ATI RN Maternal Newborn OB Exam Prep
2026 | 70 NGN-Style Q&A, Detailed
Rationales, Bow-Tie & NGN Scenarios Study
Guide
Exam Overview: This practice set mirrors the ATI RN Maternal Newborn Proctored
Exam format: 70 questions covering antepartum, intrapartum, postpartum, newborn
care, and high-risk OB pharmacology. NGN item types include multiple-choice,
SATA, Bow-Tie, Matrix, and Prioritization. Each question is followed by italicized
rationales with evidence-based explanations. Passing benchmark: Level 2 or higher
(approximately 75–80%, or 53–56/70 correct).
Question 1 (Multiple Choice)
A nurse is calculating the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on March 5. Using Naegele's rule, which date should
the nurse calculate?
A) December 5
B) December 12
C) December 19
D) November 12
Correct Answer: B
Rationale: Naegele's rule requires subtracting 3 months from the first day of the LMP
and adding 7 days. March 5 minus 3 months = December 5; December 5 + 7 days =
,December 12. This calculation assumes a 28-day menstrual cycle and provides a
reliable EDD for prenatal planning and fetal assessment scheduling.
Question 2 (Multiple Choice)
A nurse is reviewing expected physiologic changes during pregnancy. Which finding
is considered a normal cardiovascular adaptation?
A) Decreased cardiac output
B) Increased cardiac output
C) Persistent hypertension
D) Decreased plasma volume
Correct Answer: B
Rationale: Cardiac output increases 30–50% during pregnancy to meet maternal and
fetal metabolic demands. Blood volume increases 40–50%, while blood pressure
typically decreases slightly in the second trimester due to peripheral vasodilation.
Persistent hypertension is pathologic, not an expected adaptation.
Question 3 (Multiple Choice)
A client at 28 weeks' gestation reports heartburn. Which instruction should the nurse
provide?
A) "Lie down immediately after eating."
B) "Eat three large meals daily."
C) "Avoid fatty and spicy foods."
D) "Drink fluids with meals."
Correct Answer: C
Rationale: Fatty and spicy foods worsen heartburn by relaxing the lower esophageal
sphincter and increasing gastric acid secretion. Clients should eat small frequent
meals, avoid lying down within 2 hours after eating, and drink fluids between meals
rather than with them to reduce gastric distention.
Question 4 (Multiple Choice)
A nurse is assessing a client at 36 weeks' gestation. Which finding should the nurse
report immediately?
,A) Braxton Hicks contractions
B) Visual disturbances and severe headache
C) Urinary frequency
D) Lower back pain
Correct Answer: B
Rationale: Visual disturbances and severe headache are warning signs of
preeclampsia with severe features and may indicate impending seizures or cerebral
edema. Braxton Hicks contractions, urinary frequency, and lower back pain are
normal discomforts of late pregnancy. Immediate provider notification is essential for
preeclampsia management and prevention of eclampsia.
Question 5 (Multiple Choice)
A client asks when fetal movement is commonly first perceived during pregnancy.
Which response should the nurse provide?
A) 4 to 6 weeks
B) 8 to 10 weeks
C) 16 to 20 weeks
D) 28 to 32 weeks
Correct Answer: C
Rationale: Quickening — the first perception of fetal movement — is commonly felt at
16 to 20 weeks' gestation, particularly in nulliparous clients. Multiparous clients may
perceive movement earlier (14–16 weeks) because they recognize the sensation.
Perception outside this range warrants further assessment.
Question 6 (Multiple Choice)
A pregnant client asks which food is a good source of folate. Which choice should the
nurse recommend?
A) White rice
B) Leafy green vegetables
C) Hard candy
D) Butter
, Correct Answer: B
Rationale: Leafy green vegetables (spinach, kale, romaine) are rich natural sources of
folate. Adequate folate intake (400–800 mcg/day) before conception and during early
pregnancy reduces the risk of neural tube defects. Fortified grains and legumes are
also good sources. White rice, hard candy, and butter lack significant folate.
Question 7 (Multiple Choice)
Which finding is considered a positive sign of pregnancy?
A) Amenorrhea
B) Nausea
C) Positive pregnancy test
D) Fetal heart activity detected by ultrasound
Correct Answer: D
Rationale: Fetal heart activity detected by ultrasound is a positive (definitive) sign
because it directly confirms a developing fetus. Amenorrhea and nausea are
presumptive signs; a positive pregnancy test is a probable sign. Positive signs also
include fetal movement palpated by the examiner and visualization of the fetus.
Question 8 (Multiple Choice)
A nurse teaches a pregnant client about avoiding supine hypotension. Which
position should the client use when resting?
A) Flat on the back
B) Right lateral only
C) Left lateral
D) Prone
Correct Answer: C
Rationale: Left lateral positioning promotes venous return by reducing compression
of the inferior vena cava by the gravid uterus. Supine positioning can decrease venous
return, causing maternal hypotension, dizziness, and decreased placental perfusion.
Right lateral is also acceptable but left lateral is preferred due to renal and vascular
anatomy.
