Labor & Delivery - 2026 Intrapartum Nursing: Practice Test 1
(Units 1-7) - Questions with Correct Answers
100 questions
1. Signs of impending labor include:
A. Decreased Braxton Hicks contractions
B. Weight gain of 3 kg in a week
C. Bloody show, lightening, a burst of energy and possible rupture of membranes
D. Absent fetal movement
Correct Answer: C. Bloody show, lightening, a burst of energy and possible rupture of
membranes
Rationale: Weight often decreases slightly as fluid shifts before labor. Absent fetal movement is
a warning sign requiring evaluation.
2. A transverse lie at term in active labor means that:
A. Vaginal birth is expected
B. Vaginal birth is not possible and cesarean birth is required unless the lie can be corrected
C. The fetus is in vertex presentation
D. The fetus is engaged
Correct Answer: B. Vaginal birth is not possible and cesarean birth is required unless the lie
can be corrected
Rationale: A fetus lying crosswise cannot deliver vaginally, and a shoulder may present with risk
of arm or cord prolapse. Engagement and vertex presentation do not occur in a transverse lie.
3. When palpating contraction intensity, a contraction that feels like the tip of the nose is:
A. Moderate
B. Strong
C. Tetanic
D. Mild
Correct Answer: D. Mild
Rationale: Mild feels like the nose, moderate like the chin and strong like the forehead.
Palpation is subjective, so an intrauterine pressure catheter is needed for precise measurement.
,4. A brow presentation:
A. Presents a large diameter and often converts to face or vertex, or else requires cesarean
B. Is the most favorable presentation
C. Is identical to vertex
D. Occurs in most births
Correct Answer: A. Presents a large diameter and often converts to face or vertex, or else
requires cesarean
Rationale: Persistent brow presentation usually cannot deliver vaginally at term. It is
uncommon.
5. The smallest anteroposterior diameter of the fetal head, which presents in a well-flexed
vertex, is the:
A. Suboccipitobregmatic diameter, about 9.5 cm
B. Occipitomental diameter, about 13.5 cm
C. Occipitofrontal diameter, about 11.5 cm
D. Biparietal diameter, about 15 cm
Correct Answer: A. Suboccipitobregmatic diameter, about 9.5 cm
Rationale: Good flexion lets the smallest diameter lead. The occipitomental diameter presents
in brow presentation and generally cannot pass through a normal pelvis.
6. Adequate uterine resting tone between contractions allows:
A. Faster dilation only
B. Fetal descent only
C. Restoration of uteroplacental blood flow and fetal oxygenation
D. Maternal pushing
Correct Answer: C. Restoration of uteroplacental blood flow and fetal oxygenation
Rationale: Blood flow to the intervillous space falls during contractions and recovers during
rest. Inadequate rest can lead to fetal hypoxemia.
,7. A full bladder during labor can:
A. Speed labor
B. Improve contractions
C. Have no effect
D. Impede fetal descent and increase discomfort
Correct Answer: D. Impede fetal descent and increase discomfort
Rationale: Patients should be encouraged to void every 2 hours. Catheterization may be needed
with epidurals.
8. Contraction frequency is measured from:
A. The end of one contraction to the beginning of the next
B. The peak to the end of the same contraction
C. The beginning of one contraction to the beginning of the next
D. The beginning to the end of one contraction
Correct Answer: C. The beginning of one contraction to the beginning of the next
Rationale: Frequency is reported in minutes. The beginning-to-end measurement describes
duration, and the end-to-beginning interval is the resting time.
9. Maternal respiratory changes during labor commonly include:
A. Respiratory acidosis in all patients
B. Decreased oxygen consumption
C. Hyperventilation that can cause respiratory alkalosis, tingling and dizziness
D. Bradypnea
Correct Answer: C. Hyperventilation that can cause respiratory alkalosis, tingling and dizziness
Rationale: Pain and anxiety increase breathing rate. Slow-paced breathing or breathing into
cupped hands can help.
, 10. Extension of the fetal head occurs when:
A. The head enters the pelvic inlet
B. The shoulders deliver
C. The head reaches the perineum and passes under the symphysis pubis
D. The membranes rupture
Correct Answer: C. The head reaches the perineum and passes under the symphysis pubis
Rationale: The curve of the birth canal causes the head to extend. Flexion occurs earlier as the
head meets resistance.
11. Lightening refers to:
A. Descent of the fetus into the pelvis, which eases breathing but increases urinary frequency
B. Bright red bleeding
C. Spontaneous rupture of membranes
D. A sudden surge of energy
Correct Answer: A. Descent of the fetus into the pelvis, which eases breathing but increases
urinary frequency
Rationale: It often occurs about 2 weeks before labor in nulliparas. The burst of energy before
labor is called nesting, which is a different sign.
12. Cephalopelvic disproportion occurs when:
A. The fetal head is too large to pass through the maternal pelvis
B. The fetus is small
C. The cervix dilates rapidly
D. The membranes are intact
Correct Answer: A. The fetal head is too large to pass through the maternal pelvis
Rationale: It may cause arrest of dilation or descent. It is diagnosed during labor rather than by
pelvimetry alone.
