1
ATI Maternal Newborn Proctored Exam
Actual Exam 2026/2027 | Detailed
Rationales | Graded A+ – Complete
Exam-Style Questions – Pass Guaranteed
[SECTION 1: Antepartum Nursing — Questions 1-18]
Q1: A pregnant patient at 28 weeks gestation has blood type O negative. Her partner is blood
type positive. What is the standard nursing intervention regarding Rho(D) immune globulin
(RhoGAM)?
A. Administer RhoGAM only if the mother has a positive antibody screen.
B. Administer RhoGAM at 28 weeks and again within 72 hours after delivery if the newborn is
Rh-positive.
C. Administer RhoGAM only if the mother experiences trauma during pregnancy.
D. Wait until after delivery to determine if the newborn is Rh-positive before giving any
RhoGAM.
B. Administer RhoGAM at 28 weeks and again within 72 hours after delivery if the newborn is
Rh-positive. [CORRECT]
Correct Answer: B
Rationale: For an Rh-negative mother, the standard of care is to administer RhoGAM
prophylactically at 28 weeks gestation to prevent sensitization. A second dose is administered
within 72 hours after delivery if the newborn is Rh-positive to prevent formation of antibodies
from fetal-maternal bleeding. Administration at 28 weeks is crucial regardless of antibody screen
results.
Q2: A nurse is teaching a pregnant client about danger signs to report immediately. Which
statement by the client indicates a need for further teaching?
A. "I will report if I have vaginal bleeding."
B. "I will call if I have a severe headache or see spots before my eyes."
,2
C. "I will report if my face or hands swell significantly."
D. "I will wait to see if my leg pain goes away before calling the doctor."
D. "I will wait to see if my leg pain goes away before calling the doctor." [CORRECT]
Correct Answer: D
Rationale: Leg pain can indicate deep vein thrombosis (DVT), a serious condition in pregnancy
due to hypercoagulability. The client should report this immediately, not wait. Severe headache,
visual changes (spots), and significant edema (face/hands) are signs of pre-eclampsia and require
immediate medical attention; vaginal bleeding is always an immediate concern.
Q3: A client is scheduled for a 1-hour glucose tolerance test (GTT) at 24 weeks. What action by
the nurse is correct regarding client preparation?
A. Instruct the client to eat a high-carbohydrate meal the night before the test.
B. Instruct the client to fast for 12 hours prior to the test.
C. Instruct the client to eat a normal diet and drink the glucose solution 1 hour before the blood
draw.
D. Instruct the client to avoid all foods and fluids for 24 hours prior to the test.
C. Instruct the client to eat a normal diet and drink the glucose solution 1 hour before the blood
draw. [CORRECT]
Correct Answer: C
Rationale: The 1-hour glucose challenge test (50g glucose load) does not require fasting; the
client should maintain their normal diet. The blood is drawn exactly 1 hour after drinking the
glucose solution. If the 1-hour result is abnormal (>130-140 mg/dL), a 3-hour diagnostic OGTT
(100g load) is then performed, which does require fasting.
Q4: A nurse is reviewing the Alpha-fetoprotein (AFP) test results with a client. The AFP level is
elevated. What condition does this suggest the fetus may have?
A. Down syndrome (Trisomy 21).
B. Neural tube defect (e.g., spina bifida).
,3
C. Congenital heart defect.
D. Renal agenesis.
B. Neural tube defect (e.g., spina bifida). [CORRECT]
Correct Answer: B
Rationale: Alpha-fetoprotein is a substance produced by the fetus that crosses the placenta into
the mother's blood. An elevated level is associated with open neural tube defects (such as
anencephaly or spina bifida) because AFP leaks from the open fetal spinal canal into the amniotic
fluid and mother's circulation. A low AFP is associated with Down syndrome.
Q5: A patient in preterm labor at 30 weeks is receiving terbutaline (Brethine). What is the
priority nursing assessment?
A. Monitor fetal heart rate continuously.
B. Monitor maternal blood pressure and reflexes.
C. Monitor maternal heart rate and blood pressure.
D. Assess for pedal edema.
C. Monitor maternal heart rate and blood pressure. [CORRECT]
Correct Answer: C
Rationale: Terbutaline is a beta-agonist tocolytic medication used to stop uterine contractions. A
major side effect is maternal tachycardia (heart rate >120) and hypotension due to vasodilation.
