Labor & Delivery - 2026 Intrapartum Nursing: Practice Test 2
(Units 8-13) - Questions with Correct Answers
100 questions
1. Signs of hypovolemic shock in postpartum hemorrhage that may appear late in healthy
pregnant patients include:
A. Bradycardia first
B. Hypertension
C. Increased urine output
D. Hypotension, because compensation maintains blood pressure until significant loss
Correct Answer: D. Hypotension, because compensation maintains blood pressure until
significant loss
Rationale: Tachycardia is an earlier sign. Shock index helps detect hidden loss.
2. The most common cause of postpartum hemorrhage is:
A. Lacerations
B. Uterine atony
C. Retained tissue
D. Coagulopathy
Correct Answer: B. Uterine atony
Rationale: Atony accounts for about 70% of cases. Fundal massage and uterotonics are
first-line.
3. A common side effect of carboprost is:
A. Hypertension only
B. Bradycardia only
C. Constipation
D. Diarrhea, nausea and fever
Correct Answer: D. Diarrhea, nausea and fever
Rationale: Gastrointestinal effects are common. Antidiarrheals may be given.
,4. Vacuum-induced hemorrhage control devices (such as Jada) work by:
A. Applying low-level suction to collapse and contract the uterus
B. Inflating a balloon
C. Cooling the uterus
D. Delivering medication
Correct Answer: A. Applying low-level suction to collapse and contract the uterus
Rationale: These devices quickly control atony-related bleeding. They are an alternative to
balloon tamponade.
5. Misoprostol for postpartum hemorrhage is typically given:
A. 25 mcg vaginally
B. 800 to 1,000 mcg rectally, sublingually or orally
C. IV push
D. Subcutaneously
Correct Answer: B. 800 to 1,000 mcg rectally, sublingually or orally
Rationale: Doses differ from induction. Side effects include fever and shivering.
6. Rh(D) immune globulin is given to Rh-negative patients who deliver an Rh-positive infant
within:
A. 72 hours of birth
B. 1 week
C. 1 month
D. 6 months
Correct Answer: A. 72 hours of birth
Rationale: It prevents alloimmunization in future pregnancies. A Kleihauer-Betke test
determines if more is needed.
,7. The greatest risk factor for placenta accreta spectrum is:
A. Nulliparity
B. Young age
C. Smoking only
D. Placenta previa with prior cesarean birth
Correct Answer: D. Placenta previa with prior cesarean birth
Rationale: Risk rises with each cesarean. Prenatal imaging guides planning.
8. A vulvar or vaginal hematoma after birth typically presents with:
A. Painless bleeding
B. Fever only
C. Severe perineal or rectal pain and pressure, with a bulging mass and possible signs of
hypovolemia
D. Itching
Correct Answer: C. Severe perineal or rectal pain and pressure, with a bulging mass and
possible signs of hypovolemia
Rationale: Pain out of proportion is a key sign. Large hematomas need drainage.
9. Controlled cord traction during the third stage should be performed:
A. With counter-pressure above the symphysis to support the uterus
B. Without supporting the uterus
C. Before signs of separation by forceful pulling
D. By the patient
Correct Answer: A. With counter-pressure above the symphysis to support the uterus
Rationale: Supporting the uterus prevents inversion. Traction is gentle and only by trained
clinicians.
, 10. The nurse notices that a patient's fundus is firm but her pulse is rising and she reports rectal
pressure. The nurse should suspect:
A. Normal recovery
B. Uterine atony
C. Urinary retention only
D. A hematoma
Correct Answer: D. A hematoma
Rationale: Hematomas can conceal significant blood loss. The provider should examine
immediately.
11. Intraoperative cell salvage in obstetrics:
A. Is contraindicated in all cases
B. Requires a donor
C. Can be used during cesarean hemorrhage, with leukocyte filters to reduce amniotic fluid
contamination
D. Is used only vaginally
Correct Answer: C. Can be used during cesarean hemorrhage, with leukocyte filters to reduce
amniotic fluid contamination
Rationale: Cell salvage reduces allogeneic transfusion. It may be acceptable to some patients
who decline donor blood.
12. The immediate management of uterine inversion includes:
A. Increasing oxytocin before replacement
B. Stopping uterotonics, calling for help, attempting manual replacement and treating shock
C. Pulling on the cord
D. Removing the placenta first in all cases
Correct Answer: B. Stopping uterotonics, calling for help, attempting manual replacement and
treating shock
Rationale: Uterine relaxants may be needed for replacement. Uterotonics are given after
replacement.
