,NUR202 Maternal Newborn Nursing Exam 2
Study Guide & 150 Practice Questions Fortis
College 2026/2027
1. A nulliparous client is admitted to the labor unit. Her cervix is 4 cm dilated, 80% effaced, and
the fetus is at 0 station. According to the 2026 Fortis curriculum, which stage and phase of labor
is this client experiencing?
A. First stage, active phase
B. First stage, latent phase
C. First stage, transition phase
D. Second stage of labor
Correct Answer: B. First stage, latent phase
Rationale: The latent phase of the first stage is defined as 0–6 cm cervical dilation; active phase
begins at 6 cm per the Zhang curve update. With 4 cm dilation and 80% effacement, this client
is in the latent phase. Active phase starts at 6 cm, transition is 8–10 cm, and second stage
begins at full 10 cm dilation.
2. A laboring client at 6 cm dilation has been progressing at approximately 0.5 cm per hour for
the past 4 hours. The primary nurse recognizes that according to the 2026 Zhang curve update,
which interpretation is most accurate?
,A. This progression indicates arrest of dilation requiring oxytocin augmentation
B. Slower cervical dilation in the active phase is not abnormal and may be normal
C. This is diagnostic of secondary arrest requiring cesarean delivery
D. The Friedman curve mandates delivery within 18 hours of labor onset
Correct Answer: B. Slower cervical dilation in the active phase is not abnormal and may be
normal
Rationale: The 2026 Zhang curve update recognizes that slower dilation in active phase (6 cm
and beyond) is not automatically abnormal, unlike the Friedman curve which expected faster
progression; this avoids unnecessary interventions. Arrest criteria require no change for >4
hours with adequate contractions or >6 hours with oxytocin.
3. A nulliparous client with an epidural has been pushing effectively for 2.5 hours during the
second stage. According to AWHONN and Fortis NUR202 standards, which action by the nurse is
most appropriate?
A. Continue pushing as this is within normal limits for a nulliparous client with epidural
B. Immediately notify the provider for operative vaginal delivery
C. Prepare for cesarean section due to arrest of descent
, D. Discontinue the epidural to facilitate faster delivery
Correct Answer: A. Continue pushing as this is within normal limits for a nulliparous client with
epidural
Rationale: The second stage for nulliparous clients may last up to 3 hours with an epidural (2
hours without); 2.5 hours is still within acceptable limits and does not indicate arrest. Operative
delivery is only considered after the time limit is exceeded with no descent.
4. During the third stage of labor, the nurse observes the uterine fundus rising and becoming
globular, a gush of blood from the vagina, and lengthening of the umbilical cord. These signs
indicate which physiological event?
A. Uterine atony
B. Placental separation
C. Uterine inversion
D. Cervical laceration
Correct Answer: B. Placental separation
Study Guide & 150 Practice Questions Fortis
College 2026/2027
1. A nulliparous client is admitted to the labor unit. Her cervix is 4 cm dilated, 80% effaced, and
the fetus is at 0 station. According to the 2026 Fortis curriculum, which stage and phase of labor
is this client experiencing?
A. First stage, active phase
B. First stage, latent phase
C. First stage, transition phase
D. Second stage of labor
Correct Answer: B. First stage, latent phase
Rationale: The latent phase of the first stage is defined as 0–6 cm cervical dilation; active phase
begins at 6 cm per the Zhang curve update. With 4 cm dilation and 80% effacement, this client
is in the latent phase. Active phase starts at 6 cm, transition is 8–10 cm, and second stage
begins at full 10 cm dilation.
2. A laboring client at 6 cm dilation has been progressing at approximately 0.5 cm per hour for
the past 4 hours. The primary nurse recognizes that according to the 2026 Zhang curve update,
which interpretation is most accurate?
,A. This progression indicates arrest of dilation requiring oxytocin augmentation
B. Slower cervical dilation in the active phase is not abnormal and may be normal
C. This is diagnostic of secondary arrest requiring cesarean delivery
D. The Friedman curve mandates delivery within 18 hours of labor onset
Correct Answer: B. Slower cervical dilation in the active phase is not abnormal and may be
normal
Rationale: The 2026 Zhang curve update recognizes that slower dilation in active phase (6 cm
and beyond) is not automatically abnormal, unlike the Friedman curve which expected faster
progression; this avoids unnecessary interventions. Arrest criteria require no change for >4
hours with adequate contractions or >6 hours with oxytocin.
3. A nulliparous client with an epidural has been pushing effectively for 2.5 hours during the
second stage. According to AWHONN and Fortis NUR202 standards, which action by the nurse is
most appropriate?
A. Continue pushing as this is within normal limits for a nulliparous client with epidural
B. Immediately notify the provider for operative vaginal delivery
C. Prepare for cesarean section due to arrest of descent
, D. Discontinue the epidural to facilitate faster delivery
Correct Answer: A. Continue pushing as this is within normal limits for a nulliparous client with
epidural
Rationale: The second stage for nulliparous clients may last up to 3 hours with an epidural (2
hours without); 2.5 hours is still within acceptable limits and does not indicate arrest. Operative
delivery is only considered after the time limit is exceeded with no descent.
4. During the third stage of labor, the nurse observes the uterine fundus rising and becoming
globular, a gush of blood from the vagina, and lengthening of the umbilical cord. These signs
indicate which physiological event?
A. Uterine atony
B. Placental separation
C. Uterine inversion
D. Cervical laceration
Correct Answer: B. Placental separation