While monitoring the fetus is important, the specific pharmacodynamic effects of terbutaline
necessitate monitoring maternal vital signs for toxicity.
Q6: Which statement by a client pregnant with twins at 20 weeks indicates effective teaching
regarding warning signs of preterm labor?
A. "If I feel my belly get hard often, I should drink water and rest."
B. "I will count the baby's movements once a week."
C. "If I have back pain, I will take a warm bath."
D. "I should not worry if I have some leaking of fluid; it's probably urine."
, 4
A. "If I feel my belly get hard often, I should drink water and rest." [CORRECT]
Correct Answer: A
Rationale: Uterine contractions can feel like the belly getting hard (tightening). Increased
frequency of contractions is a sign of preterm labor. Initial interventions include hydration (often
resolves irritability) and rest to see if contractions subside. Back pain and fluid leakage are also
warning signs but require immediate assessment rather than home remedies.
Q7: A primigravida client is in her second trimester and reports experiencing "morning sickness."
What instruction should the nurse provide to manage nausea?
A. Take antiemetic medication only if vomiting blood.
B. Eat dry crackers or toast before getting out of bed in the morning.
C. Avoid all fluids until the nausea passes.
D. Skip breakfast to maintain an empty stomach.
B. Eat dry crackers or toast before getting out of bed in the morning. [CORRECT]
Correct Answer: B
Rationale: Morning sickness (nausea and vomiting of pregnancy) is common in the first trimester
but can persist. A non-pharmacologic intervention is to eat dry, bland foods (crackers, toast)
before arising in the morning to absorb gastric acid and settle the stomach. Avoiding fluids and
skipping meals can lead to dehydration and hypoglycemia.
Q8: A pregnant client is diagnosed with pre-eclampsia with severe features. Which finding would
the nurse expect to find?
A. Blood pressure 138/88 mmHg and proteinuria of 200 mg/24h.
B. Blood pressure 168/110 mmHg and 3+ proteinuria.
C. Blood pressure 120/80 mmHg and 2+ proteinuria.
D. Blood pressure 130/85 mmHg and edema of the ankles.
B. Blood pressure 168/110 mmHg and 3+ proteinuria. [CORRECT]
ATI Maternal Newborn Proctored Exam
Actual Exam 2026/2027 | Detailed
Rationales | Graded A+ – Complete
Exam-Style Questions – Pass Guaranteed
[SECTION 1: Antepartum Nursing — Questions 1-18]
Q1: A pregnant patient at 28 weeks gestation has blood type O negative. Her partner is blood
type positive. What is the standard nursing intervention regarding Rho(D) immune globulin
(RhoGAM)?
A. Administer RhoGAM only if the mother has a positive antibody screen.
B. Administer RhoGAM at 28 weeks and again within 72 hours after delivery if the newborn is
Rh-positive.
C. Administer RhoGAM only if the mother experiences trauma during pregnancy.
D. Wait until after delivery to determine if the newborn is Rh-positive before giving any
RhoGAM.
B. Administer RhoGAM at 28 weeks and again within 72 hours after delivery if the newborn is
Rh-positive. [CORRECT]
Correct Answer: B
Rationale: For an Rh-negative mother, the standard of care is to administer RhoGAM
prophylactically at 28 weeks gestation to prevent sensitization. A second dose is administered
within 72 hours after delivery if the newborn is Rh-positive to prevent formation of antibodies
from fetal-maternal bleeding. Administration at 28 weeks is crucial regardless of antibody screen
results.
Q2: A nurse is teaching a pregnant client about danger signs to report immediately. Which
statement by the client indicates a need for further teaching?
A. "I will report if I have vaginal bleeding."
B. "I will call if I have a severe headache or see spots before my eyes."
,2
C. "I will report if my face or hands swell significantly."
D. "I will wait to see if my leg pain goes away before calling the doctor."
D. "I will wait to see if my leg pain goes away before calling the doctor." [CORRECT]
Correct Answer: D
Rationale: Leg pain can indicate deep vein thrombosis (DVT), a serious condition in pregnancy
due to hypercoagulability. The client should report this immediately, not wait. Severe headache,
visual changes (spots), and significant edema (face/hands) are signs of pre-eclampsia and require
immediate medical attention; vaginal bleeding is always an immediate concern.
Q3: A client is scheduled for a 1-hour glucose tolerance test (GTT) at 24 weeks. What action by
the nurse is correct regarding client preparation?
