ATI PN Maternal Proctored Exam 2026 |
ACTUAL EXAM | Complete Maternal–Newborn
& NGN OB Questions with Verified Answers |
Latest Update
1
A primigravida at 39 weeks’ gestation is admitted in active labor. Her cervix is 6 cm
dilated, 90% effaced, and 0 station. Contractions are every 3 minutes, lasting 60
seconds. Which finding should the PN report immediately?
A. Fetal heart rate 140 beats/min
B. Blood pressure 118/78 mm Hg
C. Uterine resting tone 30 mm Hg between contractions
D. Temperature 37.1 °C
Correct Answer: C
Rationale: Normal resting tone between contractions is ≤20 mm Hg; 30 mm Hg
suggests uterine hyperstimulation or inadequate relaxation, risking fetal hypoxia. FHR
140 (A) is normal, BP 118/78 (B) is acceptable, and low-grade temp (D) is not urgent.
,2
A client at 28 weeks’ gestation reports painless vaginal bleeding after intercourse. Fetal
heart rate is 145 beats/min, uterus soft and non-tender. Which complication is most
likely?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Vasa previa
Correct Answer: A
Rationale: Painless bleeding with a soft, non-tender uterus after 28 weeks is classic for
placenta previa. Abruptio (B) presents with pain and firm uterus, preterm labor (C) with
contractions, vasa previa (D) with minimal bleeding and fetal heart changes.
3
A client in the recovery room after a cesarean birth is receiving oxytocin 20 units in 1000
mL LR at 125 mL/h. The PN notes a boggy uterus 2 cm above the umbilicus. Which
action is priority?
A. Increase oxytocin rate
B. Massage the uterus fundus
,C. Check the perineal pad saturation
D. Encourage oral fluids
Correct Answer: B
Rationale: Fundal massage (B) stimulates contractions and controls bleeding. Oxytocin
rate (A) should not be altered without an order. Pad check (C) is secondary, and oral
fluids (D) do not address uterine atony.
4
A term newborn is jittery 30 minutes after birth. Blood glucose is 35 mg/dL. Which
intervention should the PN implement first?
A. Apply oxygen via nasal cannula
B. Facilitate early breastfeeding
C. Obtain a serum calcium level
D. Wrap the newborn in warm blankets
Correct Answer: B
Rationale: Early feeding (B) provides glucose and raises blood sugar. Oxygen (A) is
unnecessary, calcium (C) is not immediate, and warming (D) helps but does not correct
hypoglycemia.
, 5
A client at 34 weeks’ gestation with pregnancy-induced hypertension is receiving
magnesium sulfate 2 g/h IV. Which finding indicates toxicity?
A. Urine output 40 mL/h
B. Respiratory rate 16 breaths/min
C. Absent deep tendon reflexes
D. Flushing and warmth
Correct Answer: C
Rationale: Loss of DTRs (C) is an early sign of hypermagnesemia. Urine 40 mL/h (A) is
acceptable, RR 16 (B) is borderline but not toxic, flushing (D) is a common side effect,
not toxicity.
6
A client at 40 weeks’ gestation is experiencing late decelerations on the fetal monitor.
Which action should the PN take first?
A. Stop the oxytocin infusion
B. Turn the client onto her left side
ACTUAL EXAM | Complete Maternal–Newborn
& NGN OB Questions with Verified Answers |
Latest Update
1
A primigravida at 39 weeks’ gestation is admitted in active labor. Her cervix is 6 cm
dilated, 90% effaced, and 0 station. Contractions are every 3 minutes, lasting 60
seconds. Which finding should the PN report immediately?
A. Fetal heart rate 140 beats/min
B. Blood pressure 118/78 mm Hg
C. Uterine resting tone 30 mm Hg between contractions
D. Temperature 37.1 °C
Correct Answer: C
Rationale: Normal resting tone between contractions is ≤20 mm Hg; 30 mm Hg
suggests uterine hyperstimulation or inadequate relaxation, risking fetal hypoxia. FHR
140 (A) is normal, BP 118/78 (B) is acceptable, and low-grade temp (D) is not urgent.
,2
A client at 28 weeks’ gestation reports painless vaginal bleeding after intercourse. Fetal
heart rate is 145 beats/min, uterus soft and non-tender. Which complication is most
likely?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Vasa previa
Correct Answer: A
Rationale: Painless bleeding with a soft, non-tender uterus after 28 weeks is classic for
placenta previa. Abruptio (B) presents with pain and firm uterus, preterm labor (C) with
contractions, vasa previa (D) with minimal bleeding and fetal heart changes.
3
A client in the recovery room after a cesarean birth is receiving oxytocin 20 units in 1000
mL LR at 125 mL/h. The PN notes a boggy uterus 2 cm above the umbilicus. Which
action is priority?
A. Increase oxytocin rate
B. Massage the uterus fundus
,C. Check the perineal pad saturation
D. Encourage oral fluids
Correct Answer: B
Rationale: Fundal massage (B) stimulates contractions and controls bleeding. Oxytocin
rate (A) should not be altered without an order. Pad check (C) is secondary, and oral
fluids (D) do not address uterine atony.
4
A term newborn is jittery 30 minutes after birth. Blood glucose is 35 mg/dL. Which
intervention should the PN implement first?
A. Apply oxygen via nasal cannula
B. Facilitate early breastfeeding
C. Obtain a serum calcium level
D. Wrap the newborn in warm blankets
Correct Answer: B
Rationale: Early feeding (B) provides glucose and raises blood sugar. Oxygen (A) is
unnecessary, calcium (C) is not immediate, and warming (D) helps but does not correct
hypoglycemia.
, 5
A client at 34 weeks’ gestation with pregnancy-induced hypertension is receiving
magnesium sulfate 2 g/h IV. Which finding indicates toxicity?
A. Urine output 40 mL/h
B. Respiratory rate 16 breaths/min
C. Absent deep tendon reflexes
D. Flushing and warmth
Correct Answer: C
Rationale: Loss of DTRs (C) is an early sign of hypermagnesemia. Urine 40 mL/h (A) is
acceptable, RR 16 (B) is borderline but not toxic, flushing (D) is a common side effect,
not toxicity.
6
A client at 40 weeks’ gestation is experiencing late decelerations on the fetal monitor.
Which action should the PN take first?
A. Stop the oxytocin infusion
B. Turn the client onto her left side
