2025 VATI MATERNAL NEWBORN EXAM WITH
NGN
70 Items | Answers in bold | Rationales follow each item
MATRIX MULTIPLE-CHOICE (10 items)
1. Item Type: Matrix Multiple-Choice
Stem: G2P1 at 29 weeks arrives after MVA. She reports abdominal pain and no
fetal movement for 45 min.
Task: Select Priority to Report Immediately (Yes) vs Reassess in 15 min (No).
Table
Copy
Finding Yes No
a. FHR 98 bpm, absent variability ☒ ☐
b. Uterine contractions q 2 min ☒ ☐
c. BP 118/78 mmHg ☐ ☒
d. Small dark-red vaginal spotting ☒ ☐
e. Fundal height 29 cm ☐ ☒
a, b, d = Yes; c, e = No
Rationale: AWHONN 2025 Fetal-Maternal Alert: FHR < 110, frequent contractions,
bleeding = possible abruption; normal BP & FH not emergent.
2. Item Type: Matrix Multiple-Choice
Stem: Vacuum-assisted birth 1 hour ago. Select whether intervention is
Indicated or Not Indicated.
Table
Copy
pg. 1
, Intervention Indicated Not Indicated
a. Daily skin assessment for bruising ☒ ☐
b. Prone positioning to reduce caput ☐ ☒
c. Monitor bilirubin at 24 h ☒ ☐
d. Apply triple-antibiotic to scalp electrode site ☐ ☒
a, c = Indicated; b, d = Not Indicated
Rationale: Vacuum ↑ cephalohematoma & hyperbili risk; prone sleep unsafe; antibiotic
ointment not needed on minor electrode abrasion.
3. Item Type: Matrix Multiple-Choice
Stem: GDM client, 38 weeks, on insulin pump. Which actions prevent neonatal
hypoglycemia in first hour? (Yes/No matrix)
Table
Copy
Action Yes No
a. Immediate skin-to-skin ☒ ☐
b. Feed 15 mL formula within 30 min ☒ ☐
c. Delay feeding until after bath ☐ ☒
d. Check glucose at 30 min ☒ ☐
a, b, d = Yes; c = No
Rationale: AWHONN 2025 IDM guideline—early feed & glucose screen prevent
hypoglycemia; bath delays feeding.
4. Item Type: Matrix Multiple-Choice
Stem: Newborn of HBV+ mother. Select time window Within 12 h vs >24 h
delay acceptable.
pg. 2
, Table
Copy
Prophylaxis ≤12 h >24 h
a. Hepatitis B vaccine ☒ ☐
b. HBIG ☒ ☐
c. Vitamin K ☐ ☒
d. Erythromycin eye ointment ☐ ☒
a, b = ≤12 h; c, d = >24 h OK
Rationale: CDC 2025—HBV vaccine & HBIG must be ≤12 h; other meds not time-critical
for HBV prevention.
5. Item Type: Matrix Multiple-Choice
Stem: Severe preeclampsia on MgSO₄. Select Notify MD if vs Reassure if.
Table
Copy
Assessment Notify MD Reassure
a. RR 14/min ☐ ☒
b. DTRs 1+ ☐ ☒
c. Urine output 80 mL/2 h ☐ ☒
d. Serum Mg 5.2 mEq/L ☒ ☐
Only d = Notify; a, b, c = Reassure
Rationale: ACOG 2025—Mg 5–7 mEq/L therapeutic but >5 with renal dysfunction
warrants review; RR ≥12, DTR present, UO ≥30 mL/h safe.
6. Item Type: Matrix Multiple-Choice
Stem: 28-week preterm labor on nifedipine. Select Expected vs Report.
pg. 3
NGN
70 Items | Answers in bold | Rationales follow each item
MATRIX MULTIPLE-CHOICE (10 items)
1. Item Type: Matrix Multiple-Choice
Stem: G2P1 at 29 weeks arrives after MVA. She reports abdominal pain and no
fetal movement for 45 min.
Task: Select Priority to Report Immediately (Yes) vs Reassess in 15 min (No).
Table
Copy
Finding Yes No
a. FHR 98 bpm, absent variability ☒ ☐
b. Uterine contractions q 2 min ☒ ☐
c. BP 118/78 mmHg ☐ ☒
d. Small dark-red vaginal spotting ☒ ☐
e. Fundal height 29 cm ☐ ☒
a, b, d = Yes; c, e = No
Rationale: AWHONN 2025 Fetal-Maternal Alert: FHR < 110, frequent contractions,
bleeding = possible abruption; normal BP & FH not emergent.
2. Item Type: Matrix Multiple-Choice
Stem: Vacuum-assisted birth 1 hour ago. Select whether intervention is
Indicated or Not Indicated.
Table
Copy
pg. 1
, Intervention Indicated Not Indicated
a. Daily skin assessment for bruising ☒ ☐
b. Prone positioning to reduce caput ☐ ☒
c. Monitor bilirubin at 24 h ☒ ☐
d. Apply triple-antibiotic to scalp electrode site ☐ ☒
a, c = Indicated; b, d = Not Indicated
Rationale: Vacuum ↑ cephalohematoma & hyperbili risk; prone sleep unsafe; antibiotic
ointment not needed on minor electrode abrasion.
3. Item Type: Matrix Multiple-Choice
Stem: GDM client, 38 weeks, on insulin pump. Which actions prevent neonatal
hypoglycemia in first hour? (Yes/No matrix)
Table
Copy
Action Yes No
a. Immediate skin-to-skin ☒ ☐
b. Feed 15 mL formula within 30 min ☒ ☐
c. Delay feeding until after bath ☐ ☒
d. Check glucose at 30 min ☒ ☐
a, b, d = Yes; c = No
Rationale: AWHONN 2025 IDM guideline—early feed & glucose screen prevent
hypoglycemia; bath delays feeding.
4. Item Type: Matrix Multiple-Choice
Stem: Newborn of HBV+ mother. Select time window Within 12 h vs >24 h
delay acceptable.
pg. 2
, Table
Copy
Prophylaxis ≤12 h >24 h
a. Hepatitis B vaccine ☒ ☐
b. HBIG ☒ ☐
c. Vitamin K ☐ ☒
d. Erythromycin eye ointment ☐ ☒
a, b = ≤12 h; c, d = >24 h OK
Rationale: CDC 2025—HBV vaccine & HBIG must be ≤12 h; other meds not time-critical
for HBV prevention.
5. Item Type: Matrix Multiple-Choice
Stem: Severe preeclampsia on MgSO₄. Select Notify MD if vs Reassure if.
Table
Copy
Assessment Notify MD Reassure
a. RR 14/min ☐ ☒
b. DTRs 1+ ☐ ☒
c. Urine output 80 mL/2 h ☐ ☒
d. Serum Mg 5.2 mEq/L ☒ ☐
Only d = Notify; a, b, c = Reassure
Rationale: ACOG 2025—Mg 5–7 mEq/L therapeutic but >5 with renal dysfunction
warrants review; RR ≥12, DTR present, UO ≥30 mL/h safe.
6. Item Type: Matrix Multiple-Choice
Stem: 28-week preterm labor on nifedipine. Select Expected vs Report.
pg. 3
