ATI RN Maternal Newborn Nursing
Proctored Exam (2025) – Verified
Questions with Correct Answers &
Expert Rationales
This proctored exam for ATI RN Maternal Newborn Nursing (2025 edition) features 50 verified
questions covering antepartum, intrapartum, postpartum, and newborn care. Questions align with
ATI modules, NCLEX-RN blueprint, and ACOG/AAP guidelines. Correct answers in RED with
expert rationales including pathophysiology, nursing priorities, pharmacology.
Antepartum Care
Question 1: A nurse is reviewing prenatal labs for a client at 28 weeks gestation who is Rh-
negative. The indirect Coombs test is negative. What is the next action? Administer
RhoGAM intramuscularly Rationale: RhoGAM prevents isoimmunization in Rh-negative
mothers at 28 weeks and postpartum if newborn Rh-positive; suppresses antibody formation
against fetal Rh antigens. Negative Coombs confirms no sensitization yet. Patho: Fetal-maternal
bleed risks sensitization. Priority: Prophylaxis per ACOG.
Question 2: A client at 16 weeks gestation reports nausea and vomiting unrelieved by diet
changes. What is the priority nursing diagnosis? Fluid volume deficit related to
hyperemesis gravidarum Rationale: Persistent vomiting leads to dehydration, electrolyte
imbalance (hypokalemia), and ketosis; assess skin turgor, urine output. Patho: HCG peaks cause
gastric motility issues. Strategy: Rule out deficits first (ABC).
Question 3: During a prenatal visit, fundal height measures 24 cm at 20 weeks gestation.
What does this indicate? Appropriate for gestational age Rationale: Fundal height in cm
matches weeks from 16-36; discrepancy >3 cm needs ultrasound for IUGR or macrosomia.
Patho: Uterine growth reflects fetal/placental/amniotic status.
Question 4: A client with gestational diabetes is taught about blood glucose monitoring.
What is the target 1-hour postprandial level? Less than 140 mg/dL Rationale: ADA targets
prevent macrosomia, hypoglycemia; fasting <95, 2-hour <120. Diet/glyburide/insulin control.
Patho: Insulin resistance from placental hormones.
, Question 5: A nurse performs Leopold maneuvers on a client at term. The first maneuver
reveals a hard, round object in the fundus. What is this? Fetal head Rationale: First
maneuver identifies presenting part; head ballotable, buttock irregular. Determines position for
labor management.
Question 6: A client at 34 weeks gestation has positive group B streptococcus culture. What
intrapartum intervention is needed? Administer penicillin G IV every 4 hours during labor
Rationale: Prophylaxis reduces neonatal sepsis; allergy use clindamycin. CDC: ≥4 hours before
delivery optimal.
Question 7: What is the recommended weight gain for a client with BMI 25 entering
pregnancy? 15-25 pounds Rationale: IOM guidelines: Overweight category reduces risks of
macrosomia, cesarean. Balanced nutrition, exercise.
Question 8: A client reports fetal kick counts of 5 in 2 hours. What is the next action?
Instruct to eat a snack and recount for 1 hour Rationale: <10 movements/2 hours abnormal;
stimulation (food, juice) assesses reactivity. If persists, NST/BPP.
Question 9: Tetralogy of Fallot screening in pregnancy involves what ultrasound finding?
Ventricular septal defect and overriding aorta Rationale: Anatomy scan at 18-22 weeks
detects congenital anomalies; refer to pediatric cardiology.
Question 10: A client with preeclampsia reports epigastric pain. What lab is priority? Liver
enzymes (AST/ALT) Rationale: Indicates HELLP syndrome; platelets, LDH also. Patho:
Vasospasm causes organ ischemia.
Intrapartum Care
Question 11: A client in active labor has fetal heart rate with variable decelerations. What
is the initial intervention? Reposition the client to relieve cord compression Rationale:
Variables from cord compression; amnioinfusion if persistent. ACOG Category II management.
