ATI PN MATERNAL NEWBORN 2026: 60 EXAM QUESTIONS 60 QUESTIONS COMPLETE
Complete Proctored Assessment Prep — NGN Level 3 Marking Scheme & Rationales
Section 1: Antepartum Care & Fetal Assessment (Q1 - Q10)
Question 1 (Pregnancy Signs & Diagnostics)
A client at 10 weeks gestation reports missing her period, morning nausea, and urinary frequency. The examiner notes Chadwick's sign.
How should the PN classify these findings?
A. All reported findings are positive signs.
B. Amenorrhea and nausea are presumptive; Chadwick's sign is probable.
C. Chadwick's sign is presumptive; nausea is positive.
D. All findings are probable signs.
Ans: B — Presumptive signs are client-reported subjective symptoms (amenorrhea, nausea, fatigue). Probable signs are examiner-observed
objective changes (Chadwick's, Hegar's, positive pregnancy test). Positive signs prove fetal existence (FHR tones, ultrasound visualization).
Question 2 (GTPAL History Calculation)
A pregnant client at 12 weeks has a history of: delivery at 39 weeks (living), twins delivered at 34 weeks (both living), a spontaneous
abortion at 9 weeks. Calculate GTPAL.
A. G4, T1, P1, A1, L3
B. G3, T1, P2, A1, L3
C. G4, T2, P1, A1, L2
D. G3, T2, P1, A0, L3
Ans: A — Gravida = 4 (current + 3 past). Term = 1 (39-wk). Preterm = 1 (twin delivery at 34 wks counts as 1 event). Abortion = 1 (9-wk SAB).
Living = 3 children.
Question 3 (Naegele's Rule Calculation)
A client reports her last menstrual period (LMP) began on May 10, 2025. Using Naegele's rule, what is her estimated date of delivery
(EDD)?
A. February 17, 2026
B. February 10, 2026
C. March 17, 2026
D. February 3, 2026
Ans: A — Naegele's rule formula: LMP minus 3 months + 7 days + 1 year. May 10 minus 3 months = February 10 + 7 days = February 17, 2026.
Question 4 (Antepartum Testing — Nonstress Test)
During a 20-minute NST at 36 weeks, the PN notes FHR baseline of 140/min with two accelerations of 15 bpm above baseline lasting 15
seconds each. How should the PN interpret this?
A. Nonreactive NST requiring CST.
B. Reactive NST indicating fetal well-being.
C. Unsatisfactory test requiring prolonging.
D. Positive test indicating distress.
Ans: B — A Reactive NST requires ≥2 accelerations of at least 15 bpm above baseline lasting ≥15 seconds within a 20-minute period (reassuring
finding).
Question 5 (Maternal Nutrition — Iron Supplementation)
A PN reinforces teaching for a client prescribed oral ferrous sulfate for iron deficiency anemia. Which instruction is vital to include?
A. Take the medication with a glass of milk.
B. Take with orange juice and expect dark green or black stools.
C. Take antacids simultaneously if gastric upset occurs.
D. Take with breakfast every morning.
Ans: B — Vitamin C (orange juice) enhances non-heme iron absorption. Dark/black stools are a harmless expected side effect. Calcium/milk and
antacids inhibit iron absorption.
Question 6 (Preeclampsia Risk Identification)
A client at 32 weeks gestation with gestational hypertension reports a severe frontal headache and epigastric pain. The PN recognizes this
as indicating risk for:
A. Development of severe preeclampsia / HELLP syndrome.
B. Normal third-trimester physiological adaptation.
C. Urinary tract infection.
D Gestational diabetes decompensation
ATI PN Maternal Newborn 2026 Proctored Exam Guide Page 1 of 10
, Section 1: Antepartum Care (Cont. Q7 - Q10) & Intrapartum Care (Q11 - Q12)
Question 7 (Rh Isoimmunization Protocol)
A client at 28 weeks gestation is Rh-negative with a negative indirect Coombs test. What intervention should the PN anticipate?
A. Administer Rh(D) immune globulin (RhoGAM) IM.
B. Withhold RhoGAM until immediately after delivery.
C. Administer RhoGAM only if the father is Rh-negative.
D. Prepare client for immediate blood transfusion.
Ans: A — RhoGAM is routinely given at 28 weeks gestation to unsensitized (Coombs negative) Rh-negative clients to prevent maternal antibody
formation against fetal Rh-positive blood.
Question 8 (Diagnostic Screening — MSAFP)
A PN is reinforcing teaching about Maternal Serum Alpha-Fetoprotein (MSAFP) screening at 16 weeks gestation. Which statement
indicates client understanding?
