Galen College NUR 230 Exam 2 (pdf) | 2026/2027 | Maternal-Child
Q&A | NCLEX
1. A nurse is assessing a patient in labor. To determine the progress of labor,
the nurse should prioritize which of the following assessments?
A) Fetal heart rate pattern
B) Maternal blood pressure
C) Cervical dilation and effacement
D) Maternal pain level
Correct Answer: Cervical dilation and effacement
Rationale: Cervical dilation and effacement are the primary indicators of
labor progress. While fetal heart rate, maternal vital signs, and pain are
important, they do not directly measure the advancement of labor through
the stages.
2. A nurse is explaining the "5 P's" of labor to a nursing student. Which of the
following is NOT one of the 5 P's?
A) Passageway
B) Passenger
C) Pain
D) Powers
Correct Answer: Pain
Rationale: The 5 P's of labor are Passageway, Passenger, Position, Powers,
and Psyche. Pain is a component of the labor experience but is not one of the
primary factors that influence the process of labor.
,3. A patient asks the nurse about the shape of her pelvis. The nurse explains
that the most common and favorable pelvic shape for vaginal delivery is:
A) Android
B) Anthropoid
C) Gynecoid
D) Platypelloid
Correct Answer: Gynecoid
Rationale: The gynecoid pelvis is the most common shape, found in about
50% of women, and is considered the most favorable for vaginal delivery due
to its round, spacious shape. The android shape is associated with
cephalopelvic disproportion (CPD).
4. A patient is admitted in active labor. The nurse notes that the fetal
presenting part is at the level of the ischial spines. The nurse should
document the station as:
A) -1
B) 0
C) +1
D) +2
Correct Answer: 0
Rationale: Station 0 is the level of an imaginary line at the level of the ischial
spines. Stations above the spines are negative, and stations below are
positive. Engagement occurs when the presenting part reaches station 0.
,5. A nurse is assessing a patient's contractions. The nurse notes that the
contractions are lasting 60 seconds and occurring every 3-4 minutes. This
pattern is most consistent with which phase of labor?
A) Latent phase
B) Active phase
C) Transition phase
D) Second stage
Correct Answer: Active phase
Rationale: In the active phase of the first stage of labor, contractions
typically occur every 3-5 minutes, last 40-60 seconds, and are moderate to
strong in intensity. The cervix dilates from 6 to 10 cm during this phase.
6. A patient is in the transition phase of labor. The nurse should anticipate
which of the following assessment findings?
A) Cervical dilation of 0-3 cm
B) Contractions every 5-10 minutes
C) Cervical dilation of 8-10 cm
D) Minimal maternal anxiety
Correct Answer: Cervical dilation of 8-10 cm
Rationale: The transition phase is the most intense phase of the first stage of
labor, characterized by cervical dilation from 8 to 10 cm. Contractions are
strong, frequent (every 2-3 minutes), and may last 60-90 seconds.
7. A patient who is 6 cm dilated and 100% effaced is experiencing strong
contractions every 2-3 minutes. The nurse should document that the patient
is in which stage and phase of labor?
, A) First stage, latent phase
B) First stage, active phase
C) First stage, transition phase
D) Second stage
Correct Answer: First stage, active phase
Rationale: The active phase of the first stage of labor is characterized by
cervical dilation from 6 to 10 cm and rapid effacement. The latent phase is 0-
3 cm, and transition is 8-10 cm. The second stage begins at 10 cm.
8. A patient is 10 cm dilated and feels an urge to push. The nurse should
prepare for which stage of labor?
A) First stage
B) Second stage
C) Third stage
D) Fourth stage
Correct Answer: Second stage
Rationale: The second stage of labor begins when the cervix is fully dilated
(10 cm) and ends with the birth of the infant. The urge to push is a classic
sign of the second stage.
