NGN ATI MATERNAL NEWBORN PROCTORED EXAM
2025 ACTUAL EXAM COMPLETE 100 QUESTIONS
WITH DETAILED VERIFIED ANSWERS (100%
CORRECT ANSWERS) / ALREADY GRADED A+
1.
Case: 36-week gestation G1 presents with sudden bright-red vaginal bleeding and severe
abdominal pain. FHR shows tachycardia and late decelerations.
Item type: Multiple-choice (single best)
a. Placenta previa
b. Vasa previa
c. Placental abruption
d. Uterine rupture
Answer: c
Rationale: Sudden painful bleeding with fetal distress suggests abruption; placenta previa
usually painless.
2.
Case: 39-week laboring client with epidural reports inability to move legs and hypotension. BP
88/52. FHR reassuring.
Item type: Prioritization (select the first action)
Actions:
a. Place client in supine position and call MD
b. Administer IV fluid bolus and elevate legs
c. Turn off epidural infusion immediately
d. Give ephedrine IV per protocol
Answer: b (first), then c, d, a
Rationale: Treat hypotension first with fluid bolus to restore perfusion; then address epidural
and vasopressor per protocol and notify MD.
3.
Item type: Multiple-response (select all that apply)
Question: Risk factors for postpartum hemorrhage (PPH).
a. Uterine atony
b. Prolonged oxytocin infusion without breaks
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,c. Grand multiparity (≥5)
d. Polyhydramnios
Answers: a, c, d
Rationale: Uterine atony and high parity and polyhydramnios increase PPH risk; prolonged
oxytocin unexpected — oxytocin is used to prevent PPH.
4.
Case: Newborn 2 hours old, born vaginally, meconium-stained amniotic fluid, vigorous
respirations and strong cry.
Item type: Multiple-choice
a. Immediate intubation and tracheal suctioning
b. Routine care and monitor
c. CPAP in NICU immediately
d. Umbilical cord blood gas only
Answer: b
Rationale: Vigorous infant with meconium-stained fluid needs routine care and monitoring;
aggressive suctioning reserved for nonvigorous infants.
5.
Item type: Sequencing (put in order)
Question: Steps for managing moderate preeclampsia at 37 weeks with stable maternal and
fetal status. Options:
a. Administer magnesium sulfate for seizure prophylaxis
b. Plan induction of labor after maternal stabilization
c. Control BP with labetalol or hydralazine if needed
d. Obtain baseline labs (CBC, liver enzymes, creatinine)
Correct sequence: d → c → a (if severe features or per protocol) → b (after stabilization)
Rationale: Baseline labs first, control BP, use MgSO4 if indicated for severe features or
intrapartum prophylaxis, then induce when stable.
6.
Item type: Multiple-response
Question: Expected physiologic changes in pregnancy (select all).
a. Increased plasma volume
b. Decreased cardiac output
c. Increased respiratory tidal volume
d. Hypercoagulable state
Answers: a, c, d
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,Rationale: Pregnancy increases plasma volume, tidal volume, and clotting factors; cardiac
output increases, not decreases.
7.
Case: G2P1 with suspected PROM at 36+2 weeks; nitrazine test positive, pooling observed. No
signs of infection; FHR reactive.
Item type: Multiple-choice
a. Immediate induction with oxytocin
b. Admit, monitor, start latency antibiotics and evaluate for labor and infection
c. Discharge home and return in 48 hours
d. Immediate cesarean section
Answer: b
Rationale: Preterm PROM requires monitoring, latency antibiotics per protocol, and assessment;
immediate induction not always indicated.
8.
Item type: Multiple-response
Question: Management priorities for a nonreassuring fetal status (late decelerations).
a. Reposition mother to lateral position
b. Increase IV fluids
c. Administer oxygen via face mask
d. Start terbutaline to stop labor immediately
Answers: a, b, c
Rationale: Reposition, fluids, oxygen improve uteroplacental perfusion; terbutaline is for uterine
tachysystole, not routine for late decels.