Proctored Exam (2025) – Verified
Questions with Correct Answers &
Expert Rationales
This proctored exam for ATI RN Maternal Newborn Nursing (2025 edition) features 50 verified
questions covering antepartum, intrapartum, postpartum, and newborn care. Questions align with
ATI modules, NCLEX-RN blueprint, and ACOG/AAP guidelines. Correct answers in RED with
expert rationales including pathophysiology, nursing priorities, pharmacology.
Antepartum Care
Question 1: A nurse is reviewing prenatal labs for a client at 28 weeks gestation who is Rh-
negative. The indirect Coombs test is negative. What is the next action? Administer
RhoGAM intramuscularly Rationale: RhoGAM prevents isoimmunization in Rh-negative
mothers at 28 weeks and postpartum if newborn Rh-positive; suppresses antibody formation
against fetal Rh antigens. Negative Coombs confirms no sensitization yet. Patho: Fetal-maternal
bleed risks sensitization. Priority: Prophylaxis per ACOG.
Question 2: A client at 16 weeks gestation reports nausea and vomiting unrelieved by diet
changes. What is the priority nursing diagnosis? Fluid volume deficit related to
hyperemesis gravidarum Rationale: Persistent vomiting leads to dehydration, electrolyte
imbalance (hypokalemia), and ketosis; assess skin turgor, urine output. Patho: HCG peaks cause
gastric motility issues. Strategy: Rule out deficits first (ABC).
Question 3: During a prenatal visit, fundal height measures 24 cm at 20 weeks gestation.
What does this indicate? Appropriate for gestational age Rationale: Fundal height in cm
matches weeks from 16-36; discrepancy >3 cm needs ultrasound for IUGR or macrosomia.
Patho: Uterine growth reflects fetal/placental/amniotic status.
Question 4: A client with gestational diabetes is taught about blood glucose monitoring.
What is the target 1-hour postprandial level? Less than 140 mg/dL Rationale: ADA targets
prevent macrosomia, hypoglycemia; fasting <95, 2-hour <120. Diet/glyburide/insulin control.
Patho: Insulin resistance from placental hormones.
, Question 5: A nurse performs Leopold maneuvers on a client at term. The first maneuver
reveals a hard, round object in the fundus. What is this? Fetal head Rationale: First
maneuver identifies presenting part; head ballotable, buttock irregular. Determines position for
labor management.
Question 6: A client at 34 weeks gestation has positive group B streptococcus culture. What
intrapartum intervention is needed? Administer penicillin G IV every 4 hours during labor
Rationale: Prophylaxis reduces neonatal sepsis; allergy use clindamycin. CDC: ≥4 hours before
delivery optimal.
Question 7: What is the recommended weight gain for a client with BMI 25 entering
pregnancy? 15-25 pounds Rationale: IOM guidelines: Overweight category reduces risks of
macrosomia, cesarean. Balanced nutrition, exercise.
Question 8: A client reports fetal kick counts of 5 in 2 hours. What is the next action?
Instruct to eat a snack and recount for 1 hour Rationale: <10 movements/2 hours abnormal;
stimulation (food, juice) assesses reactivity. If persists, NST/BPP.
Question 9: Tetralogy of Fallot screening in pregnancy involves what ultrasound finding?
Ventricular septal defect and overriding aorta Rationale: Anatomy scan at 18-22 weeks
detects congenital anomalies; refer to pediatric cardiology.
Question 10: A client with preeclampsia reports epigastric pain. What lab is priority? Liver
enzymes (AST/ALT) Rationale: Indicates HELLP syndrome; platelets, LDH also. Patho:
Vasospasm causes organ ischemia.
Intrapartum Care
Question 11: A client in active labor has fetal heart rate with variable decelerations. What
is the initial intervention? Reposition the client to relieve cord compression Rationale:
Variables from cord compression; amnioinfusion if persistent. ACOG Category II management.
