SG 3500 Maternal Health Nursing Exam 2
N
Official Practice Exam Actual Exam 2026/2027
with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed – A+
Graded
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SECTION 1: LABOR & DELIVERY Q1 – Q10
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Question 1 of 50
A 26-year-old primigravida at 39 weeks gestation arrives at the labor unit reporting
contractions every 5 minutes lasting 45 seconds. During cervical exam, the nurse notes
the cervix is 6 cm dilated, 80% effaced, and the fetal presenting part is at 0 station. The
patient is uncomfortable but breathing through contractions with coaching. Based on
these findings, the nurse recognizes the patient is in which stage and phase of labor?
. First stage, latent phase — the cervix is early in dilation and contractions are mild
A
B. First stage, active phase — cervical dilation from 6 to 10 cm with stronger, more
frequent contractions defines this phase ✓ CORRECT
C. Second stage, active phase — the cervix is fully dilated and the presenting part is
descending
D. First stage, transition phase — the patient is near complete dilation and showing
signs of advanced labor
Correct Answer: B
,Rationale: The active phase of the first stage of labor begins at 6 cm dilation and
extends to 10 cm, characterized by more frequent, intense contractions and faster
cervical change. The latent phase involves dilation from 0 to 6 cm with slower progress,
while transition occurs near 8 to 10 cm with contractions every 1.5 to 2 minutes lasting
60 to 90 seconds. Station of 0 indicates the presenting part is at the level of the ischial
spines, which does not define the phase but confirms engagement has occurred.
Question 2 of 50
A 31-year-old multipara at 40 weeks gestation is admitted in active labor. The fetal
monitor shows a baseline fetal heart rate of 145 with accelerations of 15 beats per
minute lasting 15 seconds associated with contractions. The nurse interprets these
accelerations as indicative of which clinical finding?
. Early signs of fetal distress requiring immediate oxygen administration
A
B. Umbilical cord compression requiring maternal repositioning
C. Uteroplacental insufficiency requiring IV fluid bolus
D. Fetal well-being indicating a reactive and healthy fetal status ✓ CORRECT
orrect Answer: D
C
Rationale: Fetal heart rate accelerations of 15 beats per minute lasting at least 15
seconds are a reassuring sign of fetal well-being and indicate adequate fetal
oxygenation and a non-acidotic fetal condition. Cord compression produces variable
decelerations, not accelerations, and uteroplacental insufficiency produces late
decelerations. Recognizing reassuring patterns prevents unnecessary interventions and
supports the normal labor process.
Question 3 of 50
,A 28-year-old primigravida at 38 weeks gestation calls the labor unit reporting a sudden
gush of clear fluid from her vagina. She denies regular contractions but states she felt
the baby move normally this morning. The nurse's priority instruction to this patient is to
come to the hospital immediately for evaluation, with the primary concern being which
potential complication?
. Risk of umbilical cord prolapse following rupture of membranes with an unengaged
A
fetal head ✓ CORRECT
B. Risk of maternal infection from prolonged rupture of membranes before labor onset
C. Risk of placental abruption caused by sudden release of amniotic fluid pressure
D. Risk of fetal distress from decreased amniotic fluid volume and cord compression
orrect Answer: A
C
Rationale: When membranes rupture and the fetal head is not engaged, the greatest
immediate risk is umbilical cord prolapse, which can compromise fetal circulation
within minutes and is a true obstetric emergency. Maternal infection risk increases after
18 to 24 hours of ruptured membranes, but cord prolapse is the life-threatening priority
that requires immediate assessment. The nurse should instruct the patient to come in
immediately and may recommend a towel or pad while monitoring for any signs of cord
protrusion.
Question 4 of 50
A 24-year-old patient at 39 weeks gestation is in active labor at 7 cm dilation. The
external fetal monitor shows a baseline heart rate of 150 with repetitive variable
decelerations dropping to 110 lasting 30 seconds with each contraction. The nurse's
initial intervention should be to reposition the patient, which directly addresses the
, underlying cause of this fetal heart rate pattern. Which pathophysiological mechanism
causes variable decelerations?
. Uteroplacental insufficiency reducing oxygen transfer across the placenta
A
B. Fetal head compression during the second stage of labor
C. Umbilical cord compression interrupting fetal blood flow ✓ CORRECT
D. Maternal hypotension decreasing placental perfusion pressure
orrect Answer: C
C
Rationale: Variable decelerations are caused by umbilical cord compression, which
temporarily interrupts fetal blood flow and produces an abrupt decrease in fetal heart
rate with a variable onset and return to baseline. Uteroplacental insufficiency produces
late decelerations that begin after the peak of the contraction, and fetal head
compression produces early decelerations that mirror the contraction. Repositioning the
mother, particularly to a knee-chest or lateral position, can relieve cord compression and
improve the fetal heart rate pattern.
Question 5 of 50
A 33-year-old multipara at 41 weeks gestation is in labor and progressing rapidly. During
a vaginal exam, the nurse palpates the sagittal suture of the fetal skull in the
anteroposterior diameter of the maternal pelvis with the occiput facing toward the
maternal symphysis. The nurse documents this fetal presentation as which position?
