ATI RN Maternal Newborn 2026 Proctored Exam with
NGN 70 Questions and Correct Answers
Question 1 of 70 (NGN Matrix)
Scenario: A nurse is caring for a client who is experiencing a postpartum hemorrhage and has a
new prescription for misoprostol.
Medical History:
• Preeclampsia
• Cesarean birth of viable twin male newborns
Task: The nurse is assessing the client 30 min later. How should the nurse interpret the findings?
For each finding, click to specify whether the finding is unrelated to the diagnosis, an indication
of potential improvement, or an indication of potential worsening condition.
,Findings 30 min Unrelated to Indication of potential Indication of potential
later diagnosis improvement worsening condition
Fundus at level
of umbilicus
Cloudy urine
Blood pressure
80/50 mm Hg
Moderate lochia
rubra
Thready pulse
Fundus firm to
palpation
Correct Answer:
• Fundus at level of umbilicus: Indication of potential improvement
• Cloudy urine: Unrelated to diagnosis
• Blood pressure 80/50 mm Hg: Indication of potential worsening condition
• Moderate lochia rubra: Indication of potential improvement
• Thready pulse: Indication of potential worsening condition
• Fundus firm to palpation: Indication of potential improvement
,Extended Rationale:
Postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL after a vaginal birth
or 1000 mL after a cesarean birth. Misoprostol is a prostaglandin E1 analog prescribed to
stimulate uterine contractions and manage PPH, especially when other uterotonics like oxytocin
are ineffective or contraindicated (e.g., in clients with preeclampsia, methylergonovine is
contraindicated due to its hypertensive effects).
• Fundus at level of umbilicus / Firm to palpation / Moderate lochia rubra: These are the
expected, desired outcomes of misoprostol therapy. A firm fundus located at the
umbilicus indicates that the uterine muscle is contracting effectively to compress
bleeding vessels at the placental site. Lochia rubra is the normal vaginal discharge for the
first 3-4 days postpartum; a moderate amount indicates normal sloughing without
excessive bleeding.
• Cloudy urine: This finding is unrelated to the diagnosis of PPH. Cloudy urine typically
indicates a urinary tract infection, dehydration, or the presence of sediment, but it does
not directly reflect the status of uterine bleeding or hemodynamic stability.
• Blood pressure 80/50 mm Hg / Thready pulse: These are classic signs of worsening
condition and hypovolemic shock. A blood pressure of 80/50 mm Hg represents
hypotension, and a thready (weak, rapid) pulse indicates the heart is attempting to
compensate for a rapidly decreasing circulating blood volume. In PPH, these vital signs
precede cardiovascular collapse; immediate intervention (fluid resuscitation, blood
products, additional uterotonics) is required. The client's history of preeclampsia and
twin gestation also places her at a significantly higher risk for PPH due to uterine
overdistention and potential placental abnormalities.
Question 2 of 70 (NGN Cloze)
Scenario: A nurse is assessing a postpartum client during a follow-up visit.
Vital Signs:
• 0930: Temperature 37° C (98.6° F), Pulse rate 78/min, Respiratory rate 12/min, Blood
pressure 124/80 mm Hg, Pulse oximetry 100%.
Task: Complete the following sentence by using the list of options.
The nurse is teaching the client about postpartum depression. The nurse should encourage the
, client to maintain a set schedule Blank 1, and exercise 30 min per day Blank 2 to help prevent
postpartum depression.
Options:
• Blank 1: for sleeping / for feeding the newborn / for household chores / for visiting
relatives
• Blank 2: to promote weight loss / to increase energy / to enhance cardiac output / to
improve appetite
Correct Answer:
• Blank 1: for sleeping
• Blank 2: to increase energy
Extended Rationale:
Postpartum depression (PPD) is a serious mood disorder that affects approximately 1 in 7
birthing individuals. Prevention and early intervention are critical.
• Maintain a set schedule for sleeping: Sleep deprivation is one of the strongest, most
modifiable risk factors for the development of PPD. The nurse should emphasize the
importance of sleep hygiene, including maintaining a consistent sleep-wake schedule,
napping when the baby sleeps, and accepting help from family to ensure at least one 4-5
hour uninterrupted stretch of sleep per 24 hours.
• Exercise 30 minutes per day to increase energy: Physical activity releases endorphins,
which act as natural mood elevators and analgesics. Furthermore, regular exercise helps
combat the overwhelming fatigue associated with the postpartum period. While weight
loss and cardiac output are general benefits of exercise, increasing energy and improving
mood are the primary psychological rationales for prescribing exercise specifically to
prevent PPD.
• Incorrect options for Blank 1: While feeding schedules are important, rigid feeding
schedules can actually increase stress and are not the priority for PPD prevention.
Household chores and visiting relatives can be overwhelming and should be limited, not
rigidly scheduled.
• Incorrect options for Blank 2: Weight loss is a secondary goal and should not be the
primary focus during the early postpartum period as it can contribute to negative body
image and depression if unrealistic expectations are set.
