ATI Maternal Newborn Retake Proctored 2023 – 2026 Questions &
Answers
NGN Unfolding Case Study 1 – Preeclampsia (Questions 1–10)
Scenario: A nurse is caring for a client at 34 weeks gestation who was admitted with blood pressure
160/100 mm Hg, 3+ protein in urine, and complaints of headache and epigastric pain.
1. Which of the following conditions is the client most likely experiencing?
A) Gestational hypertension
B) Severe preeclampsia
C) Chronic hypertension
D) HELLP syndrome
Correct Answer: B
Rationale: Severe preeclampsia is defined as blood pressure ≥160/110 mm Hg with proteinuria and
symptoms such as headache and epigastric pain. HELLP syndrome would include hemolysis, elevated
liver enzymes, and low platelets.
2. The provider orders magnesium sulfate. Which of the following findings indicates magnesium
toxicity?
A) Deep tendon reflexes 2+
B) Respiratory rate 16/min
C) Urine output 20 mL/hr
D) Blood pressure 140/90 mm Hg
Correct Answer: C
Rationale: Urine output <30 mL/hr is a sign of magnesium toxicity because magnesium is excreted
renally. Other signs include absent reflexes and respiratory rate <12/min.
3. The nurse administers magnesium sulfate. Which of the following medications should the nurse
have readily available as an antidote?
A) Naloxone
B) Calcium gluconate
C) Vitamin K
D) Protamine sulfate
Correct Answer: B
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity. Naloxone reverses
opioids. Vitamin K reverses warfarin. Protamine sulfate reverses heparin.
,4. The client asks why she needs magnesium sulfate. Which of the following responses should the
nurse give?
A) "It will lower your blood pressure."
B) "It will prevent you from having seizures."
C) "It will help your baby's lungs mature."
D) "It will stop your labor contractions."
Correct Answer: B
Rationale: Magnesium sulfate is used for seizure prophylaxis in severe preeclampsia and eclampsia.
5. The nurse assesses the client's deep tendon reflexes and finds them to be 1+. Which of the
following actions should the nurse take first?
A) Continue the infusion as ordered
B) Decrease the infusion rate
C) Discontinue the infusion and notify the provider
D) Administer calcium gluconate
Correct Answer: B
Rationale: Hyporeflexia (1+) is an early sign of magnesium toxicity. The nurse should decrease the
infusion rate and notify the provider.
6. The client reports shortness of breath. The nurse notes crackles in the lung bases. Which of the
following complications of magnesium sulfate should the nurse suspect?
A) Anaphylaxis
B) Pulmonary edema
C) Pneumonia
D) Asthma exacerbation
Correct Answer: B
Rationale: Magnesium sulfate can cause fluid overload and pulmonary edema, especially if given
rapidly or if the client has renal impairment.
7. The provider orders labetalol for blood pressure control. Which of the following findings would
contraindicate the use of labetalol?
A) Gestational age 34 weeks
B) Fetal heart rate 140 bpm
C) Maternal heart rate 55 bpm
D) Urine output 40 mL/hr
, Correct Answer: C
Rationale: Labetalol is a beta-blocker and can cause bradycardia. A maternal heart rate of 55 bpm is a
relative contraindication.
8. The nurse notes that the client's platelet count is 80,000/mm³. Which of the following conditions
should the nurse suspect?
A) HELLP syndrome
B) Gestational thrombocytopenia
C) Disseminated intravascular coagulation
D) Immune thrombocytopenic purpura
Correct Answer: A
Rationale: Low platelets (thrombocytopenia) in a client with severe preeclampsia suggest HELLP
syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets).
9. The client reports right upper quadrant pain. Which of the following is the priority action?
A) Administer acetaminophen
B) Notify the provider immediately
C) Apply a warm compress
D) Position the client on her left side
Correct Answer: B
Rationale: Right upper quadrant pain (epigastric pain) indicates liver involvement and is a sign of
severe preeclampsia/HELLP syndrome. The provider should be notified immediately.
10. The provider decides to induce labor at 34 weeks. Which of the following medications should the
nurse anticipate administering to promote fetal lung maturity?
A) Magnesium sulfate
B) Betamethasone
C) Nifedipine
D) Oxytocin
Correct Answer: B
Rationale: Betamethasone is a corticosteroid given to accelerate fetal lung maturation when preterm
delivery is anticipated between 24-34 weeks.
NGN Unfolding Case Study 2 – Postpartum Hemorrhage (Questions 11–20)
Scenario: A nurse is caring for a client who is 2 hours postpartum after a vaginal delivery of a 9 lb
newborn. The client's fundus is boggy and displaced to the right. Lochia is heavy with large clots.
