NS 1 QUIZ 3 OB 1

1. Which nursing assessment indicates that a woman who is in second-stage labor is almost ready
to give birth?
A. The fetal head is felt at 0 station during vaginal examination.
B. Bloody mucus discharge increases.
C. The vulva bulges and encircles the fetal head.
D. The membranes rupture during a contraction.

ANSWER C. During the active pushing (descent) phase, the woman has strong urges to bear down as
the presenting part of the fetus descends and presses on the stretch receptors of the pelvic floor. The
vulva stretches and begins to bulge encircling the fetal head. Birth of the head occurs when the station is
+4. A 0 station indicates engagement. Bloody show occurs throughout the labor process and is not an
indication of an imminent birth. Rupture of membranes can occur at any time during the labor process
and does not indicate an imminent birth

2. The nurse assesses a client in labor and finds that the fetal long axis is longitudinal to the
maternal long axis. The nurse documents this finding as which of the following?
A. Attitude
B. Lie
C. Position
D. Presentation

ANSWER B. The nurse is assessing fetal lie, the relationship of the fetal long axis to the maternal long
axis. When the fetal long axis is longitudinal to the maternal long axis, the lie is said to longitudinal.
Presentation is the portion of the fetus that overlies the maternal pelvic inlet. Attitude is the relationship
of the different fetal parts to one another. Position is the relationship of the fetal denominator to the
different sides of the maternal pelvis

3. The nurse should initially implement which intervention when a nulliparous woman telephones
the hospital to report that she is in labor.
A. Emphasize that food and fluid should stop or be light
B. Tell the woman to stay home until her membranes rupture
C. Ask the woman to describe why she believes that she is in labor
D. Arrange for the woman to come to the hospital for labor evaluation

ANSWER C. The nurse needs further information to assist in determining if the woman is in true or
false labor. She will need to ask the patient questions to seek further assessment and triage information.
Having her wait until membranes rupture may be dangerous, as she may give birth before reaching the
hospital. She should continue fluid intake until it is determined whether or not she is in labor. She may
be in false labor, and more information should be obtained before she is brought to the hospital.

4. The nurse is assessing the pH level of the vaginal environment of a 26-year-old client. Which of
the following would be an expected finding for this client?
A. pH level of 3.4
B. pH level of 4.6
 C. pH level of 5.7
D. pH level of 6.9

Answer B. The normal range for vaginal pH levels for a client during the childbearing years is 4.0-5.0. The
environment of the vagina is acidic. Below 4.0 is too low and above 5.0 is too high.

5. Which statement best describes the correct order of the four phases of the menstrual cycle?
A. Menstrual, follicular, secretory, ischemic
B. Luteal, follicular, secretory, menstrual
C. Menstrual, proliferative, secretory, ischemic
D. Luteal, secretory, ischemic, follicular

Answer C. Menstrual, proliferative, secretory, ischemic is the correct order for the four phases of the
menstrual cycle. There is no luteal or follicular phase in the menstrual cycle

6. When going through the transition phase of labor women often feel out of control. What do
women in the transition phase of labor need?
A. Their significant other beside them
B. Intense nursing care
C. Just to be left alone
D. Positive reinforcement

ANSWER D. Any women, even ones who have had natural childbirth classes, have a difficult time
maintaining positive coping strategies during this phase of labor. Many women describe feeling out of
control during this phase of labor. A woman in transition needs support, encouragement, and positive
reinforcement

7. The initial descent of the fetus into the pelvis to zero station is which one of the cardinal
movements of labor?
A. Engagement
B. Felxion
C. Extension
D. Expulsion

ANSWER A. The movement of the fetus into the pelvis from the upper uterus is engagement. This is
the first cardinal movement of the fetus in preparation for the spontaneous vaginal delivery. Flexion
occurs as the fetus encounters resistance from the soft tissues and muscles of the pelvic floor. Extension
is the state in which the fetal head is well flexed with the chin on the chest as the fetus travels through
the birth canal. Expulsion occurs after delivery of the anterior and posterior shoulders.

8. One of the theories about the onset of labor is the prostaglandin theory. While not being
conclusively proven that the action of prostaglandins initiate labor, it is known that
prostaglandins do play a role in labor. What is an action of prostaglandins?
A. Stimulates uterine muscle to relax
B. Softens cervix
C. Initiates relaxation of perineum
D. Initiates cervical dilation
ANSWER B. The prostaglandin theory is another theory of labor initiation. Prostaglandins influence
labor in several ways, which include softening the cervix and stimulating the uterus to contract. However,
evidence supporting the theory that prostaglandins are the agents that trigger labor to begin is
inconclusive

9. Which of the following would be least effective in promoting a positive birth outcome for a
woman in labor?
A. Promoting the woman's feelings of control
B. Providing clear information about procedures
C. Encouraging the woman to use relaxation techniques
D. Allowing the woman time to be alone

ANSWER D. Positive support, not being alone, promotes a positive birth experience. Being alone can
increase anxiety and fear, decreasing the woman's ability to cope. Feelings of control promote self-
confidence and self-esteem, which in turn help the woman to cope with the challenges of labor.
Information about procedures reduces anxiety about the unknown and fosters cooperation and self-
confidence in her abilities to deal with labor. Catecholamines are secreted in response to anxiety and
fear and can inhibit uterine blood flow and placental perfusion. Relaxation techniques can help to reduce
anxiety and fear, in turn decreasing the secretion of catecholamines and ultimately improving the
woman's ability to cope with labor

10. There are four essential components of labor. The first is the passageway. It is composed of the
bony pelvis and soft tissues. What is one component of the passageway?
A. Uterus
B. False pelvis
C. Cervix
D. Perineum

ANSWER C. The cervix and vagina are soft tissues that form the part of the passageway known as the
birth canal

11. A client in labor is agitated and nervous about the birth of her child. The nurse explains to the
client that fear and anxiety cause the release of certain compounds which can prolong labor.
Which of the following is the nurse referring to in the explanation?
A. Catecholamines
B. Relaxin
C. Prostaglandins
D. Oxytocin

ANSWER A. Fear and anxiety cause the release of catecholamines, such as norepinephrine and
epinephrine which stimulate the adrenergic receptors of the myometrium. This in turn interferes with
effective uterine contractions and results in prolonged labor. Estrogen promotes the release of
prostaglandins and oxytocin. Relaxin is a hormone that is involved in producing backache by acting on
the pelvic joints. Prostaglandins, oxytocin and relaxin are not produced due to fear or anxiety in clients
during labor
 12. A pregnant client tells the clinic nurse that she wants to know the sex of her baby as soon as it
can be determined. The nurse informs the client that she should be able to find out the sex at 12
weeks' gestation because of which factor?
A. The appearance of the fetal external genitalia
B. The beginning of differentiation in the fetal groin
C. The fetal testes are descended into the scrotal sac
D. The internal differences in males and females become apparent

ANSWER A. By the end of the twelfth week, the external genitalia of the fetus have developed to such a
degree that the sex of the fetus can be determined visually. Differentiation of the external genitalia
occurs at the end of the ninth week. Testes descend into the scrotal sac at the end of the thirty-eighth
week. Internal differences in the male and female occur at the end of the seventh week.

13. The nurse is performing an assessment on a client who is at 38 weeks' gestation and notes that
the fetal heart rate (FHR) is 174 beats/minute. On the basis of this finding, what is the priority
nursing action?
A. Document the finding.
B. Check the mother's heart rate.
C. Notify the health care provider (HCP).
D. Tell the client that the fetal heart rate is normal.

ANSWER C. The FHR depends on gestational age and ranges from 160 to 170 beats/minute in the first
trimester, but slows with fetal growth to 110 to 160 beats/minute near or at term. At or near term, if the
FHR is less than 110 beats/minute or more than 160 beats/minute with the uterus at rest, the fetus may
be in distress. Because the FHR is increased from the reference range, the nurse should notify the HCP.
Options 2 and 4 are inappropriate actions based on the information in the question. Although the nurse
documents the findings, based on the information in the question, the HCP needs to be notified.

14. Which hormone is necessary for a positive pregnancy test?

A. Progesterone
B. Human chorionic gonadotropin
C. Estrogen
D. Lactogen

ANSWER: B Human chorionic gonadotropin is a hormone produced primarily by syncytiotrophoblastic

cells of the placenta during pregnancy. The hormone stimulates the corpus luteum to produce
progesterone to maintain the pregnancy

15. When teaching Aling Nena about her pregnancy, you should include personal common
discomforts. Which of the following is an indication for prompt professional supervision?
A. Constipation and hemorrhoids
B. Backache
C. Facial edema
D. Frequency of urination
ANSWER: C Choices A, B, and D are common discomforts during pregnancy that can be easily avoided
or attended to by the mother. Choice C however is an indication that the mother may have pregnancy
induced hypertension and needs immediate professional help.

