,ATI Maternal-Newborn/OB Practice Questions
1. Rubella immunity
A nurse reviews the prenatal laboratory results of a client whose rubella titer is 1:8. Which
teaching should the nurse provide?
A. “The result confirms an active rubella infection.”
B. “You should receive the MMR vaccine during pregnancy.”
C. “This result may indicate inadequate immunity, so vaccination is recommended after
delivery.”
D. “You will need rubella immune globulin immediately.”
Correct answer: C
Rationale: A low or borderline rubella titer may indicate susceptibility. Because MMR is a live-
attenuated vaccine, it is contraindicated during pregnancy. A nonimmune client should receive
MMR postpartum and avoid pregnancy for 28 days afterward. Modern laboratories commonly
define immunity using rubella IgG of at least 10 IU/mL rather than titers alone. CDC rubella
guidance
2. Intrauterine device contraindication
Which finding is a contraindication to immediate insertion of an intrauterine device?
A. History of dysmenorrhea
B. Current pelvic inflammatory disease
C. Previous cesarean birth
D. Nulliparity
Correct answer: B
Rationale: Current pelvic infection, purulent cervicitis, pregnancy, unexplained uterine bleeding
and certain uterine abnormalities are contraindications. A remote history of PID without current
infection is not automatically an absolute contraindication.
3. Diaphragm insertion
Place the steps for diaphragm insertion in the correct order.
1. Insert the folded diaphragm into the vagina.
, 2. Apply spermicidal cream or jelly inside the dome and around the rim.
3. Verify that the cervix is completely covered.
4. Wash the hands and empty the bladder.
5. Assume a comfortable position, such as squatting.
Correct order: 4, 2, 5, 1, 3
Rationale: The client first performs hand hygiene and empties the bladder, applies spermicide,
assumes a comfortable position, inserts the diaphragm and confirms that the cervix is covered. It
should generally remain in place for at least 6 hours after intercourse.
4. Tubal ligation
Which statement by a client following tubal ligation demonstrates understanding?
A. “I will no longer ovulate.”
B. “My menstrual periods will stop.”
C. “My ovaries will continue to release hormones and ova.”
D. “I will need monthly hormone injections.”
Correct answer: C
Rationale: Tubal ligation blocks or interrupts the fallopian tubes. It does not remove the ovaries
or normally change ovulation, hormone production or menstruation.
5. Neonatal abstinence syndrome
Which intervention should the nurse use for a newborn experiencing neonatal opioid withdrawal
syndrome?
A. Stimulate the newborn frequently.
B. Swaddle the newborn with the extremities flexed.
C. Feed large volumes every 6 hours.
D. Keep the room brightly illuminated.
Correct answer: B
Rationale: Swaddling, flexed positioning, reduced noise and light, gentle handling and small
frequent feedings decrease stimulation and promote comfort.
1. Rubella immunity
A nurse reviews the prenatal laboratory results of a client whose rubella titer is 1:8. Which
teaching should the nurse provide?
A. “The result confirms an active rubella infection.”
B. “You should receive the MMR vaccine during pregnancy.”
C. “This result may indicate inadequate immunity, so vaccination is recommended after
delivery.”
D. “You will need rubella immune globulin immediately.”
Correct answer: C
Rationale: A low or borderline rubella titer may indicate susceptibility. Because MMR is a live-
attenuated vaccine, it is contraindicated during pregnancy. A nonimmune client should receive
MMR postpartum and avoid pregnancy for 28 days afterward. Modern laboratories commonly
define immunity using rubella IgG of at least 10 IU/mL rather than titers alone. CDC rubella
guidance
2. Intrauterine device contraindication
Which finding is a contraindication to immediate insertion of an intrauterine device?
A. History of dysmenorrhea
B. Current pelvic inflammatory disease
C. Previous cesarean birth
D. Nulliparity
Correct answer: B
Rationale: Current pelvic infection, purulent cervicitis, pregnancy, unexplained uterine bleeding
and certain uterine abnormalities are contraindications. A remote history of PID without current
infection is not automatically an absolute contraindication.
3. Diaphragm insertion
Place the steps for diaphragm insertion in the correct order.
1. Insert the folded diaphragm into the vagina.
, 2. Apply spermicidal cream or jelly inside the dome and around the rim.
3. Verify that the cervix is completely covered.
4. Wash the hands and empty the bladder.
5. Assume a comfortable position, such as squatting.
Correct order: 4, 2, 5, 1, 3
Rationale: The client first performs hand hygiene and empties the bladder, applies spermicide,
assumes a comfortable position, inserts the diaphragm and confirms that the cervix is covered. It
should generally remain in place for at least 6 hours after intercourse.
4. Tubal ligation
Which statement by a client following tubal ligation demonstrates understanding?
A. “I will no longer ovulate.”
B. “My menstrual periods will stop.”
C. “My ovaries will continue to release hormones and ova.”
D. “I will need monthly hormone injections.”
Correct answer: C
Rationale: Tubal ligation blocks or interrupts the fallopian tubes. It does not remove the ovaries
or normally change ovulation, hormone production or menstruation.
5. Neonatal abstinence syndrome
Which intervention should the nurse use for a newborn experiencing neonatal opioid withdrawal
syndrome?
A. Stimulate the newborn frequently.
B. Swaddle the newborn with the extremities flexed.
C. Feed large volumes every 6 hours.
D. Keep the room brightly illuminated.
Correct answer: B
Rationale: Swaddling, flexed positioning, reduced noise and light, gentle handling and small
frequent feedings decrease stimulation and promote comfort.
