ATI Maternal Newborn Proctored Exam
(NGN ATI)
(Detailed Exam Prep Solutions and
Resources for the test in 2024/2025)
1. A nurse is teaching a client about Rho(D) immunoglobulin
(RhoGAM). Which of the following statements by the client
indicated an understanding of the teaching?
a. I will receive this medication if my baby is Rh-negative
b. I will receive this medication at time of delivery
c. I will need a second dose of this medication when my baby
is 6 weeks old
d. I will need this medication if I have an amniocentesis-
Recommended because of the potential of fetal RBCs
entering the maternal circulation
2. A nurse is caring for a client who is to receive oxytocin (Pitocin)
to augment her labor. Which of the following contraindicates the
initiation of the oxytocin infusion and requires notification of
the provider?
a. Late decelerations- Oxytocin is contraindicated based on
late decelerations noted on fetal assessment findings
because they indicate uteroplacental insufficiency.
b. Baseline variability
c. Cessation of uterine dilation
d. Prolonged active phase of labor
3. A nurse on the newborn unit is planning discharge for four
clients. Which of the following will require care beyond that of
a standard follow-up visit with the provider after delivery?
, a. A newborn being sent home after 22 hr after birth-
Screening tests must be repeated if they were performed
before he newborn was 24 hr. old.
b. A newborn at 38 weeks of gestational age
c. A newborn who is bottle feeding
d. Twin newborns with Apgar scores of 8 and 9
4. A nurse is assessing a newborn who has a weak cry and is
grimacing. The nurse notes the newborn has a heart rate of
102/min, blueish extremities, and a flaccid muscle tone. Which
of the following reflects the appropriate APGAR score?
a. 4
b. 5
c. 6
d. 7
5. A nurse is caring for a client who has a history of rheumatic
disease, but no physical symptoms prior to pregnancy. The
client begins to experience dyspnea, orthopnea, and pulmonary
edema. Which of the following biological alterations explains
this change?
a. Increased maternal weight
b. Increased blood volume- Increase in blood volume during
pregnancy increase the workload of the heart, which
causes the symptoms
c. Change in hematocrit levels
d. Change in heart size
6. A nurse is providing teaching about nonpharmacological pain
management for a postpartum client who is breastfeed and has
engorgement. Which of the following methods should the nurse
recommend?
a. Cold cabbage leaves- Application of this is an effective
nonpharmacological method to relieve pain associated
with engorgement
b. Modified lanolin cream
c. A breast binder
d. Breast shells
,7. A nurse is providing discharge teaching to a client who is
postpartum about resuming sexual activity. Which of the
following instructions should the nurse include in the teaching?
a. You should use a water soluble gel for lubrication- This
will prevent discomfort
b. You can resume sexual activity in 10 days
c. Your physical reaction to sexual stimulation ill not be
altered
d. You will not ovulate for 3 months after delivery
8. A nurse is admitting a client who is in labor. The client admits
to recent cocaine use. For which of the following complications
should the nurse assess?
a. Abruptio placenta- Cocaines increases the risk for
vasoconstriction and possible abruption placenta
b. Placenta previa
c. Preeclampsia
d. Maternal bradycardia
9. A nurse is providing dietary teaching with a client who has
hyperemesis gravidarum. Which of the following statements by
the client indicates an understanding of the teaching?
a. I should eat to taste instead of trying to balance my meals-
Eat to taste to avoid nausea
b. I will avoid having a snack at bedtime
c. I will have 8 oz of hot tea with each meal
d. I should pair my sweets with a starch instead of eating
them alone
10. A nurse is preparing to collect a blood specimen from a
newborn via a heel stick. Which of the following techniques
should the nurse use to help minimize the pain of the procedure
for the newborn?
a. Warm the heel prior to the puncture
b. Request a prescription for IM analgesic
c. Use a manual lance blade to pierce the skin
d. Swaddle the newborn after the heel puncture- Effective
technique to diminish the pain experience for the newborn.
, 11. A nurse is conducting an initial prenatal visit for a client
who is at 6 weeks gestation. Which of the following laboratory
tests should be performed?
a. 24 hour urine for protein
b. Group B streptococcus culture
c. 3-hr glucose tolerance
d. Rubella titer- Obtained at the initial prenatal visit to
determine immunity to rubella
12. A nurse is caring for a newborn who was transferred to the
nursery 30 min after delivery. Which of the following actions
should the nurse take first?
a. Confirm the newborn’s Apgar score
b. Verify the newborn’s identification- Mandatory to
continue ongoing identification of the newborn whenever
the newborn is removed from the mother’s direct presence
and care.
c. Administer vitamin K IM to the newborn
d. Determine the obstetrical risk factors
13. A nurse is assessing a young adult client in a women’s
health clinic who asks for a contraceptive. The client reports to
the nurse a familial history of osteoporosis. Which of the
following contraceptive methods is contraindicated for this
client?
a. Combined estrogen-progestin oral contraceptives
b. An intrauterine device
c. Medroxyprogestrone acetate (Depo-provera)- causes a
decrease in bone mineral density and places the client at
risk for the development of osteoporosis
d. Norelgestromin/ethinyl estradiol (Ortho Evra)
14. A nurse is admitting a client to the labor and delivery unit
when the client states, “my water just broke”, which of the
following is the priority intervention for the nurse to take?
a. Perform Nitrazine testing
b. Assess the amniotic fluid
c. Check cervical dilation
d. Monitor the fetal heart rate- Rupture of the membranes
places the fetus at risk for umbilical cord prolapse.
