NGN ATI MATERNAL NEWBORN PROCTORED
EXAM – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS PLUS
RATIONALES | GUARANTEED PASS | LATEST
EXAM UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A nurse is caring for a client who is at 36 weeks of gestation and presents to
the clinic for a routine prenatal visit. The nurse notes the client’s blood
pressure is 142/92 mm Hg, which is an increase from her baseline of 118/76
mm Hg. Which of the following laboratory tests should the nurse anticipate
the provider ordering first to evaluate for preeclampsia?
A. Serum creatinine
B. 24-hour urine protein collection
C. Urine dipstick for protein
D. Liver function panel
RATIONALE: A urine dipstick for protein is the quickest initial screening tool used
in a clinical setting to assess for proteinuria when preeclampsia is suspected.
While a 24-hour urine collection is the gold standard for diagnostic
confirmation, the dipstick provides immediate data to guide next steps. Serum
creatinine and liver function panels are important for evaluating severe features
of preeclampsia but are not the initial screening choice.
2. A nurse is providing education to a client who is at 12 weeks of gestation
and experiencing severe morning sickness. Which of the following dietary
modifications should the nurse recommend?
A. Drink large amounts of fluids with meals.
B. Consume high-fat foods to increase caloric intake.
C. Eat dry carbohydrates before arising from bed in the morning.
D. Avoid eating snacks between meals to rest the stomach.
RATIONALE: Eating dry carbohydrates, such as crackers or toast, 30 minutes
before getting out of bed helps blood glucose levels stabilize and reduces
morning nausea. Fluids should be consumed between meals rather than with
meals to prevent overdistension of the stomach. High-fat foods delay gastric
,emptying and can worsen nausea, and eating small, frequent meals or snacks
prevents an empty stomach, which triggers nausea.
3. A nurse is assessing a newborn 1 hour following a vaginal delivery. Which
of the following findings should the nurse report to the provider as a potential
manifestation of respiratory distress?
A. Acrocyanosis
B. Respiratory rate of 48/min
C. Synchronous chest movements
D. Nasal flaring
RATIONALE: Nasal flaring, intercostal retractions, expiratory grunting, and
tachypnea are classic signs of newborn respiratory distress and must be reported
immediately. Acrocyanosis (blue color of hands and feet) is a normal finding in
the first 24 to 48 hours of life due to peripheral circulatory adaptation. A
respiratory rate of 48/min is within the expected normal newborn reference
range of 30 to 60/min, and chest movements should be synchronous with
abdominal movements.
4. A nurse is reviewing the electronic medical record of a client who is at 38
weeks of gestation and in active labor. The nurse notes the client is positive for
Group B Streptococcus (GBS). Which of the following interventions is the
priority for the nurse to implement?
A. Administer IV ampicillin every 4 hours until delivery.
B. Obtain a vaginal-rectal swab for repeat culture.
C. Monitor the client’s temperature every 4 hours.
D. Prepare the newborn for immediate blood cultures at birth.
RATIONALE: Intrapartum antibiotic prophylaxis (IAP) with IV ampicillin or
penicillin G is the priority intervention for GBS-positive clients to prevent
vertical transmission to the newborn during birth. Repeating the swab is
unnecessary because a positive result at 35 to 37 weeks dictates treatment. While
monitoring maternal temperature is important to screen for chorioamnionitis, it
does not prevent GBS transmission. Newborn blood cultures are reserved for
infants showing signs of neonatal sepsis, not as a routine prophylactic measure.
5. A nurse is performing a physical assessment on a client who is 12 hours
postpartum following a normal spontaneous vaginal delivery. Where should
the nurse expect to palpate the fundus of the uterus?
, A. Two centimeters below the umbilicus
B. At the level of the umbilicus
C. One centimeter above the umbilicus
D. Midway between the symphysis pubis and umbilicus
RATIONALE: Approximately 12 hours postpartum, the uterine fundus typically
rises to the level of the umbilicus. After this point, it should descend at a rate of
approximately 1 to 2 cm per 24 hours. A fundus located midway between the
symphysis pubis and umbilicus is expected immediately after delivery before the
uterus rises. A fundus above the umbilicus can indicate a distended bladder,
which displaces the uterus.
6. A nurse in a prenatal clinic is caring for a client who is at 28 weeks of
gestation and is Rh-negative. The client’s indirect Coombs test is negative.
Which of the following actions should the nurse take?
A. Prepare to administer Rho(D) immune globulin intramuscularly.
B. Inform the client that she will need Rho(D) immune globulin within 72 hours
after delivery only.
C. Reschedule the client for a repeat Coombs test in 4 weeks.
D. Document that the client does not require Rho(D) immune globulin due to a
negative test.
RATIONALE: An Rh-negative client with a negative indirect Coombs test indicates
she has not yet developed antibodies against Rh-positive blood (she is not
sensitized). To prevent sensitization, Rho(D) immune globulin is routinely
administered prophylactically at 28 weeks of gestation. It will also be
administered within 72 hours post-delivery if the newborn is found to be Rh-
positive. Waiting until delivery or skipping the 28-week dose leaves the client
vulnerable to sensitization during the third trimester.
7. A nurse is assessing a client who is in the first stage of labor and notes a
slow deceleration on the fetal heart rate monitor that starts after the peak of a
uterine contraction and returns to baseline well after the contraction has
ended. Which of the following actions should the nurse take first?
