Stages of Labor and Delivery: Comprehensive Guide for Nursing Students

Question 1

Which of the following nursing interventions is used to prevent perineal tears?

Accepted Answer

Controlled delivery of the baby's head

Answer

Routine episiotomy

Answer

Warm perineal compresses

Answer

Application of ice packs

Question 2

Which of the following medications is commonly used to induce labor?

Accepted Answer

Oxytocin

Answer

Meperidine

Answer

Magnesium sulfate

Answer

Epidural anesthesia

Question 3

During the active phase of the first stage of labor, which nursing intervention is most appropriate?

Accepted Answer

Providing continuous labor support

Answer

Administering IV fluids

Answer

Promoting rest and relaxation

Question 4

How is cervical dilation typically measured during labor?

Accepted Answer

Vaginal exam

Answer

Uterine palpation

Answer

Fetal heart monitoring

Answer

Ultrasound

Question 5

To provide personalized care during labor, how should a nurse adapt nursing interventions to meet the unique needs and preferences of each woman?

Accepted Answer

Continuously assess the woman's physical and emotional well-being throughout labor.

Answer

Follow a rigid protocol for all women in labor.

Answer

Give instructions to the woman and expect her to follow them strictly.

Question 6

Which of the following is a characteristic of true labor contractions?

Accepted Answer

Occur irregularly and intensify over time

Answer

Relieved by walking or changing positions

Answer

Confined to the lower abdomen

Answer

Accompanied by bloody show

Question 7

Which of the following fetal heart rate patterns is considered reassuring during labor?

Accepted Answer

Variable decelerations

Answer

Bradycardia

Answer

Tachycardia

Answer

Late decelerations

Question 8

Which type of anesthesia is most commonly used for vaginal deliveries?

Accepted Answer

Regional anesthesia

Answer

General anesthesia

Answer

Local anesthesia

Answer

Conscious sedation

Question 9

During labor, which hormone is primarily responsible for triggering uterine contractions?

Accepted Answer

Oxytocin

Answer

Estrogen

Answer

Progesterone

Answer

Relaxin

Question 10

Which sign is NOT typically associated with the onset of labor?

Accepted Answer

Increased fetal movement

Answer

Bloody show

Answer

Regular contractions

Answer

Lightening

Question 11

The nurse's primary focus during the transition phase of labor should be on:

Accepted Answer

Providing emotional support and encouragement

Answer

Administering pain medication

Answer

Monitoring fetal heart tones

Answer

Facilitating pushing

Question 12

The primary goal of fundal massage in the immediate postpartum period is to:

Accepted Answer

Promote uterine involution and reduce bleeding

Answer

Prevent postpartum hemorrhage

Answer

Reduce pain

Answer

Stimulate lactation

Question 13

Which of the following is NOT typically considered an imminent sign of labor?

Accepted Answer

Sudden weight gain

Answer

Bloody show (mucus plug with blood streaks)

Answer

Increased vaginal discharge

Answer

Pelvic pressure or a feeling that the baby is 'dropping'

Question 14

Which nursing intervention is most appropriate during the second stage of labor?

Accepted Answer

Encouraging the mother to push during contractions

Answer

Administering an epidural anesthetic

Answer

Performing a gentle massage on the mother's back

Answer

Monitoring the fetal heart rate every 15 minutes

Question 15

Which of the following is a life-threatening obstetrical emergency that can occur during labor?

Accepted Answer

Uterine rupture

Answer

Breech presentation

Answer

Low amniotic fluid

Answer

Normal labor

Question 16

During the first stage of labor, which physiological change is most prominent?

Accepted Answer

Uterine contractions intensify, leading to cervical effacement and dilation.

Answer

Cervical dilation reaches 10 cm, enabling fetal passage.

Answer

Amniotic sac ruptures, releasing amniotic fluid.

Answer

Fetus descends into the pelvic cavity.

Question 17

Which of the following is NOT a reliable sign of the onset of labor?

Accepted Answer

Fetal heart rate below 120 bpm

Answer

Bloody show

Answer

Regular uterine contractions

Question 18

Which of the following is a potential complication of the second stage of labor?

Accepted Answer

Shoulder dystocia

Answer

Abruptio placenta

Answer

Uterine inversion

Answer

Eclampsia

Question 19

What is the first cardinal movement of fetal descent?

Accepted Answer

Engagement

Answer

Internal rotation

Answer

Flexion

Question 20

What is the primary purpose of episiotomy?

Accepted Answer

To prevent severe perineal lacerations

Answer

To reduce the risk of postpartum hemorrhage

Answer

To relieve pain

Answer

To facilitate the delivery of the baby's head

Question 21

What does the Apgar score assess?

Accepted Answer

Neonatal well-being

Answer

Maternal health

Answer

Uterine contractions

Answer

Fetal heart rate

Question 22

What is the fundamental difference between vaginal delivery and cesarean delivery?

Accepted Answer

Vaginal delivery occurs through the birth canal, while cesarean delivery occurs through an abdominal incision.

Answer

Vaginal delivery is more painful than cesarean delivery.

