ATI PROCTORED EXAM OB MATERNAL
NEWBORN 2026 CLINICAL REASONING
CASES AND STEP BY STEP EXPLANATIONS
GUIDE
◉ Variable decels mean:
Answer: Umbilical cord compression
Short cord
Prolapsed cord
Nuchal cord
Oligohydraminos
◉ Fetal descent and cervical dilation are caused by
Answer: Frequency, duration, and strength of contractions
◉ What is the sensation the patient will feel when completion of
dilation and fetal descent?
Answer: She will feel like she needs to take a big ole poooo!
◉ First degree laceration extends through:
Answer: skin of perineum
,◉ Second degree laceration extends through:
Answer: skin of perineum
muscles of perineum
◉ Third degree laceration extends through:
Answer: skin of perineum
muscles of perineum
anal sphincter
◉ Fourth degree laceration extends through:
Answer: skin of perineum
muscles of perineum
anal sphincter
anterior rectal wall
◉ Third stage:
Signs of placental separation from the uterus are indicated by:
Answer: fundus firmly contracting
swift gush from introitus of dark blood
umbilical cord appears to lengthen as placenta descends
vaginal fullness of exam
,◉ There is a high risk of _________ surrounding external cephalic
version.
Answer: Cord prolapse
◉ Regarding BISHOP scoring, when is a woman ready for labor?
Answer: A score of
9 for nulliparas
5 or more for multiparas
◉ Mechanical methods to ripen cervix:
Answer: balloon caths
hydroscopic dilators and sponges
laminara tents
synthetic dilators and sponges
◉ Methods of induction
Answer: prostaglandins applied cervically
admin of IV oxytocin
amniotomy
stripping of membranes
nipple stimulation
, ◉ Dystocia
Answer: prolonged, difficult labor
◉ Before administering pitocin, where should the fetus be?
Answer: engaged in the birth canal at a minimum of 0 station.
◉ Discontinue oxytocin if:
Answer: contraction frequency more often than every 2 mins
contraction duration longer than 90 seconds
no relaxation of uterus between contractions
uterine resting tone greater than 20 mmHg between ctx
◉ Labor typically begins within ___ hours after ROM.
Answer: 12
◉ An amnioinfusion can be used to:
Answer: Reduce severity of variable decelerations (cord
compression)
Dilute meconium-stained amniotic fluid
◉ Caput Succedaneum is:
NEWBORN 2026 CLINICAL REASONING
CASES AND STEP BY STEP EXPLANATIONS
GUIDE
◉ Variable decels mean:
Answer: Umbilical cord compression
Short cord
Prolapsed cord
Nuchal cord
Oligohydraminos
◉ Fetal descent and cervical dilation are caused by
Answer: Frequency, duration, and strength of contractions
◉ What is the sensation the patient will feel when completion of
dilation and fetal descent?
Answer: She will feel like she needs to take a big ole poooo!
◉ First degree laceration extends through:
Answer: skin of perineum
,◉ Second degree laceration extends through:
Answer: skin of perineum
muscles of perineum
◉ Third degree laceration extends through:
Answer: skin of perineum
muscles of perineum
anal sphincter
◉ Fourth degree laceration extends through:
Answer: skin of perineum
muscles of perineum
anal sphincter
anterior rectal wall
◉ Third stage:
Signs of placental separation from the uterus are indicated by:
Answer: fundus firmly contracting
swift gush from introitus of dark blood
umbilical cord appears to lengthen as placenta descends
vaginal fullness of exam
,◉ There is a high risk of _________ surrounding external cephalic
version.
Answer: Cord prolapse
◉ Regarding BISHOP scoring, when is a woman ready for labor?
Answer: A score of
9 for nulliparas
5 or more for multiparas
◉ Mechanical methods to ripen cervix:
Answer: balloon caths
hydroscopic dilators and sponges
laminara tents
synthetic dilators and sponges
◉ Methods of induction
Answer: prostaglandins applied cervically
admin of IV oxytocin
amniotomy
stripping of membranes
nipple stimulation
, ◉ Dystocia
Answer: prolonged, difficult labor
◉ Before administering pitocin, where should the fetus be?
Answer: engaged in the birth canal at a minimum of 0 station.
◉ Discontinue oxytocin if:
Answer: contraction frequency more often than every 2 mins
contraction duration longer than 90 seconds
no relaxation of uterus between contractions
uterine resting tone greater than 20 mmHg between ctx
◉ Labor typically begins within ___ hours after ROM.
Answer: 12
◉ An amnioinfusion can be used to:
Answer: Reduce severity of variable decelerations (cord
compression)
Dilute meconium-stained amniotic fluid
◉ Caput Succedaneum is:
