1.

What is a direct influence on cervical dilation? Select all that apply.

a. positioning of the pregnant person

b. strength of uterine contractions
c. length of time since ROM
d. fetal presentation
e. time of last bowel movement

2.
The nurse is providing discharge instructions to a person who was evaluated for possible labor.
How does the nurse explain how losing the mucus plug could be a sign of impending labor?

a. The mucus plug starts to be expelled due to increased estrogen before contractions begin.
b. The mucus plug is expelled after the membranes rupture during labor.
c. Effacement and dilation of the cervix decrease the area where the mucus plug sits.
d. Labor is unable to begin until the mucus plug is expelled and creates a space for the fetus.

3.
If the fetal attitude is assessed to be completely deflexed on sonogram or via Leopold’s
maneuvers, what presenting part do you anticipate palpating in a vaginal exam?

a. brow
b. breech
c. face
d. occiput

4.
What makes up the powers of labor and birth?

a. contractions and pushing efforts

b. pelvis and pelvic floor tissues
c. fetal position, attitude, lie, and presentation
d. oxytocin

5.
When does the active phase of labor begin according to ACOG?

a. 6 cm
b. 3 cm
c. 5 cm
d. 10 cm

6.
The nurse hears the laboring patient making grunting noises. How will the nurse determine if the
person is in the active second stage of labor?
 a. Assess for rupture of membranes.
b. Assess for bloody show.
c. Assess for dilation of the cervix.
d. Assess for stool.

7.
When does the second stage of labor begin?

a. at birth
b. when the early phase ends
c. when the cervix is completely dilated and effaced
d. when pushing begins

8.
How long is the expected length of the third stage of labor?

a. 60 minutes or less
b. 30 minutes or less
c. 1 hour for a multiparous person, 2 hours for a nulliparous person
d. 3 hours for a multiparous person, 4 hours for a nulliparous person

9.
How can a nurse support the patient during the fourth stage of labor?

a. Support pushing efforts with feedback on how much progress is being made.
b. Ensure epidural anesthesia is adequate for pain control, reposition frequently, provide
dietary intake per provider’s order.
c. Assess for any bleeding or amniotic fluid presence in the vaginal discharge.
d. Provide rest, space, and time for bonding between assessments, support for feeding
preferences, diligent monitoring for complications, pain management.

10.
The nurse is caring for a patient during the first stage of labor. What is an abnormal finding?

a. patient moaning with contractions

b. contractions 3 minutes apart lasting 60 seconds
c. blood pressure 142/88
d. respiratory rate 22

11.
What changes in hormones initiate labor?

a. decreased progesterone, decreased estrogen, absence of oxytocin

b. increased progesterone, decreased estrogen, absence of oxytocin
c. increased progesterone, decreased estrogen, presence of oxytocin
d. decreased progesterone, increased estrogen, effects of oxytocin
12.
During the second stage, what do the birthing person’s vital signs most likely show?

a. increased heart rate during contractions, baseline heart rate between contractions
b. increased heart rate during contractions, decreased heart rate between contractions
c. decreased heart rate during contractions, increased heart rate between contractions
d. decreased heart rate during contractions, baseline heart rate between contractions

13.
During the third stage of labor, what may the birthing person experience?

a. expulsion of their fetus with vaginal bleeding

b. cramping, gush of fresh vaginal bleeding, lengthening of the umbilical cord
c. frequent episodes of dyspnea
d. increased blood pressure and pain due to expulsive efforts

14.
What should the nurse consider when the birthing person has a decrease in blood pressure after
the placenta is delivered?

a. The birthing person is in pain.

b. Place the newborn skin-to-skin.
c. The bladder is distended.
d. Check for possible hemorrhage.

15.
How does becoming a parent cause the birthing person to feel?

a. overwhelming feelings of joy or a sense of euphoria

b. a wide variety of emotions specific to each person’s experience
c. overwhelming fear or sadness at the loss of their previous life
d. exhausted with little interest the newborn

16.
How should the nurse respect the rapid psychologic changes occurring in the fourth stage of
labor?

a. Invite the family to come in and see the newborn.

b. Take the lead from the parents regarding interruption of the bonding.
c. Ask multiple questions about taking pictures of the newborn.
d. Take the newborn to the nursery to encourage the parents to rest.

17.
What anticipatory guidance should the nurse provide for new parents regarding sociologic
changes?
 a. Explain that roles will not change at home.
b. Explain that stresses will be over now that the newborn is born.
c. Tell the parents not to stress over household changes.
d. Prepare them for possible strains on relationships.

18.
What effect will the presence of support people in labor most likely have?

a. improve the experience of the birthing person

b. improve the outcomes of the birthing person
c. improve the outcomes and experience of the birthing person
d. cause birth trauma and/or postpartum depression

19.
The nurse is caring for a laboring patient with multiple family members in the room. How can
the nurse address this situation?

a. Educate the family that the pain the laboring person is experiencing is normal.
b. Ask them all to leave the room.
c. Explain that if the laboring person got an epidural, she would be more comfortable.
d. Assume the laboring person wants the family in the room.

20.
During the COVID-19 pandemic, what was revealed about the importance of labor support?

a. Labor support can only be provided by the significant other.

b. Laboring patients did not need support from outside sources.
c. Outcomes for birth were not changed by pandemic requirements.
d. Patients during the pandemic’s support ban experienced more depression.

21.
When should the nurse consider suggesting a doula?

a. when the patient asks for an epidural

b. if the nurse is unable to support the patient
c. when the support person is in the military and cannot attend the birth
d. if the patient is going to have an emergency cesarean birth

1.
What is a FHR that falls within the normal baseline?

a. 135 bpm
b. 95 bpm
c. 170 bpm
d. 105 bpm
2.
What periodic change in the FHR baseline is associated with fetal hypoxia?

a. early deceleration
b. late deceleration
c. variable deceleration
d. acceleration

3.
What is a reassuring pattern a nurse would see on an FHR tracing?

a. accelerations
b. marked variability
c. prolonged decelerations
d. absent variability

4.
What type of FHR decelerations are a sign of possible fetal descent?

a. early
b. late
c. variable
d. prolonged

5.
The advantage of this type of monitoring includes more patient mobility and freedom of
movement.

a. internal electronic monitor

b. external electronic monitor
c. intermittent auscultation
d. IUPC and scalp electrode

6.
Leopold’s maneuvers allow the nurse to determine presentation and lie of the fetus. What
additional information do the maneuvers provide?

a. fetal head or buttocks in the uterine fundus

b. location of the placenta
c. stage of labor
d. detection of fetal movement

7.
What is the most accurate way to monitor the FHR?

a. applying a fetal scalp electrode

 b. monitoring with the external ultrasound
c. using the Doppler monitor for intermittent auscultation
d. auscultating with the fetoscope

8.
What type of monitor can measure the strength of a contraction?

a. fetal scalp electrode

b. intrauterine pressure catheter
c. toco
d. ultrasound

9.
The nurse evaluates the FHR and UC in the following tracing.

Copyright Rice University, OpenStax, under CC BY 4.0 license

How does the nurse document this finding?

a. uterine tachysystole
b. active labor
c. latent labor
d. tachycardia

10.
A 20-year-old, G1P0, presents to the labor and delivery unit. The patient is contracting every 5
minutes. They rate their pain as 6/10 and say the only thing that helps with the pain is walking.
The patient is afraid to get into the bed because it hurts more to lie down. What type of
monitoring can you offer?

a. intermittent auscultation
b. external monitoring
c. internal monitoring
d. intrauterine pressure monitoring

11.
The FHR tracing has shown moderate variability with variable decelerations over the last 30
minutes. The FHR tracing now shows minimal variability between variable decelerations. What
is the probable cause of this FHR change?

a. fetal scalp stimulation

b. loss of fetal reserve
c. fetal heart block
d. fetal arrhythmia

12.
The nurse is having difficulty determining the FHR with the external monitor. A fetal scalp
electrode is placed, and FHR spiking is noted. What is the cause of this abnormal tracing?

a. cardiac arrythmia
b. fetal hypoxia
c. uterine rupture
d. labor dystocia

13.
As the fetal nervous system matures, the FHR baseline changes in what way?

a. FHR decreases.
b. FHR increases.
c. Marked variability occurs.
d. Minimal variability occurs.