Question 23

Which of the following physiological changes primarily occurs during the first stage of labor?

Accepted Answer

Cervical effacement and dilation

Answer

Show

Answer

Uterine contractions

Answer

Placental separation

Question 24

What is the main objective of pushing during the second stage of labor?

Accepted Answer

Delivering the baby's head and shoulders

Answer

Thinning the cervix

Answer

Expelling the placenta

Answer

Dilating the vagina

Question 25

Which of the following nursing interventions is crucial during the immediate postpartum period?

Accepted Answer

Assessing for hemorrhage and evaluating uterine tone

Answer

Massaging the mother's back

Answer

Initiating breastfeeding

Answer

Administering pain medication

Question 26

What is the key difference between spontaneous and augmented labor?

Accepted Answer

Spontaneous labor occurs naturally, while augmented labor is induced or stimulated with medical interventions.

Answer

Spontaneous labor is typically longer than augmented labor.

Answer

Augmented labor is more painful than spontaneous labor.

Question 27

What is the primary purpose of the Friedman Curve?

Accepted Answer

Monitoring and assessing the progress of labor

Answer

Predicting the exact length of labor

Answer

Evaluating maternal well-being

Answer

Diagnosing fetal distress

Question 28

What is the primary responsibility of the nurse during the postpartum period?

Accepted Answer

Promoting the well-being of both the mother and the newborn

Answer

Monitoring vital signs frequently

Answer

Providing pain management as needed

Answer

Administering medications as prescribed

Question 29

Which of the following marks the onset of the first stage of labor?

Accepted Answer

Regular, painful uterine contractions causing cervical dilation

Answer

Delivery of the baby

Answer

Rupture of membranes

Answer

Expulsion of the placenta

Question 30

Which of the following nursing interventions is most appropriate during the active phase of the first stage of labor?

Accepted Answer

Encourage frequent position changes and provide emotional support

Answer

Perform a cervical exam every 15 minutes

Answer

Monitor fetal heart rate continuously

Answer

Administer an epidural

Question 31

Which of the following events characterizes the second stage of labor?

Accepted Answer

Complete cervical dilation and descent of the baby's head

Answer

Expulsion of the placenta

Answer

Involution of the uterus

Answer

Onset of regular contractions

Question 32

Which of the following is considered a medical indication for performing an episiotomy?

Accepted Answer

Imminent perineal laceration during delivery

Answer

Breech presentation

Answer

Maternal preference

Answer

Nulliparity

Question 33

Which of the following physiological events occurs during the third stage of labor?

Accepted Answer

Separation and expulsion of the placenta

Answer

Uterine involution

Answer

Cervical dilation

Answer

Rupture of membranes

Question 34

Which of the following nursing interventions is essential for preventing postpartum hemorrhage?

Accepted Answer

Continuous monitoring of uterine tone and lochia

Answer

Encouraging early ambulation

Answer

Administration of pain medication

Answer

Application of ice packs to the perineum

Question 35

The fourth stage of labor is commonly referred to as:

Accepted Answer

Recovery and bonding

Answer

Cervical dilation

Answer

Placental expulsion

Answer

Uterine involution

Question 36

Which hormone is primarily responsible for initiating and maintaining uterine contractions during labor?

Accepted Answer

Oxytocin

Answer

Progesterone

Answer

Estrogen

Answer

Relaxin

Question 37

In which stage of labor is the cervix completely dilated (10 cm) and the fetus descends into the vagina?

Accepted Answer

Second stage

Answer

First stage

Answer

Fourth stage

Answer

Third stage

Question 38

Which of the following factors increases the risk of uterine rupture during labor?

Accepted Answer

Previous uterine surgery

Answer

Normal fetal presentation

Answer

Adequate prenatal care

Answer

Young maternal age

Question 39

What is the reflex that triggers uterine contractions and placental separation immediately after birth?

Accepted Answer

Ferguson reflex

Answer

Moro reflex

Answer

Rooting reflex

Answer

Babinski reflex

Question 40

What is the primary reason for administering an epidural during labor?

Accepted Answer

Pain relief

Answer

Accelerating labor

Answer

Preventing postpartum hemorrhage

Answer

Treating preeclampsia

Question 41

During which stage of labor does the fetus descend into the pelvis and the involuntary urge to push becomes noticeable?

Accepted Answer

Second stage labor

Answer

Fourth stage labor

Answer

Third stage labor

Answer

First stage labor

Question 42

Which fetal position is considered optimal for a vaginal delivery?

Accepted Answer

Occiput anterior (OA)

Answer

Occiput posterior (OP)

Answer

Transverse lie

Question 43

What is the main purpose of monitoring the fetal heart rate during labor?

Accepted Answer

To assess fetal oxygenation and well-being

Answer

To guide the use of anesthesia

Answer

To determine the stage of labor

Question 44

Which factor is most strongly associated with the development of postpartum hemorrhage?

Accepted Answer

Uterine atony

Answer

Eclampsia

Answer

Gestational diabetes

Answer

Preeclampsia

Question 45

What is the primary purpose of an episiotomy?

