ATI RN Maternal Newborn OB Proctored
Retake Exam 2023 With NGN: All 70
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70 Questions and Ansẉers
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Expert-Verified Explanation
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───────────────────────────────────────────────────────
─
A nurse in a prenatal clinic is reviewing the medical record of a client who is at
33 weeks of gestation and has placenta previa. Which of the following
prescriptions should the nurse clarify with the provider?
A) Perform a vaginal examination
B) Perform continuous external fetal monitoring
C) Insert a large-bore IV catheter
D) Obtain a blood sample for laboratory testing
Correct answerA
Expert-Explanation In the context of placenta previa, the placenta is implanted
abnormally low in the uterus, often covering the cervical os. Digital vaginal
examination can disrupt the placental attachment, leading to catastrophic
hemorrhage for both the mother and fetus. Current ACOG guidelines classify
any vaginal exam in a known or suspected previa as a contraindication due to
the risk of provoking painless bleeding into a life-threatening emergency .
Continuous monitoring (B) is essential for assessing fetal well-being and
contraction patterns. Establishing IV access (C) is a priority safety intervention
for fluid resuscitation if bleeding occurs. Blood sampling (D) allows for baseline
hemoglobin and hematocrit levels and type and crossmatch preparation.
However, the critical, "clarify immediately" action is to halt the order for a
vaginal exam.
Question 2
A nurse is caring for a client at 37 weeks gestation who reports sudden,
painless, bright red vaginal bleeding. The fetal heart rate is 145/min with
moderate variability, and the client’s vital signs are stable. What is the priority
nursing action?
A) Prepare the client for an immediate vaginal examination to assess cervical
dilation
B) Administer oxytocin to augment contractions and expedite delivery
C) Avoid vaginal examination and prepare for an abdominal ultrasound
D) Encourage the client to ambulate to promote labor progression
,Correct answerC
Expert-Explanation The classic presentation of painless, bright red bleeding in
the third trimester is placenta previa until proven otherwise. Digital vaginal
exams are strictly contraindicated because they can cause a sudden, massive
hemorrhage from the placental site . The priority action is to avoid any cervical
manipulation and prepare for an abdominal ultrasound to confirm placental
location. This is a classic "trap" question where the nursing intervention is often
to prevent an action (the vaginal exam) rather than to do something active like
giving oxygen or fluids first. While preparing for a potential cesarean section is
likely, the immediate nursing action is to prevent the precipitating event (the
exam).
Question 3
A client in active labor is receiving oxytocin for augmentation. The nurse notes
the contractions are occurring every 90 seconds and lasting 90 seconds. The
fetal heart rate tracing shows late decelerations. What is the nurse's priority
action?
A) Stop the oxytocin infusion immediately
B) Administer oxygen via face mask at 10 L/min
C) Reposition the client onto her left side
D) Increase the maintenance IV fluid rate
Correct answerA
Expert-Explanation The contraction pattern described
(hyperstimulation/tachysystole) combined with late decelerations indicates
uteroplacental insufficiency and fetal compromise. While repositioning and
oxygen (B, C) are appropriate secondary interventions, the priority is to remove
the cause of the hyperstimulation, which is the oxytocin . The uterus needs
time to relax to allow for placental perfusion. The nurse should turn off the
infusion, increase the mainline IV fluid rate to promote placental perfusion, and
then reposition the client and apply oxygen. However, the first step in the chain
of command for oxytocin-induced distress is always to stop the pitocin.
Notifying the provider comes after these immediate lifesaving interventions.
Question 4
A nurse is assessing a newborn who is 3 hours old. The nurse notes
acrocyanosis, irregular respirations at 42/min, and a positive Moro reflex.
Which action should the nurse take?