A. Perform a vaginal examination to check for cord prolapse.
B. Increase the rate of the maintenance IV fluids.
C. Turn the client onto her lateral position.
D. Administer oxygen via a nonrebreather face mask at 10 L/min.
EXAM – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS PLUS
RATIONALES | GUARANTEED PASS | LATEST
EXAM UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A nurse is caring for a client who is at 36 weeks of gestation and presents to
the clinic for a routine prenatal visit. The nurse notes the client’s blood
pressure is 142/92 mm Hg, which is an increase from her baseline of 118/76
mm Hg. Which of the following laboratory tests should the nurse anticipate
the provider ordering first to evaluate for preeclampsia?
A. Serum creatinine
B. 24-hour urine protein collection
C. Urine dipstick for protein
D. Liver function panel
RATIONALE: A urine dipstick for protein is the quickest initial screening tool used
in a clinical setting to assess for proteinuria when preeclampsia is suspected.
While a 24-hour urine collection is the gold standard for diagnostic
confirmation, the dipstick provides immediate data to guide next steps. Serum
creatinine and liver function panels are important for evaluating severe features
of preeclampsia but are not the initial screening choice.
2. A nurse is providing education to a client who is at 12 weeks of gestation
and experiencing severe morning sickness. Which of the following dietary
modifications should the nurse recommend?
A. Drink large amounts of fluids with meals.
B. Consume high-fat foods to increase caloric intake.
C. Eat dry carbohydrates before arising from bed in the morning.
D. Avoid eating snacks between meals to rest the stomach.
RATIONALE: Eating dry carbohydrates, such as crackers or toast, 30 minutes
before getting out of bed helps blood glucose levels stabilize and reduces
morning nausea. Fluids should be consumed between meals rather than with
meals to prevent overdistension of the stomach. High-fat foods delay gastric
,emptying and can worsen nausea, and eating small, frequent meals or snacks
prevents an empty stomach, which triggers nausea.
3. A nurse is assessing a newborn 1 hour following a vaginal delivery. Which
of the following findings should the nurse report to the provider as a potential
manifestation of respiratory distress?
A. Acrocyanosis
B. Respiratory rate of 48/min
C. Synchronous chest movements
D. Nasal flaring
RATIONALE: Nasal flaring, intercostal retractions, expiratory grunting, and
tachypnea are classic signs of newborn respiratory distress and must be reported
immediately. Acrocyanosis (blue color of hands and feet) is a normal finding in
the first 24 to 48 hours of life due to peripheral circulatory adaptation. A
respiratory rate of 48/min is within the expected normal newborn reference
range of 30 to 60/min, and chest movements should be synchronous with
abdominal movements.
4. A nurse is reviewing the electronic medical record of a client who is at 38
weeks of gestation and in active labor. The nurse notes the client is positive for
Group B Streptococcus (GBS). Which of the following interventions is the
priority for the nurse to implement?
A. Administer IV ampicillin every 4 hours until delivery.
B. Obtain a vaginal-rectal swab for repeat culture.
C. Monitor the client’s temperature every 4 hours.
D. Prepare the newborn for immediate blood cultures at birth.
RATIONALE: Intrapartum antibiotic prophylaxis (IAP) with IV ampicillin or
penicillin G is the priority intervention for GBS-positive clients to prevent
vertical transmission to the newborn during birth. Repeating the swab is
unnecessary because a positive result at 35 to 37 weeks dictates treatment. While
monitoring maternal temperature is important to screen for chorioamnionitis, it
does not prevent GBS transmission. Newborn blood cultures are reserved for
infants showing signs of neonatal sepsis, not as a routine prophylactic measure.
5. A nurse is performing a physical assessment on a client who is 12 hours
postpartum following a normal spontaneous vaginal delivery. Where should
the nurse expect to palpate the fundus of the uterus?
, A. Two centimeters below the umbilicus
B. At the level of the umbilicus
C. One centimeter above the umbilicus
D. Midway between the symphysis pubis and umbilicus
RATIONALE: Approximately 12 hours postpartum, the uterine fundus typically
rises to the level of the umbilicus. After this point, it should descend at a rate of
approximately 1 to 2 cm per 24 hours. A fundus located midway between the
symphysis pubis and umbilicus is expected immediately after delivery before the
uterus rises. A fundus above the umbilicus can indicate a distended bladder,
which displaces the uterus.
6. A nurse in a prenatal clinic is caring for a client who is at 28 weeks of
gestation and is Rh-negative. The client’s indirect Coombs test is negative.
Which of the following actions should the nurse take?
A. Prepare to administer Rho(D) immune globulin intramuscularly.
B. Inform the client that she will need Rho(D) immune globulin within 72 hours
after delivery only.
C. Reschedule the client for a repeat Coombs test in 4 weeks.
D. Document that the client does not require Rho(D) immune globulin due to a
negative test.
RATIONALE: An Rh-negative client with a negative indirect Coombs test indicates
she has not yet developed antibodies against Rh-positive blood (she is not
sensitized). To prevent sensitization, Rho(D) immune globulin is routinely
administered prophylactically at 28 weeks of gestation. It will also be
administered within 72 hours post-delivery if the newborn is found to be Rh-
positive. Waiting until delivery or skipping the 28-week dose leaves the client
vulnerable to sensitization during the third trimester.
7. A nurse is assessing a client who is in the first stage of labor and notes a
slow deceleration on the fetal heart rate monitor that starts after the peak of a
uterine contraction and returns to baseline well after the contraction has
ended. Which of the following actions should the nurse take first?
A. Perform a vaginal examination to check for cord prolapse.
B. Increase the rate of the maintenance IV fluids.
C. Turn the client onto her lateral position.
D. Administer oxygen via a nonrebreather face mask at 10 L/min.
