Management of Labor: A Comprehensive Guide for Nursing Students

Question 1

Which of the following is a non-pharmacological pain management technique commonly used during labor?

Accepted Answer

Transcutaneous electrical nerve stimulation (TENS)

Answer

Epidural analgesia

Answer

Intravenous opioids

Answer

Patient-controlled analgesia (PCA)

Question 2

What is the first step in managing a woman in active labor?

Accepted Answer

Perform a vaginal examination

Answer

Start an IV infusion

Answer

Administer pain medication

Answer

Prepare the patient for surgery

Question 3

What is the most common complication associated with epidural analgesia?

Accepted Answer

Headache

Answer

Hypotension

Answer

Infection

Answer

Allergic reaction

Question 4

Which of the following is a sign of uterine rupture?

Accepted Answer

Sudden onset of severe abdominal pain

Answer

Fetal distress

Answer

Vaginal bleeding

Answer

Uterine tenderness

Question 5

Which of these is an indication for amniotomy?

Accepted Answer

Induction of labor

Answer

Prolongation of second stage of labor

Answer

Assessment of fetal maturity

Answer

Prevention of postpartum hemorrhage

Question 6

What is the first-line treatment for preeclampsia during pregnancy?

Accepted Answer

Magnesium sulfate

Answer

Hydralazine

Answer

Labetalol

Answer

Bed rest

Question 7

Which of the following is considered a non-pharmacological technique for managing pain during labor?

Accepted Answer

Transcutaneous electrical nerve stimulation (TENS)

Answer

Epidural anesthesia

Answer

Intravenous opioids

Answer

Nitrous oxide inhalation

Question 8

During which stage of labor are episiotomies most frequently performed?

Accepted Answer

Second stage

Answer

First stage

Answer

Third stage

Answer

Fourth stage

Question 9

What is the main purpose of continuous intrapartum electronic fetal monitoring (EFM)?

Accepted Answer

To assess fetal well-being and prevent fetal distress

Answer

To monitor uterine contractions

Answer

To identify potential maternal complications

Answer

To determine fetal position

Question 10

During labor, what ethical considerations should be taken into account when using pharmacological pain relief methods? Discuss the potential advantages and disadvantages for both the mother and the newborn.

Accepted Answer

Ethical considerations in pharmacological pain relief during labor involve balancing the mother's right to pain relief with potential risks to the newborn.

Answer

Pharmacological pain relief methods always provide benefits without risks.

Answer

Pharmacological pain relief methods should be avoided due to ethical concerns.

Answer

The decision to use pharmacological pain relief methods should be made solely by the healthcare provider.

Question 11

Which of the following best describes the primary purpose of labor pain management?

Accepted Answer

To reduce stress and anxiety for the mother

Answer

To completely eliminate pain

Answer

To make the labor process faster

Answer

To ensure epidural anesthesia is administered

Question 12

Which of the following fetal heart rate patterns is suggestive of fetal compromise?

Accepted Answer

Late decelerations

Answer

Sinusoidal pattern

Answer

Accelerations

Answer

Normal baseline heart rate

Question 13

Which of the following is NOT a common sign of placental abruption?

Accepted Answer

Hypertension

Answer

Vaginal bleeding

Answer

Uterine tenderness

Answer

Fetal distress

Question 14

What is the recommended postpartum recovery position for women who have had an episiotomy?

Accepted Answer

Lateral with ice packs to the perineum

Answer

Supine with legs elevated

Answer

Sitting with feet on the floor

Answer

Standing with perineal support

Question 15

What is the purpose of a sterile vaginal exam?

Accepted Answer

To assess cervical dilation and effacement

Answer

To confirm the presentation of the baby

Answer

To check for uterine contractions

Answer

To collect a urine sample

Question 16

During labor, what is the nurse's primary responsibility when evaluating a fetal heart rate pattern?

Accepted Answer

Interpreting the pattern for abnormalities

Answer

Documenting the heart rate regularly

Answer

Informing the doctor about pattern changes

Answer

Giving medications to change the heart rate

Question 17

During labor, which pain management technique involves using small needles inserted into specific points on the body?

Accepted Answer

Acupuncture

Answer

Epidural

Answer

Hypnosis

Answer

Massage

Question 18

What is the primary goal of nursing care during the first stage of labor?

Accepted Answer

To ensure the well-being of both mother and baby

Answer

To promote cervical dilation

Answer

To prepare for delivery

Answer

To reduce pain and anxiety

Question 19

How should a nurse respond when a woman requests an epidural during labor?

Accepted Answer

Assess the woman's pain level and reason for requesting an epidural

Answer

Contact the anesthesiologist immediately

Answer

Administer the epidural without delay

Answer

Wait until the cervix is fully dilated

Question 20

What is the primary goal of pain management during labor?