A) Continue routine monitoring as these are expected findings
, B) Initiate supplemental oxygen via hood immediately
C) Notify the provider for signs of respiratory distress
D) Place the newborn under a radiant warmer for hypothermia
Correct answerA
Expert-Explanation Acrocyanosis (bluish discoloration of hands and feet only)
is a normal finding in the newborn period due to immature peripheral
circulation and does not indicate hypoxemia. Irregular respirations with rates
between 30 and 60 breaths/min are standard for a newborn transitioning to
extrauterine life, provided there is no grunting, nasal flaring, or retractions .
The Moro reflex is a primitive reflex that should be present. The nurse must
distinguish between normal transitional findings and pathological distress.
Providing oxygen (B) or a warmer (D) without clear indication (central cyanosis,
hypothermia) constitutes unnecessary intervention and separation of the
parent-infant dyad.
Question 5
A nurse is providing discharge teaching to a new parent about car seat safety.
Which of the following statements by the parent indicates an understanding of
the teaching?
A) "I will position the car seat at a 45-degree angle in the back seat."
B) "I will place the car seat forward-facing so I can see my baby."
C) "I will place the harness straps in the slots above my baby's shoulders."
D) "I will position the retainer clip over my baby's abdomen."
Correct answerA
Expert-Explanation The 45-degree angle is critical to prevent the infant's head
from flopping forward, which can occlude the airway. Infants have heavy heads
and weak neck muscles, so a semi-reclined position maintains an open airway.
The car seat must remain rear-facing until at least age 2 (B is unsafe). Harness
straps should be at or below the shoulders for rear-facing infants to prevent
spinal ejection (C is incorrect). The retainer clip (chest clip) should be at armpit
level, not the abdomen, to keep the harness properly positioned over the bony
thorax (D is incorrect) .
Question 6
A nurse is caring for a client who is 2 hours postpartum after a vaginal delivery.
The client's fundus is firm, midline, and at the umbilicus. However, the client
reports dizziness and appears pale. Vital signs are BP 86/54, HR 124, RR 20.
What is the nurse's first action?
Retake Exam 2023 With NGN: All 70
Screenshot Questions and Ansẉers with
Expert-Verified Explanation 2026 update
This Exam contains:
Guarantee passing score
70 Questions and Ansẉers
format set of multiple-choice
Expert-Verified Explanation
, Verified ẉith trusted textbooks
───────────────────────────────────────────────────────
─
A nurse in a prenatal clinic is reviewing the medical record of a client who is at
33 weeks of gestation and has placenta previa. Which of the following
prescriptions should the nurse clarify with the provider?
A) Perform a vaginal examination
B) Perform continuous external fetal monitoring
C) Insert a large-bore IV catheter
D) Obtain a blood sample for laboratory testing
Correct answerA
Expert-Explanation In the context of placenta previa, the placenta is implanted
abnormally low in the uterus, often covering the cervical os. Digital vaginal
examination can disrupt the placental attachment, leading to catastrophic
hemorrhage for both the mother and fetus. Current ACOG guidelines classify
any vaginal exam in a known or suspected previa as a contraindication due to
the risk of provoking painless bleeding into a life-threatening emergency .
Continuous monitoring (B) is essential for assessing fetal well-being and
contraction patterns. Establishing IV access (C) is a priority safety intervention
for fluid resuscitation if bleeding occurs. Blood sampling (D) allows for baseline
hemoglobin and hematocrit levels and type and crossmatch preparation.
However, the critical, "clarify immediately" action is to halt the order for a
vaginal exam.
Question 2
A nurse is caring for a client at 37 weeks gestation who reports sudden,
painless, bright red vaginal bleeding. The fetal heart rate is 145/min with
moderate variability, and the client’s vital signs are stable. What is the priority
nursing action?
