ATI PN Maternal Proctored Exam 2026 | ACTUAL
EXAM | Complete Maternal–Newborn & NGN OB
actual Questions with Verified Answers | Latest
Update
Traditional Multiple-Choice (Items 1–60)
1
A gravida 2 para 1 client at 39 weeks reports painless, bright-red vaginal bleeding and a
fundal height of 34 cm. Fetal heart rate is 150 bpm, category I. Which action should the
PN take first?
A. Perform a sterile vaginal exam to check dilation
B. Start an IV line with a large-bore catheter
C. Obtain consent for immediate cesarean birth
D. Apply a fetal scalp electrode
Correct Answer: B
Rationale: Painless, bright-red bleeding at term suggests placenta previa until proven
otherwise; vaginal exams can precipitate catastrophic hemorrhage. Starting IV access
provides fluid resuscitation and blood-delivery route while awaiting provider evaluation.
Cesarean may be needed but is not the first nursing action. Scalp electrode is
contraindicated with active bleeding.
,2
A client receiving magnesium sulfate 2 g/h IV for preeclampsia has a urine output of 25
mL/h. Which order should the PN anticipate?
A. Increase maintenance fluids
B. Decrease magnesium dose by 50%
C. Administer furosemide 20 mg IV
D. Obtain magnesium level
Correct Answer: B
Rationale: UO < 30 mL/h signals possible magnesium toxicity; anticipate dose reduction
or discontinuation. Increasing fluids risks fluid overload; furosemide is not first-line.
3
During transition phase (8–9 cm), a multiparous client suddenly reports intense rectal
pressure with contractions every 1½ min. FHR baseline 150 with moderate variability.
Which action is most appropriate?
A. Coach open-glottis pushing with each contraction
B. Encourage breathing techniques and notify provider
C. Prepare for immediate vaginal delivery in bed
D. Administer terbutaline 0.25 mg SQ
,Correct Answer: B
Rationale: Multiparous cervix can dilate rapidly; urge to push before full dilation risks
cervical edema. Breathing techniques buy time while provider assesses dilation.
Premature pushing or terbutaline is inappropriate without orders.
4
A full-term newborn weighs 2,600 g and is 48 cm long. Which classification is
appropriate?
A. Appropriate for gestational age
B. Small for gestational age
C. Large for gestational age
D. Low birth weight
Correct Answer: B
Rationale: Birth weight < 10th percentile for gestational age (≈ 2,500 g at 40 weeks) is
SGA. This infant is not LGA or macrosomic, and although < 2,500 g, “SGA” is more
precise.
5
Which finding indicates effective neonatal thermoregulation in a 1-hour-old newborn?
A. Axillary temp 36.2 °C
, B. Cold, pale extremities
C. Axillary temp 37.1 °C
D. Shivering noted
Correct Answer: C
Rationale: Normal neonatal axillary range is 36.5–37.4 °C; 37.1 °C reflects successful
thermoregulation. Hypothermia (36.2 °C), cold extremities, and shivering indicate heat
loss; newborns rely on brown fat and cannot shiver effectively.
6
A postpartum client on post-op day 1 after cesarean reports sudden calf pain on
dorsiflexion. Which action is priority?
A. Massage the calf vigorously
B. Measure calf circumference
C. Elevate foot on pillow
D. Apply warm compress
Correct Answer: B
Rationale: Homans’ sign and pain suggest deep vein thrombosis; measure
circumference and notify provider. Massage could dislodge clot; elevation and heat are
secondary.
EXAM | Complete Maternal–Newborn & NGN OB
actual Questions with Verified Answers | Latest
Update
Traditional Multiple-Choice (Items 1–60)
1
A gravida 2 para 1 client at 39 weeks reports painless, bright-red vaginal bleeding and a
fundal height of 34 cm. Fetal heart rate is 150 bpm, category I. Which action should the
PN take first?
A. Perform a sterile vaginal exam to check dilation
B. Start an IV line with a large-bore catheter
C. Obtain consent for immediate cesarean birth
D. Apply a fetal scalp electrode
Correct Answer: B
Rationale: Painless, bright-red bleeding at term suggests placenta previa until proven
otherwise; vaginal exams can precipitate catastrophic hemorrhage. Starting IV access
provides fluid resuscitation and blood-delivery route while awaiting provider evaluation.
Cesarean may be needed but is not the first nursing action. Scalp electrode is
contraindicated with active bleeding.
,2
A client receiving magnesium sulfate 2 g/h IV for preeclampsia has a urine output of 25
mL/h. Which order should the PN anticipate?
A. Increase maintenance fluids
B. Decrease magnesium dose by 50%
C. Administer furosemide 20 mg IV
D. Obtain magnesium level
Correct Answer: B
Rationale: UO < 30 mL/h signals possible magnesium toxicity; anticipate dose reduction
or discontinuation. Increasing fluids risks fluid overload; furosemide is not first-line.
3
During transition phase (8–9 cm), a multiparous client suddenly reports intense rectal
pressure with contractions every 1½ min. FHR baseline 150 with moderate variability.
Which action is most appropriate?
A. Coach open-glottis pushing with each contraction
B. Encourage breathing techniques and notify provider
C. Prepare for immediate vaginal delivery in bed
D. Administer terbutaline 0.25 mg SQ
,Correct Answer: B
Rationale: Multiparous cervix can dilate rapidly; urge to push before full dilation risks
cervical edema. Breathing techniques buy time while provider assesses dilation.
Premature pushing or terbutaline is inappropriate without orders.
4
A full-term newborn weighs 2,600 g and is 48 cm long. Which classification is
appropriate?
A. Appropriate for gestational age
B. Small for gestational age
C. Large for gestational age
D. Low birth weight
Correct Answer: B
Rationale: Birth weight < 10th percentile for gestational age (≈ 2,500 g at 40 weeks) is
SGA. This infant is not LGA or macrosomic, and although < 2,500 g, “SGA” is more
precise.
5
Which finding indicates effective neonatal thermoregulation in a 1-hour-old newborn?
A. Axillary temp 36.2 °C
, B. Cold, pale extremities
C. Axillary temp 37.1 °C
D. Shivering noted
Correct Answer: C
Rationale: Normal neonatal axillary range is 36.5–37.4 °C; 37.1 °C reflects successful
thermoregulation. Hypothermia (36.2 °C), cold extremities, and shivering indicate heat
loss; newborns rely on brown fat and cannot shiver effectively.
6
A postpartum client on post-op day 1 after cesarean reports sudden calf pain on
dorsiflexion. Which action is priority?
A. Massage the calf vigorously
B. Measure calf circumference
C. Elevate foot on pillow
D. Apply warm compress
Correct Answer: B
Rationale: Homans’ sign and pain suggest deep vein thrombosis; measure
circumference and notify provider. Massage could dislodge clot; elevation and heat are
secondary.