16. Which of the following statements would be appropriate for you to include in Aling Nena’s
prenatal teaching plan?
A. Exercise is very stressful, it is not recommended
B. Limit your food intake to vegetables only
C. Alcohol has no harmful effects on the fetus
D. Avoid unnecessary fatigue, rest periods should be included in your schedule

ANSWER: D Exercises are still needed during pregnancy, especially pelvic muscle exercises in order to
facilitate easy delivery. The mother should never limit her food intake to vegetables only since she needs
other sources of food that is rich in protein and other nutrients. Alcohol can have a harmful effect on the
fetus which can cause fetal alcohol syndrome. Letter D is the correct answer, unnecessary fatigue can
stress the mother especially if the mother is working, this can sometimes have an effect on pregnancy.
Rest periods should always be included.

17. An adolescent boy asks, "Does the scrotum have a function?" The nurse's best response is:
A. "The scrotum maintains a higher temperature than the core body temperature."
B. "The scrotum is an insensitive structure that houses the testicles."
C. "The scrotum is the source of ejaculation."
D. "The scrotum helps to protect the testes and provides an ideal environment to create sperm."

Answer D. The scrotum's main purpose is to protect the testes and maintain a temperature that is lower
than body temperature so spermatogenesis can occur. Because it is sensitive to touch, pain, and
pressure, the scrotum defends against potential harm to the testes. Ejaculation occurs with sexual
stimulation and expulsion of semen by rhythmic contractions of the penile muscles.

18. A nurse is teaching a sex education class about the female reproductive system for 6th-grade
girls in a local middle school. The nurse explains that the primary components of the external
female reproductive system are:
A. The clitoris, vaginal canal, and perineal body.
B. The labia, clitoris, and urethra.
C. The mons, labia, and clitoris.
D. The mons, labia, and vagina.

Answer C. The mons, labia, and the clitoris make up part of the external female reproductive system.
They can be seen directly and inspected. The vaginal canal, urethra, and vagina are all part of the
internal female reproductive system.

19. The couple has finally chosen the intrauterine device as a method of contraception. Nurse Dina
must inform Aling Sion of which of the following?
A. Breast tenderness after insertion of the IUD
B. Vaginal discoloration 1 week after insertion of the IUD
C. Amenorrhea for 6 months after the insertion of the IUD
D. Vaginal spotting and uterine cramping during the first 2 or 3 weeks after IUD insertion.
ANSWER: D The most common discomfort the female can have related to IUD is Letter D. Choices B, C,
and D are not related with IUD usage.

20. The nursing instructor asks a nursing student to explain the characteristics of the amniotic fluid.
The student responds correctly by explaining which as characteristics of amniotic fluid? Select all
that apply.
A. Allows for fetal movement
B. Surrounds, cushions, and protects the fetus
C. Maintains the body temperature of the fetus
D. Can be used to measure fetal kidney function
E. All of the above

ANSWER E. Rationale: The amniotic fluid surrounds, cushions, and protects the fetus. It allows the
fetus to move freely and maintains the body temperature of the fetus. In addition, the amniotic fluid
contains urine from the fetus and can be used to assess fetal kidney function. The placenta prevents
large particles such as bacteria from passing to the fetus and provides an exchange of nutrients and
waste products between the mother and the fetus.

21. The nurse should make which statement to a pregnant client found to have a gynecoid pelvis?
A. "Your type of pelvis has a narrow pubic arch."
B. "Your type of pelvis is the most favorable for labor and birth."
C. "Your type of pelvis is a wide pelvis, but it has a short diameter."
D. "You will need a cesarean section because this type of pelvis is not favorable for a vaginal
delivery."

ANSWER B. A gynecoid pelvis is a normal female pelvis and is the most favorable for successful labor
and birth. An android pelvis (resembling a male pelvis) would be unfavorable for labor because of the
narrow pelvic planes. An anthropoid pelvis has an outlet that is adequate, with a normal or moderately
narrow pubic arch. A platypelloid pelvis (flat pelvis) has a wide transverse diameter, but the
anteroposterior diameter is short, making the outlet inadequate.

22. Which purposes of placental functioning should the nurse include in a prenatal class? Select all
that apply.
A. It cushions and protects the baby.
B. It maintains the temperature of the baby.
C. It is the way the baby gets food and oxygen.
D. It prevents all antibodies and viruses from passing to the baby.

ANSWER C. The placenta provides an exchange of oxygen, nutrients, and waste products between the
mother and the fetus. The amniotic fluid surrounds, cushions, and protects the fetus and maintains the
body temperature of the fetus. Nutrients, medications, antibodies, and viruses can pass through the
placenta.

