Maternal Newborn Nursing Test Intrapartum and Labor and Delivery 3

Question 1

The nurse is assessing a patient in labor and notes the fetal heart rate drops to 90 bpm following each contraction and gradually returns to baseline. This pattern is described as:

Accepted Answer

Late decelerations

Answer

Variable decelerations

Answer

Early decelerations

Answer

Sinusoidal pattern

Question 2

A patient in active labor requests pain relief. She is 7 cm dilated. Which analgesic option is CONTRAINDICATED this close to delivery due to risk of neonatal respiratory depression?

Accepted Answer

IV morphine sulfate

Answer

Epidural analgesia

Answer

Nitrous oxide

Answer

Intrathecal opioids via spinal block

Question 3

During a vaginal examination, the nurse notes the presenting part is not engaged and the fetal heart rate suddenly drops to 60 bpm. The nurse suspects cord prolapse. What is the immediate nursing action?

Accepted Answer

Manually elevate the presenting part off the cord while calling for help

Answer

Reassess the fetal heart rate in 5 minutes

Answer

Remove the examiner's hand and apply a fetal scalp electrode

Answer

Administer oxygen and increase IV fluid rate

Question 4

Which assessment finding would indicate that a patient is in the transition phase of the first stage of labor?

Accepted Answer

Cervical dilation of 8–10 cm with intense contractions every 2 minutes

Answer

Cervical dilation of 4 cm with mild contractions

Answer

Complete cervical dilation with an urge to push

Answer

Cervical dilation of 6 cm with contractions every 4 minutes

Question 5

A patient has been pushing for 1.5 hours. The nurse observes crowning with each push but the head retracts between pushes. What technique should the nurse encourage to facilitate delivery?

Accepted Answer

Open-glottis pushing with breathing between contractions

Answer

Valsalva maneuver with sustained breath-holding for 10 seconds

Answer

Supine positioning with legs in stirrups

Answer

Increasing oxytocin to strengthen contractions

Question 6

The nurse is assessing fetal heart rate monitoring strips. Which characteristic of fetal heart rate variability is MOST reassuring of fetal well-being?

Accepted Answer

Moderate variability (6–25 bpm)

Answer

Absent variability

Answer

Minimal variability (less than 5 bpm)

Answer

Marked variability (greater than 25 bpm)