Labor

Question 1

Which of the following is NOT a potential trigger for the start of labor?
A. Placental aging
B. Prostaglandin release from uterine stretching
C. Increased levels of cortisol in the fetus
D. Sudden maternal blood sugar spike

Answer 1

D. Sudden maternal blood sugar spike

Question 2

During a Leopold’s maneuver, the third step is intended to determine:
A. The part of the fetus located in the fundus
B. The location of the fetal back
C. The fetal presenting part
D. The position of the cephalic prominence

Answer 2

C. The fetal presenting part

Question 3

“Fetal attitude” refers to:
A. The fetus’s head flexion in relation to its body
B. The station of the fetal head within the pelvis
C. The fetus’s movement frequency
D. The size of the fetal head

Answer 3

A. The fetus’s head flexion in relation to its body

Question 4

Which fetal presentation is considered most optimal for navigating the pelvis during labor?
A. Breech
B. Shoulder
C. Cephalic
D. Transverse

Answer 4

C. Cephalic

Question 5

The “Four P’s” that influence labor progression include all of the following EXCEPT:
A. Passageway
B. Passenger
C. Placenta
D. Powers

Answer 5

C. Placenta

Question 6

In terms of fetal head positioning, which of the following closes around 6-8 weeks after birth?
A. Anterior fontanel
B. Posterior fontanel
C. Occipital fontanel
D. Parietal fontanel

Answer 6

B. Posterior fontanel

Question 7

In determining fetal station, a +1 station indicates that the presenting part is:
A. 1 cm above the ischial spines
B. 1 cm below the ischial spines
C. At the level of the ischial spines
D. 2 cm above the ischial spines

Answer 7

1 cm below the ischial spines

Question 8

The “Passageway” involved in labor progression does NOT include:
A. The bony pelvis
B. Pelvic musculature
C. Cervix
D. Amniotic sac

Answer 8

D. Amniotic sac

Question 9

Which factor related to the fetus can impact the ease of labor progression?
A. Fetal size and presentation
B. Maternal position
C. Cervical dilation
D. Contraction strength

Answer 9

Answer: A. Fetal size and presentation

Question 10

During the first stage of labor, contractions aim to:
A. Expel the fetus from the uterus
B. Push the fetal head into a lower station
C. Efface and dilate the cervix
D. Separate the placenta from the uterine wall

Answer 10

C. Efface and dilate the cervix

Question 11

The Ferguson reflex stimulates which hormone to aid in labor progression?
A. Estrogen
B. Progesterone
C. Prostaglandin
D. Oxytocin

Answer 11

D. Oxytocin

Question 12

The passageway in labor includes all of the following EXCEPT:
A. Bony pelvis
B. Amniotic sac
C. Cervix
D. Pelvic musculature

Answer 12

Answer: B. Amniotic sac

Question 13

The primary purpose of contractions in the first stage of labor is to:
A. Deliver the placenta
B. Efface and dilate the cervix
C. Stop fetal movement
D. Maintain fetal heart rate

Answer 13

Answer: B. Efface and dilate the cervix

Question 14

The first stage of labor is characterized by:
A. Delivery of the placenta
B. Cervical dilation and effacement
C. Crowning of the baby’s head
D. Skin-to-skin contact

Answer 14

Answer: B. Cervical dilation and effacement

Question 15

The second stage of labor lasts from:
A. Full dilation until birth of the fetus
B. Start of regular contractions to complete effacement
C. Delivery of the fetus until delivery of the placenta
D. Complete effacement to start of transition

Answer 15

Answer: A. Full dilation until birth of the fetus

Question 16

The third stage of labor involves:
A. Full dilation until delivery of the baby
B. Delivery of the placenta
C. Onset of regular contractions
D. Complete cervical effacement

Answer 16

Answer: B. Delivery of the placenta

Question 17

The fourth stage of labor is primarily focused on:
A. Skin-to-skin bonding and monitoring recovery
B. Cervical effacement
C. Delivery of the fetus
D. Pushing during contractions

Answer 17

Answer: A. Skin-to-skin bonding and monitoring recovery

Question 18

In assessing the psychological response during labor, which of the following factors is LEAST likely to impact a laboring person’s emotions?
A. Cultural background
B. Support system
C. Weather outside
D. Prenatal education