2026 | 70 NGN-Style Q&A, Detailed
Rationales, Bow-Tie & NGN Scenarios Study
Guide
Exam Overview: This practice set mirrors the ATI RN Maternal Newborn Proctored
Exam format: 70 questions covering antepartum, intrapartum, postpartum, newborn
care, and high-risk OB pharmacology. NGN item types include multiple-choice,
SATA, Bow-Tie, Matrix, and Prioritization. Each question is followed by italicized
rationales with evidence-based explanations. Passing benchmark: Level 2 or higher
(approximately 75–80%, or 53–56/70 correct).
Question 1 (Multiple Choice)
A nurse is calculating the estimated date of delivery (EDD) for a client whose last
menstrual period (LMP) began on March 5. Using Naegele's rule, which date should
the nurse calculate?
A) December 5
B) December 12
C) December 19
D) November 12
Correct Answer: B
Rationale: Naegele's rule requires subtracting 3 months from the first day of the LMP
and adding 7 days. March 5 minus 3 months = December 5; December 5 + 7 days =
,December 12. This calculation assumes a 28-day menstrual cycle and provides a
reliable EDD for prenatal planning and fetal assessment scheduling.
Question 2 (Multiple Choice)
A nurse is reviewing expected physiologic changes during pregnancy. Which finding
is considered a normal cardiovascular adaptation?
A) Decreased cardiac output
B) Increased cardiac output
C) Persistent hypertension
D) Decreased plasma volume
Correct Answer: B
Rationale: Cardiac output increases 30–50% during pregnancy to meet maternal and
fetal metabolic demands. Blood volume increases 40–50%, while blood pressure
typically decreases slightly in the second trimester due to peripheral vasodilation.
Persistent hypertension is pathologic, not an expected adaptation.
Question 3 (Multiple Choice)
A client at 28 weeks' gestation reports heartburn. Which instruction should the nurse
provide?
A) "Lie down immediately after eating."
B) "Eat three large meals daily."
C) "Avoid fatty and spicy foods."
D) "Drink fluids with meals."
Correct Answer: C
Rationale: Fatty and spicy foods worsen heartburn by relaxing the lower esophageal
sphincter and increasing gastric acid secretion. Clients should eat small frequent
meals, avoid lying down within 2 hours after eating, and drink fluids between meals
rather than with them to reduce gastric distention.
Question 4 (Multiple Choice)
A nurse is assessing a client at 36 weeks' gestation. Which finding should the nurse
report immediately?
,A) Braxton Hicks contractions
B) Visual disturbances and severe headache
C) Urinary frequency
D) Lower back pain
Correct Answer: B
Rationale: Visual disturbances and severe headache are warning signs of
preeclampsia with severe features and may indicate impending seizures or cerebral
edema. Braxton Hicks contractions, urinary frequency, and lower back pain are
normal discomforts of late pregnancy. Immediate provider notification is essential for
preeclampsia management and prevention of eclampsia.
Question 5 (Multiple Choice)
A client asks when fetal movement is commonly first perceived during pregnancy.
Which response should the nurse provide?
A) 4 to 6 weeks
B) 8 to 10 weeks
C) 16 to 20 weeks
D) 28 to 32 weeks
Correct Answer: C
Rationale: Quickening — the first perception of fetal movement — is commonly felt at
16 to 20 weeks' gestation, particularly in nulliparous clients. Multiparous clients may
perceive movement earlier (14–16 weeks) because they recognize the sensation.
Perception outside this range warrants further assessment.
Question 6 (Multiple Choice)
A pregnant client asks which food is a good source of folate. Which choice should the
nurse recommend?
A) White rice
B) Leafy green vegetables
C) Hard candy
D) Butter
, Correct Answer: B
Rationale: Leafy green vegetables (spinach, kale, romaine) are rich natural sources of
folate. Adequate folate intake (400–800 mcg/day) before conception and during early
pregnancy reduces the risk of neural tube defects. Fortified grains and legumes are
also good sources. White rice, hard candy, and butter lack significant folate.
Question 7 (Multiple Choice)
Which finding is considered a positive sign of pregnancy?
A) Amenorrhea
B) Nausea
C) Positive pregnancy test
D) Fetal heart activity detected by ultrasound
Correct Answer: D
Rationale: Fetal heart activity detected by ultrasound is a positive (definitive) sign
because it directly confirms a developing fetus. Amenorrhea and nausea are
presumptive signs; a positive pregnancy test is a probable sign. Positive signs also
include fetal movement palpated by the examiner and visualization of the fetus.
Question 8 (Multiple Choice)
A nurse teaches a pregnant client about avoiding supine hypotension. Which
position should the client use when resting?
A) Flat on the back
B) Right lateral only
C) Left lateral
D) Prone
Correct Answer: C
Rationale: Left lateral positioning promotes venous return by reducing compression
of the inferior vena cava by the gravid uterus. Supine positioning can decrease venous
return, causing maternal hypotension, dizziness, and decreased placental perfusion.
Right lateral is also acceptable but left lateral is preferred due to renal and vascular
anatomy.
