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Labor, Birth, and Immediate Postpartum Care – Quiz 7

Question 1 of 30

Which finding indicates that a client is in the active phase of the first stage of labor?

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Labor, Birth, and Immediate Postpartum Care – Quiz 7 Practice Questions

Review these Labor, Birth, and Immediate Postpartum Care – Quiz 7 nursing practice questions with answer choices and explanations.

Question 1

Which finding indicates that a client is in the active phase of the first stage of labor?

  1. Cervical dilation of 2 cm
  2. Regular contractions every 10 minutes
  3. Cervical dilation of 6 cm
  4. Rupture of membranes without contractions
View answer and explanation

Correct answer:

  1. Cervical dilation of 6 cm

Explanation: The active phase of the first stage of labor is characterized by cervical dilation of approximately 4–7 cm with regular, stronger contractions.

Question 2

Which stage of labor begins with full cervical dilation and ends with birth of the infant?

  1. First stage
  2. Second stage
  3. Third stage
  4. Fourth stage
View answer and explanation

Correct answer:

  1. Second stage

Explanation: The second stage of labor starts at full dilation (10 cm) and ends with delivery of the baby.

Question 3

Which nursing action is the priority immediately after birth of the newborn?

  1. Obtain newborn measurements
  2. Initiate breastfeeding
  3. Maintain airway and respirations
  4. Administer vitamin K
View answer and explanation

Correct answer:

  1. Maintain airway and respirations

Explanation: Airway and breathing are the highest priority immediately after birth to ensure adequate oxygenation.

Question 4

Which sign indicates placental separation during the third stage of labor?

  1. Sudden uterine relaxation
  2. Lengthening of the umbilical cord
  3. Decreased vaginal bleeding
  4. Maternal urge to push
View answer and explanation

Correct answer:

  1. Lengthening of the umbilical cord

Explanation: Placental separation is indicated by lengthening of the umbilical cord, a firm uterus, and a gush of blood.

Question 5

Which fetal heart rate finding is considered reassuring?

  1. Absent variability
  2. Late decelerations
  3. Moderate variability
  4. Prolonged decelerations
View answer and explanation

Correct answer:

  1. Moderate variability

Explanation: Moderate variability indicates adequate fetal oxygenation and intact neurologic pathways.

Question 6

Which fetal heart rate pattern is associated with uteroplacental insufficiency?

  1. Early decelerations
  2. Variable decelerations
  3. Late decelerations
  4. Accelerations
View answer and explanation

Correct answer:

  1. Late decelerations

Explanation: Late decelerations occur after contractions and indicate decreased placental perfusion.

Question 7

A nurse notes variable decelerations on the fetal monitor. What is the most appropriate initial nursing action?

  1. Administer oxytocin
  2. Reposition the client
  3. Prepare for emergency cesarean birth
  4. Increase IV fluids rapidly
View answer and explanation

Correct answer:

  1. Reposition the client

Explanation: Variable decelerations are usually caused by cord compression; repositioning can relieve pressure on the cord.

Question 8

Which pain management option provides regional anesthesia during labor?

  1. IV opioid analgesics
  2. Pudendal nerve block
  3. Epidural anesthesia
  4. Lamaze breathing
View answer and explanation

Correct answer:

  1. Epidural anesthesia

Explanation: Epidural anesthesia provides regional pain relief by blocking nerve transmission in the lower spine.

Question 9

Which maternal assessment finding is expected after administration of epidural anesthesia?

  1. Hypertension
  2. Urinary retention
  3. Increased uterine contractions
  4. Increased sensation in lower extremities
View answer and explanation

Correct answer:

  1. Urinary retention

Explanation: Epidural anesthesia can cause urinary retention due to decreased bladder sensation.

Question 10

Which breathing technique is most appropriate during the transition phase of labor?

  1. Slow-paced breathing
  2. Pant-blow breathing
  3. Deep abdominal breathing
  4. Normal relaxed breathing
View answer and explanation

Correct answer:

  1. Pant-blow breathing

Explanation: Pant-blow breathing helps prevent pushing before full cervical dilation during the transition phase.

Question 11

Which medication is routinely administered to the newborn to prevent hemorrhagic disease?

  1. Erythromycin
  2. Hepatitis B vaccine
  3. Vitamin K
  4. Surfactant
View answer and explanation

Correct answer:

  1. Vitamin K

Explanation: Vitamin K is given to prevent bleeding due to immature clotting factor synthesis.

Question 12

Which assessment finding in the postpartum client requires immediate nursing intervention?

  1. Lochia rubra for 3 days
  2. Uterus firm and midline
  3. Saturated perineal pad within 15 minutes
  4. Mild uterine cramping during breastfeeding
View answer and explanation

Correct answer:

  1. Saturated perineal pad within 15 minutes

Explanation: Heavy bleeding indicated by rapid pad saturation may signal postpartum hemorrhage.

Question 13

Which uterine assessment finding is normal on the first postpartum day?

  1. Boggy uterus
  2. Uterus at the level of the umbilicus
  3. Uterus displaced to the right
  4. Absence of lochia
View answer and explanation

Correct answer:

  1. Uterus at the level of the umbilicus

Explanation: On the first postpartum day, the fundus is typically firm and at or near the level of the umbilicus.

Question 14

Which hormone is responsible for uterine involution after delivery?

  1. Progesterone
  2. Estrogen
  3. Oxytocin
  4. Prolactin
View answer and explanation

Correct answer:

  1. Oxytocin

Explanation: Oxytocin stimulates uterine contractions that promote involution and reduce bleeding.

Question 15

Which lochia stage is characterized by a pinkish-brown discharge?