Answer 18

C. Weather outside

Question 19

Which of the following is most likely to positively impact the psychological response of the birthing person during labor?
A. Anxiety and fear
B. Cultural support
C. Minimal prenatal education
D. Limited support system

Answer 19

Answer: B. Cultural support

Question 20

True labor can be distinguished from false labor by:
A. The presence of cervical change
B. Contractions felt only in the lower abdomen
C. Contractions that weaken with activity
D. Contractions with no pattern

Answer 20

A. The presence of cervical change

Question 21

When triaging a laboring patient, which question is most relevant to determining if the patient is experiencing labor?
A. How is your baby moving?
B. Are you feeling thirsty?
C. What time did you wake up today?
D. Do you have any body aches?

Answer 21

A. How is your baby moving?

Question 22

Fetal heart rate monitoring is essential during labor. A normal baseline for fetal heart rate is:
A. 80-120 beats per minute
B. 110-160 beats per minute
C. 150-180 beats per minute
D. 170-200 beats per minute

Answer 22

B. 110-160 beats per minute

Question 23

The second stage of labor lasts from:
A. The start of regular contractions to complete effacement
B. Full dilation until birth of the fetus
C. Delivery of the fetus until delivery of the placenta
D. Onset of labor until complete dilation

Answer 23

B. Full dilation until birth of the fetus

Question 24

During external fetal monitoring, a tocometer (toco) is used to measure:
A. Fetal heart rate only
B. Contraction frequency and duration
C. Contraction intensity in mmHg
D. Baseline uterine pressure

Answer 24

B. Contraction frequency and duration

Question 25

Which deceleration type mirrors contractions, is usually benign, and often caused by fetal head compression? A. Early deceleration B. Late deceleration C. Variable deceleration D. Prolonged deceleration

Answer 25

A. Early deceleration

Question 26

Late decelerations in fetal heart rate may indicate: A. Fetal sleep cycles B. Umbilical cord compression C. Poor placental perfusion D. Excessive fetal movement

Answer 26

C. Poor placental perfusion

Question 27

Moderate variability in fetal heart rate indicates: A. Neurological impairment B. Fetal hypoxemia C. Acid-base balance and fetal well-being D. The need for immediate intervention

Answer 27

C. Acid-base balance and fetal well-being

Question 28

Moderate variability in fetal heart rate is defined by fluctuations of: A. Less than 5 bpm B. Greater than 25 bpm C. 5-25 bpm D. No detectable fluctuation

Answer 28

Answer: C. 5-25 bpm

Question 29

Minimal variability in fetal heart rate is defined by fluctuations of: A. Less than 5 bpm B. 5-25 bpm C. Greater than 25 bpm D. No fluctuation

Answer 29

Answer: A. Less than 5 bpm

Question 30

Marked variability in fetal heart rate is characterized by fluctuations of: A. 5-25 bpm B. Greater than 25 bpm C. Less than 5 bpm D. No detectable fluctuation

Answer 30

Answer: B. Greater than 25 bpm

Question 31

Absent variability in fetal heart rate means there is: A. No detectable fluctuation B. Greater than 25 bpm fluctuation C. 5-25 bpm fluctuation D. Less than 5 bpm fluctuation

Answer 31

Answer: A. No detectable fluctuation

Question 32

Moderate variability in fetal heart rate generally indicates: A. Fetal hypoxemia or neurological impairment B. Fetal well-being and balanced acid-base status C. Fetal sleep cycles or medication effects D. Fetal distress or excessive movement

Answer 32

Answer: B. Fetal well-being and balanced acid-base status

Question 33

Minimal variability in fetal heart rate may indicate: A. Normal fetal movement and oxygenation B. Fetal distress or excessive movement C. Fetal sleep cycles or effects of certain medications D. A relaxed uterine environment

Answer 33

Answer: C. Fetal sleep cycles or effects of certain medications

Question 34

Marked variability in fetal heart rate is often a sign of: A. Fetal distress or excessive movement B. Well-being and balanced acid-base status C. Fetal sleep cycles D. Fetal hypoxemia or neurological impairment

Answer 34

Answer: A. Fetal distress or excessive movement

Question 35

Absent variability in fetal heart rate is concerning because it may indicate: A. Fetal well-being and acid-base balance B. Fetal hypoxemia or neurological impairment C. Normal fetal sleep cycles D. A calm uterine environment

