NUR 230 Exam 2 Questions and Correct Answers plus
Rationale| New 2026-2027 Update | Graded A+
1. Which of the following best describes the primary purpose of the five P's of
labor?
A) To assess the psychological state of the laboring patient
B) To evaluate the critical factors that influence the labor and birth process
C) To determine the need for a cesarean section
D) To monitor fetal heart rate patterns during contractions
Correct Answer: To evaluate the critical factors that influence the labor and birth
process
Rationale: The five P's—Passenger (fetus), Passageway (pelvis and birth canal),
Powers (contractions), Position (maternal), and Psyche (psychological state)—
provide a comprehensive framework for assessing the factors that affect labor
progression and birth outcomes. They are not limited to psychological
assessment, surgical decision-making, or fetal monitoring alone.
2. What is the primary function of cervical effacement during labor?
A) To thin and shorten the cervix, allowing the fetus to descend
B) To dilate the cervix from 0 to 10 centimeters
C) To rotate the fetal head into the optimal position
D) To stimulate uterine contractions through oxytocin release
Correct Answer: To thin and shorten the cervix, allowing the fetus to descend
Rationale: Effacement refers to the thinning, shortening, and drawing up of the
cervix, measured in percentages from 0% to 100%. It occurs before and during
labor to allow the fetus to descend into the birth canal. Dilation is the opening of
the cervix, and rotation is a separate fetal mechanism.
3. According to the exam blueprint, which pelvic shape is most favorable for a
successful vaginal delivery?
,A) Android
B) Anthropoid
C) Gynecoid
D) Platypelloid
Correct Answer: Gynecoid
Rationale: The gynecoid pelvis is the most favorable shape for vaginal delivery
because its rounded inlet and adequate diameters allow for fetal descent and
rotation. The platypelloid pelvis is flat and often leads to cesarean delivery, while
android and anthropoid shapes present varying degrees of difficulty.
4. Which finding is most consistent with true labor compared to false labor?
A) Contractions that decrease in intensity with ambulation
B) Irregular contractions that do not intensify over time
C) Progressive cervical dilation and effacement
D) Pain that is primarily felt in the lower abdomen
Correct Answer: Progressive cervical dilation and effacement
Rationale: True labor is characterized by regular contractions that intensify with
activity and produce progressive cervical change. False labor contractions are
irregular, do not cause cervical dilation, and often decrease with ambulation. Pain
location alone is not a reliable differentiator.
5. What is the normal baseline fetal heart rate range?
A) 90 to 120 beats per minute
B) 100 to 140 beats per minute
C) 110 to 160 beats per minute
D) 120 to 180 beats per minute
Correct Answer: 110 to 160 beats per minute
Rationale: The normal baseline fetal heart rate is 110 to 160 beats per minute,
observed over a 10-minute period. Rates below 110 indicate bradycardia, and
rates above 160 indicate tachycardia. Both may suggest fetal distress and require
further evaluation.
6. Which fetal heart rate pattern is caused by umbilical cord compression?
,A) Early decelerations
B) Variable decelerations
C) Late decelerations
D) Sinusoidal pattern
Correct Answer: Variable decelerations
Rationale: Variable decelerations are abrupt decreases in fetal heart rate caused
by umbilical cord compression. They are characterized by a rapid onset and
recovery, often with a V-shaped appearance. Early decelerations are caused by
head compression, and late decelerations by uteroplacental insufficiency.
7. A nurse is assessing a patient in labor and notes late decelerations on the
fetal monitor. Which action should the nurse take first?
A) Administer oxygen via face mask
B) Reposition the patient to a lateral position
C) Increase the intravenous fluid rate
D) Notify the provider immediately
Correct Answer: Reposition the patient to a lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal
hypoxia. The first nursing action is to reposition the patient to a lateral position to
improve uterine perfusion. Oxygen, IV fluids, and provider notification may follow,
but repositioning is the immediate priority.
8. Which medication is used to prevent seizures in a patient with severe
preeclampsia?
A) Labetalol
B) Hydralazine
C) Magnesium sulfate
D) Betamethasone
Correct Answer: Magnesium sulfate
Rationale: Magnesium sulfate is the anticonvulsant of choice for seizure
prophylaxis in severe preeclampsia and eclampsia. Labetalol and hydralazine are
, antihypertensives used for blood pressure control. Betamethasone is a
corticosteroid used to promote fetal lung maturity.
9. Which finding indicates magnesium sulfate toxicity in a patient receiving the
medication for preeclampsia?
A) Respiratory rate of 8 breaths per minute
B) Deep tendon reflexes of 2+
C) Urine output of 40 mL per hour
D) Serum magnesium level of 5.5 mg/dL
Correct Answer: Respiratory rate of 8 breaths per minute
Rationale: Magnesium sulfate toxicity is characterized by loss of deep tendon
reflexes, respiratory depression (rate below 12 breaths per minute), oliguria, and
cardiac arrest. A respiratory rate of 8 is a critical finding requiring immediate
discontinuation of the infusion and administration of calcium gluconate.
10.What is the antidote for magnesium sulfate toxicity?
A) Naloxone
B) Calcium gluconate
C) Protamine sulfate
D) Vitamin K
Correct Answer: Calcium gluconate
Rationale: Calcium gluconate is the specific antidote for magnesium sulfate
toxicity. It antagonizes the neuromuscular blocking effects of magnesium.
Naloxone reverses opioids, protamine sulfate reverses heparin, and vitamin K
reverses warfarin.
11.Which medication is administered to a patient in preterm labor to promote
fetal lung maturity?
