About the ATI PN Maternal Newborn Proctored Exam 2026
The ATI PN Maternal Newborn proctored assessment measures how well practical nursing students apply obstetric and newborn knowledge to real client situations. It is less about memorizing the stages of pregnancy and more about recognizing warning signs, choosing safe interventions, reinforcing teaching for new families and knowing when a finding must be reported to the RN or provider.
Most PN programs give the ATI PN Maternal Newborn 2026 proctored exam at the end of the maternal health or maternal-child nursing course. The result is often a course requirement, and it gives your program an early read on your readiness for the PN Comprehensive Predictor and the NCLEX-PN. Because it is proctored, you take it on a secure browser under supervision, either on campus or through remote proctoring, depending on your school.
Item count, time limit and the proficiency level you need are set by ATI and your program, and they can change between versions. Check your syllabus or ATI student account for your exact requirements.
ATI PN Maternal Newborn 2023 — the previous edition with its own 58-question bank.
How this practice test is built
These 60 questions are original practice items modeled on the content and style of the ATI PN Maternal Newborn assessment. They are not actual exam questions. Each one is written for the LPN/LVN scope of practice, so answers focus on data collection, reinforcing teaching, safe care of stable mothers and newborns, and timely reporting rather than RN-only actions such as initial assessment, interpreting fetal monitor strips independently or titrating oxytocin.
How the ATI PN Maternal Newborn 2026 Exam Is Scored
ATI does not report a simple pass or fail. It converts your score into a proficiency level:
Level 3 — Exceeds expectations
Strong readiness in maternal newborn nursing. High probability of passing related NCLEX-PN content.
Level 2 — Meets expectations
Readily meets expectations. The most common program benchmark and minimum target.
Level 1 — Below expectations
Just meets the minimum. Most programs require focused remediation at this level.
Below Level 1
Does not meet the minimum. Remediation and often a retake are required.
Your score report also breaks results down by topic. Use that list alongside the rationales in this practice test: if the report flags “postpartum complications,” go back to every question in that area and reread why each wrong option is wrong.
For a full explanation of ATI levels, retakes and remediation, see our ATI proctored exam guide.
High-Yield ATI PN Maternal Newborn 2026 Topics
These are the maternal newborn topics that show up again and again in PN questions. The “report immediately” boxes cover the findings the exam most often expects you to recognize.
Prenatal and Antepartum Care
- Due date and history: Naegele’s rule (first day of last menstrual period, minus 3 months, plus 7 days); GTPAL for obstetric history
- Signs of pregnancy: presumptive (amenorrhea, nausea, quickening), probable (Chadwick, Goodell and Hegar signs, positive pregnancy test), positive (fetal heart tones, ultrasound, fetal movement felt by the examiner)
- Fundal height: at the umbilicus around 20 weeks; from 20 to 36 weeks, centimeters roughly equal weeks of gestation
- Prenatal screening: glucose screening at 24–28 weeks, group B strep culture at 36–37 weeks, Rh and antibody screen early in pregnancy
- Fetal well-being tests: a reactive nonstress test shows at least two accelerations of 15 bpm lasting 15 seconds within 20 minutes; a biophysical profile of 8–10 is reassuring
- Teaching: folic acid supplementation, side-lying rest to avoid supine hypotension, kick counts, avoiding alcohol, smoking and raw or undercooked foods
Report immediately: vaginal bleeding, leaking fluid, decreased fetal movement, severe headache or visual changes, signs of preterm labor before 37 weeks.
Pregnancy Complications
- Preeclampsia: blood pressure of 140/90 mm Hg or higher after 20 weeks with proteinuria or signs of organ involvement; severe features include headache, visual changes, epigastric or right upper quadrant pain
- HELLP syndrome: hemolysis, elevated liver enzymes and low platelets; watch for right upper quadrant pain, nausea and bleeding
- Eclampsia: seizure precautions, side-lying position, padded side rails, quiet low-light room
- Placenta previa vs. placental abruption: previa causes painless bright red bleeding (no vaginal exams); abruption causes painful bleeding with a firm, board-like uterus
- Gestational diabetes: diet, glucose monitoring, insulin if prescribed; risk of a large-for-gestational-age baby and newborn hypoglycemia
- Preterm labor: regular contractions and cervical change before 37 weeks; tocolytics may be prescribed, and betamethasone promotes fetal lung maturity
- Hyperemesis gravidarum and ectopic pregnancy: dehydration and weight loss; sudden one-sided pelvic pain with shoulder pain suggests ectopic rupture
Report immediately: blood pressure of 160/110 or higher, headache with visual changes, epigastric or right upper quadrant pain, any seizure activity, bleeding with abdominal pain.
