NUR 404 OB EXAM 1 NCLEX QUESTION & ANSWERS
1. The husband of a laboring woman asks the nurse how he can help his wife
throughout the first stage of labor. The nurse informs him that in addition to all that he's
doing now, he could tell her when the contractions are:
a. 2 minutes apart.
b. at their acme.
c. at their increment.
d. at their decrement. - Answer -ANS: B
When the contraction is most intense, the coach can tell the laboring woman that this
contraction will be over soon to help her remain focused. Describing the frequency of
the contractions is not usually helpful. The increment occurs as the contraction begins in
the fundus and spreads through the uterus. Calling attention to this phase may cause
the woman to become tense. The woman does not need anyone to tell her that the
contraction is decreasing in intensity.
PTS: 1 DIF: Cognitive Level: Understanding REF: 196, 197
2. The nurse is explaining to a group of nursing students what occurs during active labor
as the uterus contracts. Which statement explains the maternal-fetal exchange of
oxygen and waste products during a contraction?
a. Is not significantly affected
b. Increases as blood pressure decreases
c. Diminishes as the spiral arteries are compressed
d. Continues except when placental functions are reduced - Answer -ANS: C
During labor contractions, the maternal blood supply to the placenta gradually stops as
the spiral arteries supplying the intervillous space are compressed by the contracting
uterine muscle. The exchange of oxygen and waste products is affected by
contractions. The exchange of oxygen and waste products decreases. The maternal
blood supply to the placenta gradually stops with contractions.
PTS: 1 DIF: Cognitive Level: Application REF: 199
3. The nurse is directing an unlicensed assistive personnel (UAP) to take maternal vital
signs between contractions. Which statement is the best rationale for assessing
maternal vital signs between contractions?
,a. Vital signs taken during contractions are not accurate.
b. During a contraction, assessing fetal heart rate is the priority.
c. Maternal blood flow to the heart is reduced during contractions.
d. Maternal circulating blood volume increases temporarily during contractions. -
Answer -ANS: D
During uterine contractions, blood flow to the placenta temporarily stops, causing a
relative increase in the mother's blood volume, which in turn temporarily increases blood
pressure and slows the pulse. Vital signs are altered by contractions but are considered
accurate for a period of time. It is important to monitor the fetal response to
contractions, but the question is concerned with the maternal vital signs. Maternal blood
flow is increased during a contraction.
PTS: 1 DIF: Cognitive Level: Application REF: 198
4. Uncontrolled maternal hyperventilation during labor results in:
a. metabolic acidosis.
b. metabolic alkalosis.
c. respiratory acidosis.
d. respiratory alkalosis. - Answer -ANS: D
Rapid deep respirations cause the laboring woman to lose carbon dioxide through
exhalation, resulting in respiratory alkalosis. Hyperventilation does not cause respiratory
acidosis, metabolic acidosis, or metabolic alkalosis.
PTS: 1 DIF: Cognitive Level: Understanding REF: 198
5. The nurse is assessing a client in the active phase of labor. What should the nurse
expect during this phase?
a. The client is sociable and excited.
b. The client is requesting pain medication.
c. The client begins to experience the urge to push.
d. The client experiences loss of control and irritability. - Answer -ANS: B
,During the active phase of labor, contraction intensity and discomfort increase to the
point where women often request pain medication. Sociability and excitability occur
during the latent phase. The urge to push occurs at the end of the transition phase or
the second stage of labor. Loss of control and irritability occur during the transition
phase of labor.
PTS: 1 DIF: Cognitive Level: Application REF: 212
6. The laboring client asks the nurse how the labor contractions work to dilate the
cervix. The best response by the nurse is that labor contractions facilitate cervical
dilation by:
a. promoting blood flow to the cervix.
b. contracting the lower uterine segment.
c. enlarging the internal size of the uterus.
d. pulling the cervix over the fetus and amniotic sac. - Answer -ANS: D
Effective uterine contractions pull the cervix upward at the same time the fetus and
amniotic sac are pushed downward. Blood flow decreases to the uterus during a
contraction. The contractions are stronger at the fundus. The internal size becomes
smaller with the contractions; this helps push the fetus down.
PTS: 1 DIF: Cognitive Level: Application REF: 198
7. Pregnant clients can usually tolerate the normal blood loss associated with childbirth
because they have:
a. higher hematocrit.
b. increased leukocytes.
c. increased blood volume.
d. a lower fibrinogen level. - Answer -ANS: C
Women have a significant increase in blood volume during pregnancy. After birth, the
additional circulating volume is no longer necessary. The hematocrit decreases with
pregnancy because of the high fluid volume. Leukocyte levels increase during labor, but
that is not the reason for the toleration of blood loss. Fibrinogen levels increase with
pregnancy.
PTS: 1 DIF: Cognitive Level: Understanding REF: 198
, 8. The nurse is assessing the duration of a client's labor contractions. Which action
does the nurse implement to assess the duration of labor contractions?
a. Assess the strongest intensity of each contraction.
b. Assess uterine relaxation between two contractions.
c. Assess from the beginning to the end of each contraction.
d. Assess from the beginning of one contraction to the beginning of the next. - Answer -
ANS: C
Duration of labor contractions is the average length of contractions from beginning to
end. Assessing the strongest intensity of each contraction assesses the strength or
intensity of the contractions. Assessing uterine relaxation between two contractions is
the interval of the contraction phase. Assessing from the beginning of one contraction to
the beginning of the next is the frequency of the contractions.
PTS: 1 DIF: Cognitive Level: Application REF: 196, 197
9. Which event is the best indicator of true labor?
a. Bloody show
b. Cervical dilation and effacement
c. Fetal descent into the pelvic inlet
d. Uterine contractions every 7 minutes - Answer -ANS: B
The conclusive distinction between true and false labor is that contractions of true labor
cause progressive change in the cervix. Bloody show can occur before true labor. Fetal
descent can occur before true labor. False labor may have contractions that occur this
frequently but is usually inconsistent.
PTS: 1 DIF: Cognitive Level: Understanding REF: 198
10. Which factor ensures that the smallest anterior-posterior diameter of the fetal head
enters the pelvis?
a. Station
b. Flexion
c. Descent
1. The husband of a laboring woman asks the nurse how he can help his wife
throughout the first stage of labor. The nurse informs him that in addition to all that he's
doing now, he could tell her when the contractions are:
a. 2 minutes apart.
b. at their acme.
c. at their increment.
d. at their decrement. - Answer -ANS: B
When the contraction is most intense, the coach can tell the laboring woman that this
contraction will be over soon to help her remain focused. Describing the frequency of
the contractions is not usually helpful. The increment occurs as the contraction begins in
the fundus and spreads through the uterus. Calling attention to this phase may cause
the woman to become tense. The woman does not need anyone to tell her that the
contraction is decreasing in intensity.
PTS: 1 DIF: Cognitive Level: Understanding REF: 196, 197
2. The nurse is explaining to a group of nursing students what occurs during active labor
as the uterus contracts. Which statement explains the maternal-fetal exchange of
oxygen and waste products during a contraction?
a. Is not significantly affected
b. Increases as blood pressure decreases
c. Diminishes as the spiral arteries are compressed
d. Continues except when placental functions are reduced - Answer -ANS: C
During labor contractions, the maternal blood supply to the placenta gradually stops as
the spiral arteries supplying the intervillous space are compressed by the contracting
uterine muscle. The exchange of oxygen and waste products is affected by
contractions. The exchange of oxygen and waste products decreases. The maternal
blood supply to the placenta gradually stops with contractions.
PTS: 1 DIF: Cognitive Level: Application REF: 199
3. The nurse is directing an unlicensed assistive personnel (UAP) to take maternal vital
signs between contractions. Which statement is the best rationale for assessing
maternal vital signs between contractions?
,a. Vital signs taken during contractions are not accurate.
b. During a contraction, assessing fetal heart rate is the priority.
c. Maternal blood flow to the heart is reduced during contractions.
d. Maternal circulating blood volume increases temporarily during contractions. -
Answer -ANS: D
During uterine contractions, blood flow to the placenta temporarily stops, causing a
relative increase in the mother's blood volume, which in turn temporarily increases blood
pressure and slows the pulse. Vital signs are altered by contractions but are considered
accurate for a period of time. It is important to monitor the fetal response to
contractions, but the question is concerned with the maternal vital signs. Maternal blood
flow is increased during a contraction.
