ATI PN Maternal Proctored Exam 2026 |
ACTUAL EXAM | Complete Maternal–Newborn
& NGN OB Actual Questions with Verified
Answers | Latest Update
1
A client at 28 weeks’ gestation reports painless, bright-red vaginal bleeding after
intercourse. Her fundal height is appropriate for gestational age, and fetal heart rate is
140 bpm with moderate variability. Which condition should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Vasa previa
Correct Answer: A
Rationale: Painless, bright-red bleeding in the third trimester, especially after
intercourse, is classic for placenta previa. The stable fetal heart rate and absence of
uterine tenderness further support this diagnosis. Abruptio placentae presents with
painful bleeding and uterine irritability. Preterm labor involves contractions and cervical
change. Vasa previa bleeding is fetal in origin and often causes fetal bradycardia.
2
,A client in active labor at 6 cm dilation receives an epidural. Within 10 minutes, her
blood pressure drops from 118/78 to 88/50 mmHg. What is the nurse’s immediate
action?
A. Place the client in Trendelenburg position
B. Administer oxygen at 8–10 L/min via face mask
C. Increase the IV rate rapidly and give ephedrine 5–10 mg IV
D. Turn off the epidural infusion
Correct Answer: C
Rationale: Hypotension after epidural is caused by sympathetic blockade and decreased
venous return. Rapid IV fluid bolus restores preload; ephedrine (a vasopressor) is the
first-line pharmacologic intervention. Trendelenburg may worsen aortocaval
compression. Oxygen is adjunctive but does not treat the primary cause. Stopping the
infusion is not the initial priority.
3
Case Study (NGN) – Part A
Client: G2P1 at 39 weeks admitted in active labor. Cervix 8 cm/100%/0 station.
Membranes ruptured 2 h ago, clear fluid. Baseline FHR 135 bpm.
Moderate variability, no decelerations noted for 20 min.
Q3A: Which finding requires immediate notification of the provider?
A. FHR 155 bpm for 15 min
B. Moderate variability
,C. Early decelerations with contractions
D. Late decelerations beginning at 6 cm
Correct Answer: D
Rationale: Late decelerations indicate uteroplacental insufficiency and require prompt
intervention. FHR 155 bpm is within normal range (110–160). Moderate variability is
reassuring. Early decelerations are benign, reflecting fetal head compression.
4
Case Study – Part B
Same client now 9 cm; late decelerations persist despite IV fluid bolus and lateral
positioning.
Q3B: Select the two most appropriate nursing actions at this time. (Select all that apply.)
A. Administer terbutaline 0.25 mg SQ
B. Apply oxygen at 10 L/min via tight face mask
C. Start amnioinfusion
D. Perform scalp stimulation
Correct Answer: A, B
Rationale: Terbutaline relaxes uterine tone, improving placental perfusion; oxygen
increases fetal oxygenation. Amnioinfusion is used for variable decelerations due to
cord compression. Scalp stimulation assesses fetal well-being but does not treat
uteroplacental insufficiency.
, 5
Matrix / NGN Select-by-Cell
Client: Postpartum day 1 after vaginal birth with epidural.
Match potential complication with the most appropriate assessment finding.
TableCopy
Complication Finding
A. Uterine atony Boggy fundus above umbilicus
B. Infection Temperature 38.4 °C × 2
C. Urinary retention Fundus deviated right, 2 cm above umbilicus
Correct Answer: A–Boggy fundus; B–Temp 38.4 °C; C–Fundus deviated right
Rationale: Uterine atony presents with a soft, boggy fundus that rises. Infection causes
low-grade fever >38 °C on two occasions. A full bladder displaces the uterus upward
and rightward.
6
Bow-Tie (NGN) – Client: 34 weeks, BP 160/110, proteinuria 3+, epigastric pain.
Diagnosis: severe preeclampsia.
