ATI RN MATERNAL NEWBORN FINAL EXAM QUESTIONS AND ANSWERS 2025
Exhibit 1: Medical hx
Newborn delivered by repeat cesarean birth at 40 weeks of gestation. Birth weight 3,515 g (7 lb 12 oz)
Apgar scores 8 at 1 min and 9 at 5 min. Maternal history of methadone use during pregnancy.
Exhibit 2: VS
@0700: Heart rate 156/min. Respiratory rate 58/min. Temperature 37.2° C (98.9° F) Oxygen saturation
98% on room air
@1100: Heart rate 160/min. Respiratory rate 60/min. Temperature 37.3° C (99.2° F) Oxygen saturation
96% on room air
Exhibit 3: Phys Exam
Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorously on pacifier but breastfeeds
poorly. Respirations unlabored. Lungs sound clear on auscultation. Increased muscle tone with
moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Several loose stools today.
Exhibit 4: Diagnostic Results
Maternal urine toxicology screen positive for opiates (-). Newborn urine toxicology screen positive for
opiates (- - (ANSWER)Respiratory findings is incorrect. The newborn's respiratory rate is within the
expected reference range of 30 to 60/min. There is no indication the newborn has an alteration in
respiratory status; therefore, this finding does not need to be reported to the provider.
Temperature is incorrect. The newborn's temperature is within the expected reference range of 36.5° to
37.5° C (97.7° to 99.5° F). Therefore, this finding does not need to be reported to the provider.
Oxygen saturation is incorrect. The newborn's oxygen saturation is within the expected reference range
of greater than 94%; therefore, this finding does not need to be reported to the provider.
Central nervous system findings is correct. The newborn is displaying inconsolability, high-pitched cry,
increased muscle tone, tremors, hyperactive Moro reflex, and excessive sucking. These findings are
manifestations of NAS and should be reported to the provider.
Gastrointestinal findings is correct. The newborn is displaying poor feeding and loose stools. These
findings are manifestations of NAS and should be reported to the provider.
Exhibit 1: RN note
@ 0900: Client reports a small amount of bright red blood in their underwear upon awakening. Client
denies contractions or abdominal pain. External fetal monitor applied.
@0930: Client passed large amount of bright red blood from vagina. Denies pain. Uterine tone soft and
nontender to palpation. Contraction pattern: no contractions noted. Fetal heart rate pattern: Fetal heart
rate baseline 135/min. Moderate variability. No decelerations noted.
,ATI RN MATERNAL NEWBORN FINAL EXAM QUESTIONS AND ANSWERS 2025
Exhibit 2: VS
@0900: Temperature 36.2°C (97.2° F)Pulse rate 78/min. Respiratory rate 20/min. Blood pressure 112/64
mmHg. Fetal heart rate 132/min
@0930: Pulse rate 82/min. Blood pressure 116/60 mmHg. Fetal heart rate 160/min
Exhibit 3: Medical hx
G4P3. 30 weeks gestation. Previous pregnancies delivered via cesarean section - (ANSWER)When
generating solutions, inserting a large bore intravenous catheter is indicated. Clients who have third
trimester vaginal bleeding may experience a sudden hemorrhage and require fluid resuscitation or the
administration of blood products. The nurse should weigh perineal pads. Weighing perineal pads after
use will provide a more accurate assessment of the volume of blood loss that the client is experiencing.
When generating solutions, the nurse should not administer methotrexate or assess for cervical dilation
because it is contraindicated for this client. Methotrexate is an antimetabolite and folic acid antagonist
which destroys rapidly dividing cells. It can be administered during pregnancy to medically resolve an
ectopic pregnancy during the first trimester. Assessing cervical dilation is contraindicated for any
pregnant client who is experiencing vaginal bleeding. Manipulation of the cervix during the examination
may result in further damage to the placenta and compromise the well-being of the client and fetus.
A nurse is assessing the newborn of a client who took selective serotonin reuptake inhibitor (SSRI)
during pregnancy. Which of the following manifestations should the nurse identify as an indication of
withdrawal from an SSRI?
a. Large for gestational age
b. Hyperglycemia
c. Bradypnea
d. Vomiting - (ANSWER)d. Vomiting
Expected manifestations associated with fetal exposure to SSRIs include irritability, agitation, tremors,
diarrhea, and vomiting. These manifestations typically last 2 days.
