Maternal/Newborn Test 2 NCLEX Questions
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1. 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
2. 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
3. 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
4. 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
5. 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 contrac-
tions?
A. Little or no effect
B. Increase the frequency
C. Increase the intensity
D. Stop the contractions: C. Increase the intensity
Also less frequent
6. 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
, Maternal/Newborn Test 2 NCLEX Questions
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C. Cervix is dilated 4cm to dilation of 8cm
D. No contraction to contractions every 3 minutes: B. Onset of contractions to
4cm
7. 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
8. 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
9. 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
10. 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
B. Assure the client that this is normal
C. Put the client on the bedpan to void
D. Start a count of the pads and chart it: A. Notify the primary nurse immediately
Any bleeding in excess of one pad per hour is abnormal
11. The nurse admits a client who suspects she is in labor to the labor and
delivery unit. Which of the following characteristics would indicate the client
is in true labor?
A. Contractions are regular, becoming stronger and lasting longer.
B. Cervix shows no significant change.
C. Contractions stop when the client is ambulating.
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D. Contractions are irregular.: A. Contractions are regular, becoming stronger and
lasting longer.
12. The nurse is caring for a client who is 3 cm dilated and 80% effaced,
with her fetus at -1 station. The client states she is beginning to experience
discomfort with each contraction. Which of the following breathing techniques
would be appropriate?
A. Cleansing breath
B. Slow-paced breathing
C. Patterned-paced breathing
D. Modified-paced breathing: B. Slow-paced breathing
13. The following data have been recorded on the client's chart: 5/80/+1. How
does the nurse interpret this data?
A. The cervix is 5 cm dilated, 80% effaced, and the presenting part is 5 cm
above the ischial spine.
B. The cervix is 5 cm dilated, 80% effaced, and the presenting part is 1 cm
below the ischial spine.
C. The cervix is 5 cm dilated, 80% effaced, and the presenting part is 1 cm
above the ischial spine.
D. The cervix is 5% effaced, 80 cm dilated, and the presenting part is 1 cm
above the ischial spine.: C. The cervix is 5 cm dilated, 80% effaced, and the
presenting part is 1 cm above the ischial spine.
14. The nurse is checking the client's chart and notes the abbreviation ROA.
The nurse knows this means that the presenting part is:
A. Occiput. The fetal position is at the left side of the maternal pelvis, occiput
directed toward anterior (front) of passage.
B. Occiput. The fetal position is at the right side of the maternal pelvis, occiput
directed toward anterior (front) of passage.
C. Occiput. The fetal position is at the left side of the maternal pelvis, occiput
directed toward anterior (front) of passage.
D. Occiput. The fetal position is at the right side of the maternal pelvis, occiput
transverse.: B. Occiput. The fetal position is at the right side of the maternal pelvis,
occiput directed toward anterior (front) of passage.
15. The nurse is caring for a Mexican client during labor. Which of the following
interventions should the nurse be prepared to perform?
A. Ask the father to leave when client is ready to push.
B. Ask the client if she needs pain medication while she is in the 1st stage of
labor.
C. Ask the client if she needs pain medication when she reaches the 2nd stage
of labor.
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1. 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
2. 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
3. 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
4. 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
5. 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 contrac-
tions?
A. Little or no effect
B. Increase the frequency
C. Increase the intensity
D. Stop the contractions: C. Increase the intensity
Also less frequent
6. 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
, Maternal/Newborn Test 2 NCLEX Questions
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C. Cervix is dilated 4cm to dilation of 8cm
D. No contraction to contractions every 3 minutes: B. Onset of contractions to
4cm
7. 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
8. 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
9. 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
10. 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
B. Assure the client that this is normal
C. Put the client on the bedpan to void
D. Start a count of the pads and chart it: A. Notify the primary nurse immediately
Any bleeding in excess of one pad per hour is abnormal
11. The nurse admits a client who suspects she is in labor to the labor and
delivery unit. Which of the following characteristics would indicate the client
is in true labor?
A. Contractions are regular, becoming stronger and lasting longer.
B. Cervix shows no significant change.
C. Contractions stop when the client is ambulating.
, Maternal/Newborn Test 2 NCLEX Questions
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D. Contractions are irregular.: A. Contractions are regular, becoming stronger and
lasting longer.
12. The nurse is caring for a client who is 3 cm dilated and 80% effaced,
with her fetus at -1 station. The client states she is beginning to experience
discomfort with each contraction. Which of the following breathing techniques
would be appropriate?
A. Cleansing breath
B. Slow-paced breathing
C. Patterned-paced breathing
D. Modified-paced breathing: B. Slow-paced breathing
13. The following data have been recorded on the client's chart: 5/80/+1. How
does the nurse interpret this data?
A. The cervix is 5 cm dilated, 80% effaced, and the presenting part is 5 cm
above the ischial spine.
B. The cervix is 5 cm dilated, 80% effaced, and the presenting part is 1 cm
below the ischial spine.
C. The cervix is 5 cm dilated, 80% effaced, and the presenting part is 1 cm
above the ischial spine.
D. The cervix is 5% effaced, 80 cm dilated, and the presenting part is 1 cm
above the ischial spine.: C. The cervix is 5 cm dilated, 80% effaced, and the
presenting part is 1 cm above the ischial spine.
14. The nurse is checking the client's chart and notes the abbreviation ROA.
The nurse knows this means that the presenting part is:
A. Occiput. The fetal position is at the left side of the maternal pelvis, occiput
directed toward anterior (front) of passage.
B. Occiput. The fetal position is at the right side of the maternal pelvis, occiput
directed toward anterior (front) of passage.
C. Occiput. The fetal position is at the left side of the maternal pelvis, occiput
directed toward anterior (front) of passage.
D. Occiput. The fetal position is at the right side of the maternal pelvis, occiput
transverse.: B. Occiput. The fetal position is at the right side of the maternal pelvis,
occiput directed toward anterior (front) of passage.
15. The nurse is caring for a Mexican client during labor. Which of the following
interventions should the nurse be prepared to perform?
A. Ask the father to leave when client is ready to push.
B. Ask the client if she needs pain medication while she is in the 1st stage of
labor.
C. Ask the client if she needs pain medication when she reaches the 2nd stage
of labor.