Answer 35

Answer: B. Fetal hypoxemia or neurological impairment

Question 36

An intervention appropriate for managing variable decelerations due to umbilical cord compression might include: A. Providing narcotics B. Changing maternal position C. Increasing pitocin dosage D. Applying an external monitor

Answer 36

B. Changing maternal position

Question 37

An acceleration in fetal heart rate is defined as: A. A decrease of 15 beats per minute lasting at least 10 seconds B. An increase of 15 beats per minute lasting at least 15 seconds C. A steady heart rate with no fluctuation D. A decrease of 10 beats per minute lasting at least 15 seconds

Answer 37

B. An increase of 15 beats per minute lasting at least 15 seconds

Question 38

Which of the following is true about accelerations in fetal heart rate? A. They indicate potential fetal distress B. They reflect fetal hypoxia C. They are a sign of fetal well-being D. They are caused by head compression

Answer 38

C. They are a sign of fetal well-being

Question 39

Early decelerations in fetal heart rate are typically caused by: A. Umbilical cord compression B. Fetal hypoxia C. Placental insufficiency D. Fetal head compression

Answer 39

D. Fetal head compression

Question 40

What is the most appropriate nursing intervention for early decelerations? A. Change the mother’s position B. Administer oxygen C. No intervention needed D. Increase IV fluids

Answer 40

C. No intervention needed

Question 41

Variable decelerations in fetal heart rate are often related to: A. Fetal head compression B. Umbilical cord compression C. Placental insufficiency D. Contractions only

Answer 41

B. Umbilical cord compression

Question 42

Which intervention is most appropriate for managing variable decelerations? A. Administering a fluid bolus B. Applying a fetal scalp electrode C. Position change and amnioinfusion if needed D. Giving narcotics

Answer 42

C. Position change and amnioinfusion if needed

Question 43

Late decelerations typically begin: A. Before the start of a contraction B. At the peak of a contraction C. After the peak of a contraction D. At the end of the contraction

Answer 43

C. After the peak of a contraction

Question 44

Late decelerations are concerning because they may indicate: A. Umbilical cord compression B. Fetal sleep cycles C. Placental insufficiency or fetal hypoxia D. Fetal head compression

Answer 44

C. Placental insufficiency or fetal hypoxia

Question 45

A common cause of late decelerations includes: A. Maternal fever B. Umbilical cord prolapse C. Maternal hypotension or poor placental perfusion D. Fetal movement

Answer 45

C. Maternal hypotension or poor placental perfusion

Question 46

Which of the following interventions is appropriate for late decelerations? A. Increasing pitocin B. Positioning the patient on her side and stopping pitocin C. Performing a cervical exam D. Giving the mother food or water

Answer 46

B. Positioning the patient on her side and stopping pitocin

Question 47

Minimal variability in fetal heart rate may be observed during: A. Fetal sleep cycles B. Accelerations C. Placental insufficiency D. Maternal positioning

Answer 47

A. Fetal sleep cycles

Question 48

Which fetal heart rate pattern requires immediate intervention to prevent fetal distress? A. Early decelerations B. Accelerations C. Late decelerations with minimal variability D. Moderate variability

Answer 48

C. Late decelerations with minimal variability

Question 49

Variable decelerations are characterized by: A. Gradual onset and a shallow decrease in heart rate B. Sharp, abrupt decreases in heart rate C. A pattern that mirrors contractions D. A gradual return to baseline over time

Answer 49

B. Sharp, abrupt decreases in heart rate

Question 50

What is the primary purpose of monitoring fetal accelerations during labor? A. To confirm fetal sleep patterns B. To ensure fetal heart rate remains steady C. To assess fetal oxygenation and neurological well-being D. To measure contraction strength

Answer 50

C. To assess fetal oxygenation and neurological well-being

Question 51

Spontaneous rupture of membranes (SROM) requires the nurse to assess all of the following EXCEPT: A. Color B. Amount C. Cervical dilation D. Odor

Answer 51

C. Cervical dilation

Question 52

Artificial rupture of membranes (AROM) is typically performed when: A. The fetus is in a transverse position B. The fetal head is well engaged in the pelvis C. There is a need to confirm SROM D. Labor has already reached the second stage

