UWORLD MATERNAL AND NEWBORN UPDATED
COMPREHENSIVE EXAM SCRIPT 2026
QUESTIONS AND ANSWERS GUARANTEED TO
PASS
◉ Define intensity (used to describe labor contractions). Answer:
strength of the contraction at its peak
◉ Define resting tone (used to describe labor contractions). Answer:
tension in the uterine muscle between contractions
◉ Function of the resting tone during labor. Answer: allow fetal
oxygenation between contractions
◉ What is a normal resting tone during the first stage of labor.
Answer: average is 10 mm Hg and should not exceed 20 mm Hg
◉ What does a duration of uterine contractions greater than 90
seconds during the first stage of labor result in?. Answer: reduction
of blood flow to the placenta due to uterine hypertonicity
◉ What can occur if uterine contractions occurs less than 2 minutes
apart?. Answer: fetal distress due to uteroplacental insufficiency
,◉ What is a sign of hypertonicity of the uterus?. Answer: an
intrauterine pressure more than 80 mm Hg
◉ A client gives birth within an hour of arriving at labor and delivery
unit and delivers the placenta 5 minutes later. During assessment,
the nurse notes that the uterus is midline and boggy. Which action
should the nurse take FIRST?
--check for pooled blood under buttocks
--increase IV oxytocin infusion rate
--monitor blood pressure and pulse
--perform firm fundal massage. Answer: perform firm fundal
massage
◉ What are the clinical features of postpartum uterine atony?.
Answer: enlarged, soft, boggy, poorly contracted uterus
◉ What are the risk factors for postpartum uterine atony?. Answer: -
-uterine fatigue from prolonged, induced, or precipitous labor
--intramniotic infection
--uterine overdistention (multiple gestation, macrosomia,
polyhydramnios)
--retained placenta
--grand multiparity (>5 prior deliveries)
,◉ What are the interventions for postpartum uterine atony?.
Answer: --bimanual uterine massage (INITIAL NURSING ACTION)
--correction of bladder distension
--high-dose oxytocin, misoprostol
--tranexamic acid
--carboprost, methylergonovine (uterotonics)
--intrauterine balloon tamponade
--possible surgical interventions (if unresolved)
◉ What is the function of uterotonics?. Answer: stimulate the uterus
to contract. Administration is indicated if the uterus fails to contract
despite massage
◉ A client in labor has reached 8 cm dilation, is fully effaced, and
feels an urge to push. The nurse observed thick, blood-tinged mucus
during the vaginal examination. What is the nurse's BEST action?
--administer prescribed IV meperidine for pain relief
--encourage client to bear down with spontaneous urges to push
--place client in the lithotomy position in preparation for birth
--provide encouragement and coaching in breathing techniques.
Answer: provide encouragement and coaching in breathing
techniques
, --Meperidine is an opioid occasionally used for analgesia during
labor. It should be avoided within 1-4 hours of birth d/t potential for
neonatal respiratory depression. Clients may feel the urge to push
(Ferguson reflex) prior to complete dilation, but pushing should be
delayed until complete dilation is achieved to avoid cervical
swelling/lacerations. The client has not yet reached complete
dilation and should be allowed to move freely, although lithotomy
positioning may be more convenient for birth attendant
◉ Which labor positions encourage fetal rotation and descent,
increase client comfort, and decrease the risk of perineal trauma?.
Answer: upright or lateral positions
◉ What cm dilation is the period of active labor (AKA transition)?.
Answer: 8-10 cm
◉ What are the signs of near-complete dilation?. Answer: bloody
show and urge to push
◉ The precepting nurse is supervising a new obstetric nurse
performing a labor admission assessment on a client with suspected
spontaneous rupture of membranes. Which action by the new nurse
would cause the precepting nurse to intervene?
1. Documenting a positive nitrazine test result when the test strip
turns blue
COMPREHENSIVE EXAM SCRIPT 2026
QUESTIONS AND ANSWERS GUARANTEED TO
PASS
◉ Define intensity (used to describe labor contractions). Answer:
strength of the contraction at its peak
◉ Define resting tone (used to describe labor contractions). Answer:
tension in the uterine muscle between contractions
◉ Function of the resting tone during labor. Answer: allow fetal
oxygenation between contractions
◉ What is a normal resting tone during the first stage of labor.
Answer: average is 10 mm Hg and should not exceed 20 mm Hg
◉ What does a duration of uterine contractions greater than 90
seconds during the first stage of labor result in?. Answer: reduction
of blood flow to the placenta due to uterine hypertonicity
◉ What can occur if uterine contractions occurs less than 2 minutes
apart?. Answer: fetal distress due to uteroplacental insufficiency
,◉ What is a sign of hypertonicity of the uterus?. Answer: an
intrauterine pressure more than 80 mm Hg
◉ A client gives birth within an hour of arriving at labor and delivery
unit and delivers the placenta 5 minutes later. During assessment,
the nurse notes that the uterus is midline and boggy. Which action
should the nurse take FIRST?
--check for pooled blood under buttocks
--increase IV oxytocin infusion rate
--monitor blood pressure and pulse
--perform firm fundal massage. Answer: perform firm fundal
massage
◉ What are the clinical features of postpartum uterine atony?.
Answer: enlarged, soft, boggy, poorly contracted uterus
◉ What are the risk factors for postpartum uterine atony?. Answer: -
-uterine fatigue from prolonged, induced, or precipitous labor
--intramniotic infection
--uterine overdistention (multiple gestation, macrosomia,
polyhydramnios)
--retained placenta
--grand multiparity (>5 prior deliveries)
,◉ What are the interventions for postpartum uterine atony?.
Answer: --bimanual uterine massage (INITIAL NURSING ACTION)
--correction of bladder distension
--high-dose oxytocin, misoprostol
--tranexamic acid
--carboprost, methylergonovine (uterotonics)
--intrauterine balloon tamponade
--possible surgical interventions (if unresolved)
◉ What is the function of uterotonics?. Answer: stimulate the uterus
to contract. Administration is indicated if the uterus fails to contract
despite massage
◉ A client in labor has reached 8 cm dilation, is fully effaced, and
feels an urge to push. The nurse observed thick, blood-tinged mucus
during the vaginal examination. What is the nurse's BEST action?
--administer prescribed IV meperidine for pain relief
--encourage client to bear down with spontaneous urges to push
--place client in the lithotomy position in preparation for birth
--provide encouragement and coaching in breathing techniques.
Answer: provide encouragement and coaching in breathing
techniques
, --Meperidine is an opioid occasionally used for analgesia during
labor. It should be avoided within 1-4 hours of birth d/t potential for
neonatal respiratory depression. Clients may feel the urge to push
(Ferguson reflex) prior to complete dilation, but pushing should be
delayed until complete dilation is achieved to avoid cervical
swelling/lacerations. The client has not yet reached complete
dilation and should be allowed to move freely, although lithotomy
positioning may be more convenient for birth attendant
◉ Which labor positions encourage fetal rotation and descent,
increase client comfort, and decrease the risk of perineal trauma?.
Answer: upright or lateral positions
◉ What cm dilation is the period of active labor (AKA transition)?.
Answer: 8-10 cm
◉ What are the signs of near-complete dilation?. Answer: bloody
show and urge to push
◉ The precepting nurse is supervising a new obstetric nurse
performing a labor admission assessment on a client with suspected
spontaneous rupture of membranes. Which action by the new nurse
would cause the precepting nurse to intervene?
1. Documenting a positive nitrazine test result when the test strip
turns blue