Labor and Delivery
- Stages of labor: first stage (latent, active, transition), second stage (birth of the baby), third stage (delivery of the placenta), fourth stage (first 1–4 hours of recovery)
- True vs. false labor: true labor contractions get stronger and closer and cause cervical change; false labor eases with walking or rest
- Rupture of membranes: check the fetal heart rate first, then note the color, amount and odor of the fluid; clear is expected, green suggests meconium
- Epidural: watch for maternal hypotension; IV fluids as prescribed, side-lying position, monitor bladder distension
- Umbilical cord prolapse: call for help, keep pressure off the cord with the presenting part, knee-chest or Trendelenburg position, never push the cord back
Report immediately: visible or palpable cord, green or foul-smelling amniotic fluid, late decelerations, maternal hypotension after an epidural.
Postpartum Care and Complications
- BUBBLE-HE assessment: breasts, uterus, bladder, bowel, lochia, episiotomy or incision, Homans/legs, emotions
- Fundus: firm and at the umbilicus in the first 24 hours, then descends about 1 cm a day; a fundus above the umbilicus and deviated to one side usually means a full bladder
- Lochia: rubra (days 1–3), serosa (about days 4–10), alba (up to about 6 weeks); large clots or a pad soaked in an hour is excessive
- Postpartum hemorrhage: a boggy uterus is the most common cause; massage the fundus, have the client void, report and prepare uterotonic medications as prescribed
- Postpartum blues vs. depression: blues start in the first days and resolve within 2 weeks; persistent sadness, hopelessness or thoughts of harm must be reported
- Rh and rubella: Rh-negative mothers with an Rh-positive newborn receive Rho(D) immune globulin within 72 hours; nonimmune mothers receive the rubella (MMR) vaccine and avoid pregnancy for 4 weeks
Report immediately: a boggy fundus that does not firm with massage, a steady trickle of bright red blood, rising heart rate with falling blood pressure, unilateral calf pain or swelling, fever of 100.4°F (38°C) or higher after the first 24 hours.
Newborn Assessment and Care
- APGAR score: at 1 and 5 minutes; 7–10 is normal, 4–6 needs some help, 0–3 needs immediate resuscitation
- Expected findings: acrocyanosis, milia, vernix, lanugo, molding, caput succedaneum (crosses suture lines), cephalohematoma (does not cross suture lines), congenital dermal melanocytosis
- Thermoregulation: dry the newborn, skin-to-skin contact, hat; cold stress raises the risk of hypoglycemia and respiratory distress
- Newborn hypoglycemia: jitteriness, poor feeding, temperature instability; higher risk with maternal diabetes, preterm or large babies
- Hyperbilirubinemia: physiologic jaundice appears after 24 hours; jaundice within the first 24 hours is pathologic and must be reported
- Phototherapy: eye shields, skin exposed except for the diaper, reposition often, monitor temperature and hydration, no lotions
- Neonatal abstinence syndrome: high-pitched cry, tremors, poor feeding, sneezing; swaddle, dim quiet room, small frequent feedings
- Neonatal infection: temperature instability (often low), lethargy, poor feeding and breathing changes are early signs
Report immediately: respiratory rate above 60 or grunting, flaring and retractions, central cyanosis, jaundice within 24 hours, no void or stool within the first 24–48 hours, bleeding from the circumcision site.