23. The nurse would expect which maternal cardiovascular finding during labor?
A. Increased cardiac output
B. Decreased pulse rate
C. Decreased white blood cell (WBC) count
 D. Decreased blood pressure

ANSWER A. During each contraction, 400 mL of blood is emptied from the uterus into the maternal
vascular system. This increases cardiac output by about 51% above baseline pregnancy values at term.
The heart rate increases slightly during labor. The WBC count can increase during labor. During the first
stage of labor, uterine contractions cause systolic readings to increase by about 10 mm Hg. During the
second stage, contractions may cause systolic pressures to increase by 30 mm Hg and diastolic readings
to increase by 25 mm Hg.

24. The factors that affect the process of labor and birth, known commonly as the five Ps, include all
except:
A. Passenger.
B. Powers.
C. Passageway.
D. Pressure.

ANSWER D. The five Ps are passenger (fetus and placenta), passageway (birth canal), powers
(contractions), position of the mother, and psychologic response.

25. The slight overlapping of cranial bones or shaping of the fetal head during labor is called:
A. Lightening.
B. Molding.
C. Ferguson reflex.
D. Valsalva maneuver.

ANSWER B. Fetal head formation is called molding. Molding also permits adaptation to various
diameters of the maternal pelvis. Lightening is the mother's sensation of decreased abdominal
distention, which usually occurs the week before labor. The Ferguson reflex is the contraction urge of the
uterus after stimulation of the cervix. The Valsalva maneuver describes conscious pushing during the
second stage of labor

26. Which description of the four stages of labor is correct for both definition and duration?
A. First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours
B. Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours
C. Third state: active pushing to birth; 20 minutes (multiparous women), 50 minutes (first-timer)
D. Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour

ANSWER A. Full dilation may occur in less than 1 hour, but in first-time pregnancies it can take up to 20
hours. The second stage extends from full dilation to birth and takes an average of 20 to 50 minutes,
although 2 hours is still considered normal. The third stage extends from birth to expulsion of the
placenta and usually takes a few minutes. The fourth stage begins after expulsion of the placenta and
lasts until homeostasis is reestablished (about 2 hours)

27. With regard to factors that affect how the fetus moves through the birth canal, nurses should be
aware that:
A. The fetal attitude describes the angle at which the fetus exits the uterus.
B. Of the two primary fetal lies, the horizontal lie is that in which the long axis of the fetus is
parallel to the long axis of the mother.
 C. The normal attitude of the fetus is called general flexion.
D. The transverse lie is preferred for vaginal birth.

ANSWER C. The normal attitude of the fetus is general flexion. The fetal attitude is the relation of fetal
body parts to one another. The horizontal lie is perpendicular to the mother; in the longitudinal (or
vertical) lie the long axes of the fetus and the mother are parallel. Vaginal birth cannot occur if the fetus
stays in a transverse lie

28. Which statement is the best rationale for assessing maternal vital signs between contractions?
A. During a contraction, assessing fetal heart rates is the priority.
B. Maternal circulating blood volume increases temporarily during contractions.
C. Maternal blood flow to the heart is reduced during contractions.
D. Vital signs taken during contractions are not accurate

ANSWER B. During uterine contractions, blood flow to the placenta temporarily stops, causing a
relative increase in the mother's blood volume, which in turn temporarily increases blood pressure and
slows pulse. It is important to monitor fetal response to contractions; however, this question is
concerned with the maternal vital signs. Maternal blood flow is increased during a contraction. Vital
signs are altered by contractions but are considered accurate for that period of time.

29. While providing care to a patient in active labor, the nurse should instruct the woman that:
A. The supine position commonly used in the United States increases blood flow.
B. The "all fours" position, on her hands and knees, is hard on her back.
C. Frequent changes in position will help relieve her fatigue and increase her comfort.
D. In a sitting or squatting position, her abdominal muscles will have to work harder.

ANSWER C. Frequent position changes relieve fatigue, increase comfort, and improve circulation.
Blood flow can be compromised in the supine position; any upright position benefits cardiac output. The
"all fours" position is used to relieve backache in certain situations. In a sitting or squatting position, the
abdominal muscles work in greater harmony with uterine contractions

30. To teach patients about the process of labor adequately, the nurse knows that which event is the
best indicator of true labor?
A. Bloody show
B. Cervical dilation and effacement
C. Fetal descent into the pelvic inlet
D. Uterine contractions every 7 minutes

ANSWER B. The conclusive distinction between true and false labor is that contractions of true labor
cause progressive change in the cervix. Bloody show can occur before true labor. Fetal descent can occur
before true labor. False labor may have contractions that occur this frequently; however, this is usually
inconsistent