(Units 8-13) - Questions with Correct Answers
100 questions
1. Signs of hypovolemic shock in postpartum hemorrhage that may appear late in healthy
pregnant patients include:
A. Bradycardia first
B. Hypertension
C. Increased urine output
D. Hypotension, because compensation maintains blood pressure until significant loss
Correct Answer: D. Hypotension, because compensation maintains blood pressure until
significant loss
Rationale: Tachycardia is an earlier sign. Shock index helps detect hidden loss.
2. The most common cause of postpartum hemorrhage is:
A. Lacerations
B. Uterine atony
C. Retained tissue
D. Coagulopathy
Correct Answer: B. Uterine atony
Rationale: Atony accounts for about 70% of cases. Fundal massage and uterotonics are
first-line.
3. A common side effect of carboprost is:
A. Hypertension only
B. Bradycardia only
C. Constipation
D. Diarrhea, nausea and fever
Correct Answer: D. Diarrhea, nausea and fever
Rationale: Gastrointestinal effects are common. Antidiarrheals may be given.
,4. Vacuum-induced hemorrhage control devices (such as Jada) work by:
A. Applying low-level suction to collapse and contract the uterus
B. Inflating a balloon
C. Cooling the uterus
D. Delivering medication
Correct Answer: A. Applying low-level suction to collapse and contract the uterus
Rationale: These devices quickly control atony-related bleeding. They are an alternative to
balloon tamponade.
5. Misoprostol for postpartum hemorrhage is typically given:
A. 25 mcg vaginally
B. 800 to 1,000 mcg rectally, sublingually or orally
C. IV push
D. Subcutaneously
Correct Answer: B. 800 to 1,000 mcg rectally, sublingually or orally
Rationale: Doses differ from induction. Side effects include fever and shivering.
6. Rh(D) immune globulin is given to Rh-negative patients who deliver an Rh-positive infant
within:
A. 72 hours of birth
B. 1 week
C. 1 month
D. 6 months
Correct Answer: A. 72 hours of birth
Rationale: It prevents alloimmunization in future pregnancies. A Kleihauer-Betke test
determines if more is needed.
,7. The greatest risk factor for placenta accreta spectrum is:
A. Nulliparity
B. Young age
C. Smoking only
D. Placenta previa with prior cesarean birth
Correct Answer: D. Placenta previa with prior cesarean birth
Rationale: Risk rises with each cesarean. Prenatal imaging guides planning.
8. A vulvar or vaginal hematoma after birth typically presents with:
A. Painless bleeding
B. Fever only
C. Severe perineal or rectal pain and pressure, with a bulging mass and possible signs of
hypovolemia
D. Itching
Correct Answer: C. Severe perineal or rectal pain and pressure, with a bulging mass and
possible signs of hypovolemia
Rationale: Pain out of proportion is a key sign. Large hematomas need drainage.
9. Controlled cord traction during the third stage should be performed:
A. With counter-pressure above the symphysis to support the uterus
B. Without supporting the uterus
C. Before signs of separation by forceful pulling
D. By the patient
Correct Answer: A. With counter-pressure above the symphysis to support the uterus
Rationale: Supporting the uterus prevents inversion. Traction is gentle and only by trained
clinicians.
, 10. The nurse notices that a patient's fundus is firm but her pulse is rising and she reports rectal
pressure. The nurse should suspect:
A. Normal recovery
B. Uterine atony
C. Urinary retention only
D. A hematoma
Correct Answer: D. A hematoma
Rationale: Hematomas can conceal significant blood loss. The provider should examine
immediately.
11. Intraoperative cell salvage in obstetrics:
A. Is contraindicated in all cases
B. Requires a donor
C. Can be used during cesarean hemorrhage, with leukocyte filters to reduce amniotic fluid
contamination
D. Is used only vaginally
Correct Answer: C. Can be used during cesarean hemorrhage, with leukocyte filters to reduce
amniotic fluid contamination
Rationale: Cell salvage reduces allogeneic transfusion. It may be acceptable to some patients
who decline donor blood.
12. The immediate management of uterine inversion includes:
A. Increasing oxytocin before replacement
B. Stopping uterotonics, calling for help, attempting manual replacement and treating shock
C. Pulling on the cord
D. Removing the placenta first in all cases
Correct Answer: B. Stopping uterotonics, calling for help, attempting manual replacement and
treating shock
Rationale: Uterine relaxants may be needed for replacement. Uterotonics are given after
replacement.
