NR 327 Maternal-Child Nursing: Labor & Delivery Practice Pack 2026
|Chamberlain College
1. A nurse is assessing a client in the active phase of the first stage of labor.
Which of the following cervical dilations should the nurse expect?
A. 1 to 3 cm
B. 4 to 5 cm
C. 0 to 2 cm
D. 6 to 10 cm
Answer: D
Rationale: According to updated ACOG guidelines, the active phase of the first stage of
labor typically begins at 6 cm and continues until full dilation (10 cm).
2. While monitoring the fetal heart rate (FHR), the nurse notes a gradual
decrease in FHR that mirrors the contraction. This pattern is characteristic of:
A. Late decelerations
B. Early decelerations
C. Variable decelerations
D. Prolonged decelerations
Answer: B
Rationale: Early decelerations are characterized by a gradual decrease in FHR that starts
and ends with the contraction, usually caused by fetal head compression.
,3. A client is in the third stage of labor. Which of the following findings indicates
placental separation?
A. Shortening of the umbilical cord
B. Decrease in uterine contraction frequency
C. Lengthening of the umbilical cord and a gush of blood
D. Rupture of membranes
Answer: C
Rationale: Signs of placental separation include the lengthening of the umbilical cord, a
sudden gush of dark blood from the introitus, and the uterus changing to a globular shape.
4. The nurse identifies variable decelerations on the FHR monitor. What is the
priority nursing intervention?
A. Increase the IV fluid rate
B. Administer oxygen via non-rebreather mask
C. Prepare for immediate delivery
D. Change the client’s position
Answer: D
Rationale: Variable decelerations are caused by cord compression. The first intervention is
to change the maternal position to relieve pressure on the umbilical cord.
5. What does the ‘E’ in the acronym VEAL CHOP stand for regarding FHR
patterns?
A. Early decelerations
B. Environment
C. Epidural
D. Emergency
Answer: A
Rationale: VEAL CHOP is an acronym where V=Variable, E=Early, A=Acceleration, L=Late.
Correspondingly, C=Cord, H=Head, O=Oxygen/Ok, P=Placental insufficiency.
, 6. A nurse is caring for a client who is receiving oxytocin (Pitocin). Which finding
requires the nurse to discontinue the infusion?
A. Contractions occurring every 2 to 3 minutes
B. Contraction duration of 60 seconds
C. Contractions lasting longer than 90 seconds
D. Fetal heart rate of 140 bpm
Answer: C
Rationale: Contractions lasting longer than 90 seconds (tachysystole) can reduce placental
blood flow and fetal oxygenation, necessitating discontinuation of oxytocin.
7. Moderate variability in the fetal heart rate is defined as a range of:
A. 0 to 2 bpm
B. 6 to 25 bpm
C. More than 25 bpm
D. 3 to 5 bpm
Answer: B
Rationale: Moderate variability is defined as a fluctuation in the FHR baseline of 6 to 25
beats per minute, which is a sign of fetal well-being.
8. A client’s membranes have just ruptured. What is the nurse’s immediate
priority action?
A. Assess the fetal heart rate
B. Perform a vaginal exam
C. Assess the color of the fluid
D. Document the time of rupture
Answer: A
Rationale: The priority action after rupture of membranes is to assess the FHR to check for
cord prolapse, which can occur with the gush of fluid.
|Chamberlain College
1. A nurse is assessing a client in the active phase of the first stage of labor.
Which of the following cervical dilations should the nurse expect?
A. 1 to 3 cm
B. 4 to 5 cm
C. 0 to 2 cm
D. 6 to 10 cm
Answer: D
Rationale: According to updated ACOG guidelines, the active phase of the first stage of
labor typically begins at 6 cm and continues until full dilation (10 cm).
2. While monitoring the fetal heart rate (FHR), the nurse notes a gradual
decrease in FHR that mirrors the contraction. This pattern is characteristic of:
A. Late decelerations
B. Early decelerations
C. Variable decelerations
D. Prolonged decelerations
Answer: B
Rationale: Early decelerations are characterized by a gradual decrease in FHR that starts
and ends with the contraction, usually caused by fetal head compression.
,3. A client is in the third stage of labor. Which of the following findings indicates
placental separation?
A. Shortening of the umbilical cord
B. Decrease in uterine contraction frequency
C. Lengthening of the umbilical cord and a gush of blood
D. Rupture of membranes
Answer: C
Rationale: Signs of placental separation include the lengthening of the umbilical cord, a
sudden gush of dark blood from the introitus, and the uterus changing to a globular shape.
4. The nurse identifies variable decelerations on the FHR monitor. What is the
priority nursing intervention?
A. Increase the IV fluid rate
B. Administer oxygen via non-rebreather mask
C. Prepare for immediate delivery
D. Change the client’s position
Answer: D
Rationale: Variable decelerations are caused by cord compression. The first intervention is
to change the maternal position to relieve pressure on the umbilical cord.
5. What does the ‘E’ in the acronym VEAL CHOP stand for regarding FHR
patterns?
A. Early decelerations
B. Environment
C. Epidural
D. Emergency
Answer: A
Rationale: VEAL CHOP is an acronym where V=Variable, E=Early, A=Acceleration, L=Late.
Correspondingly, C=Cord, H=Head, O=Oxygen/Ok, P=Placental insufficiency.
, 6. A nurse is caring for a client who is receiving oxytocin (Pitocin). Which finding
requires the nurse to discontinue the infusion?
A. Contractions occurring every 2 to 3 minutes
B. Contraction duration of 60 seconds
C. Contractions lasting longer than 90 seconds
D. Fetal heart rate of 140 bpm
Answer: C
Rationale: Contractions lasting longer than 90 seconds (tachysystole) can reduce placental
blood flow and fetal oxygenation, necessitating discontinuation of oxytocin.
7. Moderate variability in the fetal heart rate is defined as a range of:
A. 0 to 2 bpm
B. 6 to 25 bpm
C. More than 25 bpm
D. 3 to 5 bpm
Answer: B
Rationale: Moderate variability is defined as a fluctuation in the FHR baseline of 6 to 25
beats per minute, which is a sign of fetal well-being.
8. A client’s membranes have just ruptured. What is the nurse’s immediate
priority action?
A. Assess the fetal heart rate
B. Perform a vaginal exam
C. Assess the color of the fluid
D. Document the time of rupture
Answer: A
Rationale: The priority action after rupture of membranes is to assess the FHR to check for
cord prolapse, which can occur with the gush of fluid.