Answers
NGN Unfolding Case Study 1 – Preeclampsia (Questions 1–10)
Scenario: A nurse is caring for a client at 34 weeks gestation who was admitted with blood pressure
160/100 mm Hg, 3+ protein in urine, and complaints of headache and epigastric pain.
1. Which of the following conditions is the client most likely experiencing?
A) Gestational hypertension
B) Severe preeclampsia
C) Chronic hypertension
D) HELLP syndrome
Correct Answer: B
Rationale: Severe preeclampsia is defined as blood pressure ≥160/110 mm Hg with proteinuria and
symptoms such as headache and epigastric pain. HELLP syndrome would include hemolysis, elevated
liver enzymes, and low platelets.
2. The provider orders magnesium sulfate. Which of the following findings indicates magnesium
toxicity?
A) Deep tendon reflexes 2+
B) Respiratory rate 16/min
C) Urine output 20 mL/hr
D) Blood pressure 140/90 mm Hg
Correct Answer: C
Rationale: Urine output <30 mL/hr is a sign of magnesium toxicity because magnesium is excreted
renally. Other signs include absent reflexes and respiratory rate <12/min.
3. The nurse administers magnesium sulfate. Which of the following medications should the nurse
have readily available as an antidote?
A) Naloxone
B) Calcium gluconate
C) Vitamin K
D) Protamine sulfate
Correct Answer: B
Rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity. Naloxone reverses
opioids. Vitamin K reverses warfarin. Protamine sulfate reverses heparin.
,4. The client asks why she needs magnesium sulfate. Which of the following responses should the
nurse give?
A) "It will lower your blood pressure."
B) "It will prevent you from having seizures."
C) "It will help your baby's lungs mature."
D) "It will stop your labor contractions."
Correct Answer: B
Rationale: Magnesium sulfate is used for seizure prophylaxis in severe preeclampsia and eclampsia.
5. The nurse assesses the client's deep tendon reflexes and finds them to be 1+. Which of the
following actions should the nurse take first?
A) Continue the infusion as ordered
B) Decrease the infusion rate
C) Discontinue the infusion and notify the provider
D) Administer calcium gluconate
Correct Answer: B
Rationale: Hyporeflexia (1+) is an early sign of magnesium toxicity. The nurse should decrease the
infusion rate and notify the provider.
6. The client reports shortness of breath. The nurse notes crackles in the lung bases. Which of the
following complications of magnesium sulfate should the nurse suspect?
A) Anaphylaxis
B) Pulmonary edema
C) Pneumonia
D) Asthma exacerbation
Correct Answer: B
Rationale: Magnesium sulfate can cause fluid overload and pulmonary edema, especially if given
rapidly or if the client has renal impairment.
7. The provider orders labetalol for blood pressure control. Which of the following findings would
contraindicate the use of labetalol?
A) Gestational age 34 weeks
B) Fetal heart rate 140 bpm
C) Maternal heart rate 55 bpm
D) Urine output 40 mL/hr
, Correct Answer: C
Rationale: Labetalol is a beta-blocker and can cause bradycardia. A maternal heart rate of 55 bpm is a
relative contraindication.
8. The nurse notes that the client's platelet count is 80,000/mm³. Which of the following conditions
should the nurse suspect?
A) HELLP syndrome
B) Gestational thrombocytopenia
C) Disseminated intravascular coagulation
D) Immune thrombocytopenic purpura
Correct Answer: A
Rationale: Low platelets (thrombocytopenia) in a client with severe preeclampsia suggest HELLP
syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets).
9. The client reports right upper quadrant pain. Which of the following is the priority action?
A) Administer acetaminophen
B) Notify the provider immediately
C) Apply a warm compress
D) Position the client on her left side
Correct Answer: B
Rationale: Right upper quadrant pain (epigastric pain) indicates liver involvement and is a sign of
severe preeclampsia/HELLP syndrome. The provider should be notified immediately.
10. The provider decides to induce labor at 34 weeks. Which of the following medications should the
nurse anticipate administering to promote fetal lung maturity?
A) Magnesium sulfate
B) Betamethasone
C) Nifedipine
D) Oxytocin
Correct Answer: B
Rationale: Betamethasone is a corticosteroid given to accelerate fetal lung maturation when preterm
delivery is anticipated between 24-34 weeks.
NGN Unfolding Case Study 2 – Postpartum Hemorrhage (Questions 11–20)
Scenario: A nurse is caring for a client who is 2 hours postpartum after a vaginal delivery of a 9 lb
newborn. The client's fundus is boggy and displaced to the right. Lochia is heavy with large clots.
