NUR 418 FINAL EXAM (2026–2027) – NURSING CARE OF THE
CHILDBEARING FAMILY
09/27/2026
NUR 418 Final Exam (2026–2027) – Nursing Care of the
Childbearing Family – Concordia St. Paul – Actual
Questions & Verified Answers
Which statements are accurate regarding the administration of pain medications during labor? Select all
that apply.
- “IVP medications should be administered during contractions.
- “Hydromorphone hydrochloride (Dilaudid) is associated with nausea.”
- “Meperidine hydrochloride (Demerol) use can increase FHR variability.”
- “The use of opioid antagonists is contraindicated in labor.”
- “The use of opioid antagonists does not cause amnesia.”
The nurse is preparing a laboring patient for an epidural. Which action should the nurse take first?
-Have the patient void
-Place the patient in a supine position with legs extended
-Start an IV infusion of lactated Ringer's solution
-Assess fetal heart rate and maternal vital signs
The nurse is caring for a patient who just received an epidural. Which finding requires the nurse's
immediate intervention?
-Maternal blood pressure 88/50 mmHg
9/27/2026
-Patient reports mild itching at the site
-Fetal heart rate baseline of 140 bpm
1
, NUR 418 FINAL EXAM (2026–2027) – NURSING CARE OF THE
CHILDBEARING FAMILY
09/27/2026
-Patient states she feels pressure during contractions
A patient in active labor has an epidural catheter in place. Which position is most appropriate to
optimize uteroplacental perfusion and minimize hypotension?
-High Fowler's position
-Supine with wedge under one hip
-Flat supine position
-Trendelenburg position
A laboring patient is experiencing severe back pain. The nurse applies firm counterpressure to the sacral
area. According to the Gate Control Theory of Pain, this intervention reduces pain by:
-Blocking pain transmission by stimulating large sensory nerve fibers
-Increasing uterine contraction frequency
-Releasing prostaglandins to inhibit pain impulses
-Activating the sympathetic nervous system to mask pain
The nurse teaches a childbirth preparation class about the Gate Control Theory of Pain. Which
statement by a participant indicates understanding?
-"Focusing on my breathing during contractions can help reduce my perception of pain."
-"If I ignore my contractions, my cervix won't dilate."
-"The only way to block pain is with medication."
-"Pain signals cannot be altered before they reach the brain
9/27/2026
Which physiological process is central to the Gate Control Theory of Pain?
2
, NUR 418 FINAL EXAM (2026–2027) – NURSING CARE OF THE
CHILDBEARING FAMILY
09/27/2026
-Pain impulses are transmitted directly from the injury site to the brain without modulation.
-Pain impulses are modulated at the spinal cord level before reaching the brain.
-Pain impulses originate in the brain and are sent to the injured area.
-Pain impulses are only influenced by emotional state, not physical factors.
A nurse is caring for a laboring patient who does not want pain medication yet. Based on the Gate
Control Theory of Pain, which nursing interventions could help decrease her perception of pain? Select
all that apply.
-Applying warm compresses to the lower back
-Encouraging patterned breathing during contractions
-Providing firm sacral counterpressure
-Placing the patient flat on her back to rest
-Offering music for relaxation and distraction
-Teaching the patient to focus on a focal point during contractions
A nurse is assessing a postpartum patient 12 hours after delivery. Which finding should the nurse
expect?
-Fundus at the level of the umbilicus
-Fundus two fingerbreadths above the umbilicus
-Fundus two fingerbreadths below the umbilicus
-Fundus deviated to the right
The nurse notes that a postpartum patient's fundus is boggy and displaced to the right. Which is the
nurse's first action?
9/27/2026
-Administer oxytocin
-Assess the patient's bladder and encourage voiding
3
, NUR 418 FINAL EXAM (2026–2027) – NURSING CARE OF THE
CHILDBEARING FAMILY
09/27/2026
-Increase IV fluids
-Call the provider immediately
Which lochia finding on day 4 postpartum should be reported to the provider?
-Lochia rubra with small clots
-Lochia serosa that is pinkish-brown
-Lochia rubra with foul odor and large clots
-Lochia alba that is yellow-white
Which assessment finding 48 hours postpartum is abnormal?
-Pulse rate of 58 bpm
-Temperature of 100.4°F (38°C)
-Fundus 2 cm below the umbilicus and firm
-Lochia serosa
The nurse is performing a postpartum assessment. Which action is most appropriate before palpating
the fundus?
-Offer pain medication
-Ask the patient to void
-Place the patient in Trendelenburg position
-Give the patient a warm blanket
9/27/2026
A nurse is assessing a newborn 2 hours after birth. Which finding should be reported to the provider
immediately?