14.
The nurse assesses late decelerations on the FHR tracing. She enters the pregnant person’s room
and notices the person lying on their back. Why should the pregnant person not lie on their back?

a. increased risk of early decelerations

b. increased risk of back pain
c. increased risk of uteroplacental insufficiency
d. increased risk of uterine labor dystocia

15.
The pregnant person recently received epidural anesthesia. The blood pressure is 90/50. What
type of periodic change in the FHR is expected?

a. early deceleration
b. late deceleration
c. variable deceleration
d. sinusoidal pattern

16.
In the three-tiered categories of fetal monitoring, what characteristic does a Category II tracing
have?

a. persistent late decelerations

b. variable decelerations with moderate variability
c. moderate variability with accelerations
d. baseline fetal heart rate of 80 bpm

17.
What causes decreased FHR baseline variability?

a. ampicillin
b. cocaine
c. magnesium sulfate
d. terbutaline

18.
Tachycardia is noted on the FHR tracing. What intervention will the nurse initiate?

a. Administer antibiotics.
b. Increase oxytocin.
c. Perform fetal scalp stimulation.
d. Start an IV fluid bolus.

19.
What does management of a category III fetal monitor tracing include?

a. decreasing the oxytocin by half

b. expediting birth
c. readjusting the fetal monitor
d. increasing the magnesium sulfate

20.
What nursing intervention should be initiated for an FHR tracing with early decelerations?

a. Decrease the oxytocin by half.

b. Expedite delivery.
 c. Perform a vaginal exam.
d. Readjust the fetal monitor.

21.
What is the cause of late decelerations?

a. descent of fetal head

b. fetal scalp stimulation
c. imminent birth
d. uteroplacental insufficiency

22.
What is an indication for administering terbutaline?

a. early decelerations
b. insufficient labor pattern
c. tachysystole with decelerations in FHR
d. fetal tachycardia

23.
What is intrauterine resuscitation designed to treat?

a. hypertension
b. hypoglycemia
c. hyperthyroid
d. fetal hypoxia

24.
Why does the nurse turn the laboring person to a side-lying position? Select all that apply.

a. to increase contractions
b. to resolve supine hypotension
c. to reverse uterine tachysystole
d. to increase placental perfusion

25.
When is terbutaline appropriate during intrauterine resuscitation?

a. absent accelerations
b. hypotension
c. dehydration
d. tachysystole

1.
The laboring person is in pain and very anxious. They do not want to use traditional pain relief
methods. What can the nurse offer the laboring person to help with relaxation and reducing
anxiety?

a. lavender oil
b. epidural
c. nalbuphine hydrochloride (Nubain)
d. cold rag

2.
What technique, usually reserved for low-risk persons, has been shown to decrease pain,
encourage movement, decrease anxiety, shorten labor, and improve labor satisfaction?

a. controlled breathing
b. aromatherapy
c. massage
d. hydrotherapy

3.
The fetus is in an occiput posterior position. What position can the nurse assist the laboring
person into that may encourage the fetus to find the occiput anterior position?

a. squatting
b. shower
c. hands and knees
d. semi-Fowler

4.
What is the term for a slow, deep inhalation through the nose and exhalation through the mouth
before a contraction for preparation and after a contraction for release of tension from the
contraction?

a. pursed-lip breathing
b. panting
c. chanting
d. cleansing breath

5.
The laboring person wants to use open glottis breathing for pushing. How can the nurse support
the person?

a. Encourage the person to breathe however is most comfortable.

b. Tell the person they should hold their breath for 10 counts.
c. Explain that open glottis pushing is not effective.
d. Discuss that the health-care provider would not allow them to use that breathing.
6.
The laboring person is using hypnosis for comfort measures. How can the nurse support the
person?

a. Talk them through the contractions.

b. Keep the lights on so that everyone can see.
c. Keep the room quiet and dimly lit.
d. During the contraction, ask them to rate the pain.

7.
The nurse provides counter pressure to relieve pain and open the pelvis to help with fetal
descent. What type of counter pressure is the nurse providing?

a. hip squeeze
b. perineal pressure
c. shoulder pressure
d. knee press

8.
The laboring person is anxious and hurting. What can the nurse do to help the laboring person?

a. Offer her an epidural.

b. Encourage frequent position changes.
c. Explain that she has to care for two other persons.
d. Tell them to call someone to come sit with them.

