ATI RN Maternal Newborn OB Proctored
Exam with NGN – Screenshot Questions
and Answers 2026/2027
1. A nurse is assessing a client who is 10 weeks pregnant. Which finding should the nurse
expect?
A. Quickening
B. Positive Chadwick sign
C. Fundus at the umbilicus
D. Fetal movement palpable by the examiner
Correct Answer: B. Positive Chadwick sign
Rationale: Chadwick sign is a bluish-purple discoloration of the cervix and vaginal mucosa
caused by increased vascularity and is an expected early pregnancy finding. Quickening
generally occurs around 16–20 weeks. The fundus reaches the umbilicus at approximately 20
weeks, and fetal movement is not usually palpable externally this early.
2. A nurse is teaching a client about folic acid supplementation during pregnancy. Which
statement indicates understanding?
A. “Folic acid helps prevent neural tube defects.”
B. “Folic acid prevents gestational diabetes.”
C. “Folic acid prevents postpartum hemorrhage.”
D. “Folic acid eliminates the need for iron supplementation.”
Correct Answer: A. “Folic acid helps prevent neural tube defects.”
Rationale: Adequate folic acid before conception and during early pregnancy reduces the risk of
fetal neural tube defects such as spina bifida. Folic acid does not prevent gestational diabetes or
postpartum hemorrhage and does not replace iron supplementation when iron is indicated.
3. A client at 28 weeks of gestation reports painless vaginal bleeding. Which condition should
the nurse suspect?
A. Abruptio placentae
B. Placenta previa
,C. Ectopic pregnancy
D. Hyperemesis gravidarum
Correct Answer: B. Placenta previa
Rationale: Placenta previa commonly presents with painless, bright-red vaginal bleeding during
the second or third trimester. Abruptio placentae is more commonly associated with painful
bleeding, uterine tenderness, and increased uterine tone.
4. A nurse is caring for a client with suspected placenta previa. Which prescription should the
nurse question?
A. External fetal monitoring
B. Ultrasound examination
C. Vaginal examination
D. Assessment of maternal vital signs
Correct Answer: C. Vaginal examination
Rationale: A vaginal examination can disrupt the placenta when placenta previa is present and
can cause severe hemorrhage. Ultrasound is used to identify placental location. Maternal vital
signs and fetal monitoring help assess maternal and fetal status.
5. A client at 34 weeks of gestation has severe preeclampsia. Which finding requires
immediate intervention?
A. Blood pressure 168/112 mm Hg
B. Proteinuria
C. Mild dependent edema
D. Urinary frequency
Correct Answer: A. Blood pressure 168/112 mm Hg
Rationale: Severe-range hypertension in pregnancy significantly increases the risk of maternal
complications such as stroke, seizures, and placental complications. A blood pressure of ≥160
systolic or ≥110 diastolic requires prompt treatment according to the clinical situation.
6. A nurse is assessing a client receiving magnesium sulfate for severe preeclampsia. Which
finding indicates magnesium toxicity?
,A. Respiratory rate 10/min
B. Urine output 50 mL/hr
C. Patellar reflexes 2+
D. Blood pressure 140/90 mm Hg
Correct Answer: A. Respiratory rate 10/min
Rationale: Magnesium sulfate depresses the central nervous system. Respiratory depression,
diminished or absent deep-tendon reflexes, and decreased urine output are warning signs of
toxicity. The nurse should stop the infusion according to protocol/prescription and notify the
provider. Calcium gluconate is the antidote.
7. Which medication should the nurse expect to administer as the antidote for magnesium
sulfate toxicity?
A. Naloxone
B. Calcium gluconate
C. Protamine sulfate
D. Vitamin K
Correct Answer: B. Calcium gluconate
Rationale: Calcium gluconate antagonizes the effects of excessive magnesium and is the
antidote for magnesium toxicity. Naloxone reverses opioid effects, protamine reverses heparin,
and vitamin K is used to reverse warfarin effects.
8. A pregnant client reports severe headache, blurred vision, and epigastric pain. What is the
nurse's priority action?
A. Encourage oral fluids
B. Place the client in a dark room and reassess tomorrow
C. Notify the provider immediately
D. Administer an antacid
Correct Answer: C. Notify the provider immediately
Rationale: Severe headache, visual disturbances, and epigastric/right-upper-quadrant pain are
warning signs of severe preeclampsia and possible hepatic involvement. Immediate evaluation
is required to reduce the risk of seizures, stroke, hepatic complications, and other maternal-fetal
complications.
, 9. A nurse is teaching a pregnant client how to count fetal movements. Which instruction is
appropriate?
A. Count movements only once per week.
B. Count fetal movements at approximately the same time each day when instructed.
C. Count only movements occurring after exercise.
D. Report decreased movement only after 48 hr.
Correct Answer: B. Count fetal movements at approximately the same time each day when
instructed.
Rationale: Consistent timing makes fetal movement patterns easier to recognize. A significant
decrease from the client's established pattern should be reported promptly according to the
provider's instructions rather than waiting 48 hr.
10. A nurse is reviewing prenatal laboratory results. Which finding requires follow-up?
A. Blood type O positive
B. Rubella immunity
C. Hemoglobin 9.2 g/dL
D. Negative HIV screening
Correct Answer: C. Hemoglobin 9.2 g/dL
Rationale: A hemoglobin of 9.2 g/dL indicates anemia requiring further assessment and
management. Physiologic hemodilution occurs during pregnancy, but significant anemia may
require iron supplementation, dietary intervention, or additional evaluation.
11. A client who is Rh-negative gives birth to an Rh-positive newborn. Which medication
should the nurse anticipate administering?
