Maternity Nursing (OB Maternal &
Newborn) NCLEX Practice Quiz #5 | 80
Questions
1. 1. Question
Mechanism of labor, also known as the cardinal movements, refers to
the sequencing of events involved in posturing and positioning that
allows the baby to find the easiest to come out of the birth
canal. Arrange the following mechanisms of labor in the order
during the course of labor and fetal delivery.
View Answers:
o Expulsion
o Flexion
o Extension
o External rotation
o Descent
o Internal rotation
o Engagement
Incorrect
The correct order is shown above.
The mechanism of fetal delivery begins with descent into the pelvic
inlet which may occur several days before true labor sets in the
primigravida. Flexion, internal rotation, and extension are mechanisms
that the fetus must perform as it accommodates through the
passageway/birth canal. Eternal rotation is done after the head is
delivered so that the shoulders will be easily delivered through the
vaginal introitus.
2. 2. Question
The first thing that a nurse must ensure when the baby’s head comes
out is
,o A. The cord is intact
o B. No part of the cord is encircling the baby’s neck
o C. The cord is still attached to the placenta
o D. The cord is still pulsating
Incorrect
Correct Answer: B. No part of the cord is encircling the baby’s
neck
The nurse should check right away for possible cord coil around the
neck because if it is present, the baby can be strangled by it and the
fetal head will have difficulty being delivered.
Option A: In a newborn who was born a few hours ago, the cord
may look plump and pale yellow. One of the umbilical arteries
may be visible and protruding from the cut edge. A normal cord
has two arteries and one vein.
Option C: The cord is expelled from the mother within a half-
hour after birth. It is still attached to the placenta, which is
commonly called “the afterbirth.” With its function completed, it
is no longer needed and so is discarded by the mother’s body.
Option D: Some cords may pulsate (the pulsation assists the
transfer of your baby’s blood back into their body) for as long as
30 minutes or more, where others may stop pulsating at 5
minutes or less after the baby is born.
3. 3. Question
To ensure that the baby will breathe as soon as the head is delivered,
the nurse’s priority action is to
A. Slap the baby’s buttocks to make the baby cry.
B. Suction the nose and mouth to remove mucous
secretions.
C. Clamp the cord about 6 inches from the base.
D. Check the baby’s color to make sure it is not cyanotic.
Incorrect
, Correct Answer: B. Suction the nose and mouth to remove
mucous secretions.
Suctioning the nose and mouth of the fetus as soon as the head is
delivered will remove any obstruction that may be present allowing for
better breathing. Also, if mucus is in the nose and mouth, aspiration of
the mucus is possible which can lead to aspiration pneumonia.
(Remember that only the baby’s head has come out as given in the
situation.)
Option A: Earlier, many doctors would hold the baby upside
down firmly around his legs and then slap the butt gently. This
not only causes slight pain to the child, but the motion also helps
loosen any residues that might be obstructing the airways.
Constantly doing so can irritate the child enough to begin crying.
Option C: Late cord clamping (performed approximately 1–3 min
after birth) is recommended for all births while initiating
simultaneous essential neonatal care. Early umbilical cord
clamping (less than 1 min after birth) is not recommended unless
the neonate is asphyxiated and needs to be moved immediately
for resuscitation.
Option D: When a baby is first born, the skin is a dark red to
purple color. As the baby starts to breathe air, the color changes
to red. This redness normally starts to fade on the first day. A
baby’s hands and feet may stay bluish in color for several days.
This is a normal response to a baby’s underdeveloped blood
circulation. But blue coloring of other parts of the body isn’t
normal.
4. 4. Question
When doing perineal care in preparation for delivery, the nurse should
observe the following, except?
A. Use up-down technique with one stroke.
B. Clean from the mons veneris to the anus.
C. Use mild soap and warm water.
D. Paint the inner thighs going towards the perineal area.
Incorrect
Correct Answer: D. Paint the inner thighs going towards the
perineal area
, Painting of the perineal area in preparation for delivery of the baby
must always be done but the stroke should be from the perineum
going outwards to the thighs. The perineal area is the one being
prepared for the delivery and must be kept clean
Option A: Wipe the perineum in one stroke to prevent the
transfer of infectious microorganisms from the anal area to the
perineum.
Option B: Always wash from front to back to prevent spreading
fecal matter from the anal area to the vagina or urethra.
Option C: Use mild soap and warm water. Mild soap would avoid
killing the normal flora that lives in and around the perineum.
5. 5. Question
What are the important considerations that the nurse must remember
after the placenta is delivered? Select all that apply.
A. Check if the placenta is complete including the
membranes
B. Check if the cord is long enough for the baby
C. Check if the umbilical cord has 3 blood vessels
D. Check if the cord has a meaty portion and a shiny portion
Incorrect
Correct Answer: A & C
The nurse after delivering the placenta must ensure that all the
cotyledons and the membranes of the placenta are complete. Also, the
nurse must check if the umbilical cord is normal which means it
contains the 3 blood vessels: 1 vein and 2 arteries.
Option B: At term, the typical umbilical cord is 55 to 60 cm in
length, with a diameter of 2.0 to 2.5 cm. The structure should
have abundant Wharton’s jelly, and no true knots or thromboses
should be present. The total cord length should be estimated in
the delivery room, since the delivering physician has access to
both the placental and fetal ends.
Option C: The maternal surface of the placenta should be dark
maroon in color and should be divided into lobules or cotyledons.
