RN ATI Maternal Newborn Test Proctored NGN 70 Screenshot
Questions and Rationales | Answers 2026 - 100 Questions and
Answers Already Graded A+ Premium Exam Tested And
Verified
Subject Area Maternal-Newborn Nursing
Description This rigorous exam covers advanced maternal-newborn nursing concepts
including antepartum, intrapartum, postpartum, and neonatal care, with emphasis
on evidence-based practice, complications, and pharmacologic management.
Designed to assess clinical reasoning and application of current guidelines.
Expected Grade A+
Total Questions 100
Duration 3 hours
Learning Outcomes 1. Analyze complex maternal-fetal physiology and identify deviations from
normal.
2. Apply evidence-based interventions for high-risk pregnancies and neonatal
emergencies.
3. Integrate pharmacokinetics and safe medication administration in perinatal care.
Accreditation Aligns with AACN Essentials and NCLEX-RN test plan standards for top US
universities.
Page 1
,1. A patient with a history of antiphospholipid syndrome presents at 28 weeks'
gestation with a blood pressure of 160/110 mmHg, 3+ proteinuria, and epigastric
pain. Which intervention is most appropriate immediately?
A. Administer labetalol 200 mg orally and repeat blood pressure in 30 minutes.
B. Initiate magnesium sulfate 4 g IV bolus followed by 1 g/hour.
C. Prepare for emergent cesarean section after corticosteroid administration.
D. Obtain a 24-hour urine collection for protein quantification.
Answer: B. Initiate magnesium sulfate 4 g IV bolus followed by 1 g/hour.
The patient has severe preeclampsia with features of impending eclampsia (epigastric
pain, severe hypertension). Magnesium sulfate is indicated for seizure prophylaxis.
Labetalol alone does not prevent seizures; emergent delivery may be needed but not
before stabilization; 24-hour urine collection delays treatment.
2. A neonate born at 39 weeks' gestation develops respiratory distress shortly after
birth. Chest radiograph shows diffuse granular opacities and air bronchograms.
Which pathophysiology is most consistent with this finding?
A. Deficiency of surfactant due to immature type II pneumocytes.
B. Meconium aspiration causing chemical pneumonitis and airway obstruction.
C. Transient tachypnea from delayed clearance of fetal lung fluid.
D. Group B streptococcal pneumonia acquired during passage through the birth canal.
Answer: A. Deficiency of surfactant due to immature type II pneumocytes.
The combination of term gestation, respiratory distress, and classic radiographic
findings of granular opacities and air bronchograms is characteristic of respiratory
distress syndrome (RDS) due to surfactant deficiency. Even in term infants, RDS can
occur if surfactant production is insufficient. Meconium aspiration typically shows
patchy infiltrates; transient tachypnea shows fluid in fissures; GBS pneumonia shows
lobar consolidation.
Page 2
,3. A patient with a history of pregestational diabetes presents at 34 weeks' gestation
with polyhydramnios. Which fetal complication is most likely contributing to this
condition?
A. Fetal renal agenesis leading to decreased urine output.
B. Fetal esophageal atresia impairing swallowing of amniotic fluid.
C. Fetal hyperglycemia causing osmotic diuresis.
D. Fetal growth restriction with reduced placental perfusion.
Answer: C. Fetal hyperglycemia causing osmotic diuresis.
In maternal diabetes, fetal hyperglycemia leads to osmotic diuresis and increased urine
production, contributing to polyhydramnios. Renal agenesis causes oligohydramnios;
esophageal atresia can cause polyhydramnios but is less common than the metabolic
effect in diabetes; growth restriction is associated with oligohydramnios.
4. A patient at 38 weeks' gestation is in active labor with ruptured membranes. The
fetal heart rate tracing shows recurrent late decelerations with minimal variability.
Which nursing intervention should be implemented first?
A. Administer oxygen at 10 L/min via non-rebreather mask.
B. Change maternal position to left lateral.
C. Increase intravenous fluid rate.
D. Discontinue oxytocin if infusing.
Answer: B. Change maternal position to left lateral.