4
CHILDBEARING FAMILY
09/27/2026
NUR 418 Final Exam (2026–2027) – Nursing Care of the
Childbearing Family – Concordia St. Paul – Actual
Questions & Verified Answers
Which statements are accurate regarding the administration of pain medications during labor? Select all
that apply.
- “IVP medications should be administered during contractions.
- “Hydromorphone hydrochloride (Dilaudid) is associated with nausea.”
- “Meperidine hydrochloride (Demerol) use can increase FHR variability.”
- “The use of opioid antagonists is contraindicated in labor.”
- “The use of opioid antagonists does not cause amnesia.”
The nurse is preparing a laboring patient for an epidural. Which action should the nurse take first?
-Have the patient void
-Place the patient in a supine position with legs extended
-Start an IV infusion of lactated Ringer's solution
-Assess fetal heart rate and maternal vital signs
The nurse is caring for a patient who just received an epidural. Which finding requires the nurse's
immediate intervention?
-Maternal blood pressure 88/50 mmHg
9/27/2026
-Patient reports mild itching at the site
-Fetal heart rate baseline of 140 bpm
1
, NUR 418 FINAL EXAM (2026–2027) – NURSING CARE OF THE
CHILDBEARING FAMILY
09/27/2026
-Patient states she feels pressure during contractions
A patient in active labor has an epidural catheter in place. Which position is most appropriate to
optimize uteroplacental perfusion and minimize hypotension?
-High Fowler's position
-Supine with wedge under one hip
-Flat supine position
-Trendelenburg position
A laboring patient is experiencing severe back pain. The nurse applies firm counterpressure to the sacral
area. According to the Gate Control Theory of Pain, this intervention reduces pain by:
-Blocking pain transmission by stimulating large sensory nerve fibers
-Increasing uterine contraction frequency
-Releasing prostaglandins to inhibit pain impulses
-Activating the sympathetic nervous system to mask pain
The nurse teaches a childbirth preparation class about the Gate Control Theory of Pain. Which
statement by a participant indicates understanding?
-"Focusing on my breathing during contractions can help reduce my perception of pain."
-"If I ignore my contractions, my cervix won't dilate."
-"The only way to block pain is with medication."
-"Pain signals cannot be altered before they reach the brain
9/27/2026
Which physiological process is central to the Gate Control Theory of Pain?
2
, NUR 418 FINAL EXAM (2026–2027) – NURSING CARE OF THE
CHILDBEARING FAMILY
09/27/2026
-Pain impulses are transmitted directly from the injury site to the brain without modulation.
-Pain impulses are modulated at the spinal cord level before reaching the brain.
-Pain impulses originate in the brain and are sent to the injured area.
-Pain impulses are only influenced by emotional state, not physical factors.
A nurse is caring for a laboring patient who does not want pain medication yet. Based on the Gate
Control Theory of Pain, which nursing interventions could help decrease her perception of pain? Select
all that apply.
-Applying warm compresses to the lower back
-Encouraging patterned breathing during contractions
-Providing firm sacral counterpressure
-Placing the patient flat on her back to rest
-Offering music for relaxation and distraction
-Teaching the patient to focus on a focal point during contractions
A nurse is assessing a postpartum patient 12 hours after delivery. Which finding should the nurse
expect?
-Fundus at the level of the umbilicus
-Fundus two fingerbreadths above the umbilicus
-Fundus two fingerbreadths below the umbilicus
-Fundus deviated to the right
The nurse notes that a postpartum patient's fundus is boggy and displaced to the right. Which is the
nurse's first action?
9/27/2026
-Administer oxytocin
-Assess the patient's bladder and encourage voiding
3
, NUR 418 FINAL EXAM (2026–2027) – NURSING CARE OF THE
CHILDBEARING FAMILY
09/27/2026
-Increase IV fluids
-Call the provider immediately
Which lochia finding on day 4 postpartum should be reported to the provider?
-Lochia rubra with small clots
-Lochia serosa that is pinkish-brown
-Lochia rubra with foul odor and large clots
-Lochia alba that is yellow-white
Which assessment finding 48 hours postpartum is abnormal?
-Pulse rate of 58 bpm
-Temperature of 100.4°F (38°C)
-Fundus 2 cm below the umbilicus and firm
-Lochia serosa
The nurse is performing a postpartum assessment. Which action is most appropriate before palpating
the fundus?
-Offer pain medication
-Ask the patient to void
-Place the patient in Trendelenburg position
-Give the patient a warm blanket
9/27/2026
A nurse is assessing a newborn 2 hours after birth. Which finding should be reported to the provider
immediately?
4
