INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
NUR231 — Labor Delivery and Postpartum Exam 2 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 laboring patient has a persistent fetal heart rate deceleration after a position change. What is the priority?
A. Promptly escalate and initiate the unit's intrauterine resuscitation measures
B. Document the tracing and continue routine observation
C. Increase uterotonic infusion without reassessment
D. Ask the patient to begin pushing immediately
Correct Answer: A — Promptly escalate and initiate the unit's intrauterine resuscitation measures
Rationale: Persistent concerning fetal heart patterns call for immediate maternal-fetal assessment and team
response.
2. 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.
3. 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.
4. 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
NUR231 | Original educational practice • 1
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
Rationale: Estimated due dates are approximate; red flags such as bleeding, ruptured membranes, or decreased
movement require assessment.
5. A laboring patient requests nonpharmacologic pain relief. Which option is appropriate?
A. Insist every patient use the same method
B. Discourage support-person presence universally
C. Offer position changes, breathing strategies, support, and counterpressure
D. Withhold hydration without indication
Correct Answer: C — Offer position changes, breathing strategies, support, and counterpressure
Rationale: Individualized comfort methods can improve coping and autonomy during labor.
6. 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.
7. A newborn remains apneic with heart rate under 100 after initial steps. What is the lifesaving first intervention?
A. Vitamin K before airway support
B. Effective positive-pressure ventilation
C. Chest compressions immediately before ventilation
D. Routine bath
Correct Answer: B — Effective positive-pressure ventilation
Rationale: Newborn bradycardia is often respiratory, so assisted ventilation is the primary early resuscitative
intervention.
8. 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.
9. What is the priority when oxytocin causes tachysystole and a concerning fetal tracing?
A. Stop or reduce oxytocin per protocol and initiate fetal resuscitative measures
B. Encourage forceful closed-glottis pushing
C. Delay all provider notifications
D. Double the infusion rate
Correct Answer: A — Stop or reduce oxytocin per protocol and initiate fetal resuscitative measures
NUR231 | Original educational practice • 2
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
Rationale: Removing the uterotonic trigger helps restore uterine resting time and placental perfusion.
10. When does the second stage of labor begin?
A. At the first prenatal contraction
B. When the placenta delivers
C. At rupture of membranes alone
D. At complete cervical dilation
Correct Answer: D — At complete cervical dilation
Rationale: The second stage runs from full cervical dilation until the infant is born.
11. Which assessment may indicate an abnormal fetal presentation during labor?
A. Persistent atypical presenting-part findings on examination or ultrasound
B. Moderate baseline variability
C. Normal vertex palpation
D. A reassuring cephalic ultrasound
Correct Answer: A — Persistent atypical presenting-part findings on examination or ultrasound
Rationale: Presentation guides delivery planning; breech or transverse lie may affect safety and approach.
12. Which labor finding defines true labor rather than Braxton Hicks contractions?
A. Progressive cervical change associated with regular contractions
B. Irregular tightening that stops with hydration
C. Contractions only while walking
D. No cervical change after repeated assessment
Correct Answer: A — Progressive cervical change associated with regular contractions
Rationale: True labor causes cervical dilation and effacement over time, not simply subjective contraction
discomfort.
13. Which maternal position can help relieve umbilical cord compression while urgent care is arranged?
A. Sitting upright and pushing repeatedly
B. Knee-chest or steep lateral position, as clinically feasible
C. Standing and bearing down
D. Flat supine with legs extended
Correct Answer: B — Knee-chest or steep lateral position, as clinically feasible
Rationale: Positions that shift the presenting part away from the cord may temporarily improve flow.
14. Which teaching best supports an accurate home fetal movement assessment in the third trimester?
A. Wait several days before contacting the care team
B. Count only during active exercise
C. Ignore a change if the pregnancy has reached 36 weeks
D. Report a noticeable decrease from the baby's usual movement pattern promptly
Correct Answer: D — Report a noticeable decrease from the baby's usual movement pattern promptly
Rationale: A decrease in the usual pattern may signal fetal compromise; do not postpone assessment for an arbitrary
count threshold.