9.
What drug is an anxiolytic that relieves apprehension and creates a feeling of calm?

a. hydroxyzine
b. fentanyl
c. codeine
d. morphine

10.
Nausea and vomiting are common discomforts in labor. When treating with promethazine, what
must the nurse do when administering this medication?

a. Administer subcutaneously.
b. Never administer with an opioid.
c. Dilute before IV administration.
d. Never administer in first stage labor.

11.
What would the nurse administer if the newborn has decreased or no respiratory effort at
delivery after the person received an opiate?
 a. naloxone (Narcan)
b. acetaminophen (Tylenol)
c. oxygen
d. sodium bicarbonate

12.
What does the nurse explain to the laboring person and partner about nitrous oxide?

a. It makes the newborn have respiratory depression.

b. It causes the laboring person to have decreased respirations.
c. It does not affect respiration as an opiate would.
d. The mask is held to the person’s face by the partner.

13.
The nurse receives orders for pharmacologic pain relief. What does the nurse explain to the
laboring person after administering fentanyl?

a. “I will need to monitor your oxygen saturation.”

b. “It’s important for me to insert a Foley catheter.”
c. “I will need to monitor for vaginal bleeding.”
d. “It’s important for me to check your cervix after I administer this medication.”

14.
What are the side effects of spinal anesthesia? Select all that apply.

a. hypotension
b. respiratory depression
c. renal damage
d. infection

15.
What is the expected effect of pudendal anesthesia?

a. loss of sensation in the perineum

b. decreased ability to move one’s legs
c. permanent loss of motor function
d. loss of consciousness

16.
The nurse is monitoring the person’s vital signs after the epidural is placed and notices a blood
pressure of 80/50 mm Hg. What nursing intervention can be performed prior to the epidural
placement to potentially reduce this side effect?

a. routine use of ephedrine

b. IV fluid bolus
c. insertion of indwelling urinary catheter
 d. upright positioning of the laboring person

17.
After insertion of the epidural catheter, what is the nurse’s responsibility regarding patient care?

a. monitoring vital signs every 5 to 15 minutes

b. intermittent FHR monitoring
c. providing the laboring person a meal
d. instructing the laboring person to get out of bed to use the restroom

18.
What is a side effect of general anesthesia that usually limits its use to cases of emergency?

a. hyperactive newborns
b. newborn respiratory depression
c. increase in uterine contractions
d. decrease in cervical dilation

19.
What is the disadvantage of local anesthesia?

a. decreased motor function

b. nausea
c. hypotension
d. pain during injection

1.
What procedure might the nurse perform to determine the presentation of the fetus?

a. vaginal exam
b. ultrasound
c. palpation of contractions
d. laboring person interview

2.
During the first stage of labor, what is the primary goal of nursing care in the early phase?

a. Administer pain medication.

b. Monitor fetal heart rate continuously.
c. Promote relaxation and provide comfort measures.
d. Prepare for imminent delivery.

3.

What assessment findings are essential components of obstetric triage? Select all that apply.
 a. history and physical
b. fetal monitoring
c. EDD
d. 24-hour diet recall

4.
A pregnant person in the first stage of labor experiences rupture of membranes. What is the
nurse’s priority action?

a. Administer an epidural for pain relief.

b. Start an IV line and administer antibiotics.
c. Document the FHR and time and characteristics of the amniotic fluid.
d. Prepare for immediate delivery.

5.
What assessment data are collected to assess progress during the second stage of labor?

a. fetal heart rate

b. fetal descent
c. bearing-down effort
d. contraction strength

6.
In a low-risk laboring person who is not receiving oxytocin, how often should the nurse assess
the fetal heart rate during the second stage of labor?

a. every 5 minutes with contractions

b. at least every 30 minutes
c. every 5–15 minutes
d. only when the physician orders assessment

7.
A laboring person on oxytocin for induction of labor should have continuous monitoring of the
fetal heart rate. How often should the nurse assess the fetal heart rate?