NGN 70 Questions and Correct Answers
Question 1 of 70 (NGN Matrix)
Scenario: A nurse is caring for a client who is experiencing a postpartum hemorrhage and has a
new prescription for misoprostol.
Medical History:
• Preeclampsia
• Cesarean birth of viable twin male newborns
Task: The nurse is assessing the client 30 min later. How should the nurse interpret the findings?
For each finding, click to specify whether the finding is unrelated to the diagnosis, an indication
of potential improvement, or an indication of potential worsening condition.
,Findings 30 min Unrelated to Indication of potential Indication of potential
later diagnosis improvement worsening condition
Fundus at level
of umbilicus
Cloudy urine
Blood pressure
80/50 mm Hg
Moderate lochia
rubra
Thready pulse
Fundus firm to
palpation
Correct Answer:
• Fundus at level of umbilicus: Indication of potential improvement
• Cloudy urine: Unrelated to diagnosis
• Blood pressure 80/50 mm Hg: Indication of potential worsening condition
• Moderate lochia rubra: Indication of potential improvement
• Thready pulse: Indication of potential worsening condition
• Fundus firm to palpation: Indication of potential improvement
,Extended Rationale:
Postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL after a vaginal birth
or 1000 mL after a cesarean birth. Misoprostol is a prostaglandin E1 analog prescribed to
stimulate uterine contractions and manage PPH, especially when other uterotonics like oxytocin
are ineffective or contraindicated (e.g., in clients with preeclampsia, methylergonovine is
contraindicated due to its hypertensive effects).
• Fundus at level of umbilicus / Firm to palpation / Moderate lochia rubra: These are the
expected, desired outcomes of misoprostol therapy. A firm fundus located at the
umbilicus indicates that the uterine muscle is contracting effectively to compress
bleeding vessels at the placental site. Lochia rubra is the normal vaginal discharge for the
first 3-4 days postpartum; a moderate amount indicates normal sloughing without
excessive bleeding.
• Cloudy urine: This finding is unrelated to the diagnosis of PPH. Cloudy urine typically
indicates a urinary tract infection, dehydration, or the presence of sediment, but it does
not directly reflect the status of uterine bleeding or hemodynamic stability.
• Blood pressure 80/50 mm Hg / Thready pulse: These are classic signs of worsening
condition and hypovolemic shock. A blood pressure of 80/50 mm Hg represents
hypotension, and a thready (weak, rapid) pulse indicates the heart is attempting to
compensate for a rapidly decreasing circulating blood volume. In PPH, these vital signs
precede cardiovascular collapse; immediate intervention (fluid resuscitation, blood
products, additional uterotonics) is required. The client's history of preeclampsia and
twin gestation also places her at a significantly higher risk for PPH due to uterine
overdistention and potential placental abnormalities.
Question 2 of 70 (NGN Cloze)
Scenario: A nurse is assessing a postpartum client during a follow-up visit.
Vital Signs:
• 0930: Temperature 37° C (98.6° F), Pulse rate 78/min, Respiratory rate 12/min, Blood
pressure 124/80 mm Hg, Pulse oximetry 100%.
Task: Complete the following sentence by using the list of options.
The nurse is teaching the client about postpartum depression. The nurse should encourage the
, client to maintain a set schedule Blank 1, and exercise 30 min per day Blank 2 to help prevent
postpartum depression.
Options:
• Blank 1: for sleeping / for feeding the newborn / for household chores / for visiting
relatives
• Blank 2: to promote weight loss / to increase energy / to enhance cardiac output / to
improve appetite
Correct Answer:
• Blank 1: for sleeping
• Blank 2: to increase energy
Extended Rationale:
Postpartum depression (PPD) is a serious mood disorder that affects approximately 1 in 7
birthing individuals. Prevention and early intervention are critical.
• Maintain a set schedule for sleeping: Sleep deprivation is one of the strongest, most
modifiable risk factors for the development of PPD. The nurse should emphasize the
importance of sleep hygiene, including maintaining a consistent sleep-wake schedule,
napping when the baby sleeps, and accepting help from family to ensure at least one 4-5
hour uninterrupted stretch of sleep per 24 hours.
• Exercise 30 minutes per day to increase energy: Physical activity releases endorphins,
which act as natural mood elevators and analgesics. Furthermore, regular exercise helps
combat the overwhelming fatigue associated with the postpartum period. While weight
loss and cardiac output are general benefits of exercise, increasing energy and improving
mood are the primary psychological rationales for prescribing exercise specifically to
prevent PPD.
• Incorrect options for Blank 1: While feeding schedules are important, rigid feeding
schedules can actually increase stress and are not the priority for PPD prevention.
Household chores and visiting relatives can be overwhelming and should be limited, not
rigidly scheduled.
• Incorrect options for Blank 2: Weight loss is a secondary goal and should not be the
primary focus during the early postpartum period as it can contribute to negative body
image and depression if unrealistic expectations are set.
