OB Maternity Nursing Exam 2026 | Labor & Delivery
Practice Scenarios
1. Stages of Labor
A nurse is caring for a client whose cervix is fully dilated to 10 cm. Which stage of labor is the
client experiencing?
A. First stage
B. Second stage
C. Third stage
D. Fourth stage
Answer: B. Second stage
Rationale:
The second stage of labor begins at full cervical dilation (10 cm) and ends with the birth of
the baby.
2. Fetal Heart Rate Concern
During labor, the fetal heart rate drops to 90 bpm after contractions. What is the nurse’s
priority action?
A. Continue monitoring
B. Reposition the mother to the left side
C. Increase oxytocin infusion
D. Encourage pushing
Answer: B. Reposition the mother to the left side
Rationale:
Late decelerations may indicate uteroplacental insufficiency. Repositioning improves
placental blood flow and oxygen delivery.
3. Signs of True Labor
Which finding indicates true labor rather than false labor?
A. Contractions stop with walking
B. Cervix remains unchanged
C. Contractions become regular and stronger
,D. Pain occurs only in the abdomen
Answer: C. Contractions become regular and stronger
Rationale:
True labor contractions increase in intensity, frequency, and duration and cause cervical
dilation.
4. Postpartum Hemorrhage
A postpartum client is bleeding heavily, and the uterus feels boggy. What should the nurse
do first?
A. Administer pain medication
B. Massage the fundus
C. Call the physician immediately
D. Encourage ambulation
Answer: B. Massage the fundus
Rationale:
A boggy uterus indicates uterine atony, the leading cause of postpartum hemorrhage.
Fundal massage stimulates contraction.
5. Umbilical Cord Prolapse
The nurse notes a prolapsed umbilical cord during labor. What is the priority nursing action?
A. Place the client in Trendelenburg position
B. Prepare for discharge
C. Administer oral fluids
D. Encourage ambulation
Answer: A. Place the client in Trendelenburg position
Rationale:
This position relieves pressure on the cord and improves fetal oxygenation until emergency
delivery occurs.
6. Normal Fetal Heart Rate
What is the normal baseline fetal heart rate?
A. 60–100 bpm
,B. 100–120 bpm
C. 110–160 bpm
D. 170–200 bpm
Answer: C. 110–160 bpm
Rationale:
A normal fetal heart rate baseline ranges from 110 to 160 bpm.
7. Oxytocin Complication
A laboring client receiving oxytocin develops contractions every 1 minute lasting 90 seconds.
What should the nurse do?
A. Increase oxytocin rate
B. Stop oxytocin infusion
C. Encourage pushing
D. Place the client supine
Answer: B. Stop oxytocin infusion
Rationale:
Frequent prolonged contractions indicate uterine tachysystole, which can reduce fetal
oxygenation.
8. APGAR Score
Which assessment is included in the APGAR score?
A. Blood glucose
B. Reflex irritability
C. Head circumference
D. Bilirubin level
Answer: B. Reflex irritability
Rationale:
APGAR evaluates Appearance, Pulse, Grimace, Activity, and Respiration.
9. Placental Separation
Which sign indicates placental separation after birth?
A. Shortening of the umbilical cord
, B. Maternal fever
C. Increased fetal movement
D. Cervical dilation
Answer: A. Shortening of the umbilical cord
Rationale:
Other signs include a gush of blood and a firm, globular uterus.
10. Pain Management in Labor
A laboring client requests nonpharmacological pain relief. Which intervention is
appropriate?
A. Breathing techniques
B. Restrict movement
C. Keep the room noisy
D. Limit support persons
Answer: A. Breathing techniques
Rationale:
Breathing and relaxation techniques help reduce labor discomfort and anxiety.
11. Preeclampsia Symptoms
Which symptom should the nurse immediately report in a pregnant client with
preeclampsia?
A. Mild ankle edema
B. Headache and visual disturbances
C. Increased appetite
D. Urinary frequency
Answer: B. Headache and visual disturbances
Rationale:
These symptoms may indicate worsening preeclampsia and risk for seizures.
12. Meconium-Stained Fluid
Meconium-stained amniotic fluid places the newborn at risk for:
A. Hypoglycemia
Practice Scenarios
1. Stages of Labor
A nurse is caring for a client whose cervix is fully dilated to 10 cm. Which stage of labor is the
client experiencing?
A. First stage
B. Second stage
C. Third stage
D. Fourth stage
Answer: B. Second stage
Rationale:
The second stage of labor begins at full cervical dilation (10 cm) and ends with the birth of
the baby.
2. Fetal Heart Rate Concern
During labor, the fetal heart rate drops to 90 bpm after contractions. What is the nurse’s
priority action?
A. Continue monitoring
B. Reposition the mother to the left side
C. Increase oxytocin infusion
D. Encourage pushing
Answer: B. Reposition the mother to the left side
Rationale:
Late decelerations may indicate uteroplacental insufficiency. Repositioning improves
placental blood flow and oxygen delivery.
3. Signs of True Labor
Which finding indicates true labor rather than false labor?
A. Contractions stop with walking
B. Cervix remains unchanged
C. Contractions become regular and stronger
,D. Pain occurs only in the abdomen
Answer: C. Contractions become regular and stronger
Rationale:
True labor contractions increase in intensity, frequency, and duration and cause cervical
dilation.
4. Postpartum Hemorrhage
A postpartum client is bleeding heavily, and the uterus feels boggy. What should the nurse
do first?
A. Administer pain medication
B. Massage the fundus
C. Call the physician immediately
D. Encourage ambulation
Answer: B. Massage the fundus
Rationale:
A boggy uterus indicates uterine atony, the leading cause of postpartum hemorrhage.
Fundal massage stimulates contraction.
5. Umbilical Cord Prolapse
The nurse notes a prolapsed umbilical cord during labor. What is the priority nursing action?
A. Place the client in Trendelenburg position
B. Prepare for discharge
C. Administer oral fluids
D. Encourage ambulation
Answer: A. Place the client in Trendelenburg position
Rationale:
This position relieves pressure on the cord and improves fetal oxygenation until emergency
delivery occurs.
6. Normal Fetal Heart Rate
What is the normal baseline fetal heart rate?
A. 60–100 bpm
,B. 100–120 bpm
C. 110–160 bpm
D. 170–200 bpm
Answer: C. 110–160 bpm
Rationale:
A normal fetal heart rate baseline ranges from 110 to 160 bpm.
7. Oxytocin Complication
A laboring client receiving oxytocin develops contractions every 1 minute lasting 90 seconds.
What should the nurse do?
A. Increase oxytocin rate
B. Stop oxytocin infusion
C. Encourage pushing
D. Place the client supine
Answer: B. Stop oxytocin infusion
Rationale:
Frequent prolonged contractions indicate uterine tachysystole, which can reduce fetal
oxygenation.
8. APGAR Score
Which assessment is included in the APGAR score?
A. Blood glucose
B. Reflex irritability
C. Head circumference
D. Bilirubin level
Answer: B. Reflex irritability
Rationale:
APGAR evaluates Appearance, Pulse, Grimace, Activity, and Respiration.
9. Placental Separation
Which sign indicates placental separation after birth?
A. Shortening of the umbilical cord
, B. Maternal fever
C. Increased fetal movement
D. Cervical dilation
Answer: A. Shortening of the umbilical cord
Rationale:
Other signs include a gush of blood and a firm, globular uterus.
10. Pain Management in Labor
A laboring client requests nonpharmacological pain relief. Which intervention is
appropriate?
A. Breathing techniques
B. Restrict movement
C. Keep the room noisy
D. Limit support persons
Answer: A. Breathing techniques
Rationale:
Breathing and relaxation techniques help reduce labor discomfort and anxiety.
11. Preeclampsia Symptoms
Which symptom should the nurse immediately report in a pregnant client with
preeclampsia?
A. Mild ankle edema
B. Headache and visual disturbances
C. Increased appetite
D. Urinary frequency
Answer: B. Headache and visual disturbances
Rationale:
These symptoms may indicate worsening preeclampsia and risk for seizures.
12. Meconium-Stained Fluid
Meconium-stained amniotic fluid places the newborn at risk for:
A. Hypoglycemia
