ATI Maternal Newborn Proctored Exam
J J J J
(NGN ATI) J
(Detailed Exam Prep Solutions and J J J J
J Resources for the test in 2024/2025) J J J J J
1. A nurse is teaching a client about Rho(D) immunoglobulin
J J J J J J J J
J(RhoGAM). Which of the following statements by the client J J J J J J J J
Jindicated an understanding of the teaching?J J J J J
a. I will receive this medication if my baby is Rh-negative
J J J J J J J J J
b. I will receive this medication at time of delivery
J J J J J J J J
c. I will need a second dose of this medication when my baby
J J J J J J J J J J J
is 6 weeks old J J J J
d. I will need this medication if I have an amniocentesis-
J J J J J J J J J
Recommended because of the potential of fetal
J J J J J J J
RBCs entering the maternal circulation
J J J J J
2. A nurse is caring for a client who is to receive oxytocin (Pitocin)
J J J J J J J J J J J J
Jto augment her labor. Which of the following contraindicates the
J J J J J J J J J
Jinitiation of the oxytocin infusion and requires notification of
J J J J J J J J
Jthe provider? J
a. Late decelerations- Oxytocin is contraindicated based on
J J J J J J
late decelerations noted on fetal assessment findings
J J J J J J J
because they indicate uteroplacental insufficiency.
J J J J J
b. Baseline variability J
c. Cessation of uterine dilation J J J
d. Prolonged active phase of labor J J J J
3. A nurse on the newborn unit is planning discharge for four
J J J J J J J J J J
Jclients. Which of the following will require care beyond that
J J J J J J J J J
Jof a standard follow-up visit with the provider after delivery?
J J J J J J J J J
, a. A newborn being sent home after 22 hr after birth-
J J J J J J J J J
Screening tests must be repeated if they were performed
J J J J J J J J J
before he newborn was 24 hr. old.
J J J J J J J
b. A newborn at 38 weeks of gestational age
J J J J J J J
c. A newborn who is bottle feeding
J J J J J
d. Twin newborns with Apgar scores of 8 and 9
J J J J J J J J
4. A nurse is assessing a newborn who has a weak cry and is
J J J J J J J J J J J J
Jgrimacing. The nurse notes the newborn has a heart rate of
J J J J J J J J J J
J102/min, blueish extremities, and a flaccid muscle tone. Which
J J J J J J J J
Jof the following reflects the appropriate APGAR score?
J J J J J J J
a. 4 J
b. 5 J
c. 6 J
d. 7 J
5. A nurse is caring for a client who has a history of rheumatic
J J J J J J J J J J J J
Jdisease, but no physical symptoms prior to pregnancy. The
J J J J J J J J
Jclient begins to experience dyspnea, orthopnea, and pulmonary
J J J J J J J
Jedema. Which of the following biological alterations explains
J J J J J J J
Jthis change?
J
a. Increased maternal weight J J
b. Increased blood volume- Increase in blood volume during J J J J J J J
pregnancy increase the workload of the heart, which
J J J J J J J J
causes the symptoms
J J J
c. Change in hematocrit levels J J J
d. Change in heart size J J J
6. A nurse is providing teaching about nonpharmacological pain
J J J J J J J
Jmanagement for a postpartum client who is breastfeed and has
J J J J J J J J J
Jengorgement. Which of the following methods should the nurse J J J J J J J J
Jrecommend?
a. Cold cabbage leaves- Application of this is an effective
J J J J J J J J
nonpharmacological method to relieve pain associated
J J J J J J
with engorgement
J J
b. Modified lanolin cream J J
c. A breast binder J J
d. Breast shells J
,7. A nurse is providing discharge teaching to a client who is
J J J J J J J J J J
Jpostpartum about resuming sexual activity. Which of the J J J J J J J
Jfollowing instructions should the nurse include in the teaching?