A. Oxytocin
B. Rho(D) immune globulin
C. Methylergonovine
D. Betamethasone
Correct Answer: B. Rho(D) immune globulin
Exam with NGN – Screenshot Questions
and Answers 2026/2027
1. A nurse is assessing a client who is 10 weeks pregnant. Which finding should the nurse
expect?
A. Quickening
B. Positive Chadwick sign
C. Fundus at the umbilicus
D. Fetal movement palpable by the examiner
Correct Answer: B. Positive Chadwick sign
Rationale: Chadwick sign is a bluish-purple discoloration of the cervix and vaginal mucosa
caused by increased vascularity and is an expected early pregnancy finding. Quickening
generally occurs around 16–20 weeks. The fundus reaches the umbilicus at approximately 20
weeks, and fetal movement is not usually palpable externally this early.
2. A nurse is teaching a client about folic acid supplementation during pregnancy. Which
statement indicates understanding?
A. “Folic acid helps prevent neural tube defects.”
B. “Folic acid prevents gestational diabetes.”
C. “Folic acid prevents postpartum hemorrhage.”
D. “Folic acid eliminates the need for iron supplementation.”
Correct Answer: A. “Folic acid helps prevent neural tube defects.”
Rationale: Adequate folic acid before conception and during early pregnancy reduces the risk of
fetal neural tube defects such as spina bifida. Folic acid does not prevent gestational diabetes or
postpartum hemorrhage and does not replace iron supplementation when iron is indicated.
3. A client at 28 weeks of gestation reports painless vaginal bleeding. Which condition should
the nurse suspect?
A. Abruptio placentae
B. Placenta previa
,C. Ectopic pregnancy
D. Hyperemesis gravidarum
Correct Answer: B. Placenta previa
Rationale: Placenta previa commonly presents with painless, bright-red vaginal bleeding during
the second or third trimester. Abruptio placentae is more commonly associated with painful
bleeding, uterine tenderness, and increased uterine tone.
4. A nurse is caring for a client with suspected placenta previa. Which prescription should the
nurse question?
A. External fetal monitoring
B. Ultrasound examination
C. Vaginal examination
D. Assessment of maternal vital signs
Correct Answer: C. Vaginal examination
Rationale: A vaginal examination can disrupt the placenta when placenta previa is present and
can cause severe hemorrhage. Ultrasound is used to identify placental location. Maternal vital
signs and fetal monitoring help assess maternal and fetal status.
5. A client at 34 weeks of gestation has severe preeclampsia. Which finding requires
immediate intervention?
A. Blood pressure 168/112 mm Hg
B. Proteinuria
C. Mild dependent edema
D. Urinary frequency
Correct Answer: A. Blood pressure 168/112 mm Hg
Rationale: Severe-range hypertension in pregnancy significantly increases the risk of maternal
complications such as stroke, seizures, and placental complications. A blood pressure of ≥160
systolic or ≥110 diastolic requires prompt treatment according to the clinical situation.
6. A nurse is assessing a client receiving magnesium sulfate for severe preeclampsia. Which
finding indicates magnesium toxicity?
,A. Respiratory rate 10/min
B. Urine output 50 mL/hr
C. Patellar reflexes 2+
D. Blood pressure 140/90 mm Hg
Correct Answer: A. Respiratory rate 10/min
Rationale: Magnesium sulfate depresses the central nervous system. Respiratory depression,
diminished or absent deep-tendon reflexes, and decreased urine output are warning signs of
toxicity. The nurse should stop the infusion according to protocol/prescription and notify the
provider. Calcium gluconate is the antidote.
7. Which medication should the nurse expect to administer as the antidote for magnesium
sulfate toxicity?
A. Naloxone
B. Calcium gluconate
C. Protamine sulfate
D. Vitamin K
Correct Answer: B. Calcium gluconate
Rationale: Calcium gluconate antagonizes the effects of excessive magnesium and is the
antidote for magnesium toxicity. Naloxone reverses opioid effects, protamine reverses heparin,
and vitamin K is used to reverse warfarin effects.
8. A pregnant client reports severe headache, blurred vision, and epigastric pain. What is the
nurse's priority action?
A. Encourage oral fluids
B. Place the client in a dark room and reassess tomorrow
C. Notify the provider immediately
D. Administer an antacid
Correct Answer: C. Notify the provider immediately
Rationale: Severe headache, visual disturbances, and epigastric/right-upper-quadrant pain are
warning signs of severe preeclampsia and possible hepatic involvement. Immediate evaluation
is required to reduce the risk of seizures, stroke, hepatic complications, and other maternal-fetal
complications.
, 9. A nurse is teaching a pregnant client how to count fetal movements. Which instruction is
appropriate?
A. Count movements only once per week.
B. Count fetal movements at approximately the same time each day when instructed.
C. Count only movements occurring after exercise.
D. Report decreased movement only after 48 hr.
Correct Answer: B. Count fetal movements at approximately the same time each day when
instructed.
Rationale: Consistent timing makes fetal movement patterns easier to recognize. A significant
decrease from the client's established pattern should be reported promptly according to the
provider's instructions rather than waiting 48 hr.
10. A nurse is reviewing prenatal laboratory results. Which finding requires follow-up?
A. Blood type O positive
B. Rubella immunity
C. Hemoglobin 9.2 g/dL
D. Negative HIV screening
Correct Answer: C. Hemoglobin 9.2 g/dL
Rationale: A hemoglobin of 9.2 g/dL indicates anemia requiring further assessment and
management. Physiologic hemodilution occurs during pregnancy, but significant anemia may
require iron supplementation, dietary intervention, or additional evaluation.
11. A client who is Rh-negative gives birth to an Rh-positive newborn. Which medication
should the nurse anticipate administering?
A. Oxytocin
B. Rho(D) immune globulin
C. Methylergonovine
D. Betamethasone
Correct Answer: B. Rho(D) immune globulin
