ATI PN Maternal Proctored Exam 2026 |
ACTUAL EXAM | Complete Maternal–Newborn &
NGN OB Actual Questions with Verified Answers
| Latest Update
PART A – TRADITIONAL ATI-STYLE MCQ (Items 1-82)
Question 1
A gravida 2 para 1 client at 39 weeks reports sudden, painless vaginal bleeding that
soaked a peripad in 30 minutes. FHR 130s, moderate variability, no decelerations. Which
action should the PN take FIRST?
A. Perform a sterile vaginal exam to check dilation
B. Start an IV line and obtain a CBC/Type & cross
C. Apply a fetal scalp electrode for continuous monitoring
D. Encourage ambulation to promote comfort
Correct Answer: B
Rationale: Sudden, painless bleeding near term suggests placenta previa until proven
otherwise; sterile vaginal exam (A) could trigger catastrophic hemorrhage. Starting IV
and labs (B) prepares for possible blood loss and surgery. Scalp electrode (C) is
contraindicated with active bleeding; ambulation (D) is unsafe.
Question 2
,Which finding in a 6-hour-old newborn requires immediate notification of the provider?
A. Acrocyanosis and irregular breathing pattern
B. Axillary temperature 37.2 °C (99 °F)
C. Blood glucose 40 mg/dL (2.2 mmol/L)
D. Respiratory rate 58 breaths/min
Correct Answer: C
Rationale: Glucose < 45 mg/dL (C) is hypoglycemia requiring rapid intervention (feed or
IV dextrose). Acrocyanosis/irregular breathing (A) can be normal transition findings;
37.2 °C (B) is within neutral thermal range; 58 rpm (D) is normal newborn respiratory
rate (30-60).
Question 3
A client in active labor receives epidural anesthesia. Which maternal parameter should
the PN monitor every 15 minutes after initiation?
A. Urine output
B. Blood pressure
C. Temperature
D. Oxygen saturation
Correct Answer: B
Rationale: Hypotension is the most common side effect of epidural analgesia due to
sympathetic blockade; BP (B) is checked q 15 min × 4, then q 30 min. Urine output (A) is
,assessed hourly; temp (C) q 4 h unless elevated; SpO₂ (D) only if respiratory depression
suspected.
Question 4
A client at 28 weeks gestation who reports constant abdominal pain and “tightening.”
Uterus is board-like on palpation; small amount of dark-red bleeding noted. FHR
baseline 150 with minimal variability. Which complication is MOST likely?
A. Placenta previa
B. Preterm labor
C. Abruptio placentae
D. Uterine rupture
Correct Answer: C
Rationale: Constant pain, board-like uterus, dark bleeding, and decreased FHR variability
are classic for abruptio placentae (C). Previa (A) is painless bright bleeding; preterm
labor (B) presents with rhythmic contractions; rupture (D) usually occurs in labor with
sudden sharp pain and fetal bradycardia.
Question 5
A client at 8 weeks gestation asks why she must continue taking prenatal vitamins with
folic acid. Which PN response is BEST?
A. “Folic acid reduces the risk of neural-tube defects in the developing embryo.”
B. “It prevents maternal iron-deficiency anemia only.”
C. “Vitamins decrease the chance of gestational diabetes.”
, D. “They ensure your baby will be a normal birth weight.”
Correct Answer: A
Rationale: Folic acid 400-800 mcg daily decreases neural-tube defects by > 70 % (A).
Iron prevents anemia (B) but is not the primary reason for folic acid; vitamins do not
prevent GDM (C) or guarantee birth weight (D).
Question 6
Which finding indicates effective breastfeeding in a 24-hour-old newborn?
A. Audible swallowing heard during feeds
B. Weight loss of 8 % from birth weight
C. Two wet diapers since birth
D. Mother reports nipple pain rated 6/10
Correct Answer: A
Rationale: Audible/visible swallowing (A) confirms milk transfer. 8 % weight loss (B) is
above expected (< 7 % at 24 h); only two wet diapers (C) suggests inadequate intake
(goal = 1 wet diaper per day of life); nipple pain > 3/10 (D) indicates poor latch.
Question 7
A client at 34 weeks gestation with gestational diabetes is receiving an oxytocin
infusion. Which maternal vital sign change requires immediate intervention?
