NUR 254 MATERNAL EXAM 3
COMPREHENSIVE | QUESTIONS AND
ANSWERS | 2026 UPDATED | WITH
COMPLETE SOLUTIONS - GALEN
COLLEGE.
SECTION 1: LABOR AND DELIVERY
Question 1
What are the "4 Ps" of labor?
A) Powers, Passageway, Passenger, Psyche
B) Pressure, Position, Pelvis, Psyche
C) Powers, Pelvis, Position, Pain
D) Passageway, Pressure, Passenger, Psyche
Rationale: The 4 Ps of labor are: Powers (uterine contractions), Passageway (maternal
pelvis), Passenger (fetus), and Psyche (maternal psychological response). These factors
interact to determine the progress and outcome of labor.
Question 2
What is the most common type of fetal presentation?
,A) Breech
B) Transverse
C) Vertex (cephalic)
D) Shoulder
Rationale: Vertex (cephalic) presentation is the most common fetal presentation at term
(approximately 95%). In this presentation, the fetal head is the presenting part, with the
occiput as the reference point.
Question 3
What is the normal fetal heart rate (FHR) range at term?
A) 80-100 beats per minute
B) 100-120 beats per minute
C) 110-160 beats per minute
D) 160-200 beats per minute
Rationale: The normal FHR at term is 110-160 beats per minute. FHR < 110
(bradycardia) or > 160 (tachycardia) may indicate fetal distress or maternal/fetal
conditions requiring further evaluation.
Question 4
An early deceleration on fetal monitoring is most commonly caused by:
A) Head compression
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Maternal hypotension
Rationale: Early decelerations mirror uterine contractions and are caused by head
compression. They are considered benign and do not require intervention. Late
decelerations are associated with uteroplacental insufficiency, and variable decelerations
are associated with cord compression.
,Question 5
A variable deceleration on fetal monitoring is most commonly caused by:
A) Head compression
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Maternal hypotension
Rationale: Variable decelerations are caused by umbilical cord compression. They
appear as abrupt, V-shaped decreases in FHR. Management includes changing maternal
position, administering oxygen, and amnioinfusion if indicated.
Question 6
A late deceleration on fetal monitoring is most commonly caused by:
A) Head compression
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Maternal hypotension
Rationale: Late decelerations are caused by uteroplacental insufficiency, resulting in
decreased oxygen delivery to the fetus. They occur after the peak of the contraction and
may indicate fetal hypoxia. Management includes maternal repositioning, oxygen
administration, IV fluids, and possible delivery.
Question 7
What is the most common cause of cephalopelvic disproportion (CPD)?
A) Fetal macrosomia
B) Maternal obesity
, C) Pelvic fractures
D) Inadequate cervical dilation
Rationale: Cephalopelvic disproportion (CPD) occurs when the fetal head is too large to
pass through the maternal pelvis. The most common cause is fetal macrosomia (large
for gestational age), often associated with maternal diabetes.
Question 8
What is the first stage of labor?
A) Onset of regular contractions to complete cervical dilation (10 cm)
B) Complete cervical dilation to delivery of the fetus
C) Delivery of the fetus to delivery of the placenta
D) Delivery of the placenta to 4 hours postpartum
Rationale: The first stage of labor is divided into latent (0-6 cm) and active (6-10 cm)
phases and ends with complete cervical dilation (10 cm). The second stage is from
complete dilation to delivery of the fetus.
Question 9
What is the normal duration of the latent phase of labor in a nulliparous woman?
A) Up to 20 hours
B) 4-8 hours
C) 1-2 hours
D) 30 minutes to 1 hour
Rationale: The latent phase of labor in a nulliparous woman can last up to 20 hours; in a
multiparous woman, it can last up to 14 hours. Active phase begins at 6 cm dilation.
COMPREHENSIVE | QUESTIONS AND
ANSWERS | 2026 UPDATED | WITH
COMPLETE SOLUTIONS - GALEN
COLLEGE.
SECTION 1: LABOR AND DELIVERY
Question 1
What are the "4 Ps" of labor?
A) Powers, Passageway, Passenger, Psyche
B) Pressure, Position, Pelvis, Psyche
C) Powers, Pelvis, Position, Pain
D) Passageway, Pressure, Passenger, Psyche
Rationale: The 4 Ps of labor are: Powers (uterine contractions), Passageway (maternal
pelvis), Passenger (fetus), and Psyche (maternal psychological response). These factors
interact to determine the progress and outcome of labor.
Question 2
What is the most common type of fetal presentation?
,A) Breech
B) Transverse
C) Vertex (cephalic)
D) Shoulder
Rationale: Vertex (cephalic) presentation is the most common fetal presentation at term
(approximately 95%). In this presentation, the fetal head is the presenting part, with the
occiput as the reference point.
Question 3
What is the normal fetal heart rate (FHR) range at term?
A) 80-100 beats per minute
B) 100-120 beats per minute
C) 110-160 beats per minute
D) 160-200 beats per minute
Rationale: The normal FHR at term is 110-160 beats per minute. FHR < 110
(bradycardia) or > 160 (tachycardia) may indicate fetal distress or maternal/fetal
conditions requiring further evaluation.
Question 4
An early deceleration on fetal monitoring is most commonly caused by:
A) Head compression
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Maternal hypotension
Rationale: Early decelerations mirror uterine contractions and are caused by head
compression. They are considered benign and do not require intervention. Late
decelerations are associated with uteroplacental insufficiency, and variable decelerations
are associated with cord compression.
,Question 5
A variable deceleration on fetal monitoring is most commonly caused by:
A) Head compression
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Maternal hypotension
Rationale: Variable decelerations are caused by umbilical cord compression. They
appear as abrupt, V-shaped decreases in FHR. Management includes changing maternal
position, administering oxygen, and amnioinfusion if indicated.
Question 6
A late deceleration on fetal monitoring is most commonly caused by:
A) Head compression
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Maternal hypotension
Rationale: Late decelerations are caused by uteroplacental insufficiency, resulting in
decreased oxygen delivery to the fetus. They occur after the peak of the contraction and
may indicate fetal hypoxia. Management includes maternal repositioning, oxygen
administration, IV fluids, and possible delivery.
Question 7
What is the most common cause of cephalopelvic disproportion (CPD)?
A) Fetal macrosomia
B) Maternal obesity
, C) Pelvic fractures
D) Inadequate cervical dilation
Rationale: Cephalopelvic disproportion (CPD) occurs when the fetal head is too large to
pass through the maternal pelvis. The most common cause is fetal macrosomia (large
for gestational age), often associated with maternal diabetes.
Question 8
What is the first stage of labor?
A) Onset of regular contractions to complete cervical dilation (10 cm)
B) Complete cervical dilation to delivery of the fetus
C) Delivery of the fetus to delivery of the placenta
D) Delivery of the placenta to 4 hours postpartum
Rationale: The first stage of labor is divided into latent (0-6 cm) and active (6-10 cm)
phases and ends with complete cervical dilation (10 cm). The second stage is from
complete dilation to delivery of the fetus.
Question 9
What is the normal duration of the latent phase of labor in a nulliparous woman?
A) Up to 20 hours
B) 4-8 hours
C) 1-2 hours
D) 30 minutes to 1 hour
Rationale: The latent phase of labor in a nulliparous woman can last up to 20 hours; in a
multiparous woman, it can last up to 14 hours. Active phase begins at 6 cm dilation.