Accepted Answer

Provide comfort and minimize anxiety

Answer

Eliminate pain entirely

Answer

Prevent fetal distress

Answer

Shorten the duration of labor

Question 21

Which type of fetal monitoring is most commonly used during labor?

Accepted Answer

Electronic fetal monitoring (EFM)

Answer

Ultrasound

Answer

Fetoscopy

Answer

Amnioscopy

Question 22

What is the primary indication for performing an episiotomy?

Accepted Answer

To prevent severe perineal lacerations

Answer

To shorten the second stage of labor

Answer

To facilitate the delivery of the placenta

Answer

To improve fetal oxygenation

Question 23

Which of the following is a contraindication for the use of epidural analgesia?

Accepted Answer

Active infection or sepsis

Answer

Mild hypotension

Answer

Nausea and vomiting

Answer

Cervical dilation of less than 4 cm

Question 24

What is the purpose of the Leopold maneuvers?

Accepted Answer

To assess fetal position, presentation, and lie

Answer

To auscultate the fetal heart rate

Answer

To induce labor

Answer

To estimate fetal weight

Question 25

What is the most effective non-pharmacological method for pain relief during labor?

Accepted Answer

Walking

Answer

Massage

Answer

Hypnosis

Answer

Acupuncture

Question 26

Which method of pain management is most effective during labor?

Accepted Answer

Epidural anesthesia

Answer

Relaxation techniques

Answer

Transcutaneous electrical nerve stimulation (TENS)

Answer

Intravenous opioids

Question 27

What is the primary purpose of fetal monitoring during labor?

Accepted Answer

Assess fetal well-being

Answer

Detect fetal abnormalities

Answer

Measure uterine activity

Answer

Predict labor duration

Question 28

Which position is generally considered optimal for laboring women?

Accepted Answer

Upright or semi-upright

Answer

Lying on the back

Answer

Kneeling

Answer

Lying on the side

Question 29

What is the primary purpose of amnioinfusion?

Accepted Answer

Increase amniotic fluid volume

Answer

Stimulate labor

Answer

Enhance fetal monitoring

Answer

Reduce infection risk

Question 30

Which action is NOT a nurse's role in supporting a laboring woman's emotional well-being?

Accepted Answer

Prescribing medication to reduce anxiety

Answer

Listening with empathy to her worries

Answer

Teaching relaxation and breathing techniques

Answer

Offering reassurance and encouragement

Question 31

Which of the following pain management techniques is considered the most effective for relieving labor pain?

Accepted Answer

Epidural anesthesia

Answer

Acupuncture

Answer

Massage

Answer

Warm baths

Question 32

Which fetal monitoring technique provides continuous real-time assessment of the fetal heart rate and uterine contractions?

Accepted Answer

External electronic fetal monitoring

Answer

Non-stress test

Answer

Amniocentesis

Answer

Ultrasound

Question 33

When is an episiotomy typically indicated during labor?

Accepted Answer

To prevent severe perineal lacerations and potential complications during the delivery of the baby

Answer

To shorten the pushing stage

Answer

To improve fetal oxygenation

Answer

To prevent postpartum bleeding

Question 34

What is the overarching goal of labor management?

Accepted Answer

To ensure the well-being and a safe, respectful birth experience for both the mother and the baby

Answer

To minimize the risk of complications

Answer

To alleviate pain during labor

Question 35

What is the recommended initial dosage range of oxytocin for induction of labor?

Accepted Answer

2-4 mIU/min, gradually increased as needed based on uterine response and fetal tolerance

Answer

10-20 mIU/min, decreased as needed

Answer

5-10 mIU/min, maintained at a constant rate

Answer

1-3 mIU/min, only if necessary

Question 36

Which of the following signs indicates that the second stage of labor has begun?

Accepted Answer

Complete cervical dilation

Answer

Bloody show

Answer

Uterine contractions lasting 60 seconds or more

Answer

Rupture of membranes

Question 37

What is the most common risk factor for shoulder dystocia?

Accepted Answer

Excessive fetal size, such as macrosomia (birth weight over 4000 grams)

Answer

Maternal obesity

Answer

Prolonged labor

Answer

Primiparity

Question 38

Which fetal monitoring device provides continuous, real-time information about the fetal heart rate, uterine contractions, and fetal movements?

Accepted Answer

Electronic fetal monitor

Answer

Fetoscope

Answer

Amnioscope

Answer

Doppler ultrasound

Question 39

When might an episiotomy be considered during labor?

Accepted Answer

To prevent severe perineal lacerations or facilitate delivery of a large baby

Answer

To allow for the use of forceps

Answer

To shorten the second stage of labor

Answer

To reduce the risk of postpartum hemorrhage

Question 40

Which of the following nursing interventions can help reduce a woman's anxiety during labor?