A) Prepare the client for an immediate vaginal examination to assess cervical
dilation
B) Administer oxytocin to augment contractions and expedite delivery
C) Avoid vaginal examination and prepare for an abdominal ultrasound
D) Encourage the client to ambulate to promote labor progression
,Correct answerC
Expert-Explanation The classic presentation of painless, bright red bleeding in
the third trimester is placenta previa until proven otherwise. Digital vaginal
exams are strictly contraindicated because they can cause a sudden, massive
hemorrhage from the placental site . The priority action is to avoid any cervical
manipulation and prepare for an abdominal ultrasound to confirm placental
location. This is a classic "trap" question where the nursing intervention is often
to prevent an action (the vaginal exam) rather than to do something active like
giving oxygen or fluids first. While preparing for a potential cesarean section is
likely, the immediate nursing action is to prevent the precipitating event (the
exam).
Question 3
A client in active labor is receiving oxytocin for augmentation. The nurse notes
the contractions are occurring every 90 seconds and lasting 90 seconds. The
fetal heart rate tracing shows late decelerations. What is the nurse's priority
action?
A) Stop the oxytocin infusion immediately
B) Administer oxygen via face mask at 10 L/min
C) Reposition the client onto her left side
D) Increase the maintenance IV fluid rate
Correct answerA
Expert-Explanation The contraction pattern described
(hyperstimulation/tachysystole) combined with late decelerations indicates
uteroplacental insufficiency and fetal compromise. While repositioning and
oxygen (B, C) are appropriate secondary interventions, the priority is to remove
the cause of the hyperstimulation, which is the oxytocin . The uterus needs
time to relax to allow for placental perfusion. The nurse should turn off the
infusion, increase the mainline IV fluid rate to promote placental perfusion, and
then reposition the client and apply oxygen. However, the first step in the chain
of command for oxytocin-induced distress is always to stop the pitocin.
Notifying the provider comes after these immediate lifesaving interventions.
Question 4
A nurse is assessing a newborn who is 3 hours old. The nurse notes
acrocyanosis, irregular respirations at 42/min, and a positive Moro reflex.
Which action should the nurse take?
A) Continue routine monitoring as these are expected findings
, B) Initiate supplemental oxygen via hood immediately
C) Notify the provider for signs of respiratory distress
D) Place the newborn under a radiant warmer for hypothermia
Correct answerA
Expert-Explanation Acrocyanosis (bluish discoloration of hands and feet only)
is a normal finding in the newborn period due to immature peripheral
circulation and does not indicate hypoxemia. Irregular respirations with rates
between 30 and 60 breaths/min are standard for a newborn transitioning to
extrauterine life, provided there is no grunting, nasal flaring, or retractions .
The Moro reflex is a primitive reflex that should be present. The nurse must
distinguish between normal transitional findings and pathological distress.
Providing oxygen (B) or a warmer (D) without clear indication (central cyanosis,
hypothermia) constitutes unnecessary intervention and separation of the
parent-infant dyad.
Question 5
A nurse is providing discharge teaching to a new parent about car seat safety.
Which of the following statements by the parent indicates an understanding of
the teaching?
A) "I will position the car seat at a 45-degree angle in the back seat."
B) "I will place the car seat forward-facing so I can see my baby."
C) "I will place the harness straps in the slots above my baby's shoulders."
D) "I will position the retainer clip over my baby's abdomen."
Correct answerA
Expert-Explanation The 45-degree angle is critical to prevent the infant's head
from flopping forward, which can occlude the airway. Infants have heavy heads
and weak neck muscles, so a semi-reclined position maintains an open airway.
The car seat must remain rear-facing until at least age 2 (B is unsafe). Harness
straps should be at or below the shoulders for rear-facing infants to prevent
spinal ejection (C is incorrect). The retainer clip (chest clip) should be at armpit
level, not the abdomen, to keep the harness properly positioned over the bony
thorax (D is incorrect) .
Question 6
A nurse is caring for a client who is 2 hours postpartum after a vaginal delivery.
The client's fundus is firm, midline, and at the umbilicus. However, the client
reports dizziness and appears pale. Vital signs are BP 86/54, HR 124, RR 20.
What is the nurse's first action?