J J J J J J J J
a. You should use a water soluble gel for lubrication- This
J J J J J J J J J
will prevent discomfort
J J J
b. You can resume sexual activity in 10 days
J J J J J J J
c. Your physical reaction to sexual stimulation ill not be
J J J J J J J J
altered J
d. You will not ovulate for 3 months after delivery
J J J J J J J J
8. A nurse is admitting a client who is in labor. The client admits
J J J J J J J J J J J J
Jto recent cocaine use. For which of the following complications
J J J J J J J J J
Jshould the nurse assess?
J J J
a. Abruptio placenta- Cocaines increases the risk for J J J J J J
vasoconstriction and possible abruption placenta
J J J J J
b. Placenta previa J
c. Preeclampsia
d. Maternal bradycardia J
9. A nurse is providing dietary teaching with a client who has
J J J J J J J J J J
Jhyperemesis gravidarum. Which of the following statements by J J J J J J J
Jthe client indicates an understanding of the teaching?
J J J J J J J
a. I should eat to taste instead of trying to balance my meals-
J J J J J J J J J J J
Eat to taste to avoid nausea J J J J J
b. I will avoid having a snack at bedtime
J J J J J J J
c. I will have 8 oz of hot tea with each meal
J J J J J J J J J J
d. I should pair my sweets with a starch instead of eating
J J J J J J J J J J
them alone
J J
10. A nurse is preparing to collect a blood specimen from a
J J J J J J J J J J
Jnewborn via a heel stick. Which of the following techniques
J J J J J J J J J
Jshould the nurse use to help minimize the pain of the
J J J J J J J J J J
Jprocedure for the newborn? J J J
a. Warm the heel prior to the puncture J J J J J J
b. Request a prescription for IM analgesic J J J J J
c. Use a manual lance blade to pierce the skin
J J J J J J J J
d. Swaddle the newborn after the heel puncture- Effective J J J J J J J
technique to diminish the pain experience for the newborn.
J J J J J J J J J
, 11. A nurse is conducting an initial prenatal visit for a client
J J J J J J J J J J
Jwho is at 6 weeks gestation. Which of the following
J J J J J J J J J
Jlaboratory tests should be performed? J J J J
a. 24 hour urine for protein
J J J J
b. Group B streptococcus culture J J J
c. 3-hr glucose tolerance J J
d. Rubella titer- Obtained at the initial prenatal visit to J J J J J J J J
determine immunity to rubella
J J J J
12. A nurse is caring for a newborn who was transferred to the
J J J J J J J J J J J
Jnursery 30 min after delivery. Which of the following actions
J J J J J J J J J
Jshould the nurse take first?
J J J J
a. Confirm the newborn’s Apgar score J J J J
b. Verify the newborn’s identification- Mandatory toJ J J J J
continue ongoing identification of the newborn whenever
J J J J J J J
the newborn is removed from the mother’s direct presence
J J J J J J J J J
and care.
J J
c. Administer vitamin K IM to the newborn J J J J J J
d. Determine the obstetrical risk factors J J J J
13. A nurse is assessing a young adult client in a women’s
J J J J J J J J J J
Jhealth clinic who asks for a contraceptive. The client reports
J J J J J J J J J
Jto the nurse a familial history of osteoporosis. Which of the
J J J J J J J J J J
Jfollowing contraceptive methods is contraindicated for this
J J J J J J
Jclient?
a. Combined estrogen-progestin oral contraceptives J J J
b. An intrauterine device J J
c. Medroxyprogestrone acetate (Depo-provera)- causes a J J J J
decrease in bone mineral density and places the client at
J J J J J J J J J J
risk for the development of osteoporosis
J J J J J J
d. Norelgestromin/ethinyl estradiol (Ortho Evra) J J J
14. A nurse is admitting a client to the labor and delivery unit
J J J J J J J J J J J
Jwhen the client states, “my water just broke”, which of the
J J J J J J J J J J
Jfollowing is the priority intervention for the nurse to take?
J J J J J J J J J
a. Perform Nitrazine testing J J
b. Assess the amniotic fluid J J J
c. Check cervical dilation J J
d. Monitor the fetal heart rate- Rupture of the membranes J J J J J J J J
places the fetus at risk for umbilical cord prolapse.