31. Which occurrence is associated with cervical dilation and effacement?

A. Bloody show
B. Lightening
C. False labor
D. Bladder distention
ANSWER A. As the cervix begins to soften, dilate, and efface, expulsion of the mucous plug that
sealed the cervix during pregnancy occurs. This causes rupture of small cervical capillaries. Cervical
dilation and effacement do not occur with false labor. Lightening is the descent of the fetus toward the
pelvic inlet before labor. Bladder distention occurs when the bladder is not emptied frequently. It may
slow down the descent of the fetus during labor

32. When teaching Aling Nena about her pregnancy, you should include personal common
discomforts. Which of the following is an indication for prompt professional supervision?
A. Constipation and hemorrhoids
B. Backache
C. Facial edema
D. Frequency of urination

ANSWER: C. Choices A, B, and D are common discomforts during pregnancy that can be easily avoided
or attended to by the mother. Choice C however is an indication that the mother may have pregnancy
induced hypertension and needs immediate professional help.

33. Which of the following statements would be appropriate for you to include in Aling Nena’s
prenatal teaching plan?
A. Exercise is very stressful, it is not recommended
B. Limit your food intake to vegetables only
C. Alcohol has no harmful effects on the fetus
D. Avoid unnecessary fatigue, rest periods should be included in your schedule

ANSWER: D Exercises are still needed during pregnancy, especially pelvic muscle exercises in order to
facilitate easy delivery. The mother should never limit her food intake to vegetables only since she needs
other sources of food that is rich in protein and other nutrients. Alcohol can have a harmful effect on the
fetus which can cause fetal alcohol syndrome. Letter D is the correct answer, unnecessary fatigue can
stress the mother especially if the mother is working, this can sometimes have an effect on pregnancy.
Rest periods should always be included.

SITUATION: Rodrigo a 35-year-old male and Leni a 33-year-old female is visiting a fertility clinic. The
couple has mentioned that they have been married for 7 years and have been trying since then to
conceive a child. They have always been unsuccessful. It was found out that the female has obstructed
fallopian tubes. The physician has recommended the couple to undergo in vitro fertilization (IVF).

34. The nurse must know that the process of in vitro fertilization involves which of the following
procedures?
A. Oophorectomy
B. Laparoscopy
C. Salpingectomy
D. Drug therapy

ANSWER: B Laparoscopy is utilized to obtain one or more oocytes from the woman’s ovary and fertilized
by exposure to sperm in a laboratory.
Case Scenario:

Miss. Julia, a 30-year-old Filipino woman, is admitted to the labor and delivery unit. She is pregnant with
her first child and is currently in the active phase of labor. Her cervix is dilated to 6 centimeters, and
contractions are occurring every 3-4 minutes. The healthcare provider has decided to closely monitor
Julia's progress during this stage.

35. During which stage of labor is Miss. Julia currently in?

A. Latent phase
B. Active phase
C. Transition phase
D. Second stage

Answer B. Active phase The active phase of labor begins when the cervix is dilated around 4-6
centimeters and lasts until the cervix is fully dilated at 10 centimeters. During this stage, contractions
become stronger, longer, and more frequent.

36. Miss. Julia's contractions are occurring every 3-4 minutes. What is the duration of each
contraction during the active phase?
A. 10-20 seconds
B. 30-40 seconds
C. 50-60 seconds
D. 70-80 seconds

Answer C. 50-60 seconds. During the active phase of labor, contractions typically last 50-60 seconds.

37. Which of the following is a characteristic of contractions during the active phase?
A. Occur every 15-20 minutes
B. Mild in intensity
C. Last 30-45 seconds
D. Felt primarily in the lower back

Answer C. Last 30-45 seconds. Contractions during the active phase of labor are typically longer in
duration, lasting approximately 30-45 seconds.

38. Miss. Julia's cervix is dilated to 6 centimeters. What does this indicate?
A. Transition phase of labor
B. Complete cervical dilation
C. Early labor stage
D. Active labor stage

Answer D. Active labor stage. A cervical dilation of 6 centimeters is considered part of the active labor
stage.

39. During the active phase of labor, what position is typically recommended for the mother?
A. Supine position
B. Trendelenburg position
 C. Semi-Fowler's position
D. Side-lying position

Answer D. Side-lying position. The side-lying position is often recommended during the active phase of
labor to enhance maternal comfort and promote optimal fetal oxygenation.