A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the
following findings in the client's history should the nurse recognize as a contraindication to oral
contraceptives? (Select all that apply)
a. Cholecystitis
, ATI RN MATERNAL NEWBORN FINAL EXAM QUESTIONS AND ANSWERS 2025
b. Hypertension
c. Human papillomavirus
d. Migraine headaches
e. Anxiety disorder - (ANSWER)Cholecystitis, hypertension, and migraine headaches is correct. A history
of gallbladder disease is a contraindication for the use of oral contraceptives. Hypertension is a
contraindication for the use of oral contraceptives. A history of migraine headaches is a contraindication
for the use of oral contraceptives.
HPV and anxiety disorder is incorrect. The presence of human papillomavirus is not a contraindication
for the use of oral contraceptives. The presence of an anxiety disorder is not a contraindication for the
use of oral contraceptives.
A nurse is caring for a newborn.
Exhibit 1: Medical hx
@1600: Apgar score 9 at 1 min and 9 at 5 min. Birth weight 4,706g (10lb 6oz). Gestational age 40 weeks.
Difficult vaginal birth with shoulder dystocia.
Exhibit 2: RN note
@1700: Newborn is active and moves all extremities except for right arm. No spontaneous movement of
the right arm noted. Right arm remains at side during Moro reflex.
Exhibit 3: Physical Exam
Absent Moro reflex noted in right arm.
Right shoulder and arm are internally rotated and adducted. Elbow extended. Forearm pronated with
wrist and fingers flexed. Diagnosis: Brachial plexus injury resulting in Erb-Duchenne (Erb's palsy)
paralysis. - (ANSWER)Educate the parents to begin range of motion exercises on the affected arm after 1
week is indicated. Passive ROM exercises of the arm are indicated to restore function of the extremity.
The initiation of these exercises is delayed for approximately 1 week to prevent additional injury to the
brachial plexus.
Exhibit 1: Medical hx
Newborn delivered by repeat cesarean birth at 40 weeks of gestation. Birth weight 3,515 g (7 lb 12 oz)
Apgar scores 8 at 1 min and 9 at 5 min. Maternal history of methadone use during pregnancy.
Exhibit 2: VS
@0700: Heart rate 156/min. Respiratory rate 58/min. Temperature 37.2° C (98.9° F) Oxygen saturation
98% on room air
@1100: Heart rate 160/min. Respiratory rate 60/min. Temperature 37.3° C (99.2° F) Oxygen saturation
96% on room air
Exhibit 3: Phys Exam
Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorously on pacifier but breastfeeds
poorly. Respirations unlabored. Lungs sound clear on auscultation. Increased muscle tone with
moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Several loose stools today.
Exhibit 4: Diagnostic Results
Maternal urine toxicology screen positive for opiates (-). Newborn urine toxicology screen positive for
opiates (- - (ANSWER)Respiratory findings is incorrect. The newborn's respiratory rate is within the
expected reference range of 30 to 60/min. There is no indication the newborn has an alteration in
respiratory status; therefore, this finding does not need to be reported to the provider.
Temperature is incorrect. The newborn's temperature is within the expected reference range of 36.5° to
37.5° C (97.7° to 99.5° F). Therefore, this finding does not need to be reported to the provider.
Oxygen saturation is incorrect. The newborn's oxygen saturation is within the expected reference range
of greater than 94%; therefore, this finding does not need to be reported to the provider.
Central nervous system findings is correct. The newborn is displaying inconsolability, high-pitched cry,
increased muscle tone, tremors, hyperactive Moro reflex, and excessive sucking. These findings are
manifestations of NAS and should be reported to the provider.
Gastrointestinal findings is correct. The newborn is displaying poor feeding and loose stools. These
findings are manifestations of NAS and should be reported to the provider.
Exhibit 1: RN note
@ 0900: Client reports a small amount of bright red blood in their underwear upon awakening. Client
denies contractions or abdominal pain. External fetal monitor applied.