A) Oxytocin
B) Betamethasone
C) Magnesium sulfate
D) Terbutaline
Correct Answer: Betamethasone
Rationale| New 2026-2027 Update | Graded A+
1. Which of the following best describes the primary purpose of the five P's of
labor?
A) To assess the psychological state of the laboring patient
B) To evaluate the critical factors that influence the labor and birth process
C) To determine the need for a cesarean section
D) To monitor fetal heart rate patterns during contractions
Correct Answer: To evaluate the critical factors that influence the labor and birth
process
Rationale: The five P's—Passenger (fetus), Passageway (pelvis and birth canal),
Powers (contractions), Position (maternal), and Psyche (psychological state)—
provide a comprehensive framework for assessing the factors that affect labor
progression and birth outcomes. They are not limited to psychological
assessment, surgical decision-making, or fetal monitoring alone.
2. What is the primary function of cervical effacement during labor?
A) To thin and shorten the cervix, allowing the fetus to descend
B) To dilate the cervix from 0 to 10 centimeters
C) To rotate the fetal head into the optimal position
D) To stimulate uterine contractions through oxytocin release
Correct Answer: To thin and shorten the cervix, allowing the fetus to descend
Rationale: Effacement refers to the thinning, shortening, and drawing up of the
cervix, measured in percentages from 0% to 100%. It occurs before and during
labor to allow the fetus to descend into the birth canal. Dilation is the opening of
the cervix, and rotation is a separate fetal mechanism.
3. According to the exam blueprint, which pelvic shape is most favorable for a
successful vaginal delivery?
,A) Android
B) Anthropoid
C) Gynecoid
D) Platypelloid
Correct Answer: Gynecoid
Rationale: The gynecoid pelvis is the most favorable shape for vaginal delivery
because its rounded inlet and adequate diameters allow for fetal descent and
rotation. The platypelloid pelvis is flat and often leads to cesarean delivery, while
android and anthropoid shapes present varying degrees of difficulty.
4. Which finding is most consistent with true labor compared to false labor?
A) Contractions that decrease in intensity with ambulation
B) Irregular contractions that do not intensify over time
C) Progressive cervical dilation and effacement
D) Pain that is primarily felt in the lower abdomen
Correct Answer: Progressive cervical dilation and effacement
Rationale: True labor is characterized by regular contractions that intensify with
activity and produce progressive cervical change. False labor contractions are
irregular, do not cause cervical dilation, and often decrease with ambulation. Pain
location alone is not a reliable differentiator.
5. What is the normal baseline fetal heart rate range?
A) 90 to 120 beats per minute
B) 100 to 140 beats per minute
C) 110 to 160 beats per minute
D) 120 to 180 beats per minute
Correct Answer: 110 to 160 beats per minute
Rationale: The normal baseline fetal heart rate is 110 to 160 beats per minute,
observed over a 10-minute period. Rates below 110 indicate bradycardia, and
rates above 160 indicate tachycardia. Both may suggest fetal distress and require
further evaluation.
6. Which fetal heart rate pattern is caused by umbilical cord compression?
,A) Early decelerations
B) Variable decelerations
C) Late decelerations
D) Sinusoidal pattern
Correct Answer: Variable decelerations
Rationale: Variable decelerations are abrupt decreases in fetal heart rate caused
by umbilical cord compression. They are characterized by a rapid onset and
recovery, often with a V-shaped appearance. Early decelerations are caused by
head compression, and late decelerations by uteroplacental insufficiency.
7. A nurse is assessing a patient in labor and notes late decelerations on the
fetal monitor. Which action should the nurse take first?
A) Administer oxygen via face mask
B) Reposition the patient to a lateral position
C) Increase the intravenous fluid rate
D) Notify the provider immediately
Correct Answer: Reposition the patient to a lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency and fetal
hypoxia. The first nursing action is to reposition the patient to a lateral position to
improve uterine perfusion. Oxygen, IV fluids, and provider notification may follow,
but repositioning is the immediate priority.
8. Which medication is used to prevent seizures in a patient with severe
preeclampsia?
A) Labetalol
B) Hydralazine
C) Magnesium sulfate
D) Betamethasone
Correct Answer: Magnesium sulfate
Rationale: Magnesium sulfate is the anticonvulsant of choice for seizure
prophylaxis in severe preeclampsia and eclampsia. Labetalol and hydralazine are
, antihypertensives used for blood pressure control. Betamethasone is a
corticosteroid used to promote fetal lung maturity.
9. Which finding indicates magnesium sulfate toxicity in a patient receiving the
medication for preeclampsia?
A) Respiratory rate of 8 breaths per minute
B) Deep tendon reflexes of 2+
C) Urine output of 40 mL per hour
D) Serum magnesium level of 5.5 mg/dL
Correct Answer: Respiratory rate of 8 breaths per minute
Rationale: Magnesium sulfate toxicity is characterized by loss of deep tendon
reflexes, respiratory depression (rate below 12 breaths per minute), oliguria, and
cardiac arrest. A respiratory rate of 8 is a critical finding requiring immediate
discontinuation of the infusion and administration of calcium gluconate.
10.What is the antidote for magnesium sulfate toxicity?
A) Naloxone
B) Calcium gluconate
C) Protamine sulfate
D) Vitamin K
Correct Answer: Calcium gluconate
Rationale: Calcium gluconate is the specific antidote for magnesium sulfate
toxicity. It antagonizes the neuromuscular blocking effects of magnesium.
Naloxone reverses opioids, protamine sulfate reverses heparin, and vitamin K
reverses warfarin.
11.Which medication is administered to a patient in preterm labor to promote
fetal lung maturity?
A) Oxytocin
B) Betamethasone
C) Magnesium sulfate
D) Terbutaline
Correct Answer: Betamethasone