Breastfeeding, Nutrition and Discharge Teaching
- Breastfeeding: 8–12 feedings in 24 hours, a deep latch including the areola, about 6 or more wet diapers a day by day 5–6
- Weight: losing up to about 10% of birth weight in the first days is expected; birth weight is usually regained by 10–14 days
- Cord care: keep it clean and dry, sponge baths until the cord falls off at about 10–14 days
- Circumcision care: a yellow film is normal healing; petroleum jelly with each diaper change (except Plastibell); report bleeding or no urination
- Safety: back to sleep on a firm flat surface with no loose bedding, rear-facing car seat in the back seat, matching ID bands, never leave the newborn unattended
- Contraception: teach the ACHES warning signs for oral contraceptives (abdominal pain, chest pain, headaches, eye problems, severe leg pain)
Fetal Heart Rate Monitoring for the 2026 Exam: Decelerations Made Simple
Fetal heart rate questions are among the most tested on any ATI maternal newborn exam. The PN role is to recognize a concerning pattern, take basic safety actions and report it, not to interpret the strip independently. The VEAL CHOP memory aid links each pattern to its cause.
| Pattern | Cause (VEAL CHOP) | What it means | Nursing action |
|---|---|---|---|
| Variable decelerations | Cord compression | Abrupt V- or W-shaped drops not tied to contractions | Reposition the client, report; prepare for further interventions |
| Early decelerations | Head compression | Gradual dip that mirrors the contraction | Expected; no intervention, keep monitoring |
| Accelerations | OK (well-oxygenated fetus) | Reassuring sign of fetal well-being | None needed |
| Late decelerations | Placental insufficiency | Gradual dip that starts after the contraction peaks | Left side-lying, stop oxytocin per protocol, IV fluids and oxygen as prescribed, report immediately |
Also know: a normal fetal heart rate baseline is 110–160 bpm; moderate variability is reassuring; minimal or absent variability, a baseline outside the normal range, or more than 5 contractions in 10 minutes (tachysystole) must be reported.
Must-Know Lab Values and Vital Signs for Maternal Newborn Nursing
ATI rarely asks you to recite a range on its own. It gives you a result and asks what the nurse should do. Know these:
| Lab / vital sign | Expected range | Clinical tip |
|---|---|---|
| Hemoglobin (pregnancy) | 11 g/dL or higher (10.5 in the second trimester) | Lower values suggest anemia; reinforce iron-rich foods and supplements. |
| Platelets | 150,000–400,000/mm³ | A falling count in preeclampsia raises concern for HELLP syndrome. |
| Magnesium (on magnesium sulfate) | Therapeutic about 4–7 mEq/L | Higher levels cause loss of reflexes, then respiratory depression. |
| Urine protein | Negative to trace | Proteinuria with high blood pressure after 20 weeks points to preeclampsia. |
| 1-hour glucose challenge | Below about 130–140 mg/dL (varies by facility) | An elevated result leads to a 3-hour glucose tolerance test. |
| Rh factor / antibody screen | Rh-positive, or Rh-negative with negative antibody screen | Rh-negative mothers receive Rho(D) immune globulin at about 28 weeks and after birth if the newborn is Rh-positive. |
| Newborn heart rate | 110–160 bpm | Count for a full minute; may rise to about 180 while crying. |
| Newborn respiratory rate | 30–60/min | Above 60 with grunting or retractions signals respiratory distress. |
| Newborn temperature | 97.7–99.5°F (36.5–37.5°C) | Hypothermia raises the risk of hypoglycemia. |
| Newborn blood glucose | Generally 40–45 mg/dL or higher in the first day (per protocol) | Feed and recheck per protocol; report persistent low values or symptoms. |
| Newborn bilirubin | Interpreted by age in hours | Any visible jaundice before 24 hours is reported. |
Study tip: for every value above, ask: “If it is high, what do I do? If it is low, what do I do?” That is exactly how ATI frames the question.
