NGN
Professor-Verified | 110 Questions | All Answers
Graded A+
This examination is a high-fidelity predictor simulation for the VATI Maternal Newborn
assessment. It comprises 110 questions meticulously aligned with the 2025 curriculum and
the Next Generation NCLEX (NGN), focusing on the application of clinical judgment in
obstetric and neonatal nursing as defined by the NCSBN Clinical Judgment Measurement
Model. All content, scenarios, and rationales are verified against current evidence-based
guidelines from AWHONN, ACOG, and the AAP. Utilize this exam for comprehensive
readiness evaluation.
Item 1 | MC
Scenario: G2P1 at 39 wks in early labor; contractions q5 min, cervix 3 cm/90%/0
station, FHR 140 w/ moderate variability.
Question: First nursing action?
A. Apply fetal scalp electrode
B. Ambulate
C. Call provider
D. Document & continue monitoring
Correct Answer: D. Document & continue monitoring
Rationale: AWHONN 2025—latent phase w/ reassuring tracing warrants ongoing
assessment, not intervention. NCJMM Step 2.
Item 2 | NGN-EMR
Scenario: 34 wks, HA, blurred vision, BP 160/110, protein 3+, DTRs 3+ clonus.
Question: Select all RN actions ≤15 min.
A. Insert Foley
B. Give labetalol IV
C. Draw CBC/coags
D. Dim lights
E. Load MgSO₄
Correct Answer: B, C, D, E
Rationale: ACOG 2025 severe preeclampsia—BP control, seizure prophylaxis, labs; Foley
non-urgent. NCJMM Step 5.
pg. 1
,Item 3 | SATA
Scenario: Term newborn vacuum delivery; Apgar 4/6, RR 70, flaring, SpO₂ 88% RA.
Question: Indicated actions?
A. CPAP
B. Blow-by O₂
C. Blood gas
D. Start IV
E. Temp monitor
Correct Answer: A, B, C, E
Rationale: AAP NRP 2025—respiratory distress w/ SpO₂ <90% → CPAP/blow-by, gas,
warmth; IV only if perfusion poor. NCJMM Step 3.
Item 4 | Drag-and-Drop
Scenario: 8 cm → sudden severe pain, FHR 90 × 3 min, uterine woody.
Question: Place immediate steps in order.
1. Turn L-lateral
2. O₂ 10 L
3. Fluid bolus
4. Check for cord
5. Call provider
Correct Answer: 1, 2, 3, 4, 5
Rationale: AWHONN 2025—rupture protocol: resuscitate, assess, escalate.
NCJMM Step 5.
Item 5 | MC
Scenario: Breastfeeding day 3: mom says “nipples burn after feeds,” latch shallow,
nipples blanched.
Question: Best teaching?
A. Limit to 10 min/side
B. Warm compress pre-feed
C. Deep asymmetric latch
D. Supplement formula
Correct Answer: C. Deep asymmetric latch
Rationale: Vasospasm from shallow latch; deep chin-first latch prevents compression.
NCJMM Step 4.
pg. 2
,Item 6 | Matrix MC
Scenario: Match FHR pattern → intervention grid.
• Late decels + baseline 150 → stop oxytocin
• Variables 140 → turn lateral
• Prolonged decel 90 → fluid bolus
Correct Answer:
Late decels → stop oxytocin; Variables → turn lateral; Prolonged → fluid bolus
Rationale: AWHONN 2025 Category II patterns. NCJMM Step 4.
Item 7 | MC
Scenario: 28 wks painless bright-red spotting after intercourse, no contractions, FHR
150.
Question: Suspected cause?
A. Abruption
B. Placenta previa
C. Vasa previa
D. Bloody show
Correct Answer: B. Placenta previa
Rationale: Classic painless third-trimester bleed; no digital exam until US rules out
previa. NCJMM Step 1.
Item 8 | SATA
Scenario: Term newborn 4 h old, mother had MgSO₄ 2 h pre-delivery; temp 36.2, HR
170, RR 65, jittery.
Question: Mg toxicity signs?
A. Hypotonia
B. Poor suck
C. Tachypnea
D. Hypothermia
E. Hyperreflexia
Correct Answer: A, B, D
Rationale: Mg crosses placenta → neuromuscular block; reflexes decreased. NCJMM Step
2.
Item 9 | Cloze DD
Scenario: 41 wks Foley bulb ripening; 6 h later bulb falls out, contractions q5 min, cervix
4 cm.
(1) document successful ripening
pg. 3
, (2) monitor labor progression
Rationale: Bulb expulsion = ripening achieved; expectant management if contractions
adequate. NCJMM Step 5.
Item 10 | MC
Scenario: Day-1 newborn: “looks yellow,” TcB 10 mg/dL, feeding well.
Question: Action?
A. Start phototherapy
B. Feed q2–3 h & recheck
C. Order blood type
D. Refer to exchange
Correct Answer: B. Feed q2–3 h & recheck
Rationale: AAP 2025: TcB 10 mg/dL at 24 h < 75th percentile for term; feeding increases
bilirubin excretion. NCJMM Step 4.
Item 11 | SATA
Scenario: 35 wks 3 cm/80% preterm labor; nifedipine ordered.
Question: Pre-admin assessments?
A. Maternal BP
B. FHR pattern
C. Glucose
D. Allergy hx
E. Pulse
Correct Answer: A, B, D, E
Rationale: Nifedipine can ↓ BP and cause fetal heart rate changes; glucose unaffected.
NCJMM Step 1.
Item 12 | MC
Scenario: Term newborn 12 h, mom had fentanyl PCA; jittery, glucose 40 mg/dL.
Question: RN action?
A. 10 mL formula cup
B. Start D₁₀ IV
C. Skin-to-skin & recheck 30 min
D. Glucose gel
Correct Answer: C. Skin-to-skin & recheck 30 min
Rationale: Asymptomatic threshold 40 mg/dL → feeding first; gel reserved <40 or
symptomatic. NCJMM Step 4.
pg. 4