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ATI RN Maternal Newborn Proctored Exam 2025–2026 –
300 NGN Practice Questions with Verified Answers &
Rationales
Question 1
A nurse is caring for a client in the first stage of labor who is experiencing severe back pain. The
fetus is in a persistent occiput posterior position. Which nonpharmacologic intervention should
the nurse implement?
A. Encourage the client to lie in a supine position
B. Apply sacral counterpressure
C. Administer warm IV fluids
D. Perform Leopold’s maneuvers
✅ Correct Answer: B. Apply sacral counterpressure
Rationale
Occiput posterior fetal position often causes back pain from fetal skull pressure on the sacrum.
Sacral counterpressure (firm pressure with the heel of the hand or fist to the sacral area) helps
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relieve this discomfort. Supine position worsens uterine perfusion; Leopold’s is for assessment;
warm IV fluids don’t relieve positional back pain.
🧠 Q2. Fundus Assessment
Question:
A nurse is assessing a client 12 hours postpartum. The fundus is firm, at the level of the
umbilicus, and deviated to the right. What is the appropriate nursing action?
A. Document this as a normal finding
B. Reassess the fundus in 4 hours
C. Assist the client to void
D. Notify the provider immediately
✅ Correct Answer: C. Assist the client to void
Rationale:
A deviated fundus usually indicates bladder distention, which can prevent proper uterine
involution and lead to hemorrhage. Voiding can correct the fundal position. This is not a normal
finding and doesn’t require provider notification unless unresolved.
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🧠 Q3. Fetal Heart Rate Interpretation
Question:
A nurse is caring for a laboring client. The fetal monitor reveals late decelerations. What is the
priority nursing action?
A. Place the client in a side-lying position
B. Administer a fluid bolus
C. Apply oxygen via nonrebreather mask
D. Prepare for emergency cesarean birth
✅ Correct Answer: A. Place the client in a side-lying position
Rationale:
Late decelerations indicate uteroplacental insufficiency. First, repositioning the client increases
placental perfusion. While other actions may be necessary, positioning is the immediate priority.
Cesarean is only required if late decels persist despite interventions.
🧠 Q4. APGAR Scoring
Question:
A newborn has a heart rate of 130/min, strong cry, active movement, pink body with blue
extremities, and flexed posture. What is the APGAR score?
A. 10
B. 9
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C. 8
D. 7
✅ Correct Answer: B. 9
Rationale:
The baby scores:
HR > 100 = 2
Strong cry = 2
Active movement = 2
Pink body, acrocyanosis = 1
Flexed posture = 2
Total: 9
🧠 Q5. Magnesium Sulfate Toxicity
Question:
A nurse is caring for a client receiving magnesium sulfate IV for preeclampsia. Which finding
requires immediate intervention?
A. Deep tendon reflexes 2+
B. Respiratory rate of 10/min
C. Urine output of 35 mL/hr
D. Client reports feeling flushed
ATI RN Maternal Newborn Proctored Exam 2025–2026 –
300 NGN Practice Questions with Verified Answers &
Rationales
Question 1
A nurse is caring for a client in the first stage of labor who is experiencing severe back pain. The
fetus is in a persistent occiput posterior position. Which nonpharmacologic intervention should
the nurse implement?
A. Encourage the client to lie in a supine position
B. Apply sacral counterpressure
C. Administer warm IV fluids
D. Perform Leopold’s maneuvers
✅ Correct Answer: B. Apply sacral counterpressure
Rationale
Occiput posterior fetal position often causes back pain from fetal skull pressure on the sacrum.
Sacral counterpressure (firm pressure with the heel of the hand or fist to the sacral area) helps
, 2
relieve this discomfort. Supine position worsens uterine perfusion; Leopold’s is for assessment;
warm IV fluids don’t relieve positional back pain.
🧠 Q2. Fundus Assessment
Question:
A nurse is assessing a client 12 hours postpartum. The fundus is firm, at the level of the
umbilicus, and deviated to the right. What is the appropriate nursing action?
A. Document this as a normal finding
B. Reassess the fundus in 4 hours
C. Assist the client to void
D. Notify the provider immediately
✅ Correct Answer: C. Assist the client to void
Rationale:
A deviated fundus usually indicates bladder distention, which can prevent proper uterine
involution and lead to hemorrhage. Voiding can correct the fundal position. This is not a normal
finding and doesn’t require provider notification unless unresolved.
, 3
🧠 Q3. Fetal Heart Rate Interpretation
Question:
A nurse is caring for a laboring client. The fetal monitor reveals late decelerations. What is the
priority nursing action?
A. Place the client in a side-lying position
B. Administer a fluid bolus
C. Apply oxygen via nonrebreather mask
D. Prepare for emergency cesarean birth
✅ Correct Answer: A. Place the client in a side-lying position
Rationale:
Late decelerations indicate uteroplacental insufficiency. First, repositioning the client increases
placental perfusion. While other actions may be necessary, positioning is the immediate priority.
Cesarean is only required if late decels persist despite interventions.
🧠 Q4. APGAR Scoring
Question:
A newborn has a heart rate of 130/min, strong cry, active movement, pink body with blue
extremities, and flexed posture. What is the APGAR score?
A. 10
B. 9
, 4
C. 8
D. 7
✅ Correct Answer: B. 9
Rationale:
The baby scores:
HR > 100 = 2
Strong cry = 2
Active movement = 2
Pink body, acrocyanosis = 1
Flexed posture = 2
Total: 9
🧠 Q5. Magnesium Sulfate Toxicity
Question:
A nurse is caring for a client receiving magnesium sulfate IV for preeclampsia. Which finding
requires immediate intervention?
A. Deep tendon reflexes 2+
B. Respiratory rate of 10/min
C. Urine output of 35 mL/hr
D. Client reports feeling flushed