A. "This test will diagnose if my baby definitely has spina bifida."
B. "It is a screening blood test to check risk for neural tube defects."
C. "I need to have a full bladder for this ultrasound."
D. "If positive, I will require immediate labor induction."
Ans: B — MSAFP is a non-invasive screening tool (not diagnostic) offered between 15–22 weeks to detect open neural tube defects (elevated
MSAFP) or chromosomal anomalies (low MSAFP).
Question 9 (Biophysical Profile Interpretation)
A BPP test result returns a total score of 4 out of 10 for a client at 38 weeks. How should the PN interpret this clinical score?
A. Normal, reassuring fetal status.
B. Abnormal score indicating potential chronic fetal asphyxia.
C. Borderline result requiring repeat test in 2 weeks.
D. Inconclusive result due to maternal medication.
Ans: B — A BPP score of 8–10 is normal; 4–6 is abnormal (suspected chronic fetal asphyxia); ≤4 strongly indicates fetal distress requiring
consideration of immediate delivery.
Question 10 (Supine Hypotensive Syndrome)
A client at 34 weeks gestation feels dizzy and faint while lying flat on her back on the exam table. What is the immediate nursing action?
A. Elevate her legs above the heart level.
B. Turn the client onto her left side.
C. Administer oxygen via nasal cannula at 2 L/min.
D. Obtain a stat 12-lead ECG.
Ans: B — Supine position causes heavy gravid uterus to compress the inferior vena cava, decreasing venous return and blood pressure. Side-
lying (lateral) positioning immediately restores venous return.
Question 11 (True vs. False Labor Differentiation)
A client at 39 weeks presents reporting uterine contractions. Which finding confirms that the client is experiencing true labor?
A. Contractions irregular and stop upon ambulation.
B. Cervical change (progressive dilation and effacement).
C. Pain felt predominantly in the upper abdomen.
D. Contractions occurring every 15 minutes without change.
Ans: B — Progressive cervical dilation and effacement is the definitive single hallmark distinguishing true labor from false labor (Braxton Hicks).
Question 12 (Stages of Labor — Active Phase)
A cervical exam reveals 6 cm dilation, 80% effacement, and station +1. The PN correctly identifies the client is in which stage and phase of
labor?
A. First stage, latent phase
B. First stage, active phase
C. First stage, transition phase
D. Second stage of labor
Ans: B — Stage 1 active phase is defined as 6 cm to 7 cm dilation (updated ACOG definitions; traditionally 4–7 cm). Latent is 0–5 cm; Transition
is 8–10 cm.
ATI PN Maternal Newborn 2026 Proctored Exam Guide Page 2 of 10
Complete Proctored Assessment Prep — NGN Level 3 Marking Scheme & Rationales
Section 1: Antepartum Care & Fetal Assessment (Q1 - Q10)
Question 1 (Pregnancy Signs & Diagnostics)
A client at 10 weeks gestation reports missing her period, morning nausea, and urinary frequency. The examiner notes Chadwick's sign.
How should the PN classify these findings?
A. All reported findings are positive signs.
B. Amenorrhea and nausea are presumptive; Chadwick's sign is probable.
C. Chadwick's sign is presumptive; nausea is positive.
D. All findings are probable signs.
Ans: B — Presumptive signs are client-reported subjective symptoms (amenorrhea, nausea, fatigue). Probable signs are examiner-observed
objective changes (Chadwick's, Hegar's, positive pregnancy test). Positive signs prove fetal existence (FHR tones, ultrasound visualization).
Question 2 (GTPAL History Calculation)
A pregnant client at 12 weeks has a history of: delivery at 39 weeks (living), twins delivered at 34 weeks (both living), a spontaneous
abortion at 9 weeks. Calculate GTPAL.
A. G4, T1, P1, A1, L3
B. G3, T1, P2, A1, L3
C. G4, T2, P1, A1, L2
D. G3, T2, P1, A0, L3
Ans: A — Gravida = 4 (current + 3 past). Term = 1 (39-wk). Preterm = 1 (twin delivery at 34 wks counts as 1 event). Abortion = 1 (9-wk SAB).
Living = 3 children.
Question 3 (Naegele's Rule Calculation)
A client reports her last menstrual period (LMP) began on May 10, 2025. Using Naegele's rule, what is her estimated date of delivery
(EDD)?
A. February 17, 2026
B. February 10, 2026
C. March 17, 2026
D. February 3, 2026
Ans: A — Naegele's rule formula: LMP minus 3 months + 7 days + 1 year. May 10 minus 3 months = February 10 + 7 days = February 17, 2026.
Question 4 (Antepartum Testing — Nonstress Test)
During a 20-minute NST at 36 weeks, the PN notes FHR baseline of 140/min with two accelerations of 15 bpm above baseline lasting 15
seconds each. How should the PN interpret this?
