West Coast University NURS 306 Exam 2 | OB Nursing (2026)
Q&A
1. A nurse is calculating a client's GTPAL. The client is currently pregnant, has had two term
deliveries, one preterm delivery at 32 weeks, and one miscarriage at 12 weeks, and has three
living children. What is the correct GTPAL?
A) G4 T2 P1 A1 L3
B) G5 T2 P1 A1 L3
C) G5 T3 P0 A1 L3
D) G4 T2 P1 A2 L3
Correct Answer: G5 T2 P1 A1 L3
Rationale: Gravida (G) is the total number of pregnancies, including the current one: 5. Term (T)
is the number of deliveries at 37 weeks or more: 2. Preterm (P) is deliveries between 20 and 36
weeks: 1. Abortions (A) are losses before 20 weeks: 1 miscarriage. Living (L) children is 3. This
calculation is a high-yield topic on NURS 306 Exam 2.
2. A client is 8 cm dilated, 90% effaced, and at +2 station. Which phase of labor is the client
experiencing?
A) Latent phase
B) Active phase
C) Transition phase
D) Second stage
Correct Answer: Transition phase
,Rationale: Transition is the final portion of the first stage of labor and occurs as the cervix dilates
from approximately 8 to 10 cm. The latent phase is 0–3 cm, the active phase is 4–7 cm, and the
second stage begins at full dilation (10 cm) and ends with delivery.
3. Which finding best indicates that a client is experiencing true labor rather than false labor?
A) Contractions decrease with walking.
B) Contractions remain irregular.
C) Contractions become progressively stronger, longer, and closer together.
D) Discomfort is relieved by hydration.
Correct Answer: Contractions become progressively stronger, longer, and closer together.
Rationale: True labor produces progressive cervical change and contractions that become
stronger, longer, and more frequent. False labor contractions are irregular, do not intensify with
activity, and may be relieved by hydration or rest.
4. Which finding is associated with the latent phase of the first stage of labor?
A) Cervical dilation from 8 to 10 cm
B) Mild, irregular contractions with early cervical dilation
C) Complete cervical dilation and active pushing
D) Placental separation
Correct Answer: Mild, irregular contractions with early cervical dilation
,Rationale: The latent phase involves early cervical dilation (0–3 cm) and generally less intense
contractions. The transition phase involves 8–10 cm dilation, and the second stage involves
complete dilation and pushing. Placental separation occurs in the third stage.
5. A laboring client is 5 cm dilated with contractions every 3 to 5 minutes lasting about 50
seconds. Which phase is most likely?
A) Latent
B) Active
C) Transition
D) Fourth stage
Correct Answer: Active
Rationale: The active phase involves progressive cervical dilation (4–7 cm) with stronger and
more regular contractions. The latent phase is 0–3 cm, transition is 8–10 cm, and the fourth
stage is the immediate postpartum period.
6. A client is 9 cm dilated and reports an intense urge to push. What should the nurse do?
A) Encourage forceful pushing immediately.
B) Tell the client to delay pushing until complete cervical dilation is confirmed.
C) Administer a laxative.
D) Place the client flat.
Correct Answer: Tell the client to delay pushing until complete cervical dilation is confirmed.
, Rationale: Pushing before complete cervical dilation can cause cervical edema and impede labor
progress. The nurse should confirm full dilation before encouraging pushing. This is a key safety
intervention during the transition phase.
7. Which finding marks the beginning of the second stage of labor?
A) Cervical dilation of 4 cm
B) Complete cervical dilation (10 cm)
C) Rupture of membranes
D) Delivery of the placenta
Correct Answer: Complete cervical dilation (10 cm)
Rationale: The second stage of labor begins at full cervical dilation (10 cm) and ends with the
birth of the newborn. The first stage ends at full dilation, and the third stage ends with placental
delivery.
8. A nurse is monitoring a client in labor who is receiving oxytocin. The nurse notes late
decelerations on the fetal heart rate monitor. What is the priority action?
A) Increase the oxytocin infusion rate.
B) Stop the oxytocin infusion and reposition the client.
C) Document the finding and continue to monitor.
D) Administer a bolus of intravenous fluids.
