1.

The fetus of a woman you care for during labor is in a vertex presentation
and at a 1 station. You would interpret this to mean that the fetal head is
A) at the ischial spines.
B) engaged.
C) floating
D) crowning.

2. Which of the following would be a danger signal of labor for a woman in

labor?
A) Blood-tinged vaginal discharge at full dilation.
B) Meconium-stained amniotic fluid.
C) Maternal pulse of 90 to 95 beats/minute.
D) Fetus presenting in an L0A position.

3. Dilation follows effacement in the primipara. Full dilation is a usual distance

of
A) 3 to 4 cm.
B) 7 to 8 cm.
C) 8 to 10 cm.
D) 12 to 14 cm.

4. To assess the frequency of a woman's labor contractions, you would time

A) the beginning of one contraction to the beginning of the next.
B) the end of one contraction to the beginning of the next.
C) the interval between the acme of two consecutive contractions.
D) how many contractions occur in 5 minutes.

5. You place an external fetal monitor on a woman in labor. Which of the

following instructions would be best to give her?
A) Lie supine so the tracing does not show a shadow.

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B) Avoid flexing her knees so her abdomen is not tense.

C) Lie on her side so she is comfortable.
D) Avoid using her call bell to reduce interference.

6. If a fetus were not receiving enough oxygen during labor because of

uteroplacental insufficiency, which of the following patterns would you
anticipate seeing on the monitor?
A) A shallow deceleration occurring with the beginning of contractions.
B) Variable decelerations, too unpredictable to count.
C) Fetal baseline rate increasing at least 5 mm Hg with contractions.
D) Fetal heart rate declining late with contractions and remaining
depressed.
7. If the monitor pattern of uteroplacental insufficiency were present, which of
the following would you do first?
A) Help the woman to sit up in a semi-Fowler's position.
B) Turn her or ask her to turn to her side.
C) Administer oxygen at 3 to 4 L by nasal cannula.
D) Ask her to pant with the next contraction.

8. A woman asks you if she can eat something during labor. Which of the
following would be your best response?
A) You could have some hard candy to suck on.
B) Stomach-emptying time increases during labor, so food is not advised.
C) Most women in labor need to drink a protein supplement.
D) Eating during labor is recommended because it increases the frequency
of contractions.
9. A woman's physician has told her he wants to use an episiotomy for
delivery. She asks you what the purpose of this is. Which of the following
would be your best answer?
A) It prevents distention of the bladder.
B) It relieves pressure on the fetal head.

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C) It aids contraction of the uterus following delivery.

D) It is done primarily for the physician's benefit.

10. As a woman enters the second stage of labor, which of the following would
you expect to assess?
A) Feelings of being frightened by the change in contractions.
B) Complaints of feeling hungry and unsatisfied.
C) Falling asleep from exhaustion.
D) Expressions of satisfaction with her labor progress.

11. As a woman enters the second stage of labor, her membranes

spontaneously rupture. When this occurs, which of the following would you
do next?
A) Test a sample of amniotic fluid for protein.
B) Ask her to bear down with the next contraction.
C) Elevate her hips to prevent cord prolapse.
D) Assess fetal heart rate (FHR) for fetal safety.

12. During the second stage of labor, a woman is generally

A) very aware of activities immediately around her.
B) anxious to have people around her.
C) no longer in need of a support person.
D) turning inward to concentrate on body sensations.

13. To deliver her infant, a woman is asked to push with contractions. Which of
the following is the most effective and safest pushing technique to teach
her?
A) Lying supine with legs in lithotomy stirrups.
B) Squatting while holding her breath.
C) Head elevated, grasping knees, breathing out.

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D) Lying on side, arms grasped on abdomen.

14. A woman is admitted to a labor unit in active labor. Which of the following
assessments would alert you to the possibility that she may have difficulty
accepting this child?
A) I'm so tired of being pregnant.
B) I haven't been able to sleep well lately.
C) I want this baby to be a boy.
D) I am so exhausted.

15. The first stage of labor is often a time of introspection. In light of this, which
of the following would guide your planning of nursing care?
A) A woman should be left entirely alone during this period.
B) A woman will rarely speak or laugh during this period.
C) A woman may spend time thinking about what is happening to her.
D) No nursing care is needed to be done during this time.

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