A. Nonreactive NST requiring CST.
B. Reactive NST indicating fetal well-being.
C. Unsatisfactory test requiring prolonging.
D. Positive test indicating distress.
Ans: B — A Reactive NST requires ≥2 accelerations of at least 15 bpm above baseline lasting ≥15 seconds within a 20-minute period (reassuring
finding).
Question 5 (Maternal Nutrition — Iron Supplementation)
A PN reinforces teaching for a client prescribed oral ferrous sulfate for iron deficiency anemia. Which instruction is vital to include?
A. Take the medication with a glass of milk.
B. Take with orange juice and expect dark green or black stools.
C. Take antacids simultaneously if gastric upset occurs.
D. Take with breakfast every morning.
Ans: B — Vitamin C (orange juice) enhances non-heme iron absorption. Dark/black stools are a harmless expected side effect. Calcium/milk and
antacids inhibit iron absorption.
Question 6 (Preeclampsia Risk Identification)
A client at 32 weeks gestation with gestational hypertension reports a severe frontal headache and epigastric pain. The PN recognizes this
as indicating risk for:
A. Development of severe preeclampsia / HELLP syndrome.
B. Normal third-trimester physiological adaptation.
C. Urinary tract infection.
D Gestational diabetes decompensation
ATI PN Maternal Newborn 2026 Proctored Exam Guide Page 1 of 10
, Section 1: Antepartum Care (Cont. Q7 - Q10) & Intrapartum Care (Q11 - Q12)
Question 7 (Rh Isoimmunization Protocol)
A client at 28 weeks gestation is Rh-negative with a negative indirect Coombs test. What intervention should the PN anticipate?
A. Administer Rh(D) immune globulin (RhoGAM) IM.
B. Withhold RhoGAM until immediately after delivery.
C. Administer RhoGAM only if the father is Rh-negative.
D. Prepare client for immediate blood transfusion.
Ans: A — RhoGAM is routinely given at 28 weeks gestation to unsensitized (Coombs negative) Rh-negative clients to prevent maternal antibody
formation against fetal Rh-positive blood.
Question 8 (Diagnostic Screening — MSAFP)
A PN is reinforcing teaching about Maternal Serum Alpha-Fetoprotein (MSAFP) screening at 16 weeks gestation. Which statement
indicates client understanding?
A. "This test will diagnose if my baby definitely has spina bifida."
B. "It is a screening blood test to check risk for neural tube defects."
C. "I need to have a full bladder for this ultrasound."
D. "If positive, I will require immediate labor induction."
Ans: B — MSAFP is a non-invasive screening tool (not diagnostic) offered between 15–22 weeks to detect open neural tube defects (elevated
MSAFP) or chromosomal anomalies (low MSAFP).
Question 9 (Biophysical Profile Interpretation)
A BPP test result returns a total score of 4 out of 10 for a client at 38 weeks. How should the PN interpret this clinical score?
A. Normal, reassuring fetal status.
B. Abnormal score indicating potential chronic fetal asphyxia.
C. Borderline result requiring repeat test in 2 weeks.
D. Inconclusive result due to maternal medication.
Ans: B — A BPP score of 8–10 is normal; 4–6 is abnormal (suspected chronic fetal asphyxia); ≤4 strongly indicates fetal distress requiring
consideration of immediate delivery.
Question 10 (Supine Hypotensive Syndrome)
A client at 34 weeks gestation feels dizzy and faint while lying flat on her back on the exam table. What is the immediate nursing action?
A. Elevate her legs above the heart level.
B. Turn the client onto her left side.
C. Administer oxygen via nasal cannula at 2 L/min.
D. Obtain a stat 12-lead ECG.
Ans: B — Supine position causes heavy gravid uterus to compress the inferior vena cava, decreasing venous return and blood pressure. Side-
lying (lateral) positioning immediately restores venous return.
Question 11 (True vs. False Labor Differentiation)
A client at 39 weeks presents reporting uterine contractions. Which finding confirms that the client is experiencing true labor?
A. Contractions irregular and stop upon ambulation.
B. Cervical change (progressive dilation and effacement).
C. Pain felt predominantly in the upper abdomen.
D. Contractions occurring every 15 minutes without change.
Ans: B — Progressive cervical dilation and effacement is the definitive single hallmark distinguishing true labor from false labor (Braxton Hicks).
Question 12 (Stages of Labor — Active Phase)
A cervical exam reveals 6 cm dilation, 80% effacement, and station +1. The PN correctly identifies the client is in which stage and phase of
labor?
A. First stage, latent phase
B. First stage, active phase
C. First stage, transition phase
D. Second stage of labor
Ans: B — Stage 1 active phase is defined as 6 cm to 7 cm dilation (updated ACOG definitions; traditionally 4–7 cm). Latent is 0–5 cm; Transition
is 8–10 cm.
ATI PN Maternal Newborn 2026 Proctored Exam Guide Page 2 of 10