9.
Case: Postpartum day 2, mom has localized breast pain, erythema, fever 38.6°C, area of
fluctuant mass.
Item type: Multiple-choice
a. Mastitis with possible abscess — evaluate and consider antibiotics and incision & drainage if
abscess confirmed
b. Normal engorgement — reassure and continue breastfeeding
c. Plugged duct — treat with massage only
d. Endometritis — start broad antibiotics
Answer: a
Rationale: Fever, fluctuant mass suggests mastitis with abscess; requires antibiotics and
drainage.
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, 10.
Item type: Multiple-choice
Question: Best initial action when uterine tachysystole with decelerations occurs after oxytocin
infusion.
a. Increase oxytocin to overcome tachysystole
b. Stop oxytocin infusion, reposition, give oxygen, and notify provider
c. Change to maternal supine position and continue infusion
d. Administer opioid for pain
Answer: b
Rationale: Stopping oxytocin and supportive measures is first-line for tachysystole-related fetal
distress.
11.
Case: Newborn at term breastfeeding initiation — latch painful and shallow. Nurse observes
areolar tissue visible and infant’s lips flanged outward.
Item type: Multiple-choice
a. Poor latch — reposition and facilitate deeper latch; teach techniques
b. Normal latch — no interventions
c. Suggest formula supplementation immediately
d. Refer to lactation if pain persists but not to reposition now
Answer: a
Rationale: Proper latch includes flanged lips and areola in mouth; shallow latch causes pain —
repositioning helps.
12.
Item type: Multiple-response
Question: Contraindications to breastfeeding.
a. Infant with classic galactosemia
b. Mother HIV positive (resource-limited settings variable)
c. Mother on isoniazid only
d. Mother using illicit methamphetamines
Answers: a, d, b (context-dependent; for high-income settings, HIV is contraindication)
Rationale: Galactosemia contraindicates breastfeeding; illicit drug use contraindicates; HIV
depends on context — in many high-resource settings, HIV-positive mothers are advised not to
breastfeed.
13.
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2025 ACTUAL EXAM COMPLETE 100 QUESTIONS
WITH DETAILED VERIFIED ANSWERS (100%
CORRECT ANSWERS) / ALREADY GRADED A+
1.
Case: 36-week gestation G1 presents with sudden bright-red vaginal bleeding and severe
abdominal pain. FHR shows tachycardia and late decelerations.
Item type: Multiple-choice (single best)
a. Placenta previa
b. Vasa previa
c. Placental abruption
d. Uterine rupture
Answer: c
Rationale: Sudden painful bleeding with fetal distress suggests abruption; placenta previa
usually painless.
2.
Case: 39-week laboring client with epidural reports inability to move legs and hypotension. BP
88/52. FHR reassuring.
Item type: Prioritization (select the first action)
Actions:
a. Place client in supine position and call MD
b. Administer IV fluid bolus and elevate legs
c. Turn off epidural infusion immediately
d. Give ephedrine IV per protocol
Answer: b (first), then c, d, a
Rationale: Treat hypotension first with fluid bolus to restore perfusion; then address epidural
and vasopressor per protocol and notify MD.
3.
Item type: Multiple-response (select all that apply)
Question: Risk factors for postpartum hemorrhage (PPH).
a. Uterine atony
b. Prolonged oxytocin infusion without breaks
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,c. Grand multiparity (≥5)
d. Polyhydramnios
Answers: a, c, d
Rationale: Uterine atony and high parity and polyhydramnios increase PPH risk; prolonged
oxytocin unexpected — oxytocin is used to prevent PPH.
4.
Case: Newborn 2 hours old, born vaginally, meconium-stained amniotic fluid, vigorous
respirations and strong cry.
Item type: Multiple-choice
a. Immediate intubation and tracheal suctioning
b. Routine care and monitor
c. CPAP in NICU immediately
d. Umbilical cord blood gas only
Answer: b
Rationale: Vigorous infant with meconium-stained fluid needs routine care and monitoring;
aggressive suctioning reserved for nonvigorous infants.