A. Instruct the client to eat a high-carbohydrate meal the night before the test.
B. Instruct the client to fast for 12 hours prior to the test.
C. Instruct the client to eat a normal diet and drink the glucose solution 1 hour before the blood
draw.
D. Instruct the client to avoid all foods and fluids for 24 hours prior to the test.
C. Instruct the client to eat a normal diet and drink the glucose solution 1 hour before the blood
draw. [CORRECT]
Correct Answer: C
Rationale: The 1-hour glucose challenge test (50g glucose load) does not require fasting; the
client should maintain their normal diet. The blood is drawn exactly 1 hour after drinking the
glucose solution. If the 1-hour result is abnormal (>130-140 mg/dL), a 3-hour diagnostic OGTT
(100g load) is then performed, which does require fasting.
Q4: A nurse is reviewing the Alpha-fetoprotein (AFP) test results with a client. The AFP level is
elevated. What condition does this suggest the fetus may have?
A. Down syndrome (Trisomy 21).
B. Neural tube defect (e.g., spina bifida).
,3
C. Congenital heart defect.
D. Renal agenesis.
B. Neural tube defect (e.g., spina bifida). [CORRECT]
Correct Answer: B
Rationale: Alpha-fetoprotein is a substance produced by the fetus that crosses the placenta into
the mother's blood. An elevated level is associated with open neural tube defects (such as
anencephaly or spina bifida) because AFP leaks from the open fetal spinal canal into the amniotic
fluid and mother's circulation. A low AFP is associated with Down syndrome.
Q5: A patient in preterm labor at 30 weeks is receiving terbutaline (Brethine). What is the
priority nursing assessment?
A. Monitor fetal heart rate continuously.
B. Monitor maternal blood pressure and reflexes.
C. Monitor maternal heart rate and blood pressure.
D. Assess for pedal edema.
C. Monitor maternal heart rate and blood pressure. [CORRECT]
Correct Answer: C
Rationale: Terbutaline is a beta-agonist tocolytic medication used to stop uterine contractions. A
major side effect is maternal tachycardia (heart rate >120) and hypotension due to vasodilation.
While monitoring the fetus is important, the specific pharmacodynamic effects of terbutaline
necessitate monitoring maternal vital signs for toxicity.
Q6: Which statement by a client pregnant with twins at 20 weeks indicates effective teaching
regarding warning signs of preterm labor?
A. "If I feel my belly get hard often, I should drink water and rest."
B. "I will count the baby's movements once a week."
C. "If I have back pain, I will take a warm bath."
D. "I should not worry if I have some leaking of fluid; it's probably urine."
, 4
A. "If I feel my belly get hard often, I should drink water and rest." [CORRECT]
Correct Answer: A
Rationale: Uterine contractions can feel like the belly getting hard (tightening). Increased
frequency of contractions is a sign of preterm labor. Initial interventions include hydration (often
resolves irritability) and rest to see if contractions subside. Back pain and fluid leakage are also
warning signs but require immediate assessment rather than home remedies.
Q7: A primigravida client is in her second trimester and reports experiencing "morning sickness."
What instruction should the nurse provide to manage nausea?
A. Take antiemetic medication only if vomiting blood.
B. Eat dry crackers or toast before getting out of bed in the morning.
C. Avoid all fluids until the nausea passes.
D. Skip breakfast to maintain an empty stomach.
B. Eat dry crackers or toast before getting out of bed in the morning. [CORRECT]
Correct Answer: B
Rationale: Morning sickness (nausea and vomiting of pregnancy) is common in the first trimester
but can persist. A non-pharmacologic intervention is to eat dry, bland foods (crackers, toast)
before arising in the morning to absorb gastric acid and settle the stomach. Avoiding fluids and
skipping meals can lead to dehydration and hypoglycemia.
Q8: A pregnant client is diagnosed with pre-eclampsia with severe features. Which finding would
the nurse expect to find?
A. Blood pressure 138/88 mmHg and proteinuria of 200 mg/24h.
B. Blood pressure 168/110 mmHg and 3+ proteinuria.
C. Blood pressure 120/80 mmHg and 2+ proteinuria.
D. Blood pressure 130/85 mmHg and edema of the ankles.
B. Blood pressure 168/110 mmHg and 3+ proteinuria. [CORRECT]
