NR 327 Maternal-Child Nursing Week 4 Practice Quiz 2026
|Chamberlain College
1. A nurse is assessing a client in active labor and notes a fetal heart rate (FHR)
of 130 bpm with periodic late decelerations. Which action should the nurse take
first?
A. Administer oxygen at 8-10 L/min via nonrebreather mask
B. Increase the rate of the maintenance IV fluid
C. Perform a vaginal exam to check for cord prolapse
D. Reposition the client to a lateral position
Answer: D
Rationale: The first action for late decelerations is to reposition the client to a lateral
position to improve uteroplacental blood flow. Following this, other intrauterine
resuscitation measures like oxygen and IV fluids are initiated.
2. A client is 6 cm dilated, 80% effaced, and at 0 station. Which stage and phase
of labor is the client experiencing?
A. First stage, active phase
B. First stage, latent phase
C. First stage, transition phase
D. Second stage, active phase
Answer: A
Rationale: The active phase of the first stage of labor is generally defined as cervical
dilation from 4 to 7 cm (or 6 to 10 cm in newer guidelines). In this scenario, 6 cm fits the
active phase.
,3. Which of the following findings is the most reliable indicator that a client is in
true labor?
A. Rupture of membranes
B. Consistent contraction frequency
C. Cervical dilation and effacement
D. Passage of the mucus plug
Answer: C
Rationale: True labor is characterized by progressive cervical changes, including dilation
and effacement, regardless of the contraction pattern.
4. A nurse is monitoring a client who just received an epidural block. Which side
effect is the most common priority to monitor for?
A. Maternal hypertension
B. Urinary frequency
C. Fetal tachycardia
D. Maternal hypotension
Answer: D
Rationale: Maternal hypotension is the most common side effect of an epidural block due
to vasodilation. It can lead to decreased placental perfusion and fetal distress.
5. The nurse observes a fetal heart rate pattern showing abrupt decreases in
FHR below the baseline with a ‘V’ or ‘W’ shape. This pattern is indicative of:
A. Head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Fetal sleep cycle
Answer: B
, Rationale: Abrupt, variable-shaped decelerations indicate cord compression. Early
decelerations indicate head compression, while late decelerations indicate uteroplacental
insufficiency.
6. What is the primary purpose of administering Magnesium Sulfate to a client
in preterm labor?
A. To stop contractions indefinitely
B. To provide neuroprotection for the fetus
C. To accelerate fetal lung maturity
D. To treat maternal hypertension
Answer: B
Rationale: While Magnesium Sulfate is a tocolytic, its primary use in preterm labor
(especially before 32 weeks) is for fetal neuroprotection to reduce the risk of cerebral
palsy.
7. A client in the second stage of labor is pushing. The nurse notes the fetal head
emerging but then retracting against the perineum (turtle sign). What is the
nurse’s priority action?
A. Apply fundal pressure
B. Prepare for an emergency Cesarean section
C. Call for help and perform McRoberts maneuver
D. Increase the Oxytocin infusion rate
Answer: C
Rationale: The turtle sign is a hallmark of shoulder dystocia. The nurse should call for help
and assist with the McRoberts maneuver (flexing the mother’s thighs toward her abdomen)
and suprapubic pressure.
|Chamberlain College
1. A nurse is assessing a client in active labor and notes a fetal heart rate (FHR)
of 130 bpm with periodic late decelerations. Which action should the nurse take
first?
A. Administer oxygen at 8-10 L/min via nonrebreather mask
B. Increase the rate of the maintenance IV fluid
C. Perform a vaginal exam to check for cord prolapse
D. Reposition the client to a lateral position
Answer: D
Rationale: The first action for late decelerations is to reposition the client to a lateral
position to improve uteroplacental blood flow. Following this, other intrauterine
resuscitation measures like oxygen and IV fluids are initiated.
2. A client is 6 cm dilated, 80% effaced, and at 0 station. Which stage and phase
of labor is the client experiencing?
A. First stage, active phase
B. First stage, latent phase
C. First stage, transition phase
D. Second stage, active phase
Answer: A
Rationale: The active phase of the first stage of labor is generally defined as cervical
dilation from 4 to 7 cm (or 6 to 10 cm in newer guidelines). In this scenario, 6 cm fits the
active phase.
,3. Which of the following findings is the most reliable indicator that a client is in
true labor?
A. Rupture of membranes
B. Consistent contraction frequency
C. Cervical dilation and effacement
D. Passage of the mucus plug
Answer: C
Rationale: True labor is characterized by progressive cervical changes, including dilation
and effacement, regardless of the contraction pattern.
4. A nurse is monitoring a client who just received an epidural block. Which side
effect is the most common priority to monitor for?
A. Maternal hypertension
B. Urinary frequency
C. Fetal tachycardia
D. Maternal hypotension
Answer: D
Rationale: Maternal hypotension is the most common side effect of an epidural block due
to vasodilation. It can lead to decreased placental perfusion and fetal distress.
5. The nurse observes a fetal heart rate pattern showing abrupt decreases in
FHR below the baseline with a ‘V’ or ‘W’ shape. This pattern is indicative of:
A. Head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Fetal sleep cycle
Answer: B
, Rationale: Abrupt, variable-shaped decelerations indicate cord compression. Early
decelerations indicate head compression, while late decelerations indicate uteroplacental
insufficiency.
6. What is the primary purpose of administering Magnesium Sulfate to a client
in preterm labor?
A. To stop contractions indefinitely
B. To provide neuroprotection for the fetus
C. To accelerate fetal lung maturity
D. To treat maternal hypertension
Answer: B
Rationale: While Magnesium Sulfate is a tocolytic, its primary use in preterm labor
(especially before 32 weeks) is for fetal neuroprotection to reduce the risk of cerebral
palsy.
7. A client in the second stage of labor is pushing. The nurse notes the fetal head
emerging but then retracting against the perineum (turtle sign). What is the
nurse’s priority action?
A. Apply fundal pressure
B. Prepare for an emergency Cesarean section
C. Call for help and perform McRoberts maneuver
D. Increase the Oxytocin infusion rate
Answer: C
Rationale: The turtle sign is a hallmark of shoulder dystocia. The nurse should call for help
and assist with the McRoberts maneuver (flexing the mother’s thighs toward her abdomen)
and suprapubic pressure.
