ATI PN Maternal Proctored Exam 2026 | ACTUAL
EXAM | Complete Maternal–Newborn & NGN OB
Practice Questions with Verified Answers | Latest
Update
1. A primigravida at 39 weeks gestation is admitted in active labor. Her cervix is 6 cm
dilated, 80% effaced, and the fetal head is at 0 station. Contractions are every 3 minutes,
lasting 60 seconds. Which finding should the PN report immediately?
A. Fetal heart rate (FHR) baseline 150 bpm with moderate variability
B. Maternal temperature 37.8 °C (100 °F)
C. FHR deceleration to 90 bpm lasting 90 seconds after contraction onset
D. Maternal BP 118/76 mm Hg
Correct Answer: C
Rationale: Late decelerations that are prolonged (>60 s) and drop to 90 bpm indicate possible
uteroplacental insufficiency (C) and require immediate intervention. Baseline 150 with moderate
variability (A) is reassuring. Mild maternal fever (B) is common but not emergent. Normal BP
(D) is reassuring.
2. A client at 28 weeks gestation reports sudden, painless vaginal bleeding that stopped after
30 minutes. Fetal movement is active. Which condition should the PN suspect first?
A. Placenta previa
B. Abruptio placentae
,C. Preterm labor
D. Bloody show
Correct Answer: A
Rationale: Sudden, painless bleeding in the third trimester (A) is classic for placenta previa.
Abruptio (B) presents with pain and often persistent bleeding. Preterm labor (C) includes
contractions. Bloody show (D) is pink-tinged mucus near term.
3. A client receives betamethasone 12 mg IM for threatened preterm labor at 30 weeks.
Which instruction should the PN reinforce?
A. Return for a second dose in 24 hours
B. Expect immediate cessation of contractions
C. Monitor for hypotension
D. Begin breastfeeding classes today
Correct Answer: A
Rationale: The standard antenatal corticosteroid regimen is two doses 24 h apart (A) to enhance
fetal lung maturity. Betamethasone does not stop contractions (B). Hypotension (C) is not a
typical concern. Breastfeeding education (D) is premature during an acute event.
4. A newborn is delivered at 38 weeks with Apgar scores of 6 and 8 at 1 and 5 minutes. The
PN notes mild subcostal retractions and nasal flaring. Which action is priority?
A. Stimulate by rubbing the back
B. Apply free-flow oxygen via mask
C. Obtain blood glucose
,D. Wrap in warm blankets
Correct Answer: B
Rationale: Signs of respiratory distress (retractions, flaring) require immediate oxygen support
(B). Stimulation (A) is for primary apnea. Glucose (C) and thermoregulation (D) are important
but not the first priority for visible respiratory compromise.
5. A laboring client’s fetal monitor shows variable decelerations to 90 bpm that recover
quickly. Which nursing action is most appropriate?
A. Administer oxygen 8–10 L/min via non-rebreather mask
B. Increase IV oxytocin to accelerate labor
C. Place client supine with legs elevated
D. Prepare for immediate cesarean delivery
Correct Answer: A
Rationale: Variable decels suggest cord compression; first-line intrauterine resuscitation includes
high-flow O2 to mother (A). Increasing oxytocin (B) worsens compression. Supine position (C)
reduces placental perfusion. Cesarean (D) is premature without persistent bradycardia.
6. A client at 34 weeks gestation with gestational hypertension reports severe headache and
blurred vision. BP is 160/110 mm Hg. Which order should the PN implement first?
A. Administer magnesium sulfate 4 g IV loading dose
B. Start 24-hour urine protein collection
C. Obtain blood for liver enzymes
D. Give hydralazine 10 mg IV
, Correct Answer: A
Rationale: Severe-range BP with neurologic symptoms indicates preeclampsia; magnesium
sulfate (A) prevents eclampsia-seizure and is the priority. Labs (B,C) and antihypertensive (D)
follow seizure prophylaxis.
7. A client in the fourth stage of labor has a fundus that is boggy, 2 cm above the umbilicus,
and deviated to the right. Which action should the PN take first?
A. Assist client to void
B. Massage fundus until firm
C. Increase IV oxytocin
D. Notify provider of possible retained placenta
Correct Answer: A
Rationale: A full bladder displaces the uterus and inhibits contraction; assisting void (A) is the
first corrective action. Massage (B) is done after bladder emptying. Increasing oxytocin (C) is
provider-ordered. Retained placenta (D) is considered only after bladder is emptied and fundus
remains boggy.
8. A breastfeeding client on postpartum day 2 reports nipple pain and fissures. Which
instruction is most appropriate?
A. Apply warm compresses before feedings
B. Use a nipple shield with every feeding
C. Position baby with nose to nipple and wide open mouth
D. Limit feeding to 5 minutes per breast
EXAM | Complete Maternal–Newborn & NGN OB
Practice Questions with Verified Answers | Latest
Update
1. A primigravida at 39 weeks gestation is admitted in active labor. Her cervix is 6 cm
dilated, 80% effaced, and the fetal head is at 0 station. Contractions are every 3 minutes,
lasting 60 seconds. Which finding should the PN report immediately?
A. Fetal heart rate (FHR) baseline 150 bpm with moderate variability
B. Maternal temperature 37.8 °C (100 °F)
C. FHR deceleration to 90 bpm lasting 90 seconds after contraction onset
D. Maternal BP 118/76 mm Hg
Correct Answer: C
Rationale: Late decelerations that are prolonged (>60 s) and drop to 90 bpm indicate possible
uteroplacental insufficiency (C) and require immediate intervention. Baseline 150 with moderate
variability (A) is reassuring. Mild maternal fever (B) is common but not emergent. Normal BP
(D) is reassuring.
2. A client at 28 weeks gestation reports sudden, painless vaginal bleeding that stopped after
30 minutes. Fetal movement is active. Which condition should the PN suspect first?
A. Placenta previa
B. Abruptio placentae
,C. Preterm labor
D. Bloody show
Correct Answer: A
Rationale: Sudden, painless bleeding in the third trimester (A) is classic for placenta previa.
Abruptio (B) presents with pain and often persistent bleeding. Preterm labor (C) includes
contractions. Bloody show (D) is pink-tinged mucus near term.
3. A client receives betamethasone 12 mg IM for threatened preterm labor at 30 weeks.
Which instruction should the PN reinforce?
A. Return for a second dose in 24 hours
B. Expect immediate cessation of contractions
C. Monitor for hypotension
D. Begin breastfeeding classes today
Correct Answer: A
Rationale: The standard antenatal corticosteroid regimen is two doses 24 h apart (A) to enhance
fetal lung maturity. Betamethasone does not stop contractions (B). Hypotension (C) is not a
typical concern. Breastfeeding education (D) is premature during an acute event.
4. A newborn is delivered at 38 weeks with Apgar scores of 6 and 8 at 1 and 5 minutes. The
PN notes mild subcostal retractions and nasal flaring. Which action is priority?
A. Stimulate by rubbing the back
B. Apply free-flow oxygen via mask
C. Obtain blood glucose
,D. Wrap in warm blankets
Correct Answer: B
Rationale: Signs of respiratory distress (retractions, flaring) require immediate oxygen support
(B). Stimulation (A) is for primary apnea. Glucose (C) and thermoregulation (D) are important
but not the first priority for visible respiratory compromise.
5. A laboring client’s fetal monitor shows variable decelerations to 90 bpm that recover
quickly. Which nursing action is most appropriate?
A. Administer oxygen 8–10 L/min via non-rebreather mask
B. Increase IV oxytocin to accelerate labor
C. Place client supine with legs elevated
D. Prepare for immediate cesarean delivery
Correct Answer: A
Rationale: Variable decels suggest cord compression; first-line intrauterine resuscitation includes
high-flow O2 to mother (A). Increasing oxytocin (B) worsens compression. Supine position (C)
reduces placental perfusion. Cesarean (D) is premature without persistent bradycardia.
6. A client at 34 weeks gestation with gestational hypertension reports severe headache and
blurred vision. BP is 160/110 mm Hg. Which order should the PN implement first?
A. Administer magnesium sulfate 4 g IV loading dose
B. Start 24-hour urine protein collection
C. Obtain blood for liver enzymes
D. Give hydralazine 10 mg IV
, Correct Answer: A
Rationale: Severe-range BP with neurologic symptoms indicates preeclampsia; magnesium
sulfate (A) prevents eclampsia-seizure and is the priority. Labs (B,C) and antihypertensive (D)
follow seizure prophylaxis.
7. A client in the fourth stage of labor has a fundus that is boggy, 2 cm above the umbilicus,
and deviated to the right. Which action should the PN take first?
A. Assist client to void
B. Massage fundus until firm
C. Increase IV oxytocin
D. Notify provider of possible retained placenta
Correct Answer: A
Rationale: A full bladder displaces the uterus and inhibits contraction; assisting void (A) is the
first corrective action. Massage (B) is done after bladder emptying. Increasing oxytocin (C) is
provider-ordered. Retained placenta (D) is considered only after bladder is emptied and fundus
remains boggy.
8. A breastfeeding client on postpartum day 2 reports nipple pain and fissures. Which
instruction is most appropriate?
A. Apply warm compresses before feedings
B. Use a nipple shield with every feeding
C. Position baby with nose to nipple and wide open mouth
D. Limit feeding to 5 minutes per breast
