Labor & Delivery - 2026 Intrapartum Nursing

1. What is the primary characteristic of true labor contractions? A. They decrease with ambulation B. They cause progressive cervical dilation and effacement C. They are felt exclusively in the abdomen D. They occur at irregular intervals Correct Answer: B. They cause progressive cervical dilation and effacement Rationale: True labor contractions bring about progressive cervical changes, unlike false labor. 2. Which fetal heart rate finding is considered a reassuring sign? A. Late decelerations B. Moderate variability C. Absent variability D. Variable decelerations Correct Answer: B. Moderate variability Rationale: Moderate variability indicates an intact autonomic nervous system and adequate fetal oxygenation. 3. What intervention is prioritized for a patient experiencing umbilical cord prolapse? A. Administering oxytocin B. Having the patient ambulate C. Elevating the presenting part off the cord D. Performing a fundal massage Correct Answer: C. Elevating the presenting part off the cord Rationale: Elevating the presenting part relieves pressure on the cord, preventing severe fetal hypoxia. 4. Which medication is commonly used for cervical ripening? A. Oxytocin B. Magnesium sulfate C. Dinoprostone D. Terbutaline Correct Answer: C. Dinoprostone Rationale: Dinoprostone is a prostaglandin used to soften and thin the cervix for labor induction. 5. The first stage of labor is divided into which three phases? A. Latent, active, transition B. First, second, third C. Effacement, dilation, expulsion D. Early, late, pushing Correct Answer: A. Latent, active, transition Rationale: The first stage of labor consists of the latent, active, and transition phases leading to full dilation. 6. A variable deceleration on the FHR monitor is most often associated with: A. Fetal head compression B. Umbilical cord compression C. Uteroplacental insufficiency D. Maternal hypotension Correct Answer: B. Umbilical cord compression Rationale: Variable decelerations are typically caused by compression of the umbilical cord. 7. What is the typical management for late decelerations? A. Administer epidural anesthesia B. Turn patient to left lateral position, administer oxygen, increase IV fluids C. Perform artificial rupture of membranes D. Administer oxytocin to speed up labor Correct Answer: B. Turn patient to left lateral position, administer oxygen, increase IV fluids Rationale: These interventions improve uteroplacental perfusion and fetal oxygenation. 8. Which assessment is crucial before administering an epidural block? A. Assess for maternal hypotension B. Check maternal platelet count C. Perform a vaginal exam D. Measure fundal height Correct Answer: B. Check maternal platelet count Rationale: Thrombocytopenia is a contraindication for epidural anesthesia due to the risk of epidural hematoma. 9. What is the expected outcome of administering magnesium sulfate to a patient in preterm labor? A. Induction of contractions B. Cervical dilation C. Tocolysis (cessation of contractions) D. Rupture of membranes Correct Answer: C. Tocolysis (cessation of contractions) Rationale: Magnesium sulfate relaxes smooth muscle, helping stop preterm contractions. 10. What does a station of +2 indicate during a vaginal exam? A. The presenting part is 2 cm above the ischial spines B. The presenting part is at the ischial spines C. The presenting part is 2 cm below the ischial spines D. The cervix is dilated 2 cm Correct Answer: C. The presenting part is 2 cm below the ischial spines Rationale: Positive numbers indicate the presenting part has descended past the maternal ischial spines. 11. Which nursing action is essential immediately following artificial rupture of membranes (AROM)? A. Assess the fetal heart rate B. Administer pain medication C. Begin oxytocin infusion D. Encourage the patient to ambulate Correct Answer: A. Assess the fetal heart rate Rationale: Fetal heart rate assessment is critical to rule out umbilical cord prolapse after AROM. 12. Which of the following describes the 'active phase' of labor? A. Cervix dilates from 0-3 cm B. Cervix dilates from 4-7 cm C. Cervix dilates from 8-10 cm D. Pushing and delivery of the fetus Correct Answer: B. Cervix dilates from 4-7 cm Rationale: The active phase is characterized by rapid cervical dilation from 4 to 7 centimeters. 13. The nurse observes an early deceleration on the fetal monitor. This is typically caused by: A. Uteroplacental insufficiency B. Fetal head compression C. Maternal hypotension D. Umbilical cord compression Correct Answer: B. Fetal head compression Rationale: Early decelerations mirror contractions and result from vagal stimulation due to head compression. 14. What is the primary purpose of the Bishop score? A. To determine fetal well-being B. To assess readiness for labor induction C. To measure the strength of contractions D. To estimate fetal weight Correct Answer: B. To assess readiness for labor induction Rationale: A Bishop score evaluates cervical favorability for successful induction of labor.