ATI PN Maternal Proctored Exam 2026 |
ACTUAL EXAM | Complete Maternal–Newborn
& NGN OB Questions with Verified Answers |
Latest Update
Traditional Multiple-Choice Items (1-60)
A gravida 2 para 1 client at 39 weeks’ gestation arrives in triage reporting “my baby isn’t
moving as much.” Which action should the PN implement first?
1. A. Perform a bedside ultrasound for fetal anomalies
B. Apply an external fetal monitor to obtain a 20-minute tracing
C. Offer the client a cold, sweet beverage and re-assess in 30 min
D. Draw blood for a maternal serum alpha-fetoprotein level
Correct Answer: B
Rationale: Current AWHONN/ATI guidelines = immediate FHR assessment (non-stress
test) is priority when decreased fetal movement is reported. Ultrasound (A) is not
first-line unless tracing is non-reassuring. Cold beverage (C) is an outdated folk remedy.
AFP (D) is irrelevant at term.
During transition (8-10 cm), the PN notes early decelerations beginning at the onset of 3
consecutive contractions and returning to baseline by the end of each contraction. The
FHR baseline is 140 bpm with moderate variability. The PN should:
, 2. A. Continue routine monitoring; this is a benign reflex
B. Turn the client onto her back and start O2 at 10 L
C. Notify the provider immediately for possible delivery
D. Document fetal hypoxemia and prepare for stat cesarean
Correct Answer: A
Rationale: Early decels = fetal head compression—benign if variability is present.
Supine/O2 (B) is unnecessary. Immediate delivery (C) or cesarean (D) is not indicated
for this pattern.
A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 10/min
and absent DTRs. Which medication should the PN prepare to administer?
3. A. Calcium gluconate 1 g IV
B. Hydralazine 10 mg IV
C. Labetalol 20 mg IV
D. Naloxone 0.4 mg IV
Correct Answer: A
Rationale: Mag toxicity—calcium gluconate is the antidote. Hydralazine/labetalol (B,C)
treat hypertension, not Mag toxicity. Naloxone (D) reverses opioids.
A term newborn’s axillary temperature is 36.0 °C (96.8 °F) 30 minutes after birth. The
PN’s initial action is to:
4. A. Bathe the newborn to stimulate circulation
B. Place the newborn skin-to-skin on the mother’s chest and cover with a warm
blanket
C. Obtain a serum glucose by heel stick
D. Apply a warmed cap and place under a radiant warmer
,Correct Answer: B
Rationale: Skin-to-skin thermoregulation plus covering is first-line per AAP/ATI. Bathing
(A) causes heat loss. Glucose (C) is next if temp does not improve. Radiant warmer (D)
is used only if skin-to-skin is not possible.
A client who delivered vaginally 4 hours ago reports a “gush of blood” when she stood.
The PN finds a boggy uterus at the umbilicus. Which intervention is priority?
5. A. Start an oxytocin infusion
B. Perform fundal massage and re-evaluate
C. Insert an indwelling catheter
D. Call the provider for stat hemoglobin
Correct Answer: B
Rationale: Fundal massage evacuates clots and contracts the uterus—first-line for
boggy fundus. Oxytocin (A) may follow if massage fails. Catheter (C) is useful only if
distension is suspected. Labs (D) do not treat the cause.
A breastfeeding primipara reports nipple pain 8/10 with each latch on day 2. The PN
observes cracked, bleeding nipples and flattened nipples post-feed. Which instruction is
best?
6. A. Limit feeding to 5 min per breast to rest nipples
B. Recommend use of a nipple shield with each feed
C. Teach asymmetric latch and multiple positioning options
D. Suggest formula supplementation until healing occurs
Correct Answer: C
, Rationale: Correct latch/positioning treats mechanical trauma. Time limits (A) reduce
milk transfer and worsen engorgement. Shields (B) are second-line. Formula (D)
undermines breastfeeding and is unnecessary.
A client at 28 weeks’ gestation with gestational diabetes has a 1-hour postprandial
glucose of 165 mg/dL. Which snack should the PN suggest for the next between-meal
interval?
7. A. 8 oz low-fat milk + 1 slice whole-grain toast
B. 1 small apple + 2 tbsp peanut butter
C. 1 cup flavored yogurt
D. 8 oz orange juice + 6 saltine crackers
Correct Answer: B
Rationale: Apple + peanut butter provides complex carbs, protein, and fiber—blunts
glucose spikes. Milk + toast (A) is too carb-dense. Flavored yogurt (C) is high in added
sugar. Juice + crackers (D) is rapid simple sugar.
A newborn is noted to have acrocyanosis at 5 minutes of life. The PN should:
8. A. Apply O2 via nasal cannula at 0.5 L
B. Document the finding and continue routine monitoring
C. Obtain a chest x-ray to rule out congenital heart disease
D. Start blow-by O2 at 5 L
Correct Answer: B
Rationale: Acrocyanosis (peripheral cyanosis) is common in first 24 h if central color
and saturations are normal. Oxygen (A,D) is unnecessary. CXR (C) is premature.