Late decelerations indicate uteroplacental insufficiency. The priority intervention is to
improve placental perfusion by repositioning the mother to left lateral, which alleviates
aortocaval compression. Oxygen and IV fluids are secondary; discontinuing oxytocin is
appropriate if it is being used, but position change is the first action.
Page 3
, 5. A patient with a history of postpartum hemorrhage is receiving oxytocin 40 units
in 500 mL lactated Ringer's at 250 mL/hour. After 30 minutes, the uterus remains
boggy and lochia is heavy. Which pharmacologic intervention should the nurse
anticipate next?
A. Administer methylergonovine 0.2 mg intramuscularly.
B. Increase oxytocin infusion rate to 500 mL/hour.
C. Administer carboprost tromethamine 250 mcg intramuscularly.
D. Insert an intrauterine balloon for tamponade.
Answer: C. Administer carboprost tromethamine 250 mcg intramuscularly.
When oxytocin fails to control hemorrhage, a prostaglandin analog such as carboprost
(Hemabate) is the next-line uterotonic. Methylergonovine is contraindicated in
hypertension; increasing oxytocin beyond standard doses is not recommended;
intrauterine balloon is a mechanical intervention after pharmacologic options.
6. A patient at 32 weeks' gestation with preterm labor is receiving terbutaline 0.25
mg subcutaneously. Which adverse effect requires immediate discontinuation of the
medication?
A. Maternal heart rate of 110 beats per minute.
B. Fetal tachycardia of 180 beats per minute.
C. Maternal blood glucose of 140 mg/dL.
D. Maternal pulmonary edema with crackles.
Answer: D. Maternal pulmonary edema with crackles.
Terbutaline, a beta-2 agonist, can cause pulmonary edema, especially when used with
corticosteroids. Crackles indicate fluid overload, which is a serious adverse effect
requiring discontinuation. Maternal tachycardia and hyperglycemia are common and
expected; fetal tachycardia may be monitored but is not an indication to stop.
Page 4
Questions and Rationales | Answers 2026 - 100 Questions and
Answers Already Graded A+ Premium Exam Tested And
Verified
Subject Area Maternal-Newborn Nursing
Description This rigorous exam covers advanced maternal-newborn nursing concepts
including antepartum, intrapartum, postpartum, and neonatal care, with emphasis
on evidence-based practice, complications, and pharmacologic management.
Designed to assess clinical reasoning and application of current guidelines.
Expected Grade A+
Total Questions 100
Duration 3 hours
Learning Outcomes 1. Analyze complex maternal-fetal physiology and identify deviations from
normal.
2. Apply evidence-based interventions for high-risk pregnancies and neonatal
emergencies.
3. Integrate pharmacokinetics and safe medication administration in perinatal care.
Accreditation Aligns with AACN Essentials and NCLEX-RN test plan standards for top US
universities.
Page 1
,1. A patient with a history of antiphospholipid syndrome presents at 28 weeks'
gestation with a blood pressure of 160/110 mmHg, 3+ proteinuria, and epigastric
pain. Which intervention is most appropriate immediately?
A. Administer labetalol 200 mg orally and repeat blood pressure in 30 minutes.
B. Initiate magnesium sulfate 4 g IV bolus followed by 1 g/hour.
C. Prepare for emergent cesarean section after corticosteroid administration.
D. Obtain a 24-hour urine collection for protein quantification.
Answer: B. Initiate magnesium sulfate 4 g IV bolus followed by 1 g/hour.
The patient has severe preeclampsia with features of impending eclampsia (epigastric
pain, severe hypertension). Magnesium sulfate is indicated for seizure prophylaxis.
Labetalol alone does not prevent seizures; emergent delivery may be needed but not
before stabilization; 24-hour urine collection delays treatment.
2. A neonate born at 39 weeks' gestation develops respiratory distress shortly after
birth. Chest radiograph shows diffuse granular opacities and air bronchograms.
Which pathophysiology is most consistent with this finding?