Maternal Newborn Medications You Must Know (2026)
| Medication | Key nursing points |
|---|---|
| Magnesium sulfate | Prevents seizures in preeclampsia. Monitor respiratory rate (12 or higher), deep tendon reflexes and urine output (30 mL/hr or higher). Calcium gluconate is the antidote and stays at the bedside. |
| Oxytocin | Induces or augments labor and controls postpartum bleeding. Stop the infusion and report for tachysystole or a concerning fetal heart rate pattern. Watch for water intoxication. |
| Methylergonovine | Treats postpartum hemorrhage. Check blood pressure first; avoid in hypertension or preeclampsia. |
| Carboprost | Treats postpartum hemorrhage. Avoid in asthma. Can cause diarrhea and fever. |
| Misoprostol | Cervical ripening and postpartum hemorrhage. Watch for tachysystole. |
| Terbutaline / nifedipine | Tocolytics for preterm labor. Terbutaline raises maternal heart rate and glucose; nifedipine can cause hypotension and headache. |
| Betamethasone | Given IM to the mother before an expected preterm birth (about 24–34 weeks) to speed fetal lung maturity. |
| Rho(D) immune globulin | Given IM to the Rh-negative mother, never the newborn, at about 28 weeks and within 72 hours of birth if the newborn is Rh-positive; also after miscarriage, amniocentesis or trauma. |
| Vitamin K (phytonadione) | Single IM dose to the newborn in the vastus lateralis to prevent bleeding. |
| Erythromycin eye ointment | Prevents newborn eye infection. Apply from the inner to outer canthus in each lower conjunctival sac. |
| Hepatitis B vaccine | Given to the newborn before discharge; add hepatitis B immune globulin within 12 hours if the mother is HBsAg-positive. |
| Rubella (MMR) vaccine | Given postpartum to nonimmune mothers. Safe with breastfeeding; avoid pregnancy for 4 weeks. |
For dosage practice on these drugs, see the ATI dosage calculation guide.
Prioritization and PN Scope of Practice in Maternal Health Nursing
Prioritization questions are where most students lose points on the ATI PN Maternal Newborn 2026 exam. Remember that you have two clients: the mother and the fetus or newborn.
How to approach a prioritization question
- Airway, breathing, circulation. A newborn with grunting and retractions or a mother with heavy bleeding comes first.
- Unstable over stable. A postpartum client with a boggy fundus outranks one with expected afterpains.
- Unexpected over expected. Jaundice at 12 hours outranks acrocyanosis; lochia rubra on day 1 is expected, a pad soaked in an hour is not.
- Actual over risk. A client actively seizing outranks a client at risk for seizures.
PN scope on ATI maternal newborn questions
- The LPN collects data such as vital signs, fundal checks, lochia and newborn observations, but does not perform the initial comprehensive assessment.
- The LPN reinforces teaching on breastfeeding, newborn care and safety that the RN has already started.
- The LPN cares for stable clients, such as an uncomplicated postpartum mother and her healthy newborn. A client in active labor or on magnesium sulfate needs the RN.
- The LPN reports changes to the RN or provider. If one option says “assess” and another says “notify the RN,” look closely at which fits the PN role.
ATI PN Maternal Newborn 2026 Sample Questions with Rationales
Each example shows the kind of reasoning ATI expects. Read the rationale even if you get the answer right, because the exam often tests the same concept from a different angle.
Question 1 — Magnesium Sulfate Toxicity (Pregnancy Complications)
A client with preeclampsia is receiving IV magnesium sulfate. The practical nurse finds a respiratory rate of 10/min and absent patellar reflexes. Which action should the nurse take first?
- Document the findings and recheck in 1 hour.
- Encourage the client to take deep breaths.
- Notify the RN immediately.
- Increase the IV fluid rate.
Question 2 — Fundal Assessment (Postpartum)
Twelve hours after a vaginal birth, a client’s fundus is firm, 2 cm above the umbilicus and deviated to the right. Which action should the practical nurse take first?
- Massage the fundus.
- Assist the client to empty her bladder.
- Notify the provider of possible hemorrhage.
- Document this as an expected finding.
Question 3 — Newborn Jaundice (Newborn Care)
A practical nurse notices yellowing of a newborn’s skin and sclera at 18 hours of age. Which action is correct?
- Tell the parents this is normal newborn jaundice.
- Place the newborn near a sunny window.
- Report the finding to the RN or provider.
- Offer water between feedings.