9. A nurse is caring for a patient in the second stage of labor. The patient is
pushing effectively with contractions. The nurse should encourage the
patient to:
A) Hold their breath and push for as long as possible
B) Push only during the peak of the contraction
Q&A | NCLEX
1. A nurse is assessing a patient in labor. To determine the progress of labor,
the nurse should prioritize which of the following assessments?
A) Fetal heart rate pattern
B) Maternal blood pressure
C) Cervical dilation and effacement
D) Maternal pain level
Correct Answer: Cervical dilation and effacement
Rationale: Cervical dilation and effacement are the primary indicators of
labor progress. While fetal heart rate, maternal vital signs, and pain are
important, they do not directly measure the advancement of labor through
the stages.
2. A nurse is explaining the "5 P's" of labor to a nursing student. Which of the
following is NOT one of the 5 P's?
A) Passageway
B) Passenger
C) Pain
D) Powers
Correct Answer: Pain
Rationale: The 5 P's of labor are Passageway, Passenger, Position, Powers,
and Psyche. Pain is a component of the labor experience but is not one of the
primary factors that influence the process of labor.
,3. A patient asks the nurse about the shape of her pelvis. The nurse explains
that the most common and favorable pelvic shape for vaginal delivery is:
A) Android
B) Anthropoid
C) Gynecoid
D) Platypelloid
Correct Answer: Gynecoid
Rationale: The gynecoid pelvis is the most common shape, found in about
50% of women, and is considered the most favorable for vaginal delivery due
to its round, spacious shape. The android shape is associated with
cephalopelvic disproportion (CPD).
4. A patient is admitted in active labor. The nurse notes that the fetal
presenting part is at the level of the ischial spines. The nurse should
document the station as:
A) -1
B) 0
C) +1
D) +2
Correct Answer: 0
Rationale: Station 0 is the level of an imaginary line at the level of the ischial
spines. Stations above the spines are negative, and stations below are
positive. Engagement occurs when the presenting part reaches station 0.
,5. A nurse is assessing a patient's contractions. The nurse notes that the
contractions are lasting 60 seconds and occurring every 3-4 minutes. This
pattern is most consistent with which phase of labor?
A) Latent phase
B) Active phase
C) Transition phase
D) Second stage
Correct Answer: Active phase
Rationale: In the active phase of the first stage of labor, contractions
typically occur every 3-5 minutes, last 40-60 seconds, and are moderate to
strong in intensity. The cervix dilates from 6 to 10 cm during this phase.
6. A patient is in the transition phase of labor. The nurse should anticipate
which of the following assessment findings?
A) Cervical dilation of 0-3 cm
B) Contractions every 5-10 minutes
C) Cervical dilation of 8-10 cm
D) Minimal maternal anxiety
Correct Answer: Cervical dilation of 8-10 cm
Rationale: The transition phase is the most intense phase of the first stage of
labor, characterized by cervical dilation from 8 to 10 cm. Contractions are
strong, frequent (every 2-3 minutes), and may last 60-90 seconds.
7. A patient who is 6 cm dilated and 100% effaced is experiencing strong
contractions every 2-3 minutes. The nurse should document that the patient
is in which stage and phase of labor?
, A) First stage, latent phase
B) First stage, active phase
C) First stage, transition phase
D) Second stage
Correct Answer: First stage, active phase
Rationale: The active phase of the first stage of labor is characterized by
cervical dilation from 6 to 10 cm and rapid effacement. The latent phase is 0-
3 cm, and transition is 8-10 cm. The second stage begins at 10 cm.
8. A patient is 10 cm dilated and feels an urge to push. The nurse should
prepare for which stage of labor?
A) First stage
B) Second stage
C) Third stage
D) Fourth stage
Correct Answer: Second stage
Rationale: The second stage of labor begins when the cervix is fully dilated
(10 cm) and ends with the birth of the infant. The urge to push is a classic
sign of the second stage.
9. A nurse is caring for a patient in the second stage of labor. The patient is
pushing effectively with contractions. The nurse should encourage the
patient to:
A) Hold their breath and push for as long as possible
B) Push only during the peak of the contraction
