During labour, the fetal heart rate rises 15 beats/min above baseline for 15 seconds after the fetus moves. What does this finding tell the nurse?

The fetus is not acidotic at that time

The fetus is having a late deceleration

The fetus needs oxygen given to the mother

The fetus is responding to cord compression

Four hours after a caesarean, a woman's pulse rises from 86 to 124/min and BP falls from 118/74 to 94/56 mmHg. Urine output was 20 mL/h for 2 hours. The fundus is firm, lochia is scant and the abdomen is becoming distended. What is most likely?

Concealed intra-abdominal bleeding

Normal recovery after spinal anaesthesia

A woman taking a combined oral contraceptive pill forgot yesterday's pill and remembers this morning. What should the nurse advise?

Take the missed pill now and continue as usual

Use condoms for 7 days and skip the missed pill

Take emergency contraception straight away

Stop the pack and start a new pack tomorrow

The fourth stage of labour, when the risk of haemorrhage is highest and close observation is needed, is:

The first 1-2 hours after the placenta is delivered

The time from full dilatation to the birth

The time from the birth to the placenta's delivery

The first 6 weeks after the birth

Labour, delivery and postpartum care

54 Gulf Prometric RN (DHA, DOH, MOH, SCFHS) practice questions on Labour, delivery and postpartum care, part of Maternal and Newborn Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
During labour, the fetal heart rate rises 15 beats/min above baseline for 15 seconds after the fetus moves. What does this finding tell the nurse?
1. AThe fetus is not acidotic at that time
2. BThe fetus is having a late deceleration
3. CThe fetus needs oxygen given to the mother
4. DThe fetus is responding to cord compression
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Answer: A · The fetus is not acidotic at that time
An acceleration is a reassuring sign that the fetal nervous system is well oxygenated. A fetus with accelerations is very unlikely to be acidotic at that moment. Accelerations often follow fetal movement or scalