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

Late decelerations begin after the uterine contraction peak and return to baseline after the contraction ends, indicating uteroplacental insufficiency.

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

IV systemic opioids such as morphine cross the placenta and can cause neonatal respiratory depression if given too close to delivery, especially at 7 cm.

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

Manually elevating the presenting part off the prolapsed cord relieves compression and maintains fetal oxygenation while emergency delivery is arranged.

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

Transition is the final part of the first stage (8–10 cm dilation), characterized by very intense contractions every 2–3 minutes lasting 60–90 seconds.

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

Open-glottis pushing (exhaling while pushing) preserves maternal oxygenation and fetal blood flow better than sustained Valsalva maneuver and is the evidence-based recommendation.

Maternal Newborn Nursing Test Practice Test

Maternal Newborn Nursing Test Practice Test

Maternal Newborn Nursing Test Intrapartum and Labor and Delivery 3