The structure should appear complete, with no missing
cotyledons. The fetal surface of the placenta should be shiny,
Newborn) NCLEX Practice Quiz #5 | 80
Questions
1. 1. Question
Mechanism of labor, also known as the cardinal movements, refers to
the sequencing of events involved in posturing and positioning that
allows the baby to find the easiest to come out of the birth
canal. Arrange the following mechanisms of labor in the order
during the course of labor and fetal delivery.
View Answers:
o Expulsion
o Flexion
o Extension
o External rotation
o Descent
o Internal rotation
o Engagement
Incorrect
The correct order is shown above.
The mechanism of fetal delivery begins with descent into the pelvic
inlet which may occur several days before true labor sets in the
primigravida. Flexion, internal rotation, and extension are mechanisms
that the fetus must perform as it accommodates through the
passageway/birth canal. Eternal rotation is done after the head is
delivered so that the shoulders will be easily delivered through the
vaginal introitus.
2. 2. Question
The first thing that a nurse must ensure when the baby’s head comes
out is
,o A. The cord is intact
o B. No part of the cord is encircling the baby’s neck
o C. The cord is still attached to the placenta
o D. The cord is still pulsating
Incorrect
Correct Answer: B. No part of the cord is encircling the baby’s
neck
The nurse should check right away for possible cord coil around the
neck because if it is present, the baby can be strangled by it and the
fetal head will have difficulty being delivered.
Option A: In a newborn who was born a few hours ago, the cord
may look plump and pale yellow. One of the umbilical arteries
may be visible and protruding from the cut edge. A normal cord
has two arteries and one vein.
Option C: The cord is expelled from the mother within a half-
hour after birth. It is still attached to the placenta, which is
commonly called “the afterbirth.” With its function completed, it
is no longer needed and so is discarded by the mother’s body.
Option D: Some cords may pulsate (the pulsation assists the
transfer of your baby’s blood back into their body) for as long as
30 minutes or more, where others may stop pulsating at 5
minutes or less after the baby is born.
3. 3. Question
To ensure that the baby will breathe as soon as the head is delivered,
the nurse’s priority action is to
A. Slap the baby’s buttocks to make the baby cry.
B. Suction the nose and mouth to remove mucous
secretions.
C. Clamp the cord about 6 inches from the base.
D. Check the baby’s color to make sure it is not cyanotic.
Incorrect
, Correct Answer: B. Suction the nose and mouth to remove
mucous secretions.
Suctioning the nose and mouth of the fetus as soon as the head is
delivered will remove any obstruction that may be present allowing for
better breathing. Also, if mucus is in the nose and mouth, aspiration of
the mucus is possible which can lead to aspiration pneumonia.
(Remember that only the baby’s head has come out as given in the
situation.)
Option A: Earlier, many doctors would hold the baby upside
down firmly around his legs and then slap the butt gently. This
not only causes slight pain to the child, but the motion also helps
loosen any residues that might be obstructing the airways.
Constantly doing so can irritate the child enough to begin crying.
Option C: Late cord clamping (performed approximately 1–3 min
after birth) is recommended for all births while initiating
simultaneous essential neonatal care. Early umbilical cord
clamping (less than 1 min after birth) is not recommended unless
the neonate is asphyxiated and needs to be moved immediately
for resuscitation.
Option D: When a baby is first born, the skin is a dark red to
purple color. As the baby starts to breathe air, the color changes
to red. This redness normally starts to fade on the first day. A
baby’s hands and feet may stay bluish in color for several days.
This is a normal response to a baby’s underdeveloped blood
circulation. But blue coloring of other parts of the body isn’t
normal.
4. 4. Question
When doing perineal care in preparation for delivery, the nurse should
observe the following, except?
A. Use up-down technique with one stroke.
B. Clean from the mons veneris to the anus.
C. Use mild soap and warm water.
D. Paint the inner thighs going towards the perineal area.
Incorrect
Correct Answer: D. Paint the inner thighs going towards the
perineal area
, Painting of the perineal area in preparation for delivery of the baby
must always be done but the stroke should be from the perineum
going outwards to the thighs. The perineal area is the one being
prepared for the delivery and must be kept clean
Option A: Wipe the perineum in one stroke to prevent the
transfer of infectious microorganisms from the anal area to the
perineum.
Option B: Always wash from front to back to prevent spreading
fecal matter from the anal area to the vagina or urethra.
Option C: Use mild soap and warm water. Mild soap would avoid
killing the normal flora that lives in and around the perineum.
5. 5. Question
What are the important considerations that the nurse must remember
after the placenta is delivered? Select all that apply.
A. Check if the placenta is complete including the
membranes
B. Check if the cord is long enough for the baby
C. Check if the umbilical cord has 3 blood vessels
D. Check if the cord has a meaty portion and a shiny portion
Incorrect
Correct Answer: A & C
The nurse after delivering the placenta must ensure that all the
cotyledons and the membranes of the placenta are complete. Also, the
nurse must check if the umbilical cord is normal which means it
contains the 3 blood vessels: 1 vein and 2 arteries.
Option B: At term, the typical umbilical cord is 55 to 60 cm in
length, with a diameter of 2.0 to 2.5 cm. The structure should
have abundant Wharton’s jelly, and no true knots or thromboses
should be present. The total cord length should be estimated in
the delivery room, since the delivering physician has access to
both the placental and fetal ends.
Option C: The maternal surface of the placenta should be dark
maroon in color and should be divided into lobules or cotyledons.
The structure should appear complete, with no missing
cotyledons. The fetal surface of the placenta should be shiny,