. Left occiput anterior (LOA) — the most common and favorable position for delivery
A
B. Occiput posterior (OP) — associated with prolonged labor and increased back pain ✓
CORRECT
C. Right occiput anterior (ROA) — a favorable position with minimal complications
D. Occiput transverse (OT) — a malposition requiring operative intervention
N
Official Practice Exam Actual Exam 2026/2027
with Detailed Rationales | Complete
Exam-Style Questions | Pass Guaranteed – A+
Graded
═════════════════════════════════════
═
SECTION 1: LABOR & DELIVERY Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 26-year-old primigravida at 39 weeks gestation arrives at the labor unit reporting
contractions every 5 minutes lasting 45 seconds. During cervical exam, the nurse notes
the cervix is 6 cm dilated, 80% effaced, and the fetal presenting part is at 0 station. The
patient is uncomfortable but breathing through contractions with coaching. Based on
these findings, the nurse recognizes the patient is in which stage and phase of labor?
. First stage, latent phase — the cervix is early in dilation and contractions are mild
A
B. First stage, active phase — cervical dilation from 6 to 10 cm with stronger, more
frequent contractions defines this phase ✓ CORRECT
C. Second stage, active phase — the cervix is fully dilated and the presenting part is
descending
D. First stage, transition phase — the patient is near complete dilation and showing
signs of advanced labor
Correct Answer: B
,Rationale: The active phase of the first stage of labor begins at 6 cm dilation and
extends to 10 cm, characterized by more frequent, intense contractions and faster
cervical change. The latent phase involves dilation from 0 to 6 cm with slower progress,
while transition occurs near 8 to 10 cm with contractions every 1.5 to 2 minutes lasting
60 to 90 seconds. Station of 0 indicates the presenting part is at the level of the ischial
spines, which does not define the phase but confirms engagement has occurred.
Question 2 of 50
A 31-year-old multipara at 40 weeks gestation is admitted in active labor. The fetal
monitor shows a baseline fetal heart rate of 145 with accelerations of 15 beats per
minute lasting 15 seconds associated with contractions. The nurse interprets these
accelerations as indicative of which clinical finding?
. Early signs of fetal distress requiring immediate oxygen administration
A
B. Umbilical cord compression requiring maternal repositioning
C. Uteroplacental insufficiency requiring IV fluid bolus
D. Fetal well-being indicating a reactive and healthy fetal status ✓ CORRECT
orrect Answer: D
C
Rationale: Fetal heart rate accelerations of 15 beats per minute lasting at least 15
seconds are a reassuring sign of fetal well-being and indicate adequate fetal
oxygenation and a non-acidotic fetal condition. Cord compression produces variable
decelerations, not accelerations, and uteroplacental insufficiency produces late
decelerations. Recognizing reassuring patterns prevents unnecessary interventions and
supports the normal labor process.
Question 3 of 50
,A 28-year-old primigravida at 38 weeks gestation calls the labor unit reporting a sudden
gush of clear fluid from her vagina. She denies regular contractions but states she felt
the baby move normally this morning. The nurse's priority instruction to this patient is to
come to the hospital immediately for evaluation, with the primary concern being which
potential complication?
. Risk of umbilical cord prolapse following rupture of membranes with an unengaged
A
fetal head ✓ CORRECT
B. Risk of maternal infection from prolonged rupture of membranes before labor onset
C. Risk of placental abruption caused by sudden release of amniotic fluid pressure
D. Risk of fetal distress from decreased amniotic fluid volume and cord compression
orrect Answer: A
C
Rationale: When membranes rupture and the fetal head is not engaged, the greatest
immediate risk is umbilical cord prolapse, which can compromise fetal circulation
within minutes and is a true obstetric emergency. Maternal infection risk increases after
18 to 24 hours of ruptured membranes, but cord prolapse is the life-threatening priority
that requires immediate assessment. The nurse should instruct the patient to come in
immediately and may recommend a towel or pad while monitoring for any signs of cord
protrusion.
Question 4 of 50
A 24-year-old patient at 39 weeks gestation is in active labor at 7 cm dilation. The
external fetal monitor shows a baseline heart rate of 150 with repetitive variable
decelerations dropping to 110 lasting 30 seconds with each contraction. The nurse's
initial intervention should be to reposition the patient, which directly addresses the
, underlying cause of this fetal heart rate pattern. Which pathophysiological mechanism
causes variable decelerations?
. Uteroplacental insufficiency reducing oxygen transfer across the placenta
A
B. Fetal head compression during the second stage of labor
C. Umbilical cord compression interrupting fetal blood flow ✓ CORRECT
D. Maternal hypotension decreasing placental perfusion pressure
orrect Answer: C
C
Rationale: Variable decelerations are caused by umbilical cord compression, which
temporarily interrupts fetal blood flow and produces an abrupt decrease in fetal heart
rate with a variable onset and return to baseline. Uteroplacental insufficiency produces
late decelerations that begin after the peak of the contraction, and fetal head
compression produces early decelerations that mirror the contraction. Repositioning the
mother, particularly to a knee-chest or lateral position, can relieve cord compression and
improve the fetal heart rate pattern.
Question 5 of 50
A 33-year-old multipara at 41 weeks gestation is in labor and progressing rapidly. During
a vaginal exam, the nurse palpates the sagittal suture of the fetal skull in the
anteroposterior diameter of the maternal pelvis with the occiput facing toward the
maternal symphysis. The nurse documents this fetal presentation as which position?
. Left occiput anterior (LOA) — the most common and favorable position for delivery
A
B. Occiput posterior (OP) — associated with prolonged labor and increased back pain ✓
CORRECT
C. Right occiput anterior (ROA) — a favorable position with minimal complications
D. Occiput transverse (OT) — a malposition requiring operative intervention
