weeks of gestation to Rh-negative clients to prevent isoimmunization, and a second
dose is given postnatally within 72 hours if the newborn is Rh-positive.
Q9. A nurse is assessing a client at 32 weeks of gestation who reports a sudden
gush of painless, bright red vaginal bleeding. The nurse should identify that these
findings are consistent with which of the following complications?
A) Abruptio placentae
B) Placenta previa
C) Cervical insufficiency
D) Preeclampsia
Answer: B) Placenta previa
Rationale: Painless, bright red vaginal bleeding during the second or third trimester is
the hallmark manifestation of placenta previa. In contrast, abruptio placentae causes
painful, dark red bleeding with a rigid, board-like abdomen.
Q10. A nurse is preparing to perform a sterile vaginal examination on a client who
is at 36 weeks of gestation and presents with active vaginal bleeding. Which of
the following actions is appropriate?
A) Perform the examination immediately using sterile gloves
B) Perform the examination only after checking the fetal station