J J J J J J J J J
J J J J
(NGN ATI) J
(Detailed Exam Prep Solutions and J J J J
J Resources for the test in 2024/2025) J J J J J
1. A nurse is teaching a client about Rho(D) immunoglobulin
J J J J J J J J
J(RhoGAM). Which of the following statements by the client J J J J J J J J
Jindicated an understanding of the teaching?J J J J J
a. I will receive this medication if my baby is Rh-negative
J J J J J J J J J
b. I will receive this medication at time of delivery
J J J J J J J J
c. I will need a second dose of this medication when my baby
J J J J J J J J J J J
is 6 weeks old J J J J
d. I will need this medication if I have an amniocentesis-
J J J J J J J J J
Recommended because of the potential of fetal
J J J J J J J
RBCs entering the maternal circulation
J J J J J
2. A nurse is caring for a client who is to receive oxytocin (Pitocin)
J J J J J J J J J J J J
Jto augment her labor. Which of the following contraindicates the
J J J J J J J J J
Jinitiation of the oxytocin infusion and requires notification of
J J J J J J J J
Jthe provider? J
a. Late decelerations- Oxytocin is contraindicated based on
J J J J J J
late decelerations noted on fetal assessment findings
J J J J J J J
because they indicate uteroplacental insufficiency.
J J J J J
b. Baseline variability J
c. Cessation of uterine dilation J J J
d. Prolonged active phase of labor J J J J
3. A nurse on the newborn unit is planning discharge for four
J J J J J J J J J J
Jclients. Which of the following will require care beyond that
J J J J J J J J J
Jof a standard follow-up visit with the provider after delivery?
J J J J J J J J J
, a. A newborn being sent home after 22 hr after birth-
J J J J J J J J J
Screening tests must be repeated if they were performed
J J J J J J J J J
before he newborn was 24 hr. old.
J J J J J J J
b. A newborn at 38 weeks of gestational age
J J J J J J J
c. A newborn who is bottle feeding
J J J J J
d. Twin newborns with Apgar scores of 8 and 9
J J J J J J J J
4. A nurse is assessing a newborn who has a weak cry and is
J J J J J J J J J J J J
Jgrimacing. The nurse notes the newborn has a heart rate of
J J J J J J J J J J
J102/min, blueish extremities, and a flaccid muscle tone. Which
J J J J J J J J
Jof the following reflects the appropriate APGAR score?
J J J J J J J
a. 4 J
b. 5 J
c. 6 J
d. 7 J
5. A nurse is caring for a client who has a history of rheumatic
J J J J J J J J J J J J
Jdisease, but no physical symptoms prior to pregnancy. The
J J J J J J J J
Jclient begins to experience dyspnea, orthopnea, and pulmonary
J J J J J J J
Jedema. Which of the following biological alterations explains
J J J J J J J
Jthis change?
J
a. Increased maternal weight J J
b. Increased blood volume- Increase in blood volume during J J J J J J J
pregnancy increase the workload of the heart, which
J J J J J J J J
causes the symptoms
J J J
c. Change in hematocrit levels J J J
d. Change in heart size J J J
6. A nurse is providing teaching about nonpharmacological pain
J J J J J J J
Jmanagement for a postpartum client who is breastfeed and has
J J J J J J J J J
Jengorgement. Which of the following methods should the nurse J J J J J J J J
Jrecommend?
a. Cold cabbage leaves- Application of this is an effective
J J J J J J J J
nonpharmacological method to relieve pain associated
J J J J J J
with engorgement
J J
b. Modified lanolin cream J J
c. A breast binder J J
d. Breast shells J
,7. A nurse is providing discharge teaching to a client who is
J J J J J J J J J J
Jpostpartum about resuming sexual activity. Which of the J J J J J J J
Jfollowing instructions should the nurse include in the teaching?