@0930: Client passed large amount of bright red blood from vagina. Denies pain. Uterine tone soft and
nontender to palpation. Contraction pattern: no contractions noted. Fetal heart rate pattern: Fetal heart
rate baseline 135/min. Moderate variability. No decelerations noted.
,ATI RN MATERNAL NEWBORN FINAL EXAM QUESTIONS AND ANSWERS 2025
Exhibit 2: VS
@0900: Temperature 36.2°C (97.2° F)Pulse rate 78/min. Respiratory rate 20/min. Blood pressure 112/64
mmHg. Fetal heart rate 132/min
@0930: Pulse rate 82/min. Blood pressure 116/60 mmHg. Fetal heart rate 160/min
Exhibit 3: Medical hx
G4P3. 30 weeks gestation. Previous pregnancies delivered via cesarean section - (ANSWER)When
generating solutions, inserting a large bore intravenous catheter is indicated. Clients who have third
trimester vaginal bleeding may experience a sudden hemorrhage and require fluid resuscitation or the
administration of blood products. The nurse should weigh perineal pads. Weighing perineal pads after
use will provide a more accurate assessment of the volume of blood loss that the client is experiencing.
When generating solutions, the nurse should not administer methotrexate or assess for cervical dilation
because it is contraindicated for this client. Methotrexate is an antimetabolite and folic acid antagonist
which destroys rapidly dividing cells. It can be administered during pregnancy to medically resolve an
ectopic pregnancy during the first trimester. Assessing cervical dilation is contraindicated for any
pregnant client who is experiencing vaginal bleeding. Manipulation of the cervix during the examination
may result in further damage to the placenta and compromise the well-being of the client and fetus.
A nurse is assessing the newborn of a client who took selective serotonin reuptake inhibitor (SSRI)
during pregnancy. Which of the following manifestations should the nurse identify as an indication of
withdrawal from an SSRI?
a. Large for gestational age
b. Hyperglycemia
c. Bradypnea
d. Vomiting - (ANSWER)d. Vomiting
Expected manifestations associated with fetal exposure to SSRIs include irritability, agitation, tremors,
diarrhea, and vomiting. These manifestations typically last 2 days.
A nurse in a family planning clinic is caring for a client who requests an oral contraceptive. Which of the
following findings in the client's history should the nurse recognize as a contraindication to oral
contraceptives? (Select all that apply)
a. Cholecystitis
, ATI RN MATERNAL NEWBORN FINAL EXAM QUESTIONS AND ANSWERS 2025
b. Hypertension
c. Human papillomavirus
d. Migraine headaches
e. Anxiety disorder - (ANSWER)Cholecystitis, hypertension, and migraine headaches is correct. A history
of gallbladder disease is a contraindication for the use of oral contraceptives. Hypertension is a
contraindication for the use of oral contraceptives. A history of migraine headaches is a contraindication
for the use of oral contraceptives.
HPV and anxiety disorder is incorrect. The presence of human papillomavirus is not a contraindication
for the use of oral contraceptives. The presence of an anxiety disorder is not a contraindication for the
use of oral contraceptives.
A nurse is caring for a newborn.
Exhibit 1: Medical hx
@1600: Apgar score 9 at 1 min and 9 at 5 min. Birth weight 4,706g (10lb 6oz). Gestational age 40 weeks.
Difficult vaginal birth with shoulder dystocia.
Exhibit 2: RN note
@1700: Newborn is active and moves all extremities except for right arm. No spontaneous movement of
the right arm noted. Right arm remains at side during Moro reflex.
Exhibit 3: Physical Exam
Absent Moro reflex noted in right arm.
Right shoulder and arm are internally rotated and adducted. Elbow extended. Forearm pronated with
wrist and fingers flexed. Diagnosis: Brachial plexus injury resulting in Erb-Duchenne (Erb's palsy)
paralysis. - (ANSWER)Educate the parents to begin range of motion exercises on the affected arm after 1
week is indicated. Passive ROM exercises of the arm are indicated to restore function of the extremity.
The initiation of these exercises is delayed for approximately 1 week to prevent additional injury to the
brachial plexus.
