ATI MATERNAL NEWBORN PROCTORED EXAM 2023 WITH
NGN 70 Questions and Ansẉers with Expert-Verified
Explanation 2026 update
NGN Hot Spot – Fetal Heart Rate Interpretation (Questions 1–10)
Scenario: A nurse is reviewing fetal heart rate tracings. Identify each pattern and
the appropriate nursing action.
1. The nurse notes variable decelerations that are becoming more frequent.
Which of the following actions should the nurse take?
A) Position the client on her right side
B) Prepare for amnioinfusion
C) Administer oxygen
D) Change the maternal position
Correct Answer: D
Rationale: Variable decelerations are caused by cord compression. Changing
maternal position is the first intervention.
2. The fetal heart tracing shows minimal variability. Which of the following is the
most likely cause?
A) Fetal sleep
B) Fetal acidosis
C) Maternal fever
D) Maternal hypotension
Correct Answer: B
Rationale: Minimal variability (≤5 bpm) for >40 minutes may indicate fetal acidosis
and requires further evaluation.
8. The fetal heart tracing shows moderate variability (6-25 bpm). Which of the
following actions should the nurse take?
,A) Document the finding as reassuring
B) Notify the provider
C) Prepare for immediate delivery
D) Administer oxygen
Correct Answer: A
Rationale: Moderate variability is a reassuring finding indicating fetal well-being.
3. The nurse notes recurrent late decelerations after turning the client to her left
side and administering oxygen. Which of the following actions should the nurse
take next?
A) Discontinue oxytocin if infusing
B) Administer a fluid bolus
C) Notify the provider
D) Prepare for cesarean section
Correct Answer: C
Rationale: If late decelerations persist after intrauterine resuscitation, the provider
should be notified immediately.
4 The nurse notes a sinusoidal pattern on the fetal heart tracing. Which of the
following conditions should the nurse suspect?
A) Fetal anemia
B) Fetal hypoxia
C) Maternal fever
D) Uterine tachysystole
Correct Answer: A
Rationale: A sinusoidal pattern (smooth, undulating waveform) is associated with
severe fetal anemia, often from Rh incompatibility or fetomaternal hemorrhage.
,1. The tracing shows a gradual decrease in FHR that begins at the start of the
contraction and returns to baseline by the end of the contraction. Which of the
following is this pattern?
A) Early deceleration
B) Late deceleration
C) Variable deceleration
D) Prolonged deceleration
Correct Answer: A
Rationale: Early decelerations mirror the contraction and are caused by fetal head
compression. They are benign and require no intervention.
2. The tracing shows a gradual decrease in FHR that begins after the contraction
starts and returns to baseline after the contraction ends. Which of the following
is this pattern? A) Early deceleration
B) Late deceleration
C) Variable deceleration
D) Prolonged deceleration
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency and require
intervention (position change, oxygen, stop oxytocin).
3. The tracing shows an abrupt decrease in FHR that varies in shape, duration,
and timing. Which of the following is this pattern?
A) Early deceleration
B) Late deceleration
C) Variable deceleration
D) Prolonged deceleration
Correct Answer: C
Rationale: Variable decelerations are caused by umbilical cord compression.
Interventions include position change and amnioinfusion.
, 4. The tracing shows a decrease in FHR to 80 bpm lasting 3 minutes. Which of
the following is this pattern?
A) Early deceleration
B) Late deceleration
C) Variable deceleration
D) Prolonged deceleration
Correct Answer: D
Rationale: A prolonged deceleration lasts ≥2 minutes but <10 minutes. It indicates
significant fetal compromise and requires immediate intervention.
5. The nurse notes recurrent late decelerations. Which of the following actions
should the nurse take first?
A) Turn the client to her left side
B) Administer oxygen
C) Discontinue oxytocin
D) Notify the provider
Correct Answer: A
Rationale: The priority is to improve placental blood flow by turning the client to
her left side.
NGN Delegation and Prioritization (Questions 11–20)
11. A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an
unlicensed assistive personnel (UAP). Which of the following tasks should the
charge nurse assign to the LPN?
A) Ambulate a client who is 1 hour postpartum
B) Reinforce teaching on breastfeeding
C) Insert a urinary catheter
D) Assess a client with preeclampsia
Correct Answer: C
Rationale: Insertion of a urinary catheter is within the scope of an LPN.
