Maternal Newborn Nursing Test Intrapartum and Labor and Delivery 1 — Questions and Answers
Question 1: A laboring patient at 8 cm dilation suddenly reports severe, constant abdominal pain with a rigid uterus and fetal heart rate decelerations. What should the nurse suspect?
- Placental abruption (Correct answer)
- Transition phase of labor
- Urinary tract infection
- Round ligament pain
Correct answer: Placental abruption
Placental abruption presents with sudden severe abdominal pain, board-like uterus rigidity, and associated fetal distress due to disrupted placental blood flow.
Question 2: Which fetal heart rate pattern requires the nurse to immediately notify the healthcare provider and prepare for possible emergency delivery?
- Early decelerations
- Moderate variability
- Prolonged deceleration lasting more than 3 minutes (Correct answer)
- Accelerations with fetal movement
Correct answer: Prolonged deceleration lasting more than 3 minutes
A prolonged deceleration lasting more than 3 minutes indicates significant fetal compromise and requires immediate intervention to prevent fetal hypoxia.
Question 3: A patient in active labor has an epidural. Her blood pressure drops to 88/52 mmHg. What is the nurse's priority intervention?
- Administer oxygen by non-rebreather mask
- Position the patient in left lateral tilt and increase IV fluids (Correct answer)
- Call the anesthesiologist immediately
- Document the finding and recheck in 5 minutes
Correct answer: Position the patient in left lateral tilt and increase IV fluids
Epidural-induced hypotension is treated first with left lateral positioning to relieve aortocaval compression and IV fluid bolus to restore maternal blood pressure.
Question 4: The nurse is caring for a patient in labor whose membranes rupture spontaneously. The fluid is green-tinged. What is the priority nursing action?
- Document the color and continue routine monitoring
- Perform a vaginal exam to check dilation
- Assess the fetal heart rate immediately (Correct answer)
- Notify dietary to hold the next meal
Correct answer: Assess the fetal heart rate immediately
Meconium-stained amniotic fluid indicates possible fetal stress, so immediate fetal heart rate assessment is the priority to detect fetal compromise.
Question 5: During the second stage of labor, the nurse identifies variable decelerations with each push. What intervention should the nurse implement first?
- Have the patient stop pushing and change position (Correct answer)
- Increase the oxytocin infusion rate
- Apply oxygen via face mask at 10 L/min
- Perform an amnioinfusion
Correct answer: Have the patient stop pushing and change position
Variable decelerations are caused by umbilical cord compression, and repositioning the patient can relieve cord pressure and resolve the pattern.
Question 6: A primigravida is 4 cm dilated and 100% effaced. She is experiencing contractions every 3 minutes lasting 60 seconds. Which phase of labor is she in?
- Latent phase of the first stage
- Active phase of the first stage (Correct answer)
- Transition phase of the first stage
- Second stage of labor
Correct answer: Active phase of the first stage
Active phase of the first stage is characterized by cervical dilation from 4–10 cm with regular, stronger contractions occurring every 2–5 minutes.
Maternal Newborn Nursing Test Intrapartum and Labor and Delivery 1
A laboring patient at 8 cm dilation suddenly reports severe, constant abdominal pain with a rigid uterus and fetal heart rate decelerations.
What should the nurse suspect?