40. Miss. Julia's labor is progressing normally. How frequently should her cervical dilation be
assessed during the active phase?
A. Every hour
B. Every 2 hours
C. Every 4 hours
D. Every 6 hours

Answer: b. Every 2 hours. During the active phase of labor, cervical dilation should be assessed every 2
hours to monitor progress and identify any deviations.

41. Miss. Julia's labor is progressing slowly. What intervention might the healthcare provider
consider?
A. Amniotomy
B. Administration of oxytocin
C. Epidural anesthesia
D. Fundal massage

Answer: b. Administration of oxytocin. If labor progresses slowly during the active phase, the healthcare
provider may consider administering oxytocin (Pitocin) to augment or stimulate contractions.

42. Miss. Julia is experiencing pain during the active phase of labor. Which nursing intervention is
most appropriate?
A. Offer her a warm bath or shower.
B. Administer opioid analgesics.
C. Encourage frequent position changes.
D. Apply a cold pack to her lower abdomen.

Answer: c. Encourage frequent position changes. Encouraging frequent position changes during the
active phase of labor can help alleviate pain by promoting comfort, facilitating optimal fetal descent, and
relieving pressure on specific areas.

43. Miss. Julia's partner asks about the signs of progress during the active phase of labor. Which
response by the nurse is accurate?
A. "The cervix will be fully dilated."
B. "The baby's head will descend into the pelvis."
C. "The contractions will become less frequent."
D. "The mother will feel a strong urge to push."

Answer: b. "The baby's head will descend into the pelvis." During the active phase of labor, a sign of
progress is the descent of the baby's head into the pelvis, indicating that labor is advancing.

44. Miss. Julia requests an epidural for pain relief. What should the nurse inform her about the
potential side effects of an epidural?
 A. Decreased blood pressure
B. Increased fetal heart rate
C. Rapid cervical dilation
D. Prolonged labor duration

Answer: a. Decreased blood pressure. Epidurals can cause a decrease in blood pressure as a side effect
due to the effects of the medication on the sympathetic nervous system.

45. Miss. Julia has an epidural in place. What nursing action is essential to prevent complications
related to the epidural anesthesia?
A. Encourage deep breathing and relaxation techniques.
B. Monitor maternal and fetal vital signs regularly.
C. Administer a bolus of intravenous fluids.
D. Assist with pushing during contractions.

Answer: b. Monitor maternal and fetal vital signs regularly. Regular monitoring of maternal and fetal vital
signs is essential when an epidural anesthesia is in place to detect any potential complications, such as
hypotension or fetal distress.

46. Miss. Julia's labor progresses, and she enters the second stage. What is the primary
characteristic of the second stage of labor?
A. Full cervical dilation
B. Onset of regular contractions
C. Strong urge to push
D. Rupture of membranes

Answer: c. Strong urge to push. The primary characteristic of the second stage of labor is the maternal
urge to bear down and push, indicating full cervical dilation and fetal descent.

47. Miss. Julia is in the second stage of labor. What position is most advantageous for pushing?
A. Supine position with legs elevated
B. Semi-Fowler's position
C. Side-lying position
D. Squatting position

Answer: d. Squatting position. The squatting position is most advantageous for pushing during the
second stage of labor as it increases the pelvic outlet diameter and utilizes gravity to aid in the descent
of the baby.

48. Miss. Julia's contractions become less frequent during the second stage. What should the nurse
do?
A. Administer oxytocin to stimulate contractions.
B. Encourage Miss. Julia to push harder during contractions.
C. Reassure Miss. Julia that this is a normal part of labor.
D. Notify the healthcare provider immediately.

Answer: c. Reassure Miss. Julia that this is a normal part of labor. During the second stage of labor,
contractions may become less frequent but more intense. This is a normal part of labor as the body
prepares for the birth of the baby. Reassuring Miss. Julia that this is a normal occurrence can help
alleviate her concerns.

49. Miss. Julia's baby's head begins to emerge during the second stage of labor. What should the
nurse do to facilitate the birth?
A. Apply gentle pressure to the perineum.
B. Perform an episiotomy.
C. Administer an oxytocic medication.
D. Prepare for immediate resuscitation of the newborn.

Answer: a. Apply gentle pressure to the perineum. Applying gentle pressure to the perineum during the
birth of the baby's head can help prevent rapid stretching and tearing, facilitating a controlled birth.

50. Miss. Julia delivers her baby's head, but the shoulder remains impacted. What maneuver should
the nurse perform?
A. McRoberts maneuver
B. Suprapubic pressure
C. Episiotomy
D. Fundal pressure

Answer: a. McRoberts maneuver. If the baby's shoulder remains impacted after the delivery of the head
(shoulder dystocia), the McRoberts maneuver is performed. This involves flexing the mother's legs
toward her shoulders to increase the pelvic outlet diameter and facilitate the release of the impacted
shoulder.

