Real ATI RN Maternal Newborn OB Proctored Exam 2026 NGN 70
Q&A 100% Correct answers and rationales
,1. A nurse is caring for a client who is 2 hours postpartum and reports a heavy
gush of blood. The fundus is boggy and displaced to the right. Which action
should the nurse take first?
A. Massage the fundus
B. Administer oxytocin
C. Assess vital signs
D. Assist the client to void
Correct Answer: D
Rationale: A boggy fundus displaced to the right suggests a full bladder, which
prevents uterine contraction. The nurse should first assist the client to void, then
reassess fundal tone. Massaging before emptying the bladder is less effective.
2. A nurse is assessing a newborn 5 minutes after birth. Heart rate is 120/min,
respiratory effort is irregular with weak cry, extremities are flexed, grimace with
stimulation, and body is pink but extremities are blue. What is the Apgar score?
A. 6
B. 7
C. 8
D. 9
Correct Answer: B
*Rationale: Heart rate >100 = 2; weak cry = 1; flexed extremities = 2; grimace =
1; acrocyanosis = 1. Total = 7. This indicates mild depression.*
3. A nurse is teaching a client with preeclampsia about magnesium sulfate.
Which adverse effect requires immediate discontinuation?
A. Nausea
B. Dry mouth
,C. Urine output <30 mL/hr
D. Mild headache
Correct Answer: C
*Rationale: Urine output <30 mL/hr indicates magnesium toxicity risk. Other
side effects (nausea, dry mouth) are common. Respiratory depression and absent
reflexes are later signs.*
4. A nurse is caring for a G1P0 client at 40 weeks gestation. Contractions every
2-3 min, cervix 7 cm/100% effaced/+1 station. FHR baseline 140 with late
decelerations to 110 for 30 seconds. What is the priority action?
A. Reposition client to left lateral
B. Prepare for immediate cesarean
C. Increase IV fluid rate
D. Give oxygen via face mask
Correct Answer: A
Rationale: Late decelerations suggest uteroplacental insufficiency. First action =
lateral position to improve blood flow. Oxygen and fluids follow. Cesarean only
if uncorrected.
5. A nurse is providing discharge teaching to a breastfeeding client about
mastitis prevention. Which statement indicates understanding?
A. “I will stop feeding on the affected side until healed”
B. “I should wear a tight bra to reduce milk supply”
C. “I will fully empty the affected breast each feeding”
D. “I should apply heat before feeding”
Correct Answer: C
Rationale: Complete emptying prevents stasis and bacterial growth. Stopping
, feeding worsens engorgement. Heat is for comfort, but emptying is key
prevention
uestions 11–20
11. A nurse assesses a newborn with jitteriness, high-pitched cry, and poor
feeding. The mother has gestational diabetes. Which action is priority?
A. Encourage early breastfeeding
B. Obtain a heel stick blood glucose
C. Place under radiant warmer
D. Assess for birth injuries
Correct Answer: B
Rationale: Jitteriness and poor feeding in an infant of a diabetic mother suggest
hypoglycemia. Heel stick glucose confirms before intervention.
12. A client at 38 weeks with oligohydramnios is admitted for induction. Which
finding requires immediate notification of the provider?
A. Contractions every 5 minutes
B. FHR variable decelerations to 90/min lasting 40 sec
C. Cervix 3 cm, 80% effaced
D. Maternal BP 128/78
Correct Answer: B
Rationale: Variable decelerations with oligohydramnios indicate cord
compression; prolonged decels suggest hypoxia.
13. A nurse is administering betamethasone to a client at 32 weeks with preterm
labor. What is the therapeutic goal?
Q&A 100% Correct answers and rationales
,1. A nurse is caring for a client who is 2 hours postpartum and reports a heavy
gush of blood. The fundus is boggy and displaced to the right. Which action
should the nurse take first?
A. Massage the fundus
B. Administer oxytocin
C. Assess vital signs
D. Assist the client to void
Correct Answer: D
Rationale: A boggy fundus displaced to the right suggests a full bladder, which
prevents uterine contraction. The nurse should first assist the client to void, then
reassess fundal tone. Massaging before emptying the bladder is less effective.
2. A nurse is assessing a newborn 5 minutes after birth. Heart rate is 120/min,
respiratory effort is irregular with weak cry, extremities are flexed, grimace with
stimulation, and body is pink but extremities are blue. What is the Apgar score?
A. 6
B. 7
C. 8
D. 9
Correct Answer: B
*Rationale: Heart rate >100 = 2; weak cry = 1; flexed extremities = 2; grimace =
1; acrocyanosis = 1. Total = 7. This indicates mild depression.*
3. A nurse is teaching a client with preeclampsia about magnesium sulfate.
Which adverse effect requires immediate discontinuation?
A. Nausea
B. Dry mouth
,C. Urine output <30 mL/hr
D. Mild headache
Correct Answer: C
*Rationale: Urine output <30 mL/hr indicates magnesium toxicity risk. Other
side effects (nausea, dry mouth) are common. Respiratory depression and absent
reflexes are later signs.*
4. A nurse is caring for a G1P0 client at 40 weeks gestation. Contractions every
2-3 min, cervix 7 cm/100% effaced/+1 station. FHR baseline 140 with late
decelerations to 110 for 30 seconds. What is the priority action?
A. Reposition client to left lateral
B. Prepare for immediate cesarean
C. Increase IV fluid rate
D. Give oxygen via face mask
Correct Answer: A
Rationale: Late decelerations suggest uteroplacental insufficiency. First action =
lateral position to improve blood flow. Oxygen and fluids follow. Cesarean only
if uncorrected.
5. A nurse is providing discharge teaching to a breastfeeding client about
mastitis prevention. Which statement indicates understanding?
A. “I will stop feeding on the affected side until healed”
B. “I should wear a tight bra to reduce milk supply”
C. “I will fully empty the affected breast each feeding”
D. “I should apply heat before feeding”
Correct Answer: C
Rationale: Complete emptying prevents stasis and bacterial growth. Stopping
, feeding worsens engorgement. Heat is for comfort, but emptying is key
prevention
uestions 11–20
11. A nurse assesses a newborn with jitteriness, high-pitched cry, and poor
feeding. The mother has gestational diabetes. Which action is priority?
A. Encourage early breastfeeding
B. Obtain a heel stick blood glucose
C. Place under radiant warmer
D. Assess for birth injuries
Correct Answer: B
Rationale: Jitteriness and poor feeding in an infant of a diabetic mother suggest
hypoglycemia. Heel stick glucose confirms before intervention.
12. A client at 38 weeks with oligohydramnios is admitted for induction. Which
finding requires immediate notification of the provider?
A. Contractions every 5 minutes
B. FHR variable decelerations to 90/min lasting 40 sec
C. Cervix 3 cm, 80% effaced
D. Maternal BP 128/78
Correct Answer: B
Rationale: Variable decelerations with oligohydramnios indicate cord
compression; prolonged decels suggest hypoxia.
13. A nurse is administering betamethasone to a client at 32 weeks with preterm
labor. What is the therapeutic goal?
