Labor & Delivery - 2026 Intrapartum Nursing: Exam 2 -
Questions with Correct Answers
100 questions
1. In the first Leopold maneuver, a soft, irregular mass in the uterine fundus suggests:
A. The fetal head, indicating breech
B. The fetal buttocks, indicating a cephalic presentation
C. A transverse lie
D. Twins
Correct Answer: B. The fetal buttocks, indicating a cephalic presentation
Rationale: The head feels hard, round and ballotable. A soft, irregular fundal part is typically the
breech.
2. A fetus in a persistent occiput posterior (OP) position commonly causes:
A. Intense back pain and a longer labor
B. Faster labor with less pain
C. Painless labor
D. Placental abruption in all cases
Correct Answer: A. Intense back pain and a longer labor
Rationale: The occiput presses on the maternal sacrum and must rotate further. Positioning
such as hands-and-knees may help, while OP does not directly cause abruption.
3. The key difference between true and false labor is that true labor:
A. Is relieved by walking
B. Has irregular contractions
C. Produces progressive cervical dilation and effacement
D. Is felt only in the lower abdomen
Correct Answer: C. Produces progressive cervical dilation and effacement
Rationale: Cervical change defines labor. False labor contractions are often irregular, felt in the
abdomen and eased by rest or hydration.
,4. Asynclitism refers to:
A. Normal flexion of the head
B. A breech position
C. Lateral tilting of the fetal head so that the sagittal suture is not midway between the
symphysis and sacrum
D. Fetal tachycardia
Correct Answer: C. Lateral tilting of the fetal head so that the sagittal suture is not midway
between the symphysis and sacrum
Rationale: Mild asynclitism is common and helps descent. Marked asynclitism may contribute
to arrest.
5. Fetal station is defined as:
A. The degree of cervical thinning
B. The fetal heart rate baseline
C. The relationship of the presenting part to the maternal ischial spines, measured in
centimeters
D. The number of fetuses
Correct Answer: C. The relationship of the presenting part to the maternal ischial spines,
measured in centimeters
Rationale: Station 0 is at the spines, negative numbers are above and positive numbers are
below. Effacement describes cervical thinning, not station.
6. Fetal adaptations that protect the fetus during labor include:
A. Low hemoglobin
B. A slow heart rate at baseline
C. Fetal hemoglobin with high oxygen affinity and the ability to redistribute blood to vital organs
D. Absent reserves
Correct Answer: C. Fetal hemoglobin with high oxygen affinity and the ability to redistribute
blood to vital organs
Rationale: These mechanisms help tolerate intermittent decreases in oxygen. Prolonged
hypoxia can overwhelm them.
,7. Engagement occurs when:
A. The cervix is fully dilated
B. The membranes rupture
C. Contractions begin
D. The widest diameter of the presenting part has passed through the pelvic inlet, usually at
station 0
Correct Answer: D. The widest diameter of the presenting part has passed through the pelvic
inlet, usually at station 0
Rationale: Engagement usually corresponds to station 0. It can happen before labor in
nulliparas and may not occur until labor in multiparas.
8. Psychologic factors that can slow labor include:
A. Calm and support
B. Continuous labor support
C. Relaxation techniques
D. Fear and anxiety, which raise catecholamines and may reduce uterine activity
Correct Answer: D. Fear and anxiety, which raise catecholamines and may reduce uterine
activity
Rationale: Stress hormones can decrease uterine blood flow and contractions. Support and
relaxation promote progress.
9. Arrest of descent in the second stage is diagnosed when:
A. The head is at +2 station
B. There is no descent or rotation after adequate pushing time, about 3 hours for nulliparas and
2 hours for multiparas
C. Pushing has lasted 30 minutes
D. The patient is tired
Correct Answer: B. There is no descent or rotation after adequate pushing time, about 3 hours
for nulliparas and 2 hours for multiparas
Rationale: Longer durations may be allowed when progress continues. Fatigue alone is not
arrest.
, 10. A labor dystocia diagnosis means:
A. Rapid labor
B. Abnormally slow labor progress
C. Normal latent phase
D. Fetal distress
Correct Answer: B. Abnormally slow labor progress
Rationale: Dystocia is the most common indication for primary cesarean. Accurate diagnosis
using current criteria prevents unnecessary surgery.
11. Green-stained amniotic fluid indicates:
A. Normal fluid
B. Infection in all cases
C. Placental abruption
D. Meconium passage, which requires notifying the neonatal team per protocol
Correct Answer: D. Meconium passage, which requires notifying the neonatal team per
protocol
Rationale: Meconium is more common after 40 weeks and may reflect fetal stress. Port-wine
fluid suggests abruption.
12. A patient states she does not feel ready to push and is exhausted. The nurse should:
A. Force pushing with every contraction
B. Apply fundal pressure
C. Offer rest, hydration, position change and encouragement, and inform the provider if
progress stalls
D. Leave the room
Correct Answer: C. Offer rest, hydration, position change and encouragement, and inform the
provider if progress stalls
Rationale: Supportive care preserves energy. Fundal pressure is not recommended for routine
use.