Assessment and teaching are the responsibility of the RN.
NGN 70 Questions and Ansẉers with Expert-Verified
Explanation 2026 update
NGN Hot Spot – Fetal Heart Rate Interpretation (Questions 1–10)
Scenario: A nurse is reviewing fetal heart rate tracings. Identify each pattern and
the appropriate nursing action.
1. The nurse notes variable decelerations that are becoming more frequent.
Which of the following actions should the nurse take?
A) Position the client on her right side
B) Prepare for amnioinfusion
C) Administer oxygen
D) Change the maternal position
Correct Answer: D
Rationale: Variable decelerations are caused by cord compression. Changing
maternal position is the first intervention.
2. The fetal heart tracing shows minimal variability. Which of the following is the
most likely cause?
A) Fetal sleep
B) Fetal acidosis
C) Maternal fever
D) Maternal hypotension
Correct Answer: B
Rationale: Minimal variability (≤5 bpm) for >40 minutes may indicate fetal acidosis
and requires further evaluation.
8. The fetal heart tracing shows moderate variability (6-25 bpm). Which of the
following actions should the nurse take?
,A) Document the finding as reassuring
B) Notify the provider
C) Prepare for immediate delivery
D) Administer oxygen
Correct Answer: A
Rationale: Moderate variability is a reassuring finding indicating fetal well-being.
3. The nurse notes recurrent late decelerations after turning the client to her left
side and administering oxygen. Which of the following actions should the nurse
take next?
A) Discontinue oxytocin if infusing
B) Administer a fluid bolus
C) Notify the provider
D) Prepare for cesarean section
Correct Answer: C
Rationale: If late decelerations persist after intrauterine resuscitation, the provider
should be notified immediately.
4 The nurse notes a sinusoidal pattern on the fetal heart tracing. Which of the
following conditions should the nurse suspect?
A) Fetal anemia
B) Fetal hypoxia
C) Maternal fever
D) Uterine tachysystole
Correct Answer: A
Rationale: A sinusoidal pattern (smooth, undulating waveform) is associated with
severe fetal anemia, often from Rh incompatibility or fetomaternal hemorrhage.
,1. The tracing shows a gradual decrease in FHR that begins at the start of the
contraction and returns to baseline by the end of the contraction. Which of the
following is this pattern?
A) Early deceleration
B) Late deceleration
C) Variable deceleration
D) Prolonged deceleration
Correct Answer: A
Rationale: Early decelerations mirror the contraction and are caused by fetal head
compression. They are benign and require no intervention.
2. The tracing shows a gradual decrease in FHR that begins after the contraction
starts and returns to baseline after the contraction ends. Which of the following
is this pattern? A) Early deceleration
B) Late deceleration
C) Variable deceleration
D) Prolonged deceleration
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency and require
intervention (position change, oxygen, stop oxytocin).
3. The tracing shows an abrupt decrease in FHR that varies in shape, duration,
and timing. Which of the following is this pattern?
A) Early deceleration
B) Late deceleration
C) Variable deceleration
D) Prolonged deceleration
Correct Answer: C
Rationale: Variable decelerations are caused by umbilical cord compression.
Interventions include position change and amnioinfusion.
, 4. The tracing shows a decrease in FHR to 80 bpm lasting 3 minutes. Which of
the following is this pattern?
A) Early deceleration
B) Late deceleration
C) Variable deceleration
D) Prolonged deceleration
Correct Answer: D
Rationale: A prolonged deceleration lasts ≥2 minutes but <10 minutes. It indicates
significant fetal compromise and requires immediate intervention.
5. The nurse notes recurrent late decelerations. Which of the following actions
should the nurse take first?
A) Turn the client to her left side
B) Administer oxygen
C) Discontinue oxytocin
D) Notify the provider
Correct Answer: A
Rationale: The priority is to improve placental blood flow by turning the client to
her left side.
NGN Delegation and Prioritization (Questions 11–20)
11. A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an
unlicensed assistive personnel (UAP). Which of the following tasks should the
charge nurse assign to the LPN?
A) Ambulate a client who is 1 hour postpartum
B) Reinforce teaching on breastfeeding
C) Insert a urinary catheter
D) Assess a client with preeclampsia
Correct Answer: C
Rationale: Insertion of a urinary catheter is within the scope of an LPN.
Assessment and teaching are the responsibility of the RN.