ACTUAL EXAM | Complete Maternal–Newborn
& NGN OB Questions with Verified Answers |
Latest Update
Traditional Multiple-Choice Items (1-60)
A gravida 2 para 1 client at 39 weeks’ gestation arrives in triage reporting “my baby isn’t
moving as much.” Which action should the PN implement first?
1. A. Perform a bedside ultrasound for fetal anomalies
B. Apply an external fetal monitor to obtain a 20-minute tracing
C. Offer the client a cold, sweet beverage and re-assess in 30 min
D. Draw blood for a maternal serum alpha-fetoprotein level
Correct Answer: B
Rationale: Current AWHONN/ATI guidelines = immediate FHR assessment (non-stress
test) is priority when decreased fetal movement is reported. Ultrasound (A) is not
first-line unless tracing is non-reassuring. Cold beverage (C) is an outdated folk remedy.
AFP (D) is irrelevant at term.
During transition (8-10 cm), the PN notes early decelerations beginning at the onset of 3
consecutive contractions and returning to baseline by the end of each contraction. The
FHR baseline is 140 bpm with moderate variability. The PN should:
, 2. A. Continue routine monitoring; this is a benign reflex
B. Turn the client onto her back and start O2 at 10 L
C. Notify the provider immediately for possible delivery
D. Document fetal hypoxemia and prepare for stat cesarean
Correct Answer: A
Rationale: Early decels = fetal head compression—benign if variability is present.
Supine/O2 (B) is unnecessary. Immediate delivery (C) or cesarean (D) is not indicated
for this pattern.
A client receiving magnesium sulfate for preeclampsia has a respiratory rate of 10/min
and absent DTRs. Which medication should the PN prepare to administer?
3. A. Calcium gluconate 1 g IV
B. Hydralazine 10 mg IV
C. Labetalol 20 mg IV
D. Naloxone 0.4 mg IV
Correct Answer: A
Rationale: Mag toxicity—calcium gluconate is the antidote. Hydralazine/labetalol (B,C)
treat hypertension, not Mag toxicity. Naloxone (D) reverses opioids.
A term newborn’s axillary temperature is 36.0 °C (96.8 °F) 30 minutes after birth. The
PN’s initial action is to:
4. A. Bathe the newborn to stimulate circulation
B. Place the newborn skin-to-skin on the mother’s chest and cover with a warm
blanket
C. Obtain a serum glucose by heel stick
D. Apply a warmed cap and place under a radiant warmer
,Correct Answer: B
Rationale: Skin-to-skin thermoregulation plus covering is first-line per AAP/ATI. Bathing
(A) causes heat loss. Glucose (C) is next if temp does not improve. Radiant warmer (D)
is used only if skin-to-skin is not possible.
A client who delivered vaginally 4 hours ago reports a “gush of blood” when she stood.
The PN finds a boggy uterus at the umbilicus. Which intervention is priority?
5. A. Start an oxytocin infusion
B. Perform fundal massage and re-evaluate
C. Insert an indwelling catheter
D. Call the provider for stat hemoglobin
Correct Answer: B
Rationale: Fundal massage evacuates clots and contracts the uterus—first-line for
boggy fundus. Oxytocin (A) may follow if massage fails. Catheter (C) is useful only if
distension is suspected. Labs (D) do not treat the cause.
A breastfeeding primipara reports nipple pain 8/10 with each latch on day 2. The PN
observes cracked, bleeding nipples and flattened nipples post-feed. Which instruction is
best?
6. A. Limit feeding to 5 min per breast to rest nipples
B. Recommend use of a nipple shield with each feed
C. Teach asymmetric latch and multiple positioning options
D. Suggest formula supplementation until healing occurs
Correct Answer: C
, Rationale: Correct latch/positioning treats mechanical trauma. Time limits (A) reduce
milk transfer and worsen engorgement. Shields (B) are second-line. Formula (D)
undermines breastfeeding and is unnecessary.
A client at 28 weeks’ gestation with gestational diabetes has a 1-hour postprandial
glucose of 165 mg/dL. Which snack should the PN suggest for the next between-meal
interval?
7. A. 8 oz low-fat milk + 1 slice whole-grain toast
B. 1 small apple + 2 tbsp peanut butter
C. 1 cup flavored yogurt
D. 8 oz orange juice + 6 saltine crackers
Correct Answer: B
Rationale: Apple + peanut butter provides complex carbs, protein, and fiber—blunts
glucose spikes. Milk + toast (A) is too carb-dense. Flavored yogurt (C) is high in added
sugar. Juice + crackers (D) is rapid simple sugar.
A newborn is noted to have acrocyanosis at 5 minutes of life. The PN should:
8. A. Apply O2 via nasal cannula at 0.5 L
B. Document the finding and continue routine monitoring
C. Obtain a chest x-ray to rule out congenital heart disease
D. Start blow-by O2 at 5 L
Correct Answer: B
Rationale: Acrocyanosis (peripheral cyanosis) is common in first 24 h if central color
and saturations are normal. Oxygen (A,D) is unnecessary. CXR (C) is premature.
