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ATI RN Maternal Newborn Proctored Exam 2025 | 90+ Real
NGN Questions with Detailed Rationales | Labor, Delivery,
Postpartum, and Newborn Nursing Review
Question 1
A nurse is caring for a client in active labor who is receiving oxytocin to augment
contractions. The fetal heart monitor reveals late decelerations with each contraction.
What is the nurse’s priority action?
A. Stop the oxytocin infusion
B. Reposition the client to left lateral position
C. Administer oxygen via face mask at 10 L/min
D. Increase IV fluids
E. Notify the healthcare provider
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Correct Answer: A. Stop the oxytocin infusion
Rationale: Late decelerations indicate uteroplacental insufficiency, and oxytocin may be
causing excessive uterine contractions that compromise fetal oxygenation. The priority is
to stop the oxytocin to reduce contraction frequency and allow for fetal recovery. While
other interventions are also important (repositioning, oxygen, fluids), stopping oxytocin
directly addresses the underlying cause first. Once contractions decrease, secondary
interventions and provider notification can follow. (ATI Maternal Newborn Review,
2025)
Question 2
A postpartum nurse is assessing a client 1 hour after vaginal delivery. The fundus is firm
and midline, but the perineal pad is saturated within 15 minutes. What is the nurse’s next
action?
A. Document findings and continue to monitor
B. Massage the fundus to stimulate contractions
C. Apply an ice pack to the perineum
D. Notify the provider immediately
E. Assess for a vaginal or perineal laceration
Correct Answer: E. Assess for a vaginal or perineal laceration
Rationale: A firm and midline uterus suggests that uterine atony is not the cause of
bleeding. Continued heavy bleeding despite a firm fundus points to a laceration of the
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birth canal as the source. The nurse should assess for signs of a vaginal or perineal
laceration. Massaging the fundus would not address this issue, and provider notification
comes after identifying the cause. (ATI Maternal Newborn, Hemorrhage, 2025)
Question 3
A nurse is caring for a newborn immediately after delivery. Which of the following
findings requires immediate intervention?
A. Respiratory rate of 60/min
B. Acrocyanosis
C. Grunting and nasal flaring
D. Positive Babinski reflex
E. Heart rate of 140 bpm
Correct Answer: C. Grunting and nasal flaring
Rationale: Grunting and nasal flaring are signs of respiratory distress and may indicate
underlying conditions like transient tachypnea of the newborn (TTN) or meconium
aspiration. These symptoms require prompt evaluation and possible respiratory support.
Acrocyanosis is normal in the first 24–48 hours. A heart rate of 140 and positive Babinski
are expected. (ATI Newborn Complications, 2025)
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Question 4
A nurse is reviewing discharge teaching with a client who had a cesarean birth. Which
statement indicates a need for further teaching?
A. "I will avoid lifting anything heavier than my baby."
B. "I can take ibuprofen as needed for pain."
C. "I will take showers instead of baths until my incision heals."
D. "I will resume sexual activity as soon as the bleeding stops."
E. "I will notify the provider if my incision becomes red or swollen."
Correct Answer: D. "I will resume sexual activity as soon as the bleeding stops."
Rationale: Resuming sexual activity is not recommended until at least 4–6 weeks
postpartum, or when cleared by the provider, even if bleeding has stopped. Engaging in
intercourse too early increases the risk of infection and poor healing. The other
statements demonstrate appropriate understanding of postpartum recovery and cesarean
wound care. (ATI Postpartum Complications, 2025)
Question 5
A nurse is caring for a client at 30 weeks’ gestation who reports headache and blurred
vision. BP is 158/98 mmHg. Which medication should the nurse expect to administer?
A. Nifedipine
B. Oxytocin
C. Terbutaline
ATI RN Maternal Newborn Proctored Exam 2025 | 90+ Real
NGN Questions with Detailed Rationales | Labor, Delivery,
Postpartum, and Newborn Nursing Review
Question 1
A nurse is caring for a client in active labor who is receiving oxytocin to augment
contractions. The fetal heart monitor reveals late decelerations with each contraction.
What is the nurse’s priority action?
A. Stop the oxytocin infusion
B. Reposition the client to left lateral position
C. Administer oxygen via face mask at 10 L/min
D. Increase IV fluids
E. Notify the healthcare provider
, 2
Correct Answer: A. Stop the oxytocin infusion
Rationale: Late decelerations indicate uteroplacental insufficiency, and oxytocin may be
causing excessive uterine contractions that compromise fetal oxygenation. The priority is
to stop the oxytocin to reduce contraction frequency and allow for fetal recovery. While
other interventions are also important (repositioning, oxygen, fluids), stopping oxytocin
directly addresses the underlying cause first. Once contractions decrease, secondary
interventions and provider notification can follow. (ATI Maternal Newborn Review,
2025)
Question 2
A postpartum nurse is assessing a client 1 hour after vaginal delivery. The fundus is firm
and midline, but the perineal pad is saturated within 15 minutes. What is the nurse’s next
action?
A. Document findings and continue to monitor
B. Massage the fundus to stimulate contractions
C. Apply an ice pack to the perineum
D. Notify the provider immediately
E. Assess for a vaginal or perineal laceration
Correct Answer: E. Assess for a vaginal or perineal laceration
Rationale: A firm and midline uterus suggests that uterine atony is not the cause of
bleeding. Continued heavy bleeding despite a firm fundus points to a laceration of the
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birth canal as the source. The nurse should assess for signs of a vaginal or perineal
laceration. Massaging the fundus would not address this issue, and provider notification
comes after identifying the cause. (ATI Maternal Newborn, Hemorrhage, 2025)
Question 3
A nurse is caring for a newborn immediately after delivery. Which of the following
findings requires immediate intervention?
A. Respiratory rate of 60/min
B. Acrocyanosis
C. Grunting and nasal flaring
D. Positive Babinski reflex
E. Heart rate of 140 bpm
Correct Answer: C. Grunting and nasal flaring
Rationale: Grunting and nasal flaring are signs of respiratory distress and may indicate
underlying conditions like transient tachypnea of the newborn (TTN) or meconium
aspiration. These symptoms require prompt evaluation and possible respiratory support.
Acrocyanosis is normal in the first 24–48 hours. A heart rate of 140 and positive Babinski
are expected. (ATI Newborn Complications, 2025)
, 4
Question 4
A nurse is reviewing discharge teaching with a client who had a cesarean birth. Which
statement indicates a need for further teaching?
A. "I will avoid lifting anything heavier than my baby."
B. "I can take ibuprofen as needed for pain."
C. "I will take showers instead of baths until my incision heals."
D. "I will resume sexual activity as soon as the bleeding stops."
E. "I will notify the provider if my incision becomes red or swollen."
Correct Answer: D. "I will resume sexual activity as soon as the bleeding stops."
Rationale: Resuming sexual activity is not recommended until at least 4–6 weeks
postpartum, or when cleared by the provider, even if bleeding has stopped. Engaging in
intercourse too early increases the risk of infection and poor healing. The other
statements demonstrate appropriate understanding of postpartum recovery and cesarean
wound care. (ATI Postpartum Complications, 2025)
Question 5
A nurse is caring for a client at 30 weeks’ gestation who reports headache and blurred
vision. BP is 158/98 mmHg. Which medication should the nurse expect to administer?
A. Nifedipine
B. Oxytocin
C. Terbutaline
