RN ATI MATERNAL NEWBORN PROCTORED EXAM
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,RN ATI MATERNAL NEWBORN PROCTORED EXAM
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1. A nurse is caring for a client who is in active labor and reports back pain. The nurse performs a
vaginal exam and determines the client is 8cm dilated, 100% effaced, and -2 station. The fetus is
in the occiput posterior position. Which of the following is an appropriate intervention?
a. Perform effleurage during contractions
b. Place the client in lithotomy position
c. Assist the client to the hands and knees position- Helps relieve back pain and help the
fetus rotate
d. Apply a fetal scalp electrode
2. A nurse is assessing a client during a weekly prenatal visit that is at 38 weeks of gestation. Which
of the following client findings should the nurse report to the provider?
a. Blood pressure 136/88
b. Report of insomnia
c. Weight gain of 2.2 kg- Above the expected reference range and could indicate
complications
d. Report of Braxton-Hicks contractions
3. A nurse is caring for a client who is pregnant and has epilepsy. The nurse observes the client
having a seizure. After turning the client’s head to one side, which of the following actions
should the nurse take next?
a. Monitor the fetal heart rate
b. Assess uterine activity
c. Administer oxygen via a non-breather mask
d. Start a bolus of IV fluids
4. A nurse is providing discharge instructions to a client who had a vaginal delivery and is
breastfeeding her newborn. Which of the following statements indicates an understanding of
the teaching?
a. I will need to eat an additional 330 calories a day while I’m breastfeeding-
b. I will change my perineal pad at least twice a day
c. I will massage my uterus daily for 7 days
d. I will breastfeed my baby every 2 hours
5. A nurse is caring for a client who is at 38 weeks of gestation. Which of the following actions
should the nurse take prior to applying an external transducer for fetal monitoring?
a. Assessment of dilation and effacement
b. Leopold maneuvers- helps the nurse assess the position of the fetus to best determine
the optimal placement for the fetal monitoring transducer.
c. Sterile speculum exam
d. Nitrazine test
6. A client who is pregnant presents to a prenatal clinic for her first visit. She tells the nurse that
her last normal menstrual period began Oct 13. Using Nagele’s rule, the nurse should determine
the client’s estimated date of delivery as which of the following?
a. July 6
b. July 13
c. July 20- Add a year, subtract 3 months, add 7 days
d. July 27
,7. A nurse is caring for a client undergoing an oxytocin-stimulated contraction test. The nurse
notes three contractions in 10 min with late decelerations occurring with two of the
contractions. Which of the following findings should the nurse report to the provider
a. Reactive
b. Nonreactive
c. Positive- Indicates an adverse reaction by the fetus and should be reported to the
provider
d. Negative
8. A nurse is providing family planning education to a client who has decided to use a diaphragm.
Which of the following should the nurse include in the plan of care?
a. You should replace the diaphragm every 3 years
b. You should leave the diaphragm in place for at least 6 hours after intercourse
c. You should use an oil based product as a lubricant when inserting the diaphragm
d. You should insert he diaphragm when your bladder is full
9. 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
10. 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
11. 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
12. 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.
13. 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
14. 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
15. 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
16. 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
17. 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
18. 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
19. 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
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