A. Deficiency of surfactant due to immature type II pneumocytes.
B. Meconium aspiration causing chemical pneumonitis and airway obstruction.
C. Transient tachypnea from delayed clearance of fetal lung fluid.
D. Group B streptococcal pneumonia acquired during passage through the birth canal.
Answer: A. Deficiency of surfactant due to immature type II pneumocytes.
The combination of term gestation, respiratory distress, and classic radiographic
findings of granular opacities and air bronchograms is characteristic of respiratory
distress syndrome (RDS) due to surfactant deficiency. Even in term infants, RDS can
occur if surfactant production is insufficient. Meconium aspiration typically shows
patchy infiltrates; transient tachypnea shows fluid in fissures; GBS pneumonia shows
lobar consolidation.
Page 2
,3. A patient with a history of pregestational diabetes presents at 34 weeks' gestation
with polyhydramnios. Which fetal complication is most likely contributing to this
condition?
A. Fetal renal agenesis leading to decreased urine output.
B. Fetal esophageal atresia impairing swallowing of amniotic fluid.
C. Fetal hyperglycemia causing osmotic diuresis.
D. Fetal growth restriction with reduced placental perfusion.
Answer: C. Fetal hyperglycemia causing osmotic diuresis.
In maternal diabetes, fetal hyperglycemia leads to osmotic diuresis and increased urine
production, contributing to polyhydramnios. Renal agenesis causes oligohydramnios;
esophageal atresia can cause polyhydramnios but is less common than the metabolic
effect in diabetes; growth restriction is associated with oligohydramnios.
4. A patient at 38 weeks' gestation is in active labor with ruptured membranes. The
fetal heart rate tracing shows recurrent late decelerations with minimal variability.
Which nursing intervention should be implemented first?
A. Administer oxygen at 10 L/min via non-rebreather mask.
B. Change maternal position to left lateral.
C. Increase intravenous fluid rate.
D. Discontinue oxytocin if infusing.
Answer: B. Change maternal position to left lateral.
Late decelerations indicate uteroplacental insufficiency. The priority intervention is to
improve placental perfusion by repositioning the mother to left lateral, which alleviates
aortocaval compression. Oxygen and IV fluids are secondary; discontinuing oxytocin is
appropriate if it is being used, but position change is the first action.
Page 3
, 5. A patient with a history of postpartum hemorrhage is receiving oxytocin 40 units
in 500 mL lactated Ringer's at 250 mL/hour. After 30 minutes, the uterus remains
boggy and lochia is heavy. Which pharmacologic intervention should the nurse
anticipate next?
A. Administer methylergonovine 0.2 mg intramuscularly.
B. Increase oxytocin infusion rate to 500 mL/hour.
C. Administer carboprost tromethamine 250 mcg intramuscularly.
D. Insert an intrauterine balloon for tamponade.
Answer: C. Administer carboprost tromethamine 250 mcg intramuscularly.
When oxytocin fails to control hemorrhage, a prostaglandin analog such as carboprost
(Hemabate) is the next-line uterotonic. Methylergonovine is contraindicated in
hypertension; increasing oxytocin beyond standard doses is not recommended;
intrauterine balloon is a mechanical intervention after pharmacologic options.
6. A patient at 32 weeks' gestation with preterm labor is receiving terbutaline 0.25
mg subcutaneously. Which adverse effect requires immediate discontinuation of the
medication?
A. Maternal heart rate of 110 beats per minute.
B. Fetal tachycardia of 180 beats per minute.
C. Maternal blood glucose of 140 mg/dL.
D. Maternal pulmonary edema with crackles.
Answer: D. Maternal pulmonary edema with crackles.
Terbutaline, a beta-2 agonist, can cause pulmonary edema, especially when used with
corticosteroids. Crackles indicate fluid overload, which is a serious adverse effect
requiring discontinuation. Maternal tachycardia and hyperglycemia are common and
expected; fetal tachycardia may be monitored but is not an indication to stop.
Page 4