a. every 30 minutes
b. every 15 minutes
c. every 5 minutes
d. every 1 hour

8.
What is the primary goal of fetal heart rate monitoring during the second stage of labor?

a. to predict when to bear down during contractions

b. to determine the strength of the uterine contractions
c. to evaluate fetal well-being
 d. to monitor vital signs of the birthing person

9.
During open glottis pushing, what is the laboring person instructed to do?

a. hold their breath and push for 10 seconds during each contraction
b. push spontaneously while exhaling during contractions
c. exhale slowly during contractions without pushing
d. perform deep breathing exercises between contractions

10.
Which statement accurately describes the importance of birthing person position changes during
the second stage of labor?

a. Position changes have an impact on fetal descent.

b. Position changes can lead to support person stress.
c. Fetal descent is solely determined by uterine contractions.
d. Maintaining a supine position is the safest option.

11.
How long should clamping of the cord be delayed in an uncomplicated delivery to increase the
newborn’s hemoglobin levels and improve circulation?

a. 30–60 seconds
b. 15–30 seconds
c. 30 seconds
d. Delayed cord clamping is not recommended.

12.
A birthing person who delivered a newborn vaginally is receiving care in the labor and birth unit.
The health-care provider diagnosed a retained placenta. What is the primary risk associated with
a retained placenta?

a. neonatal jaundice
b. postpartum hemorrhage
c. delayed bonding
d. postpartum anemia

13.
A nurse is assisting with a vaginal birth and is monitoring for signs of placental separation. What
is the most reliable clinical indicator that the placenta has separated?

a. a gush of clear amniotic fluid

b. uterine contractions every 2 to 3 minutes
c. lengthening of the umbilical cord
d. maternal report of intense pain
14.
During a vaginal birth, a birthing person experienced a second-degree perineal laceration. What
is a characteristic of a second-degree laceration?

a. It involves only the vaginal mucosa.

b. It extends through the vaginal and perineal muscles.
c. It is the least severe type of laceration.
d. It does not require suturing.

15.
A nurse is administering an uterotonic medication to a birthing person who has just delivered the
placenta. Which uterotonic medication is commonly used to prevent postpartum hemorrhage and
promote uterine contractions?

a. oxytocin (Pitocin)
b. fentanyl (Sublimaze)
c. epinephrine (Adrenaline)
d. lorazepam (Ativan)

16.
During the postpartum period, a nurse is caring for a birthing person who is receiving uterotonic
medications. The nurse’s assessment reveals a boggy and enlarged uterus. What is the nurse’s
immediate action?

a. Document the findings as normal.

b. Continue to administer the uterotonic medication.
c. Perform fundal massage to promote uterine firmness.
d. Administer an analgesic for the birthing person’s pain.

17.
How often should the nurse assess the blood pressure, pulse, and respirations of the birthing
person during the first hour of the fourth stage of labor?

a. every 15 minutes
b. every 30 minutes
c. not until after the first hour
d. once, then hourly

18.

In what ways can the nurse support involution of the uterus in the fourth stage of labor? Select all
that apply.

a. uterotonics
b. encouraging the birthing person to urinate
c. fundal massage
 d. providing the baby a bottle so that the birthing person can rest
e. delaying breast-feeding

19.
A nurse is educating a birthing person about the benefits of skin-to-skin contact with their
newborn immediately after birth. The nurse explains that this practice has numerous advantages.
Which of the following benefits is NOT typically associated with skin-to-skin contact?

a. improved bonding between parent and baby

b. enhanced thermoregulation for the newborn
c. decreased risk of neonatal infections
d. accelerated uterine involution for the birthing person

20.
During the fourth stage of labor, a nurse assesses the perineum of a birthing person who had a
vaginal birth. What is the primary purpose of this assessment?

a. to evaluate the birthing person’s readiness for discharge

b. to ensure the birthing person can ambulate safely
c. to detect any signs of perineal trauma
d. to assess the status of cervical dilation

21.
A nurse is caring for a postpartum person during the fourth stage of labor. The nurse is assessing
uterine involution to ensure that the uterus is returning to its prepregnancy size and position.
Which finding is indicative of normal uterine involution during this stage?

a. Uterus is palpable at the level of the umbilicus.

b. Uterine fundus is firm, at the level of the umbilicus.
c. Uterus is displaced to the right side of the abdomen.
d. Uterine fundus is above the level of the umbilicus.