NUR231 | Original educational practice • 3
NUR231 — Labor Delivery and Postpartum Exam 2 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 laboring patient has a persistent fetal heart rate deceleration after a position change. What is the priority?
A. Promptly escalate and initiate the unit's intrauterine resuscitation measures
B. Document the tracing and continue routine observation
C. Increase uterotonic infusion without reassessment
D. Ask the patient to begin pushing immediately
Correct Answer: A — Promptly escalate and initiate the unit's intrauterine resuscitation measures
Rationale: Persistent concerning fetal heart patterns call for immediate maternal-fetal assessment and team
response.
2. 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.
3. 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.
4. 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
NUR231 | Original educational practice • 1
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
Rationale: Estimated due dates are approximate; red flags such as bleeding, ruptured membranes, or decreased
movement require assessment.
5. A laboring patient requests nonpharmacologic pain relief. Which option is appropriate?
A. Insist every patient use the same method
B. Discourage support-person presence universally
C. Offer position changes, breathing strategies, support, and counterpressure
D. Withhold hydration without indication
Correct Answer: C — Offer position changes, breathing strategies, support, and counterpressure
Rationale: Individualized comfort methods can improve coping and autonomy during labor.
6. 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.
7. A newborn remains apneic with heart rate under 100 after initial steps. What is the lifesaving first intervention?
A. Vitamin K before airway support
B. Effective positive-pressure ventilation
C. Chest compressions immediately before ventilation
D. Routine bath
Correct Answer: B — Effective positive-pressure ventilation
Rationale: Newborn bradycardia is often respiratory, so assisted ventilation is the primary early resuscitative
intervention.
8. 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.
9. What is the priority when oxytocin causes tachysystole and a concerning fetal tracing?
A. Stop or reduce oxytocin per protocol and initiate fetal resuscitative measures
B. Encourage forceful closed-glottis pushing
C. Delay all provider notifications
D. Double the infusion rate
Correct Answer: A — Stop or reduce oxytocin per protocol and initiate fetal resuscitative measures
NUR231 | Original educational practice • 2
, INDEPENDENT STUDY RESOURCE • NUR231 • 2026–2027
Rationale: Removing the uterotonic trigger helps restore uterine resting time and placental perfusion.
10. When does the second stage of labor begin?
A. At the first prenatal contraction
B. When the placenta delivers
C. At rupture of membranes alone
D. At complete cervical dilation
Correct Answer: D — At complete cervical dilation
Rationale: The second stage runs from full cervical dilation until the infant is born.
11. Which assessment may indicate an abnormal fetal presentation during labor?
A. Persistent atypical presenting-part findings on examination or ultrasound
B. Moderate baseline variability
C. Normal vertex palpation
D. A reassuring cephalic ultrasound
Correct Answer: A — Persistent atypical presenting-part findings on examination or ultrasound
Rationale: Presentation guides delivery planning; breech or transverse lie may affect safety and approach.
12. Which labor finding defines true labor rather than Braxton Hicks contractions?
A. Progressive cervical change associated with regular contractions
B. Irregular tightening that stops with hydration
C. Contractions only while walking
D. No cervical change after repeated assessment
Correct Answer: A — Progressive cervical change associated with regular contractions
Rationale: True labor causes cervical dilation and effacement over time, not simply subjective contraction
discomfort.
13. Which maternal position can help relieve umbilical cord compression while urgent care is arranged?
A. Sitting upright and pushing repeatedly
B. Knee-chest or steep lateral position, as clinically feasible
C. Standing and bearing down
D. Flat supine with legs extended
Correct Answer: B — Knee-chest or steep lateral position, as clinically feasible
Rationale: Positions that shift the presenting part away from the cord may temporarily improve flow.
14. Which teaching best supports an accurate home fetal movement assessment in the third trimester?
A. Wait several days before contacting the care team
B. Count only during active exercise
C. Ignore a change if the pregnancy has reached 36 weeks
D. Report a noticeable decrease from the baby's usual movement pattern promptly
Correct Answer: D — Report a noticeable decrease from the baby's usual movement pattern promptly
Rationale: A decrease in the usual pattern may signal fetal compromise; do not postpone assessment for an arbitrary
count threshold.
NUR231 | Original educational practice • 3