Question 4 — Fetal Heart Rate Pattern (Labor)
During labor, the monitor shows gradual decelerations that begin and end with each contraction, with the lowest point at the peak of the contraction. What does this pattern indicate?
- Fetal head compression, an expected finding.
- Umbilical cord compression.
- Uteroplacental insufficiency.
- Fetal well-being with good oxygenation.
Study Plans for the ATI PN Maternal Newborn 2026 Exam: 4 Weeks and 2 Weeks
4-week plan
| Week | Focus | What to do |
|---|---|---|
| 1 | Prenatal care and pregnancy complications | Review your ATI Maternal Newborn module. Answer every antepartum question here and read all rationales. |
| 2 | Labor, delivery and fetal monitoring | Memorize VEAL CHOP and the labor medications. Add the medication table to your flashcards. |
| 3 | Postpartum and newborn care | Practice BUBBLE-HE and expected vs. abnormal newborn findings. Do a timed run of all 60 questions. |
| 4 | Review and weak areas | Redo missed questions, focusing on prioritization and PN scope. Do a second timed run 2 days before the exam. |
2-week plan
| Week | Focus | What to do |
|---|---|---|
| 1 | All content areas | Take the full 60-question test untimed. Mark every question you miss or guess on and sort them by topic. |
| 2 | Weak areas + timed run | Study only the topics where you missed the most. Redo those questions, then do one final timed run. |
Whichever plan you choose: read every rationale, even for questions you get right. ATI often tests the same concept from a new angle.
Common Mistakes on the ATI PN Maternal Newborn 2026 Exam
- Choosing the RN action. Interpreting a fetal strip or adjusting oxytocin is not the PN role; recognizing and reporting is.
- Treating normal findings as emergencies. Acrocyanosis, milia, molding and early decelerations are expected.
- Treating emergencies as normal. Jaundice before 24 hours, a boggy fundus and late decelerations are not.
- Massaging a firm fundus. If it is firm but displaced, think bladder first.
- Mixing up previa and abruption. Painless bleeding is previa; painful bleeding with a rigid uterus is abruption.
- Forgetting there are two clients. In labor questions, consider both the mother and the fetus before you choose.
Test-Day Strategies for the ATI PN Maternal Newborn 2026 Exam
- Pace yourself. Divide the time allowed by the number of items. Flag hard questions and come back to them.
- Read the stem carefully. Watch for “first,” “priority,” “immediately” and the newborn’s age in hours; it often changes the answer.
- Ask “expected or unexpected?” Many maternal newborn questions turn on whether a finding is normal for that point in time.
- Eliminate unsafe options first. Anything that delays reporting a danger sign is usually wrong.
- When two options look equal, pick the safest one. Safety is the ATI default.
- Do your last practice run 2 days before the exam, then use the final day for light review and rest.
Maternal Newborn Glossary: Terms You Will See on the Exam
- Gravida / para (GTPAL)
- Number of pregnancies and births; GTPAL breaks births into term, preterm, abortions and living children.
- Quickening
- The first fetal movements the mother feels, usually around 16–20 weeks.
- Chadwick sign
- Bluish color of the cervix and vagina in early pregnancy.
- Effacement
- Thinning of the cervix during labor, expressed as a percentage.
- Station
- How far the presenting part has descended in relation to the ischial spines.
- Tachysystole
- More than 5 contractions in 10 minutes, averaged over 30 minutes.
- Involution
- The uterus returning to its pre-pregnancy size after birth.
- Lochia
- Vaginal discharge after birth, progressing from rubra to serosa to alba.
- Caput succedaneum
- Scalp swelling that crosses suture lines and resolves within days.
- Cephalohematoma
- Blood collection under the scalp that does not cross suture lines; raises jaundice risk.
- Acrocyanosis
- Bluish hands and feet in the newborn; expected in the first day.
- Vernix caseosa
- White, cheesy coating that protects the newborn’s skin.
- Surfactant
- Substance that keeps the alveoli open; low in preterm newborns.
- Kernicterus
- Brain damage from very high bilirubin; the reason early jaundice is reported.
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