NU 170 Exam 3 | NU 170 Maternal-Child Nursing |
Questions and Answers with Rationales
2026/2027 Update
1. What is the primary physiological mechanism responsible for the onset of
true labor contractions at term gestation?
A) A decline in progesterone levels combined with increasing estrogen, oxytocin
receptor sensitivity, and local prostaglandin production.
B) Sudden complete depletion of maternal blood glucose stores.
C) Complete calcification of the placenta blocking all oxygen flow.
D) Sudden drop in fetal adrenal hormone production.
Correct Answer: A
Rationale: Labor is triggered by a complex interplay of endocrine changes,
including a decrease in progesterone's relaxing effect, an increase in estrogen
stimulating uterine myometrial sensitivity, and elevated prostaglandins and
oxytocin promoting contractions.
2. Which assessment finding indicates true labor progression during the first
stage of labor?
A) Contractions that become regular, increase in frequency and intensity, and
produce progressive cervical effacement and dilation.
B) Irregular contractions that disappear completely when the client walks or rests.
C) Discomfort felt exclusively in the lower anterior abdomen without lower back
radiation.
D) Braxton Hicks contractions that respond immediately to hydration.
Correct Answer: A
,Rationale: True labor is distinguished by progressive cervical changes (effacement
and dilation) driven by regular, intensifying contractions that typically start in the
lower back and radiate to the abdomen.
3. What are the three phases comprising the first stage of labor?
A) Latent phase, active phase, and transition phase.
B) Pushing phase, placental delivery phase, and recovery phase.
C) Antepartum phase, intrapartum phase, and postpartum phase.
D) Engagement phase, descent phase, and expulsion phase.
Correct Answer: A
Rationale: The first stage of labor (from onset of contractions to 10 cm dilation) is
divided into the latent phase (0-3 cm), active phase (4-7 cm), and transition phase
(8-10 cm).
4. During which phase of the first stage of labor does cervical dilation progress
most rapidly, typically from 6 to 10 centimeters?
A) Latent phase
B) Active phase (including transition)
C) Fourth stage of labor
D) Pre-labor phase
Correct Answer: B
Rationale: The active phase of labor, which encompasses transition, features
rapid cervical dilation and increased intensity of contractions.
5. What is the priority nursing assessment immediately following the
spontaneous rupture of membranes (ROM) during active labor?
A) Assess the fetal heart rate immediately to detect potential umbilical cord
prolapse.
B) Measure maternal blood pressure and pulse rate.
C) Check maternal temperature every 15 minutes.
,D) Assist the client to ambulate in the hallway.
Correct Answer: A
Rationale: The gush of amniotic fluid can displace the umbilical cord downward
into the vagina, causing cord compression. Assessing fetal heart tones
immediately is critical.
6. What color of amniotic fluid observed upon rupture of membranes indicates
potential fetal hypoxia and meconium passage in utero?
A) Clear and odorless fluid
B) Straw-colored fluid with white vernix flecks
C) Greenish-tinged or meconium-stained amniotic fluid
D) Bright red bloody fluid
Correct Answer: C
Rationale: Meconium staining gives amniotic fluid a green, brownish, or
yellowish-green hue, indicating fetal stress or hypoxia.
7. Which maternal breathing technique is taught during childbirth preparation
classes to help the client manage contractions during the transition phase of
labor?
A) Slow, deep abdominal breathing (paced breathing) and pant-pant-blow
patterns to prevent premature pushing.
B) Breath-holding Valsalva maneuvers throughout the entire first stage.
C) Hyperventilation at 60 breaths per minute.
D) Complete cessation of all breathing during contractions.
Correct Answer: A
Rationale: Paced breathing techniques help manage pain and prevent pushing
before the cervix is fully dilated (especially during transition when an urge to push
occurs).
, 8. What is the cardinal movement of labor where the fetal head enters the
pelvic inlet, typically with the sagittal suture transverse?
A) Engagement
B) Extension
C) Expulsion
D) External rotation
Correct Answer: A
Rationale: Engagement occurs when the biparietal diameter of the fetal head
passes through the pelvic inlet (typically at station 0).
9. Which cardinal movement of labor allows the smallest diameter of the fetal
head (suboccipitobregmatic) to pass through the birth canal by tucking the chin
firmly against the chest?
A) Flexion
B) Extension
C) Internal rotation
D) Restitution
Correct Answer: A
Rationale: Fetal head flexion brings the chin to the chest, presenting the smallest
transverse diameter to facilitate passage through the pelvis.
10. What occurs during internal rotation of the fetal head within the pelvis?
A) The fetal head rotates from its original transverse or oblique position so that
the occiput moves anteriorly beneath the pubic symphysis.
B) The fetal head extends backward against the perineum.
C) The shoulders rotate into a vertical alignment.
D) The infant is expelled completely from the vagina.