5.
Item type: Sequencing (put in order)
Question: Steps for managing moderate preeclampsia at 37 weeks with stable maternal and
fetal status. Options:
a. Administer magnesium sulfate for seizure prophylaxis
b. Plan induction of labor after maternal stabilization
c. Control BP with labetalol or hydralazine if needed
d. Obtain baseline labs (CBC, liver enzymes, creatinine)
Correct sequence: d → c → a (if severe features or per protocol) → b (after stabilization)
Rationale: Baseline labs first, control BP, use MgSO4 if indicated for severe features or
intrapartum prophylaxis, then induce when stable.
6.
Item type: Multiple-response
Question: Expected physiologic changes in pregnancy (select all).
a. Increased plasma volume
b. Decreased cardiac output
c. Increased respiratory tidal volume
d. Hypercoagulable state
Answers: a, c, d
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,Rationale: Pregnancy increases plasma volume, tidal volume, and clotting factors; cardiac
output increases, not decreases.
7.
Case: G2P1 with suspected PROM at 36+2 weeks; nitrazine test positive, pooling observed. No
signs of infection; FHR reactive.
Item type: Multiple-choice
a. Immediate induction with oxytocin
b. Admit, monitor, start latency antibiotics and evaluate for labor and infection
c. Discharge home and return in 48 hours
d. Immediate cesarean section
Answer: b
Rationale: Preterm PROM requires monitoring, latency antibiotics per protocol, and assessment;
immediate induction not always indicated.
8.
Item type: Multiple-response
Question: Management priorities for a nonreassuring fetal status (late decelerations).
a. Reposition mother to lateral position
b. Increase IV fluids
c. Administer oxygen via face mask
d. Start terbutaline to stop labor immediately
Answers: a, b, c
Rationale: Reposition, fluids, oxygen improve uteroplacental perfusion; terbutaline is for uterine
tachysystole, not routine for late decels.
9.
Case: Postpartum day 2, mom has localized breast pain, erythema, fever 38.6°C, area of
fluctuant mass.
Item type: Multiple-choice
a. Mastitis with possible abscess — evaluate and consider antibiotics and incision & drainage if
abscess confirmed
b. Normal engorgement — reassure and continue breastfeeding
c. Plugged duct — treat with massage only
d. Endometritis — start broad antibiotics
Answer: a
Rationale: Fever, fluctuant mass suggests mastitis with abscess; requires antibiotics and
drainage.
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, 10.
Item type: Multiple-choice
Question: Best initial action when uterine tachysystole with decelerations occurs after oxytocin
infusion.
a. Increase oxytocin to overcome tachysystole
b. Stop oxytocin infusion, reposition, give oxygen, and notify provider
c. Change to maternal supine position and continue infusion
d. Administer opioid for pain
Answer: b
Rationale: Stopping oxytocin and supportive measures is first-line for tachysystole-related fetal
distress.
11.
Case: Newborn at term breastfeeding initiation — latch painful and shallow. Nurse observes
areolar tissue visible and infant’s lips flanged outward.
Item type: Multiple-choice
a. Poor latch — reposition and facilitate deeper latch; teach techniques
b. Normal latch — no interventions
c. Suggest formula supplementation immediately
d. Refer to lactation if pain persists but not to reposition now
Answer: a
Rationale: Proper latch includes flanged lips and areola in mouth; shallow latch causes pain —
repositioning helps.
12.
Item type: Multiple-response
Question: Contraindications to breastfeeding.
a. Infant with classic galactosemia
b. Mother HIV positive (resource-limited settings variable)
c. Mother on isoniazid only
d. Mother using illicit methamphetamines
Answers: a, d, b (context-dependent; for high-income settings, HIV is contraindication)
Rationale: Galactosemia contraindicates breastfeeding; illicit drug use contraindicates; HIV
depends on context — in many high-resource settings, HIV-positive mothers are advised not to
breastfeed.
13.
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