ATI NGN Maternal
Newborn
Comprehensive
Examination V2.0
Advanced Clinical Judgment
and Next Generation NCLEX-
Style Assessment well written
one year 2025 /2026
updated graded A+
,SECTION I: ANTEPARTUM NURSING CARE (Questions 1-35)
1. A nurse is providing preconception counseling to a client who is planning to become
pregnant. The client has a history of type 1 diabetes mellitus. Which laboratory value indicates
optimal glycemic control before conception?
A) Hemoglobin A1c 6.5%
B) Hemoglobin A1c 8.0%
C) Fasting blood glucose 120 mg/dL
D) Random blood glucose 140 mg/dL
- detailed answer 100 % correct :-A
Rationale: An HbA1c of <7% (ideally <6.5%) indicates optimal glycemic control before conception.
Elevated HbA1c (≥8%) is associated with increased risk of congenital anomalies and spontaneous
abortion. Fasting blood glucose should be <95 mg/dL; random glucose should be <140 mg/dL in
pregnancy.
2. A nurse is assessing a client at 10 weeks gestation who reports severe nausea and vomiting,
weight loss of 7% of pre-pregnancy weight, and inability to tolerate oral fluids for 48 hours.
Which finding indicates the need for immediate hospitalization?
A) Urine ketones 1+
B) Serum potassium 3.8 mEq/L
C) Serum sodium 135 mEq/L
D) Urine specific gravity 1.025
- detailed answer 100 % correct :-A
Rationale: Urine ketones indicate dehydration and starvation, requiring hospitalization for IV fluids
and antiemetics. Serum potassium of 3.8 mEq/L is within normal range (3.5-5.0); sodium 135 mEq/L is
normal; specific gravity 1.025 is normal (1.005-1.030). Weight loss >5% with inability to keep fluids
down warrants hospitalization for hyperemesis gravidarum.
,3. A nurse is performing Leopold maneuvers on a client at 38 weeks gestation. The nurse
palpates a soft, irregular mass in the fundus and a firm, round mass above the symphysis pubis.
What is the fetal presentation?
A) Cephalic
B) Breech
C) Transverse lie
D) Shoulder presentation
- detailed answer 100 % correct :-A
Rationale: In cephalic presentation, the fetal head (firm, round mass) is palpated above the symphysis
pubis, and the buttocks (soft, irregular mass) are in the fundus. This is the most common and favorable
presentation for vaginal delivery.
4. A nurse is providing education about prenatal genetic screening. The client is 35 years old
and has a family history of Down syndrome. Which test should the nurse recommend for
definitive diagnosis?
A) Maternal serum alpha-fetoprotein (MSAFP)
B) Noninvasive prenatal testing (NIPT)
C) Amniocentesis
D) First-trimester ultrasound
- detailed answer 100 % correct :-C
Rationale: Amniocentesis is a diagnostic test that analyzes fetal karyotype and provides definitive
diagnosis of chromosomal abnormalities. MSAFP and NIPT are screening tests that identify risk, not
diagnosis. First-trimester ultrasound assesses nuchal translucency as a screening measure.
5. A nurse is assessing a client at 28 weeks gestation with a diagnosis of gestational diabetes.
The client's fasting blood glucose is 105 mg/dL, and 2-hour postprandial glucose is 145 mg/dL.
Which action should the nurse take?
A) Document the findings as within expected range
, B) Encourage the client to increase carbohydrate intake
C) Notify the provider of elevated glucose levels
D) Instruct the client to skip meals to lower glucose
- detailed answer 100 % correct :-C
Rationale: In GDM, target glucose levels are fasting <95 mg/dL and 2-hour postprandial <120 mg/dL.
The client's levels are elevated and require provider notification for possible medication management.
Increasing carbohydrates and skipping meals would worsen glycemic control.
6. A nurse is caring for a client with preeclampsia who is receiving magnesium sulfate. The
client's deep tendon reflexes are 1+, urinary output is 25 mL/hr, and respiratory rate is 14
breaths/min.
Which action should the nurse take?
A) Continue the infusion as prescribed
B) Decrease the infusion rate
C) Discontinue the infusion and prepare to administer calcium gluconate
D) Increase the infusion rate
- detailed answer 100 % correct :-C
Rationale: Oliguria (<30 mL/hr) indicates magnesium toxicity and renal impairment. DTRs of 1+ are
decreased, and respiratory rate of 14 is borderline. The infusion should be discontinued, calcium
gluconate (antidote) should be prepared, and the provider notified.
7. A nurse is assessing a client at 32 weeks gestation with placenta previa. The client reports
painless, bright red vaginal bleeding. Which additional finding would indicate the need for
immediate cesarean delivery?
