INP 402 Exam – Intrapartum Nursing
Practice Assessment – 2026/2027
Edition – Verified Q&A
Total Questions: 85 | Passing Standard: 72% | Time Allotted: 120
minutes
Instructions: Select the best answer for each multiple-choice question. Each
question is designed to assess knowledge of intrapartum nursing practice,
including labor physiology, fetal assessment, obstetric emergencies,
pharmacological management, and postpartum/newborn care aligned with
AWHONN standards, ACOG practice bulletins, and evidence-based maternal-
newborn nursing standards for the 2026/2027 academic cycle.
Question 1
The four factors that affect the labor process are known as the "four Ps."
Which of the following correctly lists these factors?
A. Power, Passageway, Passenger, Psyche
B. Pressure, Position, Pelvis, Pain
C. Presentation, Position, Station, Stage
D. Powers, Passage, Presentation, Psychological
Correct Answer: A) Power, Passageway, Passenger, Psyche
Rationale: The four Ps of labor are: (1) Powers – uterine contractions and
maternal pushing efforts; (2) Passageway – the maternal pelvis and birth
canal; (3) Passenger – the fetus; and (4) Psyche – the mother's psychological
state. All four factors interact to influence the progress of labor. Options B, C,
and D incorrectly identify or mislabel these factors.
Teaching Point: The four Ps provide a comprehensive framework for
assessing factors that influence labor progress.
,Question 2
A laboring client is to have a pudendal block. The nurse plans to tell the client
that once the block is working she:
A. Will not feel the episiotomy
B. May lose bladder sensation
C. May lose the ability to push
D. Will no longer feel contractions
Correct Answer: A) Will not feel the episiotomy
Rationale: A pudendal block provides anesthesia to the perineum, numbing
the area where an episiotomy would be performed or where the baby
emerges. It does not affect the ability to push or eliminate contraction pain, as
it blocks only the pudendal nerve (S2-S4) supplying the perineum.
Teaching Point: Pudendal blocks provide perineal anesthesia for episiotomy
and delivery but do not relieve contraction pain.
Question 3
A nurse is caring for a client in labor. The nurse determines that the client is
beginning the second stage of labor when which of the following assessments
is noted?
A. The client begins to expel clear vaginal fluid
B. The contractions are regular
C. The membranes have ruptured
D. The cervix is dilated completely
Correct Answer: D) The cervix is dilated completely
Rationale: The second stage of labor begins when the cervix is completely
dilated (10 cm) and ends with the birth of the neonate. This is the "pushing
stage" where the mother actively bears down to expel the fetus.
Teaching Point: Complete cervical dilation (10 cm) marks the transition from
the first to the second stage of labor.
,Question 4
What is the normal duration of the latent phase of the first stage of labor for a
primigravida?
A. 1–2 hours
B. 6–8 hours
C. 12–18 hours
D. 20–24 hours
Correct Answer: D) 20–24 hours
Rationale: The latent phase of labor for a primigravida (first-time mother)
typically lasts 20–24 hours, during which cervical dilation progresses from 0
to approximately 4–6 cm. For multiparous women, the latent phase is
typically shorter (12–18 hours).
Teaching Point: The latent phase is longer in primigravidas than in
multiparas.
Question 5
Which of the following statements about Braxton Hicks contractions is
correct?
A. They cause progressive cervical dilation
B. They are always painful
C. They are irregular and do not cause cervical change
D. They indicate the onset of true labor
Correct Answer: C) They are irregular and do not cause cervical change
Rationale: Braxton Hicks contractions are irregular, intermittent uterine
contractions that occur throughout pregnancy. They do not cause progressive
cervical dilation or effacement and are often described as "practice
contractions." True labor contractions are regular, increase in frequency and
intensity, and cause progressive cervical change.
Teaching Point: Braxton Hicks contractions are irregular and do not cause
cervical change, distinguishing them from true labor.
, Question 6
A client is experiencing back labor. Which fetal position is most likely
associated with this presentation?
A. Occiput anterior (OA)
B. Occiput posterior (OP)
C. Occiput transverse (OT)
D. Breech presentation
Correct Answer: B) Occiput posterior (OP)
Rationale: Occiput posterior (OP) position occurs when the fetal occiput is
directed toward the maternal sacrum. The fetal head presses against the
maternal sacrum, causing intense back pain (back labor) during contractions.
Occiput anterior (OA) is the optimal position associated with less discomfort.
Teaching Point: Occiput posterior position is the most common cause of back
labor.
Question 7
The intrapartum nurse monitors which of the following "clients" during labor?
A. Only the mother
B. Only the fetus
C. The mother and the fetus
D. The mother, the fetus, and the family unit
Correct Answer: D) The mother, the fetus, and the family unit
Rationale: Intrapartum nursing care is holistic, recognizing that the nurse
monitors three clients: the mother, the fetus, and the family unit. This
comprehensive approach ensures physical, emotional, and psychosocial
support for all involved.
Teaching Point: Intrapartum care addresses the needs of the mother, fetus,
and family unit.