51. Miss. Julia delivers her baby, and the healthcare provider performs fundal massage. What is the
purpose of this intervention?
A. Promote placental separation and prevent hemorrhage
B. Assess the perineum for tears or lacerations
C. Facilitate expulsion of the umbilical cord
D. Evaluate the baby's Apgar score

Answer: a. Promote placental separation and prevent hemorrhage. Fundal massage is performed after
delivery to promote uterine contractions, aid in placental separation, and prevent postpartum
hemorrhage by compressing the blood vessels at the placental site.

52. Miss. Julia delivers her placenta, but the nurse notes that a portion of the placenta remains in
the uterus. What is the priority nursing intervention?
A. Administer oxytocin to stimulate uterine contractions.
B. Prepare for immediate manual removal of the placenta.
C. Encourage Miss. Julia to breastfeed her baby.
D. Assess vital signs and monitor for signs of infection.

Answer: b. Prepare for immediate manual removal of the placenta. If a portion of the placenta remains
in the uterus after delivery, it can lead to complications such as postpartum hemorrhage or infection.
The priority nursing intervention is to prepare for the immediate manual removal of the placenta under
the guidance of a healthcare provider.
 53. Miss. Julia is in the third stage of labor. What nursing action should be prioritized during this
stage?
A. Monitoring the baby's vital signs
B. Assessing the perineum for lacerations
C. Encouraging breastfeeding initiation
D. Monitoring maternal vital signs and uterine contraction

Answer: d. Monitoring maternal vital signs and uterine contraction. During the third stage of labor, the
nurse should prioritize monitoring the mother's vital signs, including blood pressure and pulse, as well as
assessing uterine contraction to ensure the uterus is firmly contracted to prevent postpartum
hemorrhage.

54. Miss. Julia's baby is born, and the nurse assesses the Apgar score. The baby has a heart rate of
90, slow, irregular respirations, some flexion of extremities, a weak cry, and a pink body with
blue hands and feet. What is the Apgar score for this baby?
A. 5
B. 6
C. 7
D. 8

Answer: c. 7. The Apgar score is a quick assessment of a newborn's physical condition at 1 and 5 minutes
after birth. The criteria assessed include heart rate, respiratory effort, muscle tone, reflex irritability, and
color. In this case, the baby scores 1 point for heart rate (90 beats per minute), 1 point for respiratory
effort (slow, irregular respirations), 1 point for muscle tone (some flexion of extremities), 1 point for
reflex irritability (weak cry), and 3 points for color (pink body with blue hands and feet). Adding the
points together, the Apgar score is 7.

55. Miss. Julia's baby is experiencing acrocyanosis. What is the nurse's appropriate action?
A. Notify the healthcare provider immediately.
B. Administer oxygen supplementation.
C. Document the finding in the baby's chart.
D. Initiate cardiopulmonary resuscitation (CPR).

Answer: c. Document the finding in the baby's chart. Acrocyanosis, which refers to blue hands and feet,
is a common finding in newborns. It is a normal variation and does not require any immediate
intervention. The nurse should document this finding in the baby's chart for future reference.

56. Miss. Julia is interested in breastfeeding her baby. What should the nurse do to support
successful breastfeeding initiation?
A. Offer the baby a pacifier to soothe sucking reflexes.
B. Position the baby in a semi-upright position.
C. Encourage Miss. Julia to breastfeed within the first hour.
D. Supplement breastfeeding with formula to meet nutritional needs.

Answer: c. Encourage Miss. Julia to breastfeed within the first hour. To support successful breastfeeding
initiation, it is crucial to encourage Miss. Julia to breastfeed within the first hour after birth. This helps
promote bonding, stimulates milk production, and establishes breastfeeding as early as possible.
 57. Miss. Julia's baby is having difficulty latching onto the breast. What should the nurse suggest to
improve latching?
A. Apply lanolin cream to the nipples.
B. Use a nipple shield during breastfeeding.
C. Massage the breasts to stimulate milk flow.
D. Ensure proper positioning and latch technique.

Answer: d. Ensure proper positioning and latch technique. When a baby has difficulty latching onto the
breast, the nurse should suggest ensuring proper positioning and latch technique. This includes aligning
the baby's nose to the nipple, aiming the nipple toward the baby's upper lip, and ensuring a wide mouth
opening for effective latch.