Answer 52

B. The fetal head is well engaged in the pelvis

Question 53

Which of the following is NOT a non-pharmacological pain management technique during labor? A. Aromatherapy B. Epidural anesthesia C. Hydrotherapy D. Counterpressure

Answer 53

B. Epidural anesthesia

Question 54

Epidural anesthesia in labor requires careful monitoring, particularly for: A. Hypertension B. Hypotension C. Hypoglycemia D. Hyperthermia

Answer 54

B. Hypotension

Question 55

The second stage of labor, or “pushing” stage, begins when: A. The cervix reaches 10 cm dilation and 100% effacement B. The fetal head begins to crown C. Contractions become mild and irregular D. The placenta detaches

Answer 55

A. The cervix reaches 10 cm dilation and 100% effacement

Question 56

During the latent phase of the first stage of labor, a typical contraction pattern is: A. 5-20 minutes apart, mild intensity B. 3-5 minutes apart, moderate-strong intensity C. 2-3 minutes apart, strong intensity D. 10 minutes apart, mild intensity

Answer 56

A. 5-20 minutes apart, mild intensity

Question 57

In the third stage of labor, which of the following is a sign that the placenta has separated? A. Contractions cease completely B. Cord appears to lengthen and fundus rises C. Blood flow from the introitus slows D. Uterus becomes soft and uncontracted

Answer 57

B. Cord appears to lengthen and fundus rises

Question 58

Immediate newborn care after birth often includes: A. Applying general anesthesia to the birthing parent B. Skin-to-skin contact and assessment C. Administering antibiotics to the newborn D. Immediate transport to the nursery

Answer 58

B. Skin-to-skin contact and assessment

Question 59

In the fourth stage of labor, which assessment is typically performed every 15 minutes? A. Fundal height and firmness B. Cervical dilation C. Maternal oxygen saturation D. Fetal heart rate

Answer 59

A. Fundal height and firmness

Question 60

A Foley bulb is used in labor primarily to: A. Provide pain relief B. Dilate the cervix mechanically C. Increase fetal heart rate variability D. Prevent preterm labor

Answer 60

B. Dilate the cervix mechanically

Question 61

A common reason for performing an episiotomy is to: A. Speed up the delivery of the fetus B. Allow more room for instrument-assisted delivery C. Reduce the risk of postpartum hemorrhage D. Facilitate quicker healing post-delivery

Answer 61

B. Allow more room for instrument-assisted delivery

Question 62

An important consideration when administering Pitocin to augment labor is to monitor: A. Contraction pattern and intensity B. Fetal presentation C. Maternal appetite D. Blood glucose levels

Answer 62

A. Contraction pattern and intensity

Question 63

During an assisted vaginal delivery, the healthcare provider may use: A. Foley catheter and speculum B. Forceps or vacuum C. Oxygen and nasal cannula D. Pitocin and a sedative

Answer 63

B. Forceps or vacuum

Question 64

The primary function of the ovaries in the female reproductive system is to: A. Produce and release eggs B. Support fetal development C. Maintain uterine lining D. Facilitate fertilization

Answer 64

Answer: A. Produce and release eggs

Question 65

Which hormone is primarily responsible for maintaining pregnancy by stabilizing the uterine lining? A. Estrogen B. Progesterone C. Oxytocin D. Prolactin

Answer 65

Answer: B. Progesterone

Question 66

Estrogen plays a key role in reproduction by: A. Stimulating milk production B. Causing uterine contractions C. Promoting follicle development and preparing the endometrium D. Stabilizing the placenta

Answer 66

Answer: C. Promoting follicle development and preparing the endometrium

Question 67

The bony pelvis includes all of the following structures EXCEPT: A. Ilium B. Ischium C. Clavicle D. Pubis

Answer 67

Answer: C. Clavicle

Question 68

The narrowest portion of the pelvic inlet, critical in the birthing process, is the: A. Sacral promontory B. Ischial spines C. Coccyx D. Iliac crest

Answer 68

Answer: B. Ischial spines

Question 69

The pubic symphysis plays a role in childbirth by: A. Expanding to widen the birth canal B. Supporting fetal head rotation C. Anchoring the umbilical cord D. Preventing uterine prolapse

Answer 69

Answer: A. Expanding to widen the birth canal