Maternal/Newborn Test 2 NCLEX Questions
Based on the hormonal theory of labor, the nurse anticipates a rise in which of the following to begin a
chain of hormonal events that cause labor?
A. Cortisol
B. Oxytocin
C. Progesterone
D. Estrogen
A. Cortisol
The nurse would recognize that the client has experienced lightening when the pregnant woman
reports:
A. "I can breath much better"
B. "My ankles are less swollen"
C. "I don't have to urinate as often now"
D. "My lower back pain has been relieved"
A. "I can breath much better"
Fetus has descended into pelvis, relieving pressure on diaphragm
The primary nurse performs a vaginal examination and finds a prolapsed cord. The nurses priority action
will be to:
A. Give medication to hasten a vaginal delivery
B. Keep the client in a back-lying position
C. Make arrangements for an emergency cesarean section
D. Get the cord back to its original location
C. Make arrangements for an emergency cesarean section
Position client to take pressure off cord while awaiting surgery
,When the fetus is found to be in a vertex presentation, the nurse anticipates the presenting fetal part
will be the:
A. Forehead
B. Face
C. Buttocks
D. Occiput
D. Occiput
A nurse is caring for a client in labor who complains of feeling faint. The nurse turns the client onto her
side in order to have what effect on contractions?
A. Little or no effect
B. Increase the frequency
C. Increase the intensity
D. Stop the contractions
C. Increase the intensity
Also less frequent
The nurse recognizes that the client is in latent phase of the first stage of Labor. This phase is best
described as lasting from:
A. Undilated cervix to a 2cm dilation
B. Onset of contractions to 4cm
C. Cervix is dilated 4cm to dilation of 8cm
D. No contraction to contractions every 3 minutes
B. Onset of contractions to 4cm
, The nurse, working on a labor and delivery unit, anticipates active labor for a primagravida will last how
long?
A. 16-18h
B. 12-14h
C. 8-10h
D. 4-6h
D. 4-6h
A client is in the transition phase of labor irritably tells the nurse not to touch her. The nurses best action
would be to:
A. Ask for someone else to support the client
B. Tell the client to be cooperative and do as you say
C. Remind the client to focus on relaxation and breathing
D. Ask the client to push actively with each contraction
C. Remind the client to focus on relaxation and breathing
The student nurse asks the primary nurse to explain what the obstetrician meant when telling the client
that engagement has occurred. The primary nurses best response would be to explain that:
A. The fetus has now become ballotable
B. The presenting part has entered the true pelvis
C. The presenting part is just above the Ischial spine
D. There is now observable crowning
B. The presenting part has entered the true pelvis
While caring for the client in the fourth stage of labor the nurse discovers that the client has saturated
two perineal pads during the first hour. What is the nurses priority action?
A. Notify the primary nurse immediately
Based on the hormonal theory of labor, the nurse anticipates a rise in which of the following to begin a
chain of hormonal events that cause labor?
A. Cortisol
B. Oxytocin
C. Progesterone
D. Estrogen
A. Cortisol
The nurse would recognize that the client has experienced lightening when the pregnant woman
reports:
A. "I can breath much better"
B. "My ankles are less swollen"
C. "I don't have to urinate as often now"
D. "My lower back pain has been relieved"
A. "I can breath much better"
Fetus has descended into pelvis, relieving pressure on diaphragm
The primary nurse performs a vaginal examination and finds a prolapsed cord. The nurses priority action
will be to:
A. Give medication to hasten a vaginal delivery
B. Keep the client in a back-lying position
C. Make arrangements for an emergency cesarean section
D. Get the cord back to its original location
C. Make arrangements for an emergency cesarean section
Position client to take pressure off cord while awaiting surgery
,When the fetus is found to be in a vertex presentation, the nurse anticipates the presenting fetal part
will be the:
A. Forehead
B. Face
C. Buttocks
D. Occiput
D. Occiput
A nurse is caring for a client in labor who complains of feeling faint. The nurse turns the client onto her
side in order to have what effect on contractions?
A. Little or no effect
B. Increase the frequency
C. Increase the intensity
D. Stop the contractions
C. Increase the intensity
Also less frequent
The nurse recognizes that the client is in latent phase of the first stage of Labor. This phase is best
described as lasting from:
A. Undilated cervix to a 2cm dilation
B. Onset of contractions to 4cm
C. Cervix is dilated 4cm to dilation of 8cm
D. No contraction to contractions every 3 minutes
B. Onset of contractions to 4cm
, The nurse, working on a labor and delivery unit, anticipates active labor for a primagravida will last how
long?
A. 16-18h
B. 12-14h
C. 8-10h
D. 4-6h
D. 4-6h
A client is in the transition phase of labor irritably tells the nurse not to touch her. The nurses best action
would be to:
A. Ask for someone else to support the client
B. Tell the client to be cooperative and do as you say
C. Remind the client to focus on relaxation and breathing
D. Ask the client to push actively with each contraction
C. Remind the client to focus on relaxation and breathing
The student nurse asks the primary nurse to explain what the obstetrician meant when telling the client
that engagement has occurred. The primary nurses best response would be to explain that:
A. The fetus has now become ballotable
B. The presenting part has entered the true pelvis
C. The presenting part is just above the Ischial spine
D. There is now observable crowning
B. The presenting part has entered the true pelvis
While caring for the client in the fourth stage of labor the nurse discovers that the client has saturated
two perineal pads during the first hour. What is the nurses priority action?
A. Notify the primary nurse immediately