Practice Assessment – 2026/2027
Edition – Verified Q&A
Total Questions: 85 | Passing Standard: 72% | Time Allotted: 120
minutes
Instructions: Select the best answer for each multiple-choice question. Each
question is designed to assess knowledge of intrapartum nursing practice,
including labor physiology, fetal assessment, obstetric emergencies,
pharmacological management, and postpartum/newborn care aligned with
AWHONN standards, ACOG practice bulletins, and evidence-based maternal-
newborn nursing standards for the 2026/2027 academic cycle.
Question 1
The four factors that affect the labor process are known as the "four Ps."
Which of the following correctly lists these factors?
A. Power, Passageway, Passenger, Psyche
B. Pressure, Position, Pelvis, Pain
C. Presentation, Position, Station, Stage
D. Powers, Passage, Presentation, Psychological
Correct Answer: A) Power, Passageway, Passenger, Psyche
Rationale: The four Ps of labor are: (1) Powers – uterine contractions and
maternal pushing efforts; (2) Passageway – the maternal pelvis and birth
canal; (3) Passenger – the fetus; and (4) Psyche – the mother's psychological
state. All four factors interact to influence the progress of labor. Options B, C,
and D incorrectly identify or mislabel these factors.
Teaching Point: The four Ps provide a comprehensive framework for
assessing factors that influence labor progress.
,Question 2
A laboring client is to have a pudendal block. The nurse plans to tell the client
that once the block is working she:
A. Will not feel the episiotomy
B. May lose bladder sensation
C. May lose the ability to push
D. Will no longer feel contractions
Correct Answer: A) Will not feel the episiotomy
Rationale: A pudendal block provides anesthesia to the perineum, numbing
the area where an episiotomy would be performed or where the baby
emerges. It does not affect the ability to push or eliminate contraction pain, as
it blocks only the pudendal nerve (S2-S4) supplying the perineum.
Teaching Point: Pudendal blocks provide perineal anesthesia for episiotomy
and delivery but do not relieve contraction pain.
Question 3
A nurse is caring for a client in labor. The nurse determines that the client is
beginning the second stage of labor when which of the following assessments
is noted?
A. The client begins to expel clear vaginal fluid
B. The contractions are regular
C. The membranes have ruptured
D. The cervix is dilated completely
Correct Answer: D) The cervix is dilated completely
Rationale: The second stage of labor begins when the cervix is completely
dilated (10 cm) and ends with the birth of the neonate. This is the "pushing
stage" where the mother actively bears down to expel the fetus.
Teaching Point: Complete cervical dilation (10 cm) marks the transition from
the first to the second stage of labor.
,Question 4
What is the normal duration of the latent phase of the first stage of labor for a
primigravida?
A. 1–2 hours
B. 6–8 hours
C. 12–18 hours
D. 20–24 hours
Correct Answer: D) 20–24 hours
Rationale: The latent phase of labor for a primigravida (first-time mother)
typically lasts 20–24 hours, during which cervical dilation progresses from 0
to approximately 4–6 cm. For multiparous women, the latent phase is
typically shorter (12–18 hours).
Teaching Point: The latent phase is longer in primigravidas than in
multiparas.
Question 5
Which of the following statements about Braxton Hicks contractions is
correct?
A. They cause progressive cervical dilation
B. They are always painful
C. They are irregular and do not cause cervical change
D. They indicate the onset of true labor
Correct Answer: C) They are irregular and do not cause cervical change
Rationale: Braxton Hicks contractions are irregular, intermittent uterine
contractions that occur throughout pregnancy. They do not cause progressive
cervical dilation or effacement and are often described as "practice
contractions." True labor contractions are regular, increase in frequency and
intensity, and cause progressive cervical change.
Teaching Point: Braxton Hicks contractions are irregular and do not cause
cervical change, distinguishing them from true labor.
, Question 6
A client is experiencing back labor. Which fetal position is most likely
associated with this presentation?
A. Occiput anterior (OA)
B. Occiput posterior (OP)
C. Occiput transverse (OT)
D. Breech presentation
Correct Answer: B) Occiput posterior (OP)
Rationale: Occiput posterior (OP) position occurs when the fetal occiput is
directed toward the maternal sacrum. The fetal head presses against the
maternal sacrum, causing intense back pain (back labor) during contractions.
Occiput anterior (OA) is the optimal position associated with less discomfort.
Teaching Point: Occiput posterior position is the most common cause of back
labor.
Question 7
The intrapartum nurse monitors which of the following "clients" during labor?
A. Only the mother
B. Only the fetus
C. The mother and the fetus
D. The mother, the fetus, and the family unit
Correct Answer: D) The mother, the fetus, and the family unit
Rationale: Intrapartum nursing care is holistic, recognizing that the nurse
monitors three clients: the mother, the fetus, and the family unit. This
comprehensive approach ensures physical, emotional, and psychosocial
support for all involved.
Teaching Point: Intrapartum care addresses the needs of the mother, fetus,
and family unit.