Complete the bow-tie by selecting from the lists:
Causes/Risk Factors
ACTUAL EXAM | Complete Maternal–Newborn
& NGN OB Actual Questions with Verified
Answers | Latest Update
1
A client at 28 weeks’ gestation reports painless, bright-red vaginal bleeding after
intercourse. Her fundal height is appropriate for gestational age, and fetal heart rate is
140 bpm with moderate variability. Which condition should the nurse suspect?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Vasa previa
Correct Answer: A
Rationale: Painless, bright-red bleeding in the third trimester, especially after
intercourse, is classic for placenta previa. The stable fetal heart rate and absence of
uterine tenderness further support this diagnosis. Abruptio placentae presents with
painful bleeding and uterine irritability. Preterm labor involves contractions and cervical
change. Vasa previa bleeding is fetal in origin and often causes fetal bradycardia.
2
,A client in active labor at 6 cm dilation receives an epidural. Within 10 minutes, her
blood pressure drops from 118/78 to 88/50 mmHg. What is the nurse’s immediate
action?
A. Place the client in Trendelenburg position
B. Administer oxygen at 8–10 L/min via face mask
C. Increase the IV rate rapidly and give ephedrine 5–10 mg IV
D. Turn off the epidural infusion
Correct Answer: C
Rationale: Hypotension after epidural is caused by sympathetic blockade and decreased
venous return. Rapid IV fluid bolus restores preload; ephedrine (a vasopressor) is the
first-line pharmacologic intervention. Trendelenburg may worsen aortocaval
compression. Oxygen is adjunctive but does not treat the primary cause. Stopping the
infusion is not the initial priority.
3
Case Study (NGN) – Part A
Client: G2P1 at 39 weeks admitted in active labor. Cervix 8 cm/100%/0 station.
Membranes ruptured 2 h ago, clear fluid. Baseline FHR 135 bpm.
Moderate variability, no decelerations noted for 20 min.
Q3A: Which finding requires immediate notification of the provider?
A. FHR 155 bpm for 15 min
B. Moderate variability
,C. Early decelerations with contractions
D. Late decelerations beginning at 6 cm
Correct Answer: D
Rationale: Late decelerations indicate uteroplacental insufficiency and require prompt
intervention. FHR 155 bpm is within normal range (110–160). Moderate variability is
reassuring. Early decelerations are benign, reflecting fetal head compression.
4
Case Study – Part B
Same client now 9 cm; late decelerations persist despite IV fluid bolus and lateral
positioning.
Q3B: Select the two most appropriate nursing actions at this time. (Select all that apply.)
A. Administer terbutaline 0.25 mg SQ
B. Apply oxygen at 10 L/min via tight face mask
C. Start amnioinfusion
D. Perform scalp stimulation
Correct Answer: A, B
Rationale: Terbutaline relaxes uterine tone, improving placental perfusion; oxygen
increases fetal oxygenation. Amnioinfusion is used for variable decelerations due to
cord compression. Scalp stimulation assesses fetal well-being but does not treat
uteroplacental insufficiency.
, 5
Matrix / NGN Select-by-Cell
Client: Postpartum day 1 after vaginal birth with epidural.
Match potential complication with the most appropriate assessment finding.
TableCopy
Complication Finding
A. Uterine atony Boggy fundus above umbilicus
B. Infection Temperature 38.4 °C × 2
C. Urinary retention Fundus deviated right, 2 cm above umbilicus
Correct Answer: A–Boggy fundus; B–Temp 38.4 °C; C–Fundus deviated right
Rationale: Uterine atony presents with a soft, boggy fundus that rises. Infection causes
low-grade fever >38 °C on two occasions. A full bladder displaces the uterus upward
and rightward.
6
Bow-Tie (NGN) – Client: 34 weeks, BP 160/110, proteinuria 3+, epigastric pain.
Diagnosis: severe preeclampsia.
Complete the bow-tie by selecting from the lists:
Causes/Risk Factors