Correct Answer: A
Questions and Answers with Rationales
2026/2027 Update
1. What is the primary physiological mechanism responsible for the onset of
true labor contractions at term gestation?
A) A decline in progesterone levels combined with increasing estrogen, oxytocin
receptor sensitivity, and local prostaglandin production.
B) Sudden complete depletion of maternal blood glucose stores.
C) Complete calcification of the placenta blocking all oxygen flow.
D) Sudden drop in fetal adrenal hormone production.
Correct Answer: A
Rationale: Labor is triggered by a complex interplay of endocrine changes,
including a decrease in progesterone's relaxing effect, an increase in estrogen
stimulating uterine myometrial sensitivity, and elevated prostaglandins and
oxytocin promoting contractions.
2. Which assessment finding indicates true labor progression during the first
stage of labor?
A) Contractions that become regular, increase in frequency and intensity, and
produce progressive cervical effacement and dilation.
B) Irregular contractions that disappear completely when the client walks or rests.
C) Discomfort felt exclusively in the lower anterior abdomen without lower back
radiation.
D) Braxton Hicks contractions that respond immediately to hydration.
Correct Answer: A
,Rationale: True labor is distinguished by progressive cervical changes (effacement
and dilation) driven by regular, intensifying contractions that typically start in the
lower back and radiate to the abdomen.
3. What are the three phases comprising the first stage of labor?
A) Latent phase, active phase, and transition phase.
B) Pushing phase, placental delivery phase, and recovery phase.
C) Antepartum phase, intrapartum phase, and postpartum phase.
D) Engagement phase, descent phase, and expulsion phase.
Correct Answer: A
Rationale: The first stage of labor (from onset of contractions to 10 cm dilation) is
divided into the latent phase (0-3 cm), active phase (4-7 cm), and transition phase
(8-10 cm).
4. During which phase of the first stage of labor does cervical dilation progress
most rapidly, typically from 6 to 10 centimeters?
A) Latent phase
B) Active phase (including transition)
C) Fourth stage of labor
D) Pre-labor phase
Correct Answer: B
Rationale: The active phase of labor, which encompasses transition, features
rapid cervical dilation and increased intensity of contractions.
5. What is the priority nursing assessment immediately following the
spontaneous rupture of membranes (ROM) during active labor?
A) Assess the fetal heart rate immediately to detect potential umbilical cord
prolapse.
B) Measure maternal blood pressure and pulse rate.
C) Check maternal temperature every 15 minutes.
,D) Assist the client to ambulate in the hallway.
Correct Answer: A
Rationale: The gush of amniotic fluid can displace the umbilical cord downward
into the vagina, causing cord compression. Assessing fetal heart tones
immediately is critical.
6. What color of amniotic fluid observed upon rupture of membranes indicates
potential fetal hypoxia and meconium passage in utero?
A) Clear and odorless fluid
B) Straw-colored fluid with white vernix flecks
C) Greenish-tinged or meconium-stained amniotic fluid
D) Bright red bloody fluid
Correct Answer: C
Rationale: Meconium staining gives amniotic fluid a green, brownish, or
yellowish-green hue, indicating fetal stress or hypoxia.
7. Which maternal breathing technique is taught during childbirth preparation
classes to help the client manage contractions during the transition phase of
labor?
A) Slow, deep abdominal breathing (paced breathing) and pant-pant-blow
patterns to prevent premature pushing.
B) Breath-holding Valsalva maneuvers throughout the entire first stage.
C) Hyperventilation at 60 breaths per minute.
D) Complete cessation of all breathing during contractions.
Correct Answer: A
Rationale: Paced breathing techniques help manage pain and prevent pushing
before the cervix is fully dilated (especially during transition when an urge to push
occurs).
, 8. What is the cardinal movement of labor where the fetal head enters the
pelvic inlet, typically with the sagittal suture transverse?
A) Engagement
B) Extension
C) Expulsion
D) External rotation
Correct Answer: A
Rationale: Engagement occurs when the biparietal diameter of the fetal head
passes through the pelvic inlet (typically at station 0).
9. Which cardinal movement of labor allows the smallest diameter of the fetal
head (suboccipitobregmatic) to pass through the birth canal by tucking the chin
firmly against the chest?
A) Flexion
B) Extension
C) Internal rotation
D) Restitution
Correct Answer: A
Rationale: Fetal head flexion brings the chin to the chest, presenting the smallest
transverse diameter to facilitate passage through the pelvis.
10. What occurs during internal rotation of the fetal head within the pelvis?
A) The fetal head rotates from its original transverse or oblique position so that
the occiput moves anteriorly beneath the pubic symphysis.
B) The fetal head extends backward against the perineum.
C) The shoulders rotate into a vertical alignment.
D) The infant is expelled completely from the vagina.
Correct Answer: A