Correct Answer: Stop the oxytocin infusion and reposition the client.
Q&A
1. A nurse is calculating a client's GTPAL. The client is currently pregnant, has had two term
deliveries, one preterm delivery at 32 weeks, and one miscarriage at 12 weeks, and has three
living children. What is the correct GTPAL?
A) G4 T2 P1 A1 L3
B) G5 T2 P1 A1 L3
C) G5 T3 P0 A1 L3
D) G4 T2 P1 A2 L3
Correct Answer: G5 T2 P1 A1 L3
Rationale: Gravida (G) is the total number of pregnancies, including the current one: 5. Term (T)
is the number of deliveries at 37 weeks or more: 2. Preterm (P) is deliveries between 20 and 36
weeks: 1. Abortions (A) are losses before 20 weeks: 1 miscarriage. Living (L) children is 3. This
calculation is a high-yield topic on NURS 306 Exam 2.
2. A client is 8 cm dilated, 90% effaced, and at +2 station. Which phase of labor is the client
experiencing?
A) Latent phase
B) Active phase
C) Transition phase
D) Second stage
Correct Answer: Transition phase
,Rationale: Transition is the final portion of the first stage of labor and occurs as the cervix dilates
from approximately 8 to 10 cm. The latent phase is 0–3 cm, the active phase is 4–7 cm, and the
second stage begins at full dilation (10 cm) and ends with delivery.
3. Which finding best indicates that a client is experiencing true labor rather than false labor?
A) Contractions decrease with walking.
B) Contractions remain irregular.
C) Contractions become progressively stronger, longer, and closer together.
D) Discomfort is relieved by hydration.
Correct Answer: Contractions become progressively stronger, longer, and closer together.
Rationale: True labor produces progressive cervical change and contractions that become
stronger, longer, and more frequent. False labor contractions are irregular, do not intensify with
activity, and may be relieved by hydration or rest.
4. Which finding is associated with the latent phase of the first stage of labor?
A) Cervical dilation from 8 to 10 cm
B) Mild, irregular contractions with early cervical dilation
C) Complete cervical dilation and active pushing
D) Placental separation
Correct Answer: Mild, irregular contractions with early cervical dilation
,Rationale: The latent phase involves early cervical dilation (0–3 cm) and generally less intense
contractions. The transition phase involves 8–10 cm dilation, and the second stage involves
complete dilation and pushing. Placental separation occurs in the third stage.
5. A laboring client is 5 cm dilated with contractions every 3 to 5 minutes lasting about 50
seconds. Which phase is most likely?
A) Latent
B) Active
C) Transition
D) Fourth stage
Correct Answer: Active
Rationale: The active phase involves progressive cervical dilation (4–7 cm) with stronger and
more regular contractions. The latent phase is 0–3 cm, transition is 8–10 cm, and the fourth
stage is the immediate postpartum period.
6. A client is 9 cm dilated and reports an intense urge to push. What should the nurse do?
A) Encourage forceful pushing immediately.
B) Tell the client to delay pushing until complete cervical dilation is confirmed.
C) Administer a laxative.
D) Place the client flat.
Correct Answer: Tell the client to delay pushing until complete cervical dilation is confirmed.
, Rationale: Pushing before complete cervical dilation can cause cervical edema and impede labor
progress. The nurse should confirm full dilation before encouraging pushing. This is a key safety
intervention during the transition phase.
7. Which finding marks the beginning of the second stage of labor?
A) Cervical dilation of 4 cm
B) Complete cervical dilation (10 cm)
C) Rupture of membranes
D) Delivery of the placenta
Correct Answer: Complete cervical dilation (10 cm)
Rationale: The second stage of labor begins at full cervical dilation (10 cm) and ends with the
birth of the newborn. The first stage ends at full dilation, and the third stage ends with placental
delivery.
8. A nurse is monitoring a client in labor who is receiving oxytocin. The nurse notes late
decelerations on the fetal heart rate monitor. What is the priority action?
A) Increase the oxytocin infusion rate.
B) Stop the oxytocin infusion and reposition the client.
C) Document the finding and continue to monitor.
D) Administer a bolus of intravenous fluids.
Correct Answer: Stop the oxytocin infusion and reposition the client.