J J J J J J J J
a. You should use a water soluble gel for lubrication- This
J J J J J J J J J
will prevent discomfort
J J J
b. You can resume sexual activity in 10 days
J J J J J J J
c. Your physical reaction to sexual stimulation ill not be
J J J J J J J J
altered J
d. You will not ovulate for 3 months after delivery
J J J J J J J J
8. A nurse is admitting a client who is in labor. The client admits
J J J J J J J J J J J J
Jto recent cocaine use. For which of the following complications
J J J J J J J J J
Jshould the nurse assess?
J J J
a. Abruptio placenta- Cocaines increases the risk for J J J J J J
vasoconstriction and possible abruption placenta
J J J J J
b. Placenta previa J
c. Preeclampsia
d. Maternal bradycardia J
9. A nurse is providing dietary teaching with a client who has
J J J J J J J J J J
Jhyperemesis gravidarum. Which of the following statements by J J J J J J J
Jthe client indicates an understanding of the teaching?
J J J J J J J
a. I should eat to taste instead of trying to balance my meals-
J J J J J J J J J J J
Eat to taste to avoid nausea J J J J J
b. I will avoid having a snack at bedtime
J J J J J J J
c. I will have 8 oz of hot tea with each meal
J J J J J J J J J J
d. I should pair my sweets with a starch instead of eating
J J J J J J J J J J
them alone
J J
10. A nurse is preparing to collect a blood specimen from a
J J J J J J J J J J
Jnewborn via a heel stick. Which of the following techniques
J J J J J J J J J
Jshould the nurse use to help minimize the pain of the
J J J J J J J J J J
Jprocedure for the newborn? J J J
a. Warm the heel prior to the puncture J J J J J J
b. Request a prescription for IM analgesic J J J J J
c. Use a manual lance blade to pierce the skin
J J J J J J J J
d. Swaddle the newborn after the heel puncture- Effective J J J J J J J
technique to diminish the pain experience for the newborn.
J J J J J J J J J
, 11. A nurse is conducting an initial prenatal visit for a client
J J J J J J J J J J
Jwho is at 6 weeks gestation. Which of the following
J J J J J J J J J
Jlaboratory tests should be performed? J J J J
a. 24 hour urine for protein
J J J J
b. Group B streptococcus culture J J J
c. 3-hr glucose tolerance J J
d. Rubella titer- Obtained at the initial prenatal visit to J J J J J J J J
determine immunity to rubella
J J J J
12. A nurse is caring for a newborn who was transferred to the
J J J J J J J J J J J
Jnursery 30 min after delivery. Which of the following actions
J J J J J J J J J
Jshould the nurse take first?
J J J J
a. Confirm the newborn’s Apgar score J J J J
b. Verify the newborn’s identification- Mandatory toJ J J J J
continue ongoing identification of the newborn whenever
J J J J J J J
the newborn is removed from the mother’s direct presence
J J J J J J J J J
and care.
J J
c. Administer vitamin K IM to the newborn J J J J J J
d. Determine the obstetrical risk factors J J J J
13. A nurse is assessing a young adult client in a women’s
J J J J J J J J J J
Jhealth clinic who asks for a contraceptive. The client reports
J J J J J J J J J
Jto the nurse a familial history of osteoporosis. Which of the
J J J J J J J J J J
Jfollowing contraceptive methods is contraindicated for this
J J J J J J
Jclient?
a. Combined estrogen-progestin oral contraceptives J J J
b. An intrauterine device J J
c. Medroxyprogestrone acetate (Depo-provera)- causes a J J J J
decrease in bone mineral density and places the client at
J J J J J J J J J J
risk for the development of osteoporosis
J J J J J J
d. Norelgestromin/ethinyl estradiol (Ortho Evra) J J J
14. A nurse is admitting a client to the labor and delivery unit
J J J J J J J J J J J
Jwhen the client states, “my water just broke”, which of the
J J J J J J J J J J
Jfollowing is the priority intervention for the nurse to take?
J J J J J J J J J
a. Perform Nitrazine testing J J
b. Assess the amniotic fluid J J J
c. Check cervical dilation J J
d. Monitor the fetal heart rate- Rupture of the membranes J J J J J J J J
places the fetus at risk for umbilical cord prolapse.
J J J J J J J J J