1.
What type of dystocia occurs when the fetal head is unable to navigate through the pelvis?

a. uterine dystocia
b. fetal dystocia
c. pelvic dystocia
d. contraction dystocia

2.
What type of dystocia should the nurse prepare for if she palpates prominent ischial spines
during the vaginal exam?

a. pelvic dystocia
b. fetal dystocia
 c. contraction dystocia
d. uterine dystocia

3.
What pregnant person is at high risk for labor dystocia?

a. 38-week gestation
b. 41-year-old
c. prenatal anemia
d. no prenatal care

4.
The nurse is caring for a pregnant person who was in a motor vehicle accident when she was
younger and broke a bone in her pelvis. For what complication should the nurse be prepared?

a. fetal dystocia
b. pelvic dystocia
c. uterine dystocia
d. age dystocia

5.
What Bishop score describes the most favorable cervix?

a. 2
b. 4
c. 6
d. 8

6.
What is a possible complication of uterine tachysystole?

a. Category I fetal heart rate tracing

b. placenta previa
c. fetal hypoxia
d. prolapsed cord

7.
What can amniotomy cause?

a. six-hour decrease of labor

b. chorioamnionitis
c. elevated blood pressure
d. second stage labor dystocia

8.
What medication is used for cervical ripening?
 a. amniotomy
b. Hemabate
c. misoprostol
d. progesterone

9.
How often is oxytocin usually increased for induction or augmentation of labor?

a. every 10 minutes
b. every 30 minutes
c. every 60 minutes
d. every 90 minutes

10.
What is a potential complication for the neonate due to precipitous labor?

a. respiratory distress
b. low birth weight
c. prelabor rupture of membranes
d. placenta previa

11.
What nursing intervention is performed during labor for a person with preeclampsia?

a. Assess deep tendon reflexes for hyperreflexia.

b. Provide frequent IV fluid boluses.
c. Educate the laboring person that preeclampsia is only a concern for pregnancy, not labor.
d. Discourage pain medication in order to assess for headache.

12.
What is a condition in which there is an excessive amount of amniotic fluid surrounding the
fetus?

a. amniotic fluid embolism

b. gestational diabetes
c. oligohydramnios
d. polyhydramnios

13.
What is a possible complication of oligohydramnios?

a. fetal macrosomia
b. preterm labor
c. placenta previa
d. fetal growth restriction
14.
What medication should the nurse anticipate administering when caring for a person with
preeclampsia in labor?

a. ampicillin
b. magnesium sulfate
c. nalbuphine hydrocholoride (Nubain)
d. sodium bicarbonate

15.
What is a potential sign of intrauterine fetal demise?

a. increased fetal heart rate

b. vaginal bleeding
c. decreased or absent fetal movement
d. macrosomia

16.
What is a potential complication when the fetus is footling breech?

a. prolapsed cord
b. oligohydramnios
c. low biophysical profile score
d. meconium-stained fluid

17.
Gestational diabetes increases what complication of labor?

a. breech
b. macrosomia
c. postterm birth
d. precipitous birth

18.
Multiple gestation can lead to what labor complication?

a. tachysystole
b. postterm birth
c. uterine dystocia
d. early declarations

19.
With what is malnutrition during pregnancy associated?

a. fetal growth restriction

b. fetal macrosomia
 c. group B strep
d. precipitous birth

20.
What newborn complication does type 1 diabetes mellitus cause?

a. hyperglycemia
b. umbilical hernia
c. hypoglycemia
d. cyanosis

21.
With what has maternal hypertension been associated?

a. anorexia
b. low birth weight
c. macrosomia
d. symphysis pubis dysfunction

22.
What is one potential fetal complication of using obstetric forceps?

a. flexion of the head

b. abdominal complications
c. skull fracture
d. femur fracture

23.
What is one potential fetal complication of using the vacuum extractor?

a. cephalohematoma
b. face presentation
c. fetal growth restriction
d. scalp fracture

24.
What is a common reason for cesarean birth?

a. cephalic presentation
b. laboring person’s BMI of 23
c. labor dystocia
d. lack of adequate pain control

