INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
NUR231 — Maternal Nursing Exam 1 2026–2027
NUR 231 | Concepts of Nursing: The Childbearing/Child Caring Family
Institution / scope: Galen College of Nursing
Contents: 100 independently authored educational practice questions with one keyed answer and a rationale per question;
quick answer key at the end.
Original practice questions
Labor
1. A patient reports a sudden gush of fluid during labor. Which assessment is essential first?
A. Offer a meal before evaluation
B. Assess fetal heart rate and maternal status
C. Begin routine walking exercises
D. Perform repeated digital examinations without indication
Correct Answer: B — Assess fetal heart rate and maternal status
Rationale: Ruptured membranes require prompt fetal assessment and evaluation for complications such as cord
prolapse.
2. Following rupture of membranes, a cord is visible at the vagina. What should the nurse do?
A. Call for emergency help and relieve pressure on the cord while preparing urgent delivery
B. Leave the patient to obtain supplies
C. Try to push the cord back into the uterus
D. Encourage bearing down immediately
Correct Answer: A — Call for emergency help and relieve pressure on the cord while preparing urgent delivery
Rationale: Cord prolapse threatens fetal oxygenation; immediate emergency actions aim to reduce cord
compression.
3. What is an appropriate nonpharmacologic comfort measure during uncomplicated labor?
A. Withhold explanations during contractions
B. Offer positional changes and breathing support according to preference
C. Discourage the support person without asking the patient
D. Require one fixed position for all patients
Correct Answer: B — Offer positional changes and breathing support according to preference
Rationale: Individualized positioning and coping support are safe, person-centered comfort measures.
4. Which finding most suggests true labor rather than false labor?
A. Contractions only after dehydration
B. Progressive cervical change with contractions
C. Discomfort without any cervical change
D. Irregular contractions relieved by rest
Correct Answer: B — Progressive cervical change with contractions
Rationale: True labor produces progressive cervical dilation and effacement.
NUR231 | Original educational practice • 1
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
5. A first-time pregnant patient asks about expected labor timing. What is the best teaching?
A. Labor always begins exactly at 40 weeks
B. Rupture of membranes is harmless for days
C. Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date hour
D. All contractions mean active labor
Correct Answer: C — Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date
hour
Rationale: Estimated due dates are approximate; red flags such as bleeding, ruptured membranes, or decreased
movement require assessment.
6. A laboring patient has maternal fever, fetal tachycardia, and uterine tenderness. What should the nurse suspect?
A. Normal first-stage labor without concern
B. Placenta previa without bleeding
C. Isolated benign fetal hiccups
D. Intraamniotic infection requiring prompt evaluation
Correct Answer: D — Intraamniotic infection requiring prompt evaluation
Rationale: Fever with fetal tachycardia and uterine tenderness raises concern for intraamniotic infection.
7. A laboring patient has persistent tachysystole while receiving oxytocin. What should happen?
A. Increase the infusion to shorten labor
B. Withhold all fetal monitoring
C. Reduce or stop the medication per protocol and reassess fetal status
D. Start pushing regardless of dilation
Correct Answer: C — Reduce or stop the medication per protocol and reassess fetal status
Rationale: Excessive contractions reduce placental reperfusion and can cause fetal compromise.
8. A laboring patient with previous cesarean birth has abrupt fetal bradycardia and sudden loss of fetal station.
Suspect what?
A. Physiologic second-stage descent
B. Normal placental delivery
C. Uterine rupture
D. Simple bladder distention
Correct Answer: C — Uterine rupture
Rationale: These can be warning signs of a catastrophic uterine scar separation needing emergency response.
9. A labouring patient experiences a sudden prolonged fetal heart-rate deceleration. What is the most appropriate
initial nursing response?
A. Prepare discharge instructions
B. Encourage the patient to walk alone without assessment
C. Ignore the tracing until the next scheduled recording
D. Assess the mother and fetus, initiate indicated intrauterine resuscitative steps, and immediately summon the
maternity team
Correct Answer: D — Assess the mother and fetus, initiate indicated intrauterine resuscitative steps, and
immediately summon the maternity team
NUR231 | Original educational practice • 2
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
Rationale: A sustained abnormal fetal heart pattern requires prompt bedside assessment, corrective measures as
directed, and escalation.