A. Temperature 37.1 °C (98.8 °F)
B. Blood pressure 138/88 mmHg (previously 120/70)
ACTUAL EXAM | Complete Maternal–Newborn &
NGN OB Actual Questions with Verified Answers
| Latest Update
PART A – TRADITIONAL ATI-STYLE MCQ (Items 1-82)
Question 1
A gravida 2 para 1 client at 39 weeks reports sudden, painless vaginal bleeding that
soaked a peripad in 30 minutes. FHR 130s, moderate variability, no decelerations. Which
action should the PN take FIRST?
A. Perform a sterile vaginal exam to check dilation
B. Start an IV line and obtain a CBC/Type & cross
C. Apply a fetal scalp electrode for continuous monitoring
D. Encourage ambulation to promote comfort
Correct Answer: B
Rationale: Sudden, painless bleeding near term suggests placenta previa until proven
otherwise; sterile vaginal exam (A) could trigger catastrophic hemorrhage. Starting IV
and labs (B) prepares for possible blood loss and surgery. Scalp electrode (C) is
contraindicated with active bleeding; ambulation (D) is unsafe.
Question 2
,Which finding in a 6-hour-old newborn requires immediate notification of the provider?
A. Acrocyanosis and irregular breathing pattern
B. Axillary temperature 37.2 °C (99 °F)
C. Blood glucose 40 mg/dL (2.2 mmol/L)
D. Respiratory rate 58 breaths/min
Correct Answer: C
Rationale: Glucose < 45 mg/dL (C) is hypoglycemia requiring rapid intervention (feed or
IV dextrose). Acrocyanosis/irregular breathing (A) can be normal transition findings;
37.2 °C (B) is within neutral thermal range; 58 rpm (D) is normal newborn respiratory
rate (30-60).
Question 3
A client in active labor receives epidural anesthesia. Which maternal parameter should
the PN monitor every 15 minutes after initiation?
A. Urine output
B. Blood pressure
C. Temperature
D. Oxygen saturation
Correct Answer: B
Rationale: Hypotension is the most common side effect of epidural analgesia due to
sympathetic blockade; BP (B) is checked q 15 min × 4, then q 30 min. Urine output (A) is
,assessed hourly; temp (C) q 4 h unless elevated; SpO₂ (D) only if respiratory depression
suspected.
Question 4
A client at 28 weeks gestation who reports constant abdominal pain and “tightening.”
Uterus is board-like on palpation; small amount of dark-red bleeding noted. FHR
baseline 150 with minimal variability. Which complication is MOST likely?
A. Placenta previa
B. Preterm labor
C. Abruptio placentae
D. Uterine rupture
Correct Answer: C
Rationale: Constant pain, board-like uterus, dark bleeding, and decreased FHR variability
are classic for abruptio placentae (C). Previa (A) is painless bright bleeding; preterm
labor (B) presents with rhythmic contractions; rupture (D) usually occurs in labor with
sudden sharp pain and fetal bradycardia.
Question 5
A client at 8 weeks gestation asks why she must continue taking prenatal vitamins with
folic acid. Which PN response is BEST?
A. “Folic acid reduces the risk of neural-tube defects in the developing embryo.”
B. “It prevents maternal iron-deficiency anemia only.”
C. “Vitamins decrease the chance of gestational diabetes.”
, D. “They ensure your baby will be a normal birth weight.”
Correct Answer: A
Rationale: Folic acid 400-800 mcg daily decreases neural-tube defects by > 70 % (A).
Iron prevents anemia (B) but is not the primary reason for folic acid; vitamins do not
prevent GDM (C) or guarantee birth weight (D).
Question 6
Which finding indicates effective breastfeeding in a 24-hour-old newborn?
A. Audible swallowing heard during feeds
B. Weight loss of 8 % from birth weight
C. Two wet diapers since birth
D. Mother reports nipple pain rated 6/10
Correct Answer: A
Rationale: Audible/visible swallowing (A) confirms milk transfer. 8 % weight loss (B) is
above expected (< 7 % at 24 h); only two wet diapers (C) suggests inadequate intake
(goal = 1 wet diaper per day of life); nipple pain > 3/10 (D) indicates poor latch.
Question 7
A client at 34 weeks gestation with gestational diabetes is receiving an oxytocin
infusion. Which maternal vital sign change requires immediate intervention?
A. Temperature 37.1 °C (98.8 °F)
B. Blood pressure 138/88 mmHg (previously 120/70)