(NGN ATI)
(Detailed Exam Prep Solutions and
Resources for the test in 2024/2025)
1. A nurse is teaching a client about Rho(D) immunoglobulin
(RhoGAM). Which of the following statements by the client
indicated an understanding of the teaching?
a. I will receive this medication if my baby is Rh-negative
b. I will receive this medication at time of delivery
c. I will need a second dose of this medication when my baby
is 6 weeks old
d. I will need this medication if I have an amniocentesis-
Recommended because of the potential of fetal RBCs
entering the maternal circulation
2. A nurse is caring for a client who is to receive oxytocin (Pitocin)
to augment her labor. Which of the following contraindicates the
initiation of the oxytocin infusion and requires notification of
the provider?
a. Late decelerations- Oxytocin is contraindicated based on
late decelerations noted on fetal assessment findings
because they indicate uteroplacental insufficiency.
b. Baseline variability
c. Cessation of uterine dilation
d. Prolonged active phase of labor
3. A nurse on the newborn unit is planning discharge for four
clients. Which of the following will require care beyond that of
a standard follow-up visit with the provider after delivery?
, a. A newborn being sent home after 22 hr after birth-
Screening tests must be repeated if they were performed
before he newborn was 24 hr. old.
b. A newborn at 38 weeks of gestational age
c. A newborn who is bottle feeding
d. Twin newborns with Apgar scores of 8 and 9
4. A nurse is assessing a newborn who has a weak cry and is
grimacing. The nurse notes the newborn has a heart rate of
102/min, blueish extremities, and a flaccid muscle tone. Which
of the following reflects the appropriate APGAR score?
a. 4
b. 5
c. 6
d. 7
5. A nurse is caring for a client who has a history of rheumatic
disease, but no physical symptoms prior to pregnancy. The
client begins to experience dyspnea, orthopnea, and pulmonary
edema. Which of the following biological alterations explains
this change?
a. Increased maternal weight
b. Increased blood volume- Increase in blood volume during
pregnancy increase the workload of the heart, which
causes the symptoms
c. Change in hematocrit levels
d. Change in heart size
6. A nurse is providing teaching about nonpharmacological pain
management for a postpartum client who is breastfeed and has
engorgement. Which of the following methods should the nurse
recommend?
a. Cold cabbage leaves- Application of this is an effective
nonpharmacological method to relieve pain associated
with engorgement
b. Modified lanolin cream
c. A breast binder
d. Breast shells
,7. A nurse is providing discharge teaching to a client who is
postpartum about resuming sexual activity. Which of the
following instructions should the nurse include in the teaching?
a. You should use a water soluble gel for lubrication- This
will prevent discomfort
b. You can resume sexual activity in 10 days
c. Your physical reaction to sexual stimulation ill not be
altered
d. You will not ovulate for 3 months after delivery
8. A nurse is admitting a client who is in labor. The client admits
to recent cocaine use. For which of the following complications
should the nurse assess?
a. Abruptio placenta- Cocaines increases the risk for
vasoconstriction and possible abruption placenta
b. Placenta previa
c. Preeclampsia
d. Maternal bradycardia
9. A nurse is providing dietary teaching with a client who has
hyperemesis gravidarum. Which of the following statements by
the client indicates an understanding of the teaching?
a. I should eat to taste instead of trying to balance my meals-
Eat to taste to avoid nausea
b. I will avoid having a snack at bedtime
c. I will have 8 oz of hot tea with each meal
d. I should pair my sweets with a starch instead of eating
them alone
10. A nurse is preparing to collect a blood specimen from a
newborn via a heel stick. Which of the following techniques
should the nurse use to help minimize the pain of the procedure
for the newborn?
a. Warm the heel prior to the puncture
b. Request a prescription for IM analgesic
c. Use a manual lance blade to pierce the skin
d. Swaddle the newborn after the heel puncture- Effective
technique to diminish the pain experience for the newborn.
, 11. A nurse is conducting an initial prenatal visit for a client
who is at 6 weeks gestation. Which of the following laboratory
tests should be performed?
a. 24 hour urine for protein
b. Group B streptococcus culture
c. 3-hr glucose tolerance
d. Rubella titer- Obtained at the initial prenatal visit to
determine immunity to rubella
12. A nurse is caring for a newborn who was transferred to the
nursery 30 min after delivery. Which of the following actions
should the nurse take first?
a. Confirm the newborn’s Apgar score
b. Verify the newborn’s identification- Mandatory to
continue ongoing identification of the newborn whenever
the newborn is removed from the mother’s direct presence
and care.
c. Administer vitamin K IM to the newborn
d. Determine the obstetrical risk factors
13. A nurse is assessing a young adult client in a women’s
health clinic who asks for a contraceptive. The client reports to
the nurse a familial history of osteoporosis. Which of the
following contraceptive methods is contraindicated for this
client?
a. Combined estrogen-progestin oral contraceptives
b. An intrauterine device
c. Medroxyprogestrone acetate (Depo-provera)- causes a
decrease in bone mineral density and places the client at
risk for the development of osteoporosis
d. Norelgestromin/ethinyl estradiol (Ortho Evra)
14. A nurse is admitting a client to the labor and delivery unit
when the client states, “my water just broke”, which of the
following is the priority intervention for the nurse to take?
a. Perform Nitrazine testing
b. Assess the amniotic fluid
c. Check cervical dilation
d. Monitor the fetal heart rate- Rupture of the membranes
places the fetus at risk for umbilical cord prolapse.