10. A patient had GBS bacteriuria during the current pregnancy. What is the anticipated labor plan?
A. Use only postpartum oral antibiotics
B. Give intrapartum antibiotic prophylaxis regardless of later screening culture
C. Withhold antibiotics if afebrile
D. Provide an MMR booster during labor
Correct Answer: B — Give intrapartum antibiotic prophylaxis regardless of later screening culture
Rationale: GBS bacteriuria during pregnancy signals increased colonization and is an indication for intrapartum
prophylaxis.
11. A patient has a previous uterine incision and sudden pain, fetal bradycardia, and loss of station during labor.
What must be considered?
A. Uncomplicated transition labor
B. Uterine rupture
C. Normal third-stage placental separation
D. Ordinary fetal head compression
Correct Answer: B — Uterine rupture
Rationale: A scarred uterus plus sudden fetal compromise and loss of station are warning signs of rupture.
12. A sudden variable fetal-heart deceleration is most commonly associated with what?
A. Maternal fasting alone
B. Umbilical cord compression
C. Fetal head descent alone
D. Normal maternal respiratory variation
Correct Answer: B — Umbilical cord compression
Rationale: Abrupt variable decelerations often indicate transient umbilical cord compression.
13. For a GBS-positive patient in labor, what nursing responsibility is most important?
A. Use only topical antibacterial wipes
B. Administer live vaccines during contractions
C. Delay all medication until postpartum
D. Verify timely ordered intrapartum antibiotic prophylaxis
Correct Answer: D — Verify timely ordered intrapartum antibiotic prophylaxis
Rationale: Appropriate intrapartum antibiotics reduce early-onset neonatal GBS disease.
14. Late fetal-heart decelerations begin after contraction onset. What is the major concern?
A. Normal head compression
B. Effective pain control
C. Maternal bladder filling alone
D. Reduced uteroplacental oxygen exchange
Correct Answer: D — Reduced uteroplacental oxygen exchange
NUR231 | Original educational practice • 3
NUR231 — Maternal Nursing Exam 1 2026–2027
NUR 231 | Concepts of Nursing: The Childbearing/Child Caring Family
Institution / scope: Galen College of Nursing
Contents: 100 independently authored educational practice questions with one keyed answer and a rationale per question;
quick answer key at the end.
Original practice questions
Labor
1. A patient reports a sudden gush of fluid during labor. Which assessment is essential first?
A. Offer a meal before evaluation
B. Assess fetal heart rate and maternal status
C. Begin routine walking exercises
D. Perform repeated digital examinations without indication
Correct Answer: B — Assess fetal heart rate and maternal status
Rationale: Ruptured membranes require prompt fetal assessment and evaluation for complications such as cord
prolapse.
2. Following rupture of membranes, a cord is visible at the vagina. What should the nurse do?
A. Call for emergency help and relieve pressure on the cord while preparing urgent delivery
B. Leave the patient to obtain supplies
C. Try to push the cord back into the uterus
D. Encourage bearing down immediately
Correct Answer: A — Call for emergency help and relieve pressure on the cord while preparing urgent delivery
Rationale: Cord prolapse threatens fetal oxygenation; immediate emergency actions aim to reduce cord
compression.
3. What is an appropriate nonpharmacologic comfort measure during uncomplicated labor?
A. Withhold explanations during contractions
B. Offer positional changes and breathing support according to preference
C. Discourage the support person without asking the patient
D. Require one fixed position for all patients
Correct Answer: B — Offer positional changes and breathing support according to preference
Rationale: Individualized positioning and coping support are safe, person-centered comfort measures.
4. Which finding most suggests true labor rather than false labor?
A. Contractions only after dehydration
B. Progressive cervical change with contractions
C. Discomfort without any cervical change
D. Irregular contractions relieved by rest
Correct Answer: B — Progressive cervical change with contractions
Rationale: True labor produces progressive cervical dilation and effacement.