Questions with Correct Answers
100 questions
1. In the first Leopold maneuver, a soft, irregular mass in the uterine fundus suggests:
A. The fetal head, indicating breech
B. The fetal buttocks, indicating a cephalic presentation
C. A transverse lie
D. Twins
Correct Answer: B. The fetal buttocks, indicating a cephalic presentation
Rationale: The head feels hard, round and ballotable. A soft, irregular fundal part is typically the
breech.
2. A fetus in a persistent occiput posterior (OP) position commonly causes:
A. Intense back pain and a longer labor
B. Faster labor with less pain
C. Painless labor
D. Placental abruption in all cases
Correct Answer: A. Intense back pain and a longer labor
Rationale: The occiput presses on the maternal sacrum and must rotate further. Positioning
such as hands-and-knees may help, while OP does not directly cause abruption.
3. The key difference between true and false labor is that true labor:
A. Is relieved by walking
B. Has irregular contractions
C. Produces progressive cervical dilation and effacement
D. Is felt only in the lower abdomen
Correct Answer: C. Produces progressive cervical dilation and effacement
Rationale: Cervical change defines labor. False labor contractions are often irregular, felt in the
abdomen and eased by rest or hydration.
,4. Asynclitism refers to:
A. Normal flexion of the head
B. A breech position
C. Lateral tilting of the fetal head so that the sagittal suture is not midway between the
symphysis and sacrum
D. Fetal tachycardia
Correct Answer: C. Lateral tilting of the fetal head so that the sagittal suture is not midway
between the symphysis and sacrum
Rationale: Mild asynclitism is common and helps descent. Marked asynclitism may contribute
to arrest.
5. Fetal station is defined as:
A. The degree of cervical thinning
B. The fetal heart rate baseline
C. The relationship of the presenting part to the maternal ischial spines, measured in
centimeters
D. The number of fetuses
Correct Answer: C. The relationship of the presenting part to the maternal ischial spines,
measured in centimeters
Rationale: Station 0 is at the spines, negative numbers are above and positive numbers are
below. Effacement describes cervical thinning, not station.
6. Fetal adaptations that protect the fetus during labor include:
A. Low hemoglobin
B. A slow heart rate at baseline
C. Fetal hemoglobin with high oxygen affinity and the ability to redistribute blood to vital organs
D. Absent reserves
Correct Answer: C. Fetal hemoglobin with high oxygen affinity and the ability to redistribute
blood to vital organs
Rationale: These mechanisms help tolerate intermittent decreases in oxygen. Prolonged
hypoxia can overwhelm them.
,7. Engagement occurs when:
A. The cervix is fully dilated
B. The membranes rupture
C. Contractions begin
D. The widest diameter of the presenting part has passed through the pelvic inlet, usually at
station 0
Correct Answer: D. The widest diameter of the presenting part has passed through the pelvic
inlet, usually at station 0
Rationale: Engagement usually corresponds to station 0. It can happen before labor in
nulliparas and may not occur until labor in multiparas.
8. Psychologic factors that can slow labor include:
A. Calm and support
B. Continuous labor support
C. Relaxation techniques
D. Fear and anxiety, which raise catecholamines and may reduce uterine activity
Correct Answer: D. Fear and anxiety, which raise catecholamines and may reduce uterine
activity
Rationale: Stress hormones can decrease uterine blood flow and contractions. Support and
relaxation promote progress.
9. Arrest of descent in the second stage is diagnosed when:
A. The head is at +2 station
B. There is no descent or rotation after adequate pushing time, about 3 hours for nulliparas and
2 hours for multiparas
C. Pushing has lasted 30 minutes
D. The patient is tired
Correct Answer: B. There is no descent or rotation after adequate pushing time, about 3 hours
for nulliparas and 2 hours for multiparas
Rationale: Longer durations may be allowed when progress continues. Fatigue alone is not
arrest.
, 10. A labor dystocia diagnosis means:
A. Rapid labor
B. Abnormally slow labor progress
C. Normal latent phase
D. Fetal distress
Correct Answer: B. Abnormally slow labor progress
Rationale: Dystocia is the most common indication for primary cesarean. Accurate diagnosis
using current criteria prevents unnecessary surgery.
11. Green-stained amniotic fluid indicates:
A. Normal fluid
B. Infection in all cases
C. Placental abruption
D. Meconium passage, which requires notifying the neonatal team per protocol
Correct Answer: D. Meconium passage, which requires notifying the neonatal team per
protocol
Rationale: Meconium is more common after 40 weeks and may reflect fetal stress. Port-wine
fluid suggests abruption.
12. A patient states she does not feel ready to push and is exhausted. The nurse should:
A. Force pushing with every contraction
B. Apply fundal pressure
C. Offer rest, hydration, position change and encouragement, and inform the provider if
progress stalls
D. Leave the room
Correct Answer: C. Offer rest, hydration, position change and encouragement, and inform the
provider if progress stalls
Rationale: Supportive care preserves energy. Fundal pressure is not recommended for routine
use.