(Units 1-7) - Questions with Correct Answers
100 questions
1. Signs of impending labor include:
A. Decreased Braxton Hicks contractions
B. Weight gain of 3 kg in a week
C. Bloody show, lightening, a burst of energy and possible rupture of membranes
D. Absent fetal movement
Correct Answer: C. Bloody show, lightening, a burst of energy and possible rupture of
membranes
Rationale: Weight often decreases slightly as fluid shifts before labor. Absent fetal movement is
a warning sign requiring evaluation.
2. A transverse lie at term in active labor means that:
A. Vaginal birth is expected
B. Vaginal birth is not possible and cesarean birth is required unless the lie can be corrected
C. The fetus is in vertex presentation
D. The fetus is engaged
Correct Answer: B. Vaginal birth is not possible and cesarean birth is required unless the lie
can be corrected
Rationale: A fetus lying crosswise cannot deliver vaginally, and a shoulder may present with risk
of arm or cord prolapse. Engagement and vertex presentation do not occur in a transverse lie.
3. When palpating contraction intensity, a contraction that feels like the tip of the nose is:
A. Moderate
B. Strong
C. Tetanic
D. Mild
Correct Answer: D. Mild
Rationale: Mild feels like the nose, moderate like the chin and strong like the forehead.
Palpation is subjective, so an intrauterine pressure catheter is needed for precise measurement.
,4. A brow presentation:
A. Presents a large diameter and often converts to face or vertex, or else requires cesarean
B. Is the most favorable presentation
C. Is identical to vertex
D. Occurs in most births
Correct Answer: A. Presents a large diameter and often converts to face or vertex, or else
requires cesarean
Rationale: Persistent brow presentation usually cannot deliver vaginally at term. It is
uncommon.
5. The smallest anteroposterior diameter of the fetal head, which presents in a well-flexed
vertex, is the:
A. Suboccipitobregmatic diameter, about 9.5 cm
B. Occipitomental diameter, about 13.5 cm
C. Occipitofrontal diameter, about 11.5 cm
D. Biparietal diameter, about 15 cm
Correct Answer: A. Suboccipitobregmatic diameter, about 9.5 cm
Rationale: Good flexion lets the smallest diameter lead. The occipitomental diameter presents
in brow presentation and generally cannot pass through a normal pelvis.
6. Adequate uterine resting tone between contractions allows:
A. Faster dilation only
B. Fetal descent only
C. Restoration of uteroplacental blood flow and fetal oxygenation
D. Maternal pushing
Correct Answer: C. Restoration of uteroplacental blood flow and fetal oxygenation
Rationale: Blood flow to the intervillous space falls during contractions and recovers during
rest. Inadequate rest can lead to fetal hypoxemia.
,7. A full bladder during labor can:
A. Speed labor
B. Improve contractions
C. Have no effect
D. Impede fetal descent and increase discomfort
Correct Answer: D. Impede fetal descent and increase discomfort
Rationale: Patients should be encouraged to void every 2 hours. Catheterization may be needed
with epidurals.
8. Contraction frequency is measured from:
A. The end of one contraction to the beginning of the next
B. The peak to the end of the same contraction
C. The beginning of one contraction to the beginning of the next
D. The beginning to the end of one contraction
Correct Answer: C. The beginning of one contraction to the beginning of the next
Rationale: Frequency is reported in minutes. The beginning-to-end measurement describes
duration, and the end-to-beginning interval is the resting time.
9. Maternal respiratory changes during labor commonly include:
A. Respiratory acidosis in all patients
B. Decreased oxygen consumption
C. Hyperventilation that can cause respiratory alkalosis, tingling and dizziness
D. Bradypnea
Correct Answer: C. Hyperventilation that can cause respiratory alkalosis, tingling and dizziness
Rationale: Pain and anxiety increase breathing rate. Slow-paced breathing or breathing into
cupped hands can help.
, 10. Extension of the fetal head occurs when:
A. The head enters the pelvic inlet
B. The shoulders deliver
C. The head reaches the perineum and passes under the symphysis pubis
D. The membranes rupture
Correct Answer: C. The head reaches the perineum and passes under the symphysis pubis
Rationale: The curve of the birth canal causes the head to extend. Flexion occurs earlier as the
head meets resistance.
11. Lightening refers to:
A. Descent of the fetus into the pelvis, which eases breathing but increases urinary frequency
B. Bright red bleeding
C. Spontaneous rupture of membranes
D. A sudden surge of energy
Correct Answer: A. Descent of the fetus into the pelvis, which eases breathing but increases
urinary frequency
Rationale: It often occurs about 2 weeks before labor in nulliparas. The burst of energy before
labor is called nesting, which is a different sign.
12. Cephalopelvic disproportion occurs when:
A. The fetal head is too large to pass through the maternal pelvis
B. The fetus is small
C. The cervix dilates rapidly
D. The membranes are intact
Correct Answer: A. The fetal head is too large to pass through the maternal pelvis
Rationale: It may cause arrest of dilation or descent. It is diagnosed during labor rather than by
pelvimetry alone.