25.
What condition is related to an increased risk for fetal demise?
 a. diabetes
b. migraine headache
c. spina bifida
d. thyroid disorder

26.
Why is multiple gestation is a risk factor for cesarean delivery?

a. cord prolapse
b. increased pain in labor
c. inability to push
d. twins in cephalic-cephalic presentation

27.
What is the condition where the umbilical cord vessels cross the cervix?

a. placenta previa
b. placenta cervix
c. velamentous insertion
d. vasa previa

28.
What is the condition in which the umbilical cord vessels branch prior to insertion into the
placenta?

a. placenta previa
b. placenta cervix
c. velamentous insertion
d. vasa previa

29.
What is a sign of fetal distress?

a. prolonged moderate variability

b. accelerations
c. repetitive late decelerations
d. variable decelerations

30.

Shoulder dystocia is difficult to predict. What are thought to be predictors for shoulder dystocia?
Select all that apply.

a. estimated birth weight of 4,000 g

b. gestational diabetes
c. previous shoulder dystocia
 d. oligohydramnios
e. hypertension
f. preterm delivery

31.
How soon should delivery of the fetus occur when a Category III FHR tracing is diagnosed?

a. 15 minutes
b. 30 minutes
c. 45 minutes
d. 60 minutes

32.
What is a complication of uterine rupture?

a. DIC
b. nuchal cord
c. polyhydramnios
d. oligohydramnios

33.
What is the nursing intervention for prolapsed cord?

a. Turn the person to the side.

b. Give the person oxygen.
c. Lift the presenting part off the cord.
d. Increase the oxytocin.

34.
At what point is the second stage considered prolonged for a nulliparous laboring person?

a. 1 hour
b. 2 hours
c. 3 hours
d. 4 hours

35.
What is a potential risk associated with prolonged second stage labor?

a. decreased risk of instrumental delivery

b. decreased risk of cesarean birth
c. increased risk of fetal distress
d. increased risk of rapid delivery

36.
What intervention may be used to manage failure to descend during labor?
 a. administering pain medication
b. allowing the patient to rest
c. continuing to push for an extended period of time
d. using forceps or a vacuum to assist delivery

37.
The placenta is diagnosed as retained when it is not delivered in what timeframe after the birth of
the infant?

a. 10 minutes
b. 30 minutes
c. 1 hour
d. 2 hours

38.
In a spontaneous abortion, if bleeding from the retained products of conception cannot be
stopped, what is the next course of action?

a. surgery for a dilation and curettage

b. surgery for a hysterectomy
c. administration of magnesium sulfate
d. administration of calcium gluconate

39.
What is the most common cause of placenta accreta?

a. malnutrition
b. smoking
c. previous cesarean birth
d. obesity

40.
How much blood loss must occur to define the loss as a postpartum hemorrhage?

a. 250 mL
b. 500 mL
c. 750 mL
d. 1,000 mL

41.
What medication is administered to treat uterine atony?

a. ampicillin
b. nitroglycerine
c. magnesium sulfate
d. methylergonovine
42.
What complication makes uterine inversion an emergency?

a. shock
b. pain
c. retained placenta
d. hypertension

43.
Decreased capillary refill, delay in milk production, and diminished peripheral pulses are signs
of what complication?

a. alteration in perfusion
b. alteration in liver function
c. alteration in kidney function
d. alteration in uterine function

44.
The nurse is caring for a postpartum person after a hemorrhage. How does the nurse monitor for
decreased perfusion?

a. Monitor lochia.
b. Measure blood loss.
c. Check temperature.
d. Monitor 24-hour urine output.

45.
What condition do restlessness, cyanosis, nasal flaring, orthopnea, and use of accessory muscles
indicate?

a. liver failure
b. alteration in oxygenation
c. preeclampsia
d. gestational diabetes

46.
The nurse will monitor for aspiration, thought processes, and improved mobility after which
complication?

a. neurologic dysfunction
b. kidney failure
c. gestational diabetes
d. postpartum hemorrhage

47.
What complications can cocaine and methamphetamine use in pregnancy cause?
a. seizures
b. hypotonic contractions
c. prolonged second stage labor
d. prolonged first stage labor