COURSE CODE: ATI Capstone
EXAM DATE TIME ALLOWED
COURSE TITLE: Maternal Newborn Assessment
— / — / —— 120 Minutes
INSTRUCTOR: —
ATI Capstone — Maternal
Newborn
Comprehensive Nursing Assessment Examination
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS ◆ 50 Marks
Choose the single best answer for each question. Write the correct letter (A, B, C, or D) in the space provided.
1. A nurse is performing a vaginal exam on a client who is in active labor. The nurse notes
the umbilical cord protruding through the cervix. Which of the following actions should
the nurse take?
A. Apply fundal pressure to facilitate delivery
B. Assist the client into the knee-chest position
C. Immediately rupture the membranes to relieve pressure
D. Place the client in a supine position with legs elevated
◆ B — Assist the client into the knee-chest position
RATIONALE: A prolapsed umbilical cord is an obstetric emergency requiring immediate intervention to relieve cord
compression and preserve fetal oxygenation. The knee-chest position uses gravity to shift the presenting part away
from the cord, reducing compression and improving fetal circulation. Applying fundal pressure (A) increases
compression. Rupturing membranes (C) may worsen the prolapse. Supine position (D) increases cord compression
due to the presenting part pressing against the cord. The nurse should also administer oxygen and prepare for
emergency cesarean delivery.
Page 1 of 8
, 2. A nurse is assessing a newborn who is 48 hours old and is experiencing opioid
withdrawals. Which of the following findings should the nurse expect?
A. Lethargy and decreased muscle tone
B. Moderate tremors of the extremities
C. Bradycardia and hypothermia
D. Excessive weight gain and edema
◆ B — Moderate tremors of the extremities
RATIONALE: Neonatal abstinence syndrome (NAS) results from in-utero opioid exposure and manifests as central
nervous system irritability including tremors, hypertonicity, excessive high-pitched crying, and poor feeding.
Tremors are a hallmark finding at 48–72 hours. Lethargy (A) is not characteristic of withdrawal. Bradycardia (C) is
not typical. Weight loss rather than gain (D) is more common due to poor feeding and increased metabolic
demands. The Finnegan scoring system guides assessment and pharmacological management.
3. A nurse is reviewing a client's medical record and notes that the client is taking
tamoxifen. The nurse should identify that tamoxifen is used to treat which of the
following conditions?
A. Endometriosis
B. Polycystic ovary syndrome
C. Breast cancer
D. Uterine fibroids
◆ C — Breast cancer
RATIONALE: Tamoxifen is a selective estrogen receptor modulator (SERM) that blocks estrogen receptors in breast
tissue, making it a first-line hormonal therapy for hormone receptor-positive breast cancer in premenopausal
women and postmenopausal women. It is also used for breast cancer prevention in high-risk individuals.
Endometriosis (A) may be treated with GnRH agonists or hormonal contraceptives. PCOS (B) is managed with oral
contraceptives and insulin-sensitizing agents. Uterine fibroids (D) are not treated with tamoxifen.
Page 2 of 8
EXAM DATE TIME ALLOWED
COURSE TITLE: Maternal Newborn Assessment
— / — / —— 120 Minutes
INSTRUCTOR: —
ATI Capstone — Maternal
Newborn
Comprehensive Nursing Assessment Examination
ALL QUESTIONS ARE COMPULSORY
A MULTIPLE CHOICE QUESTIONS ◆ 50 Marks
Choose the single best answer for each question. Write the correct letter (A, B, C, or D) in the space provided.
1. A nurse is performing a vaginal exam on a client who is in active labor. The nurse notes
the umbilical cord protruding through the cervix. Which of the following actions should
the nurse take?
A. Apply fundal pressure to facilitate delivery
B. Assist the client into the knee-chest position
C. Immediately rupture the membranes to relieve pressure
D. Place the client in a supine position with legs elevated
◆ B — Assist the client into the knee-chest position
RATIONALE: A prolapsed umbilical cord is an obstetric emergency requiring immediate intervention to relieve cord
compression and preserve fetal oxygenation. The knee-chest position uses gravity to shift the presenting part away
from the cord, reducing compression and improving fetal circulation. Applying fundal pressure (A) increases
compression. Rupturing membranes (C) may worsen the prolapse. Supine position (D) increases cord compression
due to the presenting part pressing against the cord. The nurse should also administer oxygen and prepare for
emergency cesarean delivery.
Page 1 of 8
, 2. A nurse is assessing a newborn who is 48 hours old and is experiencing opioid
withdrawals. Which of the following findings should the nurse expect?
A. Lethargy and decreased muscle tone
B. Moderate tremors of the extremities
C. Bradycardia and hypothermia
D. Excessive weight gain and edema
◆ B — Moderate tremors of the extremities
RATIONALE: Neonatal abstinence syndrome (NAS) results from in-utero opioid exposure and manifests as central
nervous system irritability including tremors, hypertonicity, excessive high-pitched crying, and poor feeding.
Tremors are a hallmark finding at 48–72 hours. Lethargy (A) is not characteristic of withdrawal. Bradycardia (C) is
not typical. Weight loss rather than gain (D) is more common due to poor feeding and increased metabolic
demands. The Finnegan scoring system guides assessment and pharmacological management.
3. A nurse is reviewing a client's medical record and notes that the client is taking
tamoxifen. The nurse should identify that tamoxifen is used to treat which of the
following conditions?
A. Endometriosis
B. Polycystic ovary syndrome
C. Breast cancer
D. Uterine fibroids
◆ C — Breast cancer
RATIONALE: Tamoxifen is a selective estrogen receptor modulator (SERM) that blocks estrogen receptors in breast
tissue, making it a first-line hormonal therapy for hormone receptor-positive breast cancer in premenopausal
women and postmenopausal women. It is also used for breast cancer prevention in high-risk individuals.
Endometriosis (A) may be treated with GnRH agonists or hormonal contraceptives. PCOS (B) is managed with oral
contraceptives and insulin-sensitizing agents. Uterine fibroids (D) are not treated with tamoxifen.
Page 2 of 8
