NR 327 Maternal-Child Nursing Week 4 Study Guide 2026
|Chamberlain College
1. A nurse is caring for a client in the active phase of the first stage of labor. The
client’s cervix is dilated to 5 cm and contractions are every 3 minutes. Which of
the following is the priority nursing action?
A. Assess the fetal heart rate and contraction pattern.
B. Perform a vaginal examination to check for cord prolapse.
C. Encourage the client to use patterned-paced breathing techniques.
D. Administer an opioid analgesic for pain relief.
Answer: A
Rationale: Assessment is the first step of the nursing process. Monitoring fetal well-being
and labor progress through FHR and contraction assessment is the priority in the active
phase.
2. Which of the following fetal heart rate (FHR) patterns is characterized by a
gradual decrease in FHR that mirrors the contraction?
A. Variable decelerations
B. Early decelerations
C. Late decelerations
D. Prolonged decelerations
Answer: B
Rationale: Early decelerations are caused by fetal head compression and are characterized
by a gradual decrease in FHR that returns to baseline at the end of the contraction,
mirroring the shape of the contraction.
,3. A nurse observes a fetal heart rate pattern with abrupt decreases in FHR
below the baseline, appearing as a ‘U’ or ‘V’ shape. Which of the following
causes should the nurse suspect?
A. Uteroplacental insufficiency
B. Umbilical cord compression
C. Fetal head compression
D. Maternal hypotension
Answer: B
Rationale: Variable decelerations are abrupt decreases in FHR below the baseline and are
typically caused by umbilical cord compression.
4. A client at 39 weeks gestation is receiving oxytocin for labor induction. The
nurse notes contractions every 90 seconds, lasting 70 seconds. Which of the
following is the priority action?
A. Increase the oxytocin infusion rate.
B. Notify the provider to request an epidural.
C. Stop the oxytocin infusion.
D. Place the client in a supine position.
Answer: C
Rationale: Contractions every 90 seconds indicate tachysystole (more than 5 contractions
in 10 minutes). The nurse should stop the oxytocin to prevent fetal distress and uterine
rupture.
, 5. A nurse is preparing to administer an epidural block to a client in labor. Which
of the following is the most common side effect the nurse should monitor for?
A. Maternal hypotension
B. Maternal hypertension
C. Fetal tachycardia
D. Hyperventilation
Answer: A
Rationale: Maternal hypotension is a common side effect of epidural anesthesia due to
vasodilation. Pre-loading with IV fluids is often used to mitigate this risk.
6. During the third stage of labor, which of the following signs indicates that the
placenta has separated?
A. The uterus becomes soft and boggy.
B. Maternal blood pressure significantly increases.
C. The umbilical cord shortens as it enters the vagina.
D. A sudden gush of dark blood from the introitus.
Answer: D
Rationale: Signs of placental separation include a sudden gush of dark blood, lengthening
of the umbilical cord, and the uterus becoming firm and globular.
7. A client is in the second stage of labor. Which of the following best describes
this stage?
A. From full cervical dilation to the birth of the baby.
B. From the onset of regular contractions to full cervical dilation.
C. From the birth of the baby to the delivery of the placenta.
D. The first 1 to 2 hours after delivery of the placenta.
Answer: A
Rationale: The second stage of labor begins with full dilation (10 cm) and ends with the
birth of the newborn.
|Chamberlain College
1. A nurse is caring for a client in the active phase of the first stage of labor. The
client’s cervix is dilated to 5 cm and contractions are every 3 minutes. Which of
the following is the priority nursing action?
A. Assess the fetal heart rate and contraction pattern.
B. Perform a vaginal examination to check for cord prolapse.
C. Encourage the client to use patterned-paced breathing techniques.
D. Administer an opioid analgesic for pain relief.
Answer: A
Rationale: Assessment is the first step of the nursing process. Monitoring fetal well-being
and labor progress through FHR and contraction assessment is the priority in the active
phase.
2. Which of the following fetal heart rate (FHR) patterns is characterized by a
gradual decrease in FHR that mirrors the contraction?
A. Variable decelerations
B. Early decelerations
C. Late decelerations
D. Prolonged decelerations
Answer: B
Rationale: Early decelerations are caused by fetal head compression and are characterized
by a gradual decrease in FHR that returns to baseline at the end of the contraction,
mirroring the shape of the contraction.
,3. A nurse observes a fetal heart rate pattern with abrupt decreases in FHR
below the baseline, appearing as a ‘U’ or ‘V’ shape. Which of the following
causes should the nurse suspect?
A. Uteroplacental insufficiency
B. Umbilical cord compression
C. Fetal head compression
D. Maternal hypotension
Answer: B
Rationale: Variable decelerations are abrupt decreases in FHR below the baseline and are
typically caused by umbilical cord compression.
4. A client at 39 weeks gestation is receiving oxytocin for labor induction. The
nurse notes contractions every 90 seconds, lasting 70 seconds. Which of the
following is the priority action?
A. Increase the oxytocin infusion rate.
B. Notify the provider to request an epidural.
C. Stop the oxytocin infusion.
D. Place the client in a supine position.
Answer: C
Rationale: Contractions every 90 seconds indicate tachysystole (more than 5 contractions
in 10 minutes). The nurse should stop the oxytocin to prevent fetal distress and uterine
rupture.
, 5. A nurse is preparing to administer an epidural block to a client in labor. Which
of the following is the most common side effect the nurse should monitor for?
A. Maternal hypotension
B. Maternal hypertension
C. Fetal tachycardia
D. Hyperventilation
Answer: A
Rationale: Maternal hypotension is a common side effect of epidural anesthesia due to
vasodilation. Pre-loading with IV fluids is often used to mitigate this risk.
6. During the third stage of labor, which of the following signs indicates that the
placenta has separated?
A. The uterus becomes soft and boggy.
B. Maternal blood pressure significantly increases.
C. The umbilical cord shortens as it enters the vagina.
D. A sudden gush of dark blood from the introitus.
Answer: D
Rationale: Signs of placental separation include a sudden gush of dark blood, lengthening
of the umbilical cord, and the uterus becoming firm and globular.
7. A client is in the second stage of labor. Which of the following best describes
this stage?
A. From full cervical dilation to the birth of the baby.
B. From the onset of regular contractions to full cervical dilation.
C. From the birth of the baby to the delivery of the placenta.
D. The first 1 to 2 hours after delivery of the placenta.
Answer: A
Rationale: The second stage of labor begins with full dilation (10 cm) and ends with the
birth of the newborn.