  1. Lochia rubra
  2. Lochia serosa
  3. Lochia alba
  4. Lochia decidua
View answer and explanation

Correct answer:

  1. Lochia serosa

Explanation: Lochia serosa is pinkish-brown and typically occurs days 4–10 postpartum.

Question 16

Which finding suggests postpartum uterine atony?

  1. Firm uterus
  2. Moderate lochia
  3. Boggy uterus
  4. Mild afterpains
View answer and explanation

Correct answer:

  1. Boggy uterus

Explanation: A boggy uterus indicates uterine atony, the most common cause of postpartum hemorrhage.

Question 17

Which nursing intervention helps prevent postpartum hemorrhage?

  1. Encouraging early ambulation
  2. Frequent bladder emptying
  3. Restricting fluids
  4. Limiting breastfeeding
View answer and explanation

Correct answer:

  1. Frequent bladder emptying

Explanation: A full bladder can displace the uterus and prevent effective contraction; emptying the bladder promotes uterine tone.

Question 18

Which finding is normal in a term newborn?

  1. Respiratory rate of 80 breaths/min
  2. Heart rate of 140 beats/min
  3. Central cyanosis
  4. Blood glucose of 35 mg/dL
View answer and explanation

Correct answer:

  1. Heart rate of 140 beats/min

Explanation: A normal newborn heart rate ranges from 110–160 beats per minute.

Question 19

Which reflex allows the newborn to turn the head toward a stimulus on the cheek?

  1. Moro reflex
  2. Rooting reflex
  3. Babinski reflex
  4. Palmar grasp
View answer and explanation

Correct answer:

  1. Rooting reflex

Explanation: The rooting reflex helps the newborn locate the nipple for feeding.

Question 20

Which assessment finding indicates effective breastfeeding?

  1. Audible swallowing
  2. Nipple pain throughout feeding
  3. Newborn sleeping through feedings
  4. Minimal wet diapers
View answer and explanation

Correct answer:

  1. Audible swallowing

Explanation: Audible swallowing indicates milk transfer and effective breastfeeding.

Question 21

Which newborn intervention helps prevent ophthalmia neonatorum?

  1. Vitamin K injection
  2. Hepatitis B vaccine
  3. Erythromycin eye ointment
  4. Early skin-to-skin contact
View answer and explanation

Correct answer:

  1. Erythromycin eye ointment

Explanation: Erythromycin eye ointment prevents eye infection caused by gonorrhea or chlamydia.

Question 22

Which newborn temperature regulation mechanism is most important?

  1. Shivering
  2. Nonshivering thermogenesis
  3. Sweating
  4. Peripheral vasodilation
View answer and explanation

Correct answer:

  1. Nonshivering thermogenesis

Explanation: Newborns rely on nonshivering thermogenesis using brown fat to generate heat.

Question 23

Which sign in a newborn requires immediate evaluation?

  1. Acrocyanosis
  2. Mild tremors when crying
  3. Grunting respirations
  4. Irregular breathing pattern
View answer and explanation

Correct answer:

  1. Grunting respirations

Explanation: Grunting respirations indicate respiratory distress and require prompt assessment.

Question 24

Which maternal teaching is most important to prevent postpartum infection?

  1. Limit fluid intake
  2. Perform proper perineal hygiene
  3. Avoid breastfeeding
  4. Remain on bed rest
View answer and explanation

Correct answer:

  1. Perform proper perineal hygiene

Explanation: Proper perineal hygiene reduces the risk of postpartum infection.

Question 25

Which postpartum emotional response is considered normal during the first week?

  1. Postpartum psychosis
  2. Postpartum depression
  3. Postpartum blues
  4. Severe anxiety with hallucinations
View answer and explanation

Correct answer:

  1. Postpartum blues

Explanation: Postpartum blues are common, transient mood changes occurring in the first week after delivery.

Question 26

Which finding differentiates postpartum depression from postpartum blues?

  1. Crying spells
  2. Fatigue
  3. Symptoms lasting longer than 2 weeks
  4. Mild anxiety
View answer and explanation

Correct answer:

  1. Symptoms lasting longer than 2 weeks

Explanation: Postpartum depression persists beyond 2 weeks and interferes with daily functioning.

Question 27

Which client is at highest risk for postpartum hemorrhage?

  1. Primigravida with short labor
  2. Client with prolonged labor and uterine overdistention
  3. Client with spontaneous vaginal delivery
  4. Client breastfeeding immediately after birth
View answer and explanation

Correct answer:

  1. Client with prolonged labor and uterine overdistention

Explanation: Uterine overdistention and prolonged labor increase the risk of uterine atony and hemorrhage.

Question 28

Which newborn assessment is part of the APGAR score?

  1. Blood glucose level
  2. Skin color
  3. Head circumference
  4. Gestational age
View answer and explanation

Correct answer:

  1. Skin color

Explanation: The APGAR score assesses appearance (color), pulse, grimace, activity, and respiration.

Question 29

Which teaching is appropriate for a client after a vaginal delivery?

  1. Avoid ambulation for 48 hours
  2. Use a peri bottle after voiding
  3. Delay voiding for 12 hours
  4. Apply heat to the perineum
View answer and explanation

Correct answer:

  1. Use a peri bottle after voiding

Explanation: Using a peri bottle promotes cleanliness and comfort of the perineal area.

Question 30

Which newborn behavior is expected during the first 24 hours of life?

  1. Continuous alertness
  2. Sleep for long uninterrupted periods
  3. Periods of wakefulness with feeding cues
  4. Absence of crying
View answer and explanation

Correct answer:

  1. Periods of wakefulness with feeding cues

Explanation: Newborns cycle through sleep and wakefulness and exhibit feeding cues during alert periods.