PTS: 1 DIF: Cognitive Level: Application REF: 198
4. Uncontrolled maternal hyperventilation during labor results in:
a. metabolic acidosis.
b. metabolic alkalosis.
c. respiratory acidosis.
d. respiratory alkalosis. - Answer -ANS: D
Rapid deep respirations cause the laboring woman to lose carbon dioxide through
exhalation, resulting in respiratory alkalosis. Hyperventilation does not cause respiratory
acidosis, metabolic acidosis, or metabolic alkalosis.
PTS: 1 DIF: Cognitive Level: Understanding REF: 198
5. The nurse is assessing a client in the active phase of labor. What should the nurse
expect during this phase?
a. The client is sociable and excited.
b. The client is requesting pain medication.
c. The client begins to experience the urge to push.
d. The client experiences loss of control and irritability. - Answer -ANS: B
,During the active phase of labor, contraction intensity and discomfort increase to the
point where women often request pain medication. Sociability and excitability occur
during the latent phase. The urge to push occurs at the end of the transition phase or
the second stage of labor. Loss of control and irritability occur during the transition
phase of labor.
PTS: 1 DIF: Cognitive Level: Application REF: 212
6. The laboring client asks the nurse how the labor contractions work to dilate the
cervix. The best response by the nurse is that labor contractions facilitate cervical
dilation by:
a. promoting blood flow to the cervix.
b. contracting the lower uterine segment.
c. enlarging the internal size of the uterus.
d. pulling the cervix over the fetus and amniotic sac. - Answer -ANS: D
Effective uterine contractions pull the cervix upward at the same time the fetus and
amniotic sac are pushed downward. Blood flow decreases to the uterus during a
contraction. The contractions are stronger at the fundus. The internal size becomes
smaller with the contractions; this helps push the fetus down.
PTS: 1 DIF: Cognitive Level: Application REF: 198
7. Pregnant clients can usually tolerate the normal blood loss associated with childbirth
because they have:
a. higher hematocrit.
b. increased leukocytes.
c. increased blood volume.
d. a lower fibrinogen level. - Answer -ANS: C
Women have a significant increase in blood volume during pregnancy. After birth, the
additional circulating volume is no longer necessary. The hematocrit decreases with
pregnancy because of the high fluid volume. Leukocyte levels increase during labor, but
that is not the reason for the toleration of blood loss. Fibrinogen levels increase with
pregnancy.
PTS: 1 DIF: Cognitive Level: Understanding REF: 198
, 8. The nurse is assessing the duration of a client's labor contractions. Which action
does the nurse implement to assess the duration of labor contractions?
a. Assess the strongest intensity of each contraction.
b. Assess uterine relaxation between two contractions.
c. Assess from the beginning to the end of each contraction.
d. Assess from the beginning of one contraction to the beginning of the next. - Answer -
ANS: C
Duration of labor contractions is the average length of contractions from beginning to
end. Assessing the strongest intensity of each contraction assesses the strength or
intensity of the contractions. Assessing uterine relaxation between two contractions is
the interval of the contraction phase. Assessing from the beginning of one contraction to
the beginning of the next is the frequency of the contractions.
PTS: 1 DIF: Cognitive Level: Application REF: 196, 197
9. Which event is the best indicator of true labor?
a. Bloody show
b. Cervical dilation and effacement
c. Fetal descent into the pelvic inlet
d. Uterine contractions every 7 minutes - Answer -ANS: B
The conclusive distinction between true and false labor is that contractions of true labor
cause progressive change in the cervix. Bloody show can occur before true labor. Fetal
descent can occur before true labor. False labor may have contractions that occur this
frequently but is usually inconsistent.
PTS: 1 DIF: Cognitive Level: Understanding REF: 198
10. Which factor ensures that the smallest anterior-posterior diameter of the fetal head
enters the pelvis?
a. Station
b. Flexion
c. Descent
