NR 327 POSTPARTUM ISBAR
CERTIFICATION PAPER 2026 FULL
SOLUTION GRADED A+
● The nurse is caring for a client in labor who is receiving oxytocin.
Which assessment finding requires immediate action?
Urine output 75 mL in 2 hours
Six contractions in 10 minutes
Contraction duration 50-60 seconds
Fetal heart rate 125 bpm with moderate variability. Answer: Six
contractions in 10 minutes
● What are indications for labor induction? Select all that apply.
Placenta previa
Prolonged rupture of membranes
Client request to select the delivery date
Post-term gestation
History of precipitous labor. Answer: Prolonged rupture of membranes
Post-term gestation
History of precipitous labor
,● The nurse is caring for a laboring client and evaluates the
characteristics of contractions. Which questions should the nurse ask?
Select that all apply.
"When did your contractions start?"
"How long are your contractions lasting?"
"What is the resting tone of your uterus?"
"How often do you have contractions right now?"
"What is the intensity of your contractions?". Answer: "When did your
contractions start?"
"How long are your contractions lasting?"
"How often do you have contractions right now?"
● Why is it important for a client in labor to maintain an empty bladder?
Select all that apply.
To assess hydration status
To ensure that fetal descent is not impaired
To avoid delayed contraction frequency
To protect the uterus from the pressure of the bladder
To prevent damage to the bladder from uterine compression. Answer: To
ensure that fetal descent is not impaired
To prevent damage to the bladder from uterine compression
● What are possible complications associated with oxytocin for
induction of labor? Select all that apply.
,Fetal distress
Maternal bradycardia
Hypertension
Uterine hyperstimulation
Decreased urine output. Answer: Fetal distress
Hypertension
Uterine hyperstimulation
Decreased urine output
● What is the highest priority after birth of the fetus?
Establishing the newborn's airway
Medicating the mother for pain
Assisting with the quick delivery of the placenta
Promoting bonding and breastfeeding. Answer: Establishing the
newborn's airway
● The _______ process of the fetal skull is the most rounded and smooth
surface of the fetal head and is best for fitting through the pelvis and
dilating the cervix.. Answer: occiput
● A pregnant client who is 39 weeks gestation reports that she is
urinating a lot more lately and does not feel the baby up as high in her
abdomen. What is the likely reason?
, Internal rotation
Lightening
Braxton Hicks contractions
Urinary tract infection. Answer: Lightening
● The nurse is caring for a gravida 4, para 3 (G4P3) client, 37-weeks-
pregnant, who has come to the hospital because she believes her water
has broken. How should the nurse verify if the wetness the client feels is
urine or amniotic fluid?
Use nitrazine paper to test the fluid at the bedside.
Press downward on the fundus and observe for a fluid gush.
Assess the color, consistency, and odor of the fluid.
Complete a vaginal examination to assess for cervical dilation and
effacement.. Answer: Use nitrazine paper to test the fluid at the bedside.
● The nurse is caring for a gravida 2, para 1 (G2P1) client, 41-weeks-
pregnant, whose membranes ruptured prior to arrival at the hospital. The
vaginal exam reveals no cord prolapse. Fetal heart rate is 120 bpm with
moderate variability. Cervix is 8 cm dilated and 100% effaced. The
current fetal station is +1. Which stage of labor should the nurse
document?
Stage 1, Transitional phase
Stage 2
Stage 1, Active phase
CERTIFICATION PAPER 2026 FULL
SOLUTION GRADED A+
● The nurse is caring for a client in labor who is receiving oxytocin.
Which assessment finding requires immediate action?
Urine output 75 mL in 2 hours
Six contractions in 10 minutes
Contraction duration 50-60 seconds
Fetal heart rate 125 bpm with moderate variability. Answer: Six
contractions in 10 minutes
● What are indications for labor induction? Select all that apply.
Placenta previa
Prolonged rupture of membranes
Client request to select the delivery date
Post-term gestation
History of precipitous labor. Answer: Prolonged rupture of membranes
Post-term gestation
History of precipitous labor
,● The nurse is caring for a laboring client and evaluates the
characteristics of contractions. Which questions should the nurse ask?
Select that all apply.
"When did your contractions start?"
"How long are your contractions lasting?"
"What is the resting tone of your uterus?"
"How often do you have contractions right now?"
"What is the intensity of your contractions?". Answer: "When did your
contractions start?"
"How long are your contractions lasting?"
"How often do you have contractions right now?"
● Why is it important for a client in labor to maintain an empty bladder?
Select all that apply.
To assess hydration status
To ensure that fetal descent is not impaired
To avoid delayed contraction frequency
To protect the uterus from the pressure of the bladder
To prevent damage to the bladder from uterine compression. Answer: To
ensure that fetal descent is not impaired
To prevent damage to the bladder from uterine compression
● What are possible complications associated with oxytocin for
induction of labor? Select all that apply.
,Fetal distress
Maternal bradycardia
Hypertension
Uterine hyperstimulation
Decreased urine output. Answer: Fetal distress
Hypertension
Uterine hyperstimulation
Decreased urine output
● What is the highest priority after birth of the fetus?
Establishing the newborn's airway
Medicating the mother for pain
Assisting with the quick delivery of the placenta
Promoting bonding and breastfeeding. Answer: Establishing the
newborn's airway
● The _______ process of the fetal skull is the most rounded and smooth
surface of the fetal head and is best for fitting through the pelvis and
dilating the cervix.. Answer: occiput
● A pregnant client who is 39 weeks gestation reports that she is
urinating a lot more lately and does not feel the baby up as high in her
abdomen. What is the likely reason?
, Internal rotation
Lightening
Braxton Hicks contractions
Urinary tract infection. Answer: Lightening
● The nurse is caring for a gravida 4, para 3 (G4P3) client, 37-weeks-
pregnant, who has come to the hospital because she believes her water
has broken. How should the nurse verify if the wetness the client feels is
urine or amniotic fluid?
Use nitrazine paper to test the fluid at the bedside.
Press downward on the fundus and observe for a fluid gush.
Assess the color, consistency, and odor of the fluid.
Complete a vaginal examination to assess for cervical dilation and
effacement.. Answer: Use nitrazine paper to test the fluid at the bedside.
● The nurse is caring for a gravida 2, para 1 (G2P1) client, 41-weeks-
pregnant, whose membranes ruptured prior to arrival at the hospital. The
vaginal exam reveals no cord prolapse. Fetal heart rate is 120 bpm with
moderate variability. Cervix is 8 cm dilated and 100% effaced. The
current fetal station is +1. Which stage of labor should the nurse
document?
Stage 1, Transitional phase
Stage 2
Stage 1, Active phase