Accepted Answer

To prevent severe perineal tearing and facilitate delivery of the baby's head.

Answer

To reduce the risk of postpartum hemorrhage.

Answer

To improve fetal heart rate during labor.

Answer

To shorten the duration of the second stage of labor.

Question 46

Which of the following is a strong indication for immediate delivery of the placenta?

Accepted Answer

Signs of placental abruption, such as severe vaginal bleeding, abdominal pain, and a firm, tender uterus.

Answer

Delayed cord clamping for at least 3 minutes after birth.

Answer

Uterine massage performed to promote contraction.

Answer

Controlled cord traction during the third stage of labor.

Question 47

A patient in the latent phase of labor is experiencing irregular contractions and her cervix is 3 cm dilated. Which nursing intervention should be prioritized during this stage?

Accepted Answer

Provide emotional support, encouragement, and education about labor progress, including breathing techniques and relaxation strategies.

Answer

Prepare the patient for delivery and call for additional staff.

Answer

Administer pain medication as ordered and monitor vital signs closely.

Question 48

Which of the following is a hallmark characteristic of the active phase of labor?

Accepted Answer

Progressive cervical dilation from 4 cm to 7 cm, with contractions becoming more frequent, stronger, and longer.

Answer

Strong urge to push with contractions, signaling the onset of the second stage of labor.

Answer

Passage of the placenta, marking the end of the third stage of labor.

Answer

Descent of the fetal head to station +2, indicating the baby is getting closer to the birth canal.

Question 49

A patient in the transition phase of labor becomes irritable, restless, and reports she can no longer cope with the pain. What is the most likely explanation for this behavior?

Accepted Answer

Intense pain and pressure as the cervix nears full dilation (10 cm), often accompanied by nausea, vomiting, and shaking.

Answer

Fear and anxiety about the upcoming delivery, which can exacerbate discomfort.

Answer

Side effects of pain medication, such as drowsiness or dizziness.

Question 50

During the second stage of labor, a patient experiences a sudden drop in fetal heart rate. What is the immediate nursing priority?

Accepted Answer

Reposition the patient to relieve potential umbilical cord compression, such as by turning her to her side or using a knee-chest position.

Answer

Administer oxygen via face mask at 10 liters per minute to improve fetal oxygenation.

Answer

Document the findings and continue to monitor fetal heart rate closely.

Question 51

After delivery of the placenta, the nurse observes a large amount of blood loss. Which of the following is the most common cause of postpartum hemorrhage in this scenario?

Accepted Answer

Uterine atony, characterized by a soft, boggy uterus that is unable to contract effectively and control bleeding.

Answer

Retained placental fragments, which can prevent the uterus from contracting fully.

Answer

Coagulation disorders, which can impair blood clotting and increase the risk of bleeding.

Answer

Vaginal laceration, which can cause bleeding if it is not identified and repaired promptly.

Question 52

A patient in labor requests an epidural for pain management. Which of the following is a potential side effect of epidural anesthesia?

Accepted Answer

Hypotension (low blood pressure), which can occur due to the blocking of sympathetic nerves.

Answer

Fetal tachycardia (rapid heart rate), which is not a common side effect of epidural anesthesia.

Answer

Increased urge to push, which can actually be suppressed by epidural anesthesia.

Answer

Hypertension (high blood pressure), which is not a typical side effect of epidural anesthesia.

Question 53

Which fetal position is generally considered ideal for labor and delivery, promoting a smooth and efficient birth process?

Accepted Answer

Occiput anterior (OA), where the baby's head is facing the mother's spine, allowing for optimal descent and rotation.

Answer

Transverse lie, where the baby is lying sideways in the uterus, requiring a Cesarean delivery.

Answer

Occiput posterior (OP), where the baby's head is facing the mother's abdomen, potentially leading to back labor.

Answer

Brow presentation, where the baby's forehead is presenting first, which can lead to difficulties in labor.

Question 54

During the fourth stage of labor, the nurse assesses the patient and finds her uterus to be boggy and displaced to the right. What is the most appropriate nursing action in this scenario?

Accepted Answer

Massage the uterus gently to help it contract and return to its normal position, and assist the patient to void to relieve bladder pressure that can contribute to uterine displacement.

Answer

Notify the healthcare provider of a possible uterine rupture, which is an extreme scenario and unlikely in this situation.

Answer

Elevate the patient's legs and monitor vital signs closely, which is helpful for hypotension but not for uterine atony.

Answer

Administer pain medication as ordered and reassess in 30 minutes, which may not address the underlying issue.

Question 55

A patient in labor is experiencing back pain. Which intervention would be MOST effective in relieving this type of pain?

Accepted Answer

Applying counterpressure to the sacrum during contractions.

Answer

Administering intravenous pain medication.

Answer

Encouraging the patient to breathe deeply and relax.

Question 56

Which of the following is a sign of placental separation during the third stage of labor?

Accepted Answer

Lengthening of the umbilical cord

Answer

Maternal urge to push

Answer

Decrease in vaginal bleeding

Answer

Fetal heart rate acceleration