A) Fetal heart rate 150 beats/min with moderate variability
B) Maternal blood pressure 130/80 mmHg
C) Fetal heart rate 90 beats/min with minimal variability
D) Contractions every 8 minutes
- detailed answer 100 % correct :-C
Newborn
Comprehensive
Examination V2.0
Advanced Clinical Judgment
and Next Generation NCLEX-
Style Assessment well written
one year 2025 /2026
updated graded A+
,SECTION I: ANTEPARTUM NURSING CARE (Questions 1-35)
1. A nurse is providing preconception counseling to a client who is planning to become
pregnant. The client has a history of type 1 diabetes mellitus. Which laboratory value indicates
optimal glycemic control before conception?
A) Hemoglobin A1c 6.5%
B) Hemoglobin A1c 8.0%
C) Fasting blood glucose 120 mg/dL
D) Random blood glucose 140 mg/dL
- detailed answer 100 % correct :-A
Rationale: An HbA1c of <7% (ideally <6.5%) indicates optimal glycemic control before conception.
Elevated HbA1c (≥8%) is associated with increased risk of congenital anomalies and spontaneous
abortion. Fasting blood glucose should be <95 mg/dL; random glucose should be <140 mg/dL in
pregnancy.
2. A nurse is assessing a client at 10 weeks gestation who reports severe nausea and vomiting,
weight loss of 7% of pre-pregnancy weight, and inability to tolerate oral fluids for 48 hours.
Which finding indicates the need for immediate hospitalization?
A) Urine ketones 1+
B) Serum potassium 3.8 mEq/L
C) Serum sodium 135 mEq/L
D) Urine specific gravity 1.025
- detailed answer 100 % correct :-A
Rationale: Urine ketones indicate dehydration and starvation, requiring hospitalization for IV fluids
and antiemetics. Serum potassium of 3.8 mEq/L is within normal range (3.5-5.0); sodium 135 mEq/L is
normal; specific gravity 1.025 is normal (1.005-1.030). Weight loss >5% with inability to keep fluids
down warrants hospitalization for hyperemesis gravidarum.
,3. A nurse is performing Leopold maneuvers on a client at 38 weeks gestation. The nurse
palpates a soft, irregular mass in the fundus and a firm, round mass above the symphysis pubis.
What is the fetal presentation?
A) Cephalic
B) Breech
C) Transverse lie
D) Shoulder presentation
- detailed answer 100 % correct :-A
Rationale: In cephalic presentation, the fetal head (firm, round mass) is palpated above the symphysis
pubis, and the buttocks (soft, irregular mass) are in the fundus. This is the most common and favorable
presentation for vaginal delivery.
4. A nurse is providing education about prenatal genetic screening. The client is 35 years old
and has a family history of Down syndrome. Which test should the nurse recommend for
definitive diagnosis?
A) Maternal serum alpha-fetoprotein (MSAFP)
B) Noninvasive prenatal testing (NIPT)
C) Amniocentesis
D) First-trimester ultrasound
- detailed answer 100 % correct :-C
Rationale: Amniocentesis is a diagnostic test that analyzes fetal karyotype and provides definitive
diagnosis of chromosomal abnormalities. MSAFP and NIPT are screening tests that identify risk, not
diagnosis. First-trimester ultrasound assesses nuchal translucency as a screening measure.
5. A nurse is assessing a client at 28 weeks gestation with a diagnosis of gestational diabetes.
The client's fasting blood glucose is 105 mg/dL, and 2-hour postprandial glucose is 145 mg/dL.
Which action should the nurse take?
A) Document the findings as within expected range
, B) Encourage the client to increase carbohydrate intake
C) Notify the provider of elevated glucose levels
D) Instruct the client to skip meals to lower glucose
- detailed answer 100 % correct :-C
Rationale: In GDM, target glucose levels are fasting <95 mg/dL and 2-hour postprandial <120 mg/dL.
The client's levels are elevated and require provider notification for possible medication management.
Increasing carbohydrates and skipping meals would worsen glycemic control.
6. A nurse is caring for a client with preeclampsia who is receiving magnesium sulfate. The
client's deep tendon reflexes are 1+, urinary output is 25 mL/hr, and respiratory rate is 14
breaths/min.
Which action should the nurse take?
A) Continue the infusion as prescribed
B) Decrease the infusion rate
C) Discontinue the infusion and prepare to administer calcium gluconate
D) Increase the infusion rate
- detailed answer 100 % correct :-C
Rationale: Oliguria (<30 mL/hr) indicates magnesium toxicity and renal impairment. DTRs of 1+ are
decreased, and respiratory rate of 14 is borderline. The infusion should be discontinued, calcium
gluconate (antidote) should be prepared, and the provider notified.
7. A nurse is assessing a client at 32 weeks gestation with placenta previa. The client reports
painless, bright red vaginal bleeding. Which additional finding would indicate the need for
immediate cesarean delivery?
A) Fetal heart rate 150 beats/min with moderate variability
B) Maternal blood pressure 130/80 mmHg
C) Fetal heart rate 90 beats/min with minimal variability
D) Contractions every 8 minutes
- detailed answer 100 % correct :-C