58. Miss. Julia asks about the benefits of rooming-in with her baby. What should the nurse explain?
A. Rooming-in promotes better sleep for the baby.
B. Rooming-in increases the risk of infection transmission.
C. Rooming-in enhances bonding and breastfeeding.
D. Rooming-in allows more rest for the mother.

Answer: c. Rooming-in enhances bonding and breastfeeding. Rooming-in, where the mother and baby
stay together in the same room, promotes bonding between the mother and baby and facilitates
breastfeeding initiation and establishment. It allows for close proximity, facilitates frequent
breastfeeding, and promotes the development of a strong mother-infant relationship.

59. Miss. Julia asks about the signs that her baby is getting enough breast milk. What should the
nurse include in the response?
A. Frequent urination and yellow, seedy stools
B. Sleeping for longer durations between feedings
C. Rapid weight loss during the first week
D. Decreased frequency of breastfeeding

Answer: a. Frequent urination and yellow, seedy stools. Signs that indicate a baby is receiving enough
breast milk include frequent urination (at least 6-8 wet diapers per day) and the passage of yellow, seedy
stools. These signs indicate that the baby is adequately hydrated and receiving appropriate nutrition.

60. Miss. Julia expresses concern about postpartum blues. What should the nurse explain about this
condition?
A. Postpartum blues is a severe form of depression that requires immediate treatment.
B. Postpartum blues is a normal, self-limiting condition that resolves on its own.
C. Postpartum blues only occurs in women who have a history of mental illness.
D. Postpartum blues typically persists for several months after delivery.

Answer: b. Postpartum blues is a normal, self-limiting condition that resolves on its own. Postpartum
blues, characterized by mood swings, tearfulness, and mild depression, is a common condition
experienced by many women after childbirth. It is a self-limiting condition that typically resolves without
specific treatment within a few weeks.

61. Miss. Julia asks when she can expect her menstrual cycle to return after childbirth. What is the
nurse's best response?
 A. "Your menstrual cycle will return within a week after delivery."
B. "Your menstrual cycle will return within a month after weaning."
C. "Your menstrual cycle will return within 3-6 months after delivery."
D. "Your menstrual cycle will return after your first postpartum check-up."

Answer: c. "Your menstrual cycle will return within 3-6 months after delivery." The return of the
menstrual cycle varies among women. Typically, it takes 3-6 months for the menstrual cycle to resume
after childbirth. However, this can be influenced by factors such as breastfeeding and individual
variations.

62. Miss. Julia asks about contraception options while breastfeeding. What should the nurse
recommend?
A. Combined hormonal contraceptives (pill, patch, ring)
B. Intrauterine device (IUD)
C. Barrier methods (condoms, diaphragm)
D. Progestin-only contraceptives (mini-pill, implant)

Answer: d. Progestin-only contraceptives (mini-pill, implant). Progestin-only contraceptives, such as the

mini-pill or implant, are generally considered safe and effective options for breastfeeding mothers.

63. Miss. Julia's cervix is fully dilated and effaced. What is the nurse's priority action during this
stage of labor?
A. Prepare for immediate delivery.
B. Assist with pushing efforts during contractions.
C. Monitor fetal heart rate continuously.
D. Administer pain relief medications.

Answer: c. Monitor fetal heart rate continuously. When the cervix is fully dilated and effaced, it signifies
the beginning of the second stage of labor. Continuous monitoring of the fetal heart rate is essential
during this stage to assess the baby's well-being and ensure a safe delivery.

64. Miss. Julia's contractions have slowed down, and she is feeling exhausted. What nursing
intervention can help facilitate labor progress?
A. Encourage Miss. Julia to rest and conserve energy.
B. Administer an oxytocin infusion to strengthen contractions.
C. Prepare for an immediate cesarean section.
D. Assist Miss. Julia with breathing exercises.

Answer: a. Encourage Miss. Julia to rest and conserve energy. Slowed contractions and exhaustion can
occur during labor. Encouraging Miss. Julia to rest, change positions, or engage in relaxation techniques
can help conserve energy and promote labor progress. Intervention such as oxytocin infusion or
cesarean section may be considered based on the healthcare provider's assessment.

65. Why is progesterone or luteinizing hormone prescribed to a woman after undergoing IVF?

A. Due to the blockage of the fallopian tubes

B. Hormonal imbalances brought about by the procedure
C. The corpus luteum can be injured by the aspiration of the follicle
 D. Due to cysts growing on the mother’s ovaries

ANSWER: C One of the common occurrences in aspirating ova from the female’s ovaries is that the
needle tends to rupture the corpus luteum which is responsible for producing progesterone.