NCLEX FINAL EXAM QUICK REFRESHER| FROM
QUESTION TO PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027
Duration: 2 Hours
Total Marks: 70%
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, Uterine Tachysystole Answer: Assessment: > 5 contractions in 10 min with minimal relaxation.
Intervention: Stop oxytocin, reposition mother, give oxygen, start IV fluids, notify provider.
Education: Teach client to report strong, frequent contractions.
Hypertonic Uterine Dysfunction Answer: A labor pattern marked by intense contractions with
little rest, often leading to rapid delivery.
Risk factors for Hypertonic Uterine Dysfunction Answer: Excessive oxytocin, dehydration,
anxiety, maternal fatigue.
Maternal signs of Hypertonic Uterine Dysfunction Answer: Low‑back ache, abdominal
pressure, cramping, diarrhea, increased vaginal discharge.
Fetal signs of Hypertonic Uterine Dysfunction Answer: Possible distress - bradycardia, late
decelerations.
Labor progress in Hypertonic Uterine Dysfunction Answer: Very rapid cervical dilation and
effacement.
Complications of Hypertonic Uterine Dysfunction Answer: Precipitous labor, uterine atony,
postpartum hemorrhage (PPH).
Nursing actions for Hypertonic Uterine Dysfunction Answer: Never leave unattended, provide
emotional support, encourage controlled breathing, prepare precipitous birth kit, apply gentle
pressure to the fetal head, check for nuchal cord, suction airway immediately.
Precipitous Labor Answer: Assessment: Labor < 3 hrs, high risk of maternal/fetal trauma.
Intervention: Stay with client, prepare emergency delivery, monitor fetal heart rate (FHR) and
vital signs, assess for placental separation, watch for uterine atony and excessive bleeding.
Patient education: Risk of recurrence, signs of PPH (heavy bleeding, large clots, dizziness).
Dystocia Answer: The 5 P's of Dystocia: Power (Uterine contractility), Passenger (Fetal
size/shape), Passage (Maternal pelvis), Psyche (Maternal anxiety, fatigue), Position (Maternal
posture affecting fetal descent).
Hypotonic uterus Answer: Weak, ineffective contractions → may need oxytocin augmentation.
Hypertonic uterus Answer: Frequent, strong contractions → limit oxytocin, ensure hydration,
provide rest.
Interventions for Dystocia Answer: 1. Assess cervical dilation, effacement, fetal descent. 2. Use
amniotomy (if indicated) and oxytocin (avoid if hypertonic). 3. Encourage position changes
(hands‑and‑knees, lateral). 4. Apply counter‑pressure to sacral area for comfort. 5. Prepare for
operative vaginal delivery (forceps, vacuum) or cesarean section if needed.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
QUESTION TO PERFECTION| STUDY WITH CONFIDENCE!
Course Code:
Course Title:
Programme:
Academic Year: 2026/2027
Duration: 2 Hours
Total Marks: 70%
Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.
Turn Over.
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
, Uterine Tachysystole Answer: Assessment: > 5 contractions in 10 min with minimal relaxation.
Intervention: Stop oxytocin, reposition mother, give oxygen, start IV fluids, notify provider.
Education: Teach client to report strong, frequent contractions.
Hypertonic Uterine Dysfunction Answer: A labor pattern marked by intense contractions with
little rest, often leading to rapid delivery.
Risk factors for Hypertonic Uterine Dysfunction Answer: Excessive oxytocin, dehydration,
anxiety, maternal fatigue.
Maternal signs of Hypertonic Uterine Dysfunction Answer: Low‑back ache, abdominal
pressure, cramping, diarrhea, increased vaginal discharge.
Fetal signs of Hypertonic Uterine Dysfunction Answer: Possible distress - bradycardia, late
decelerations.
Labor progress in Hypertonic Uterine Dysfunction Answer: Very rapid cervical dilation and
effacement.
Complications of Hypertonic Uterine Dysfunction Answer: Precipitous labor, uterine atony,
postpartum hemorrhage (PPH).
Nursing actions for Hypertonic Uterine Dysfunction Answer: Never leave unattended, provide
emotional support, encourage controlled breathing, prepare precipitous birth kit, apply gentle
pressure to the fetal head, check for nuchal cord, suction airway immediately.
Precipitous Labor Answer: Assessment: Labor < 3 hrs, high risk of maternal/fetal trauma.
Intervention: Stay with client, prepare emergency delivery, monitor fetal heart rate (FHR) and
vital signs, assess for placental separation, watch for uterine atony and excessive bleeding.
Patient education: Risk of recurrence, signs of PPH (heavy bleeding, large clots, dizziness).
Dystocia Answer: The 5 P's of Dystocia: Power (Uterine contractility), Passenger (Fetal
size/shape), Passage (Maternal pelvis), Psyche (Maternal anxiety, fatigue), Position (Maternal
posture affecting fetal descent).
Hypotonic uterus Answer: Weak, ineffective contractions → may need oxytocin augmentation.
Hypertonic uterus Answer: Frequent, strong contractions → limit oxytocin, ensure hydration,
provide rest.
Interventions for Dystocia Answer: 1. Assess cervical dilation, effacement, fetal descent. 2. Use
amniotomy (if indicated) and oxytocin (avoid if hypertonic). 3. Encourage position changes
(hands‑and‑knees, lateral). 4. Apply counter‑pressure to sacral area for comfort. 5. Prepare for
operative vaginal delivery (forceps, vacuum) or cesarean section if needed.
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