Accepted Answer

Providing emotional support, information, and reassurance

Answer

Administering sedatives

Answer

Encouraging the use of technology

Answer

Restricting visitors

Question 41

What is the primary reason for an amniotomy?

Accepted Answer

To stimulate uterine contractions and facilitate labor progression

Answer

To relieve fetal distress

Answer

To obtain a fetal blood sample

Answer

To check fetal maturity

Question 42

Which of the following is a sign of fetal macrosomia?

Accepted Answer

Estimated fetal weight over 4,000 grams

Answer

Oligohydramnios

Answer

High fetal heart rate

Answer

Low amniotic fluid volume

Question 43

What is the recommended positioning for a woman in the second stage of labor?

Accepted Answer

Semi-Fowler's or upright position to facilitate optimal fetal descent and maternal comfort

Answer

Supine position

Answer

Lithotomy position

Question 44

Which of the following is a nursing responsibility during the management of a postpartum hemorrhage?

Accepted Answer

Measuring blood loss, administering blood products, and monitoring vital signs

Answer

Performing a vaginal exam

Answer

Administering antibiotics

Question 45

What is the purpose of a Leopold's maneuver?

Accepted Answer

To assess fetal position, presentation, and engagement in the pelvis

Answer

To measure fundal height

Answer

To check fetal heart rate

Answer

To detect uterine anomalies

Question 46

Which of the following is NOT a sign of true labor?

Accepted Answer

Increased fetal movement

Answer

Regular, progressive uterine contractions

Answer

Rupture of membranes

Answer

Cervical effacement and dilation

Question 47

What is the primary parameter measured by an external fetal monitor?

Accepted Answer

Fetal heart rate

Answer

Fetal position

Answer

Maternal blood pressure

Answer

Uterine contractions

Question 48

What is the purpose of performing an episiotomy?

Accepted Answer

To prevent severe tearing during delivery

Answer

To facilitate vaginal repair

Answer

To improve fetal oxygenation

Answer

To shorten the second stage of labor

Question 49

A laboring patient is experiencing intense back pain.  Which of the following nursing interventions would be most effective in relieving this discomfort?

Accepted Answer

Applying counterpressure to the sacral area

Answer

Performing a sterile vaginal exam

Answer

Encouraging the patient to lie flat on her back

Answer

Administering an opioid analgesic

Question 50

During a vaginal exam, you notice the fetal heart rate (FHR) drops to 80 bpm.  Which of the following actions should you take first?

Accepted Answer

Change the patient's position

Answer

Notify the physician

Answer

Administer oxygen

Answer

Prepare for an immediate Cesarean section

Question 51

A laboring patient requests an epidural.  What is the most important nursing action before administering this anesthesia?

Accepted Answer

Ensure adequate hydration

Answer

Monitor fetal heart rate

Answer

Assess the patient's pain level

Answer

Obtain informed consent

Question 52

A patient is experiencing a prolonged second stage of labor. Which of the following interventions is most likely to be recommended?

Accepted Answer

Assisted vaginal delivery with forceps

Answer

Cesarean section

Answer

Induction of labor with oxytocin

Answer

Increased fluid intake

Question 53

After an episiotomy, a patient complains of burning and pain. What is the most appropriate nursing intervention?

Accepted Answer

Apply ice packs to the perineum

Answer

Encourage ambulation

Answer

Administer an opioid analgesic

Answer

Perform a sterile vaginal exam

Question 54

What is the primary purpose of continuous electronic fetal monitoring during labor?

Accepted Answer

Identify fetal distress

Answer

Determine the fetal position

Answer

Assess maternal pain levels

Answer

Monitor labor progress

Question 55

A patient is experiencing a precipitous labor. What is the priority nursing intervention?

Accepted Answer

Control the rate of descent of the fetus

Answer

Monitor the fetal heart rate

Answer

Administer pain medication

Answer

Encourage pushing

Question 56

Which of the following is a key sign of imminent delivery?

Accepted Answer

Bulging of the perineum

Answer

Increased vaginal discharge

Answer

Frequent urination

Question 57

A patient is admitted to the labor and delivery unit with a history of a previous Cesarean delivery.  What is the primary concern in this situation?

Accepted Answer

Risk of uterine rupture

Answer

Premature birth

Answer

Increased risk of infection

Answer

Prolonged labor

Question 58

A patient in labor is diagnosed with meconium staining of the amniotic fluid. What is the most important nursing action?

Accepted Answer

Monitor the fetal heart rate

Answer

Administer oxygen to the mother

Answer

Notify the physician

Answer

Prepare for an immediate Cesarean section