NUR231 | Original educational practice • 1
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
5. A first-time pregnant patient asks about expected labor timing. What is the best teaching?
A. Labor always begins exactly at 40 weeks
B. Rupture of membranes is harmless for days
C. Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date hour
D. All contractions mean active labor
Correct Answer: C — Labor onset is variable; report concerning symptoms rather than relying on a fixed due-date
hour
Rationale: Estimated due dates are approximate; red flags such as bleeding, ruptured membranes, or decreased
movement require assessment.
6. A laboring patient has maternal fever, fetal tachycardia, and uterine tenderness. What should the nurse suspect?
A. Normal first-stage labor without concern
B. Placenta previa without bleeding
C. Isolated benign fetal hiccups
D. Intraamniotic infection requiring prompt evaluation
Correct Answer: D — Intraamniotic infection requiring prompt evaluation
Rationale: Fever with fetal tachycardia and uterine tenderness raises concern for intraamniotic infection.
7. A laboring patient has persistent tachysystole while receiving oxytocin. What should happen?
A. Increase the infusion to shorten labor
B. Withhold all fetal monitoring
C. Reduce or stop the medication per protocol and reassess fetal status
D. Start pushing regardless of dilation
Correct Answer: C — Reduce or stop the medication per protocol and reassess fetal status
Rationale: Excessive contractions reduce placental reperfusion and can cause fetal compromise.
8. A laboring patient with previous cesarean birth has abrupt fetal bradycardia and sudden loss of fetal station.
Suspect what?
A. Physiologic second-stage descent
B. Normal placental delivery
C. Uterine rupture
D. Simple bladder distention
Correct Answer: C — Uterine rupture
Rationale: These can be warning signs of a catastrophic uterine scar separation needing emergency response.
9. A labouring patient experiences a sudden prolonged fetal heart-rate deceleration. What is the most appropriate
initial nursing response?
A. Prepare discharge instructions
B. Encourage the patient to walk alone without assessment
C. Ignore the tracing until the next scheduled recording
D. Assess the mother and fetus, initiate indicated intrauterine resuscitative steps, and immediately summon the
maternity team
Correct Answer: D — Assess the mother and fetus, initiate indicated intrauterine resuscitative steps, and
immediately summon the maternity team
NUR231 | Original educational practice • 2
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
Rationale: A sustained abnormal fetal heart pattern requires prompt bedside assessment, corrective measures as
directed, and escalation.
10. A patient had GBS bacteriuria during the current pregnancy. What is the anticipated labor plan?
A. Use only postpartum oral antibiotics
B. Give intrapartum antibiotic prophylaxis regardless of later screening culture
C. Withhold antibiotics if afebrile
D. Provide an MMR booster during labor
Correct Answer: B — Give intrapartum antibiotic prophylaxis regardless of later screening culture
Rationale: GBS bacteriuria during pregnancy signals increased colonization and is an indication for intrapartum
prophylaxis.
11. A patient has a previous uterine incision and sudden pain, fetal bradycardia, and loss of station during labor.
What must be considered?
A. Uncomplicated transition labor
B. Uterine rupture
C. Normal third-stage placental separation
D. Ordinary fetal head compression
Correct Answer: B — Uterine rupture
Rationale: A scarred uterus plus sudden fetal compromise and loss of station are warning signs of rupture.
12. A sudden variable fetal-heart deceleration is most commonly associated with what?
A. Maternal fasting alone
B. Umbilical cord compression
C. Fetal head descent alone
D. Normal maternal respiratory variation
Correct Answer: B — Umbilical cord compression
Rationale: Abrupt variable decelerations often indicate transient umbilical cord compression.
13. For a GBS-positive patient in labor, what nursing responsibility is most important?
A. Use only topical antibacterial wipes
B. Administer live vaccines during contractions
C. Delay all medication until postpartum
D. Verify timely ordered intrapartum antibiotic prophylaxis
Correct Answer: D — Verify timely ordered intrapartum antibiotic prophylaxis
Rationale: Appropriate intrapartum antibiotics reduce early-onset neonatal GBS disease.
14. Late fetal-heart decelerations begin after contraction onset. What is the major concern?
A. Normal head compression
B. Effective pain control
C. Maternal bladder filling alone
D. Reduced uteroplacental oxygen exchange
Correct Answer: D — Reduced uteroplacental oxygen exchange
NUR231 | Original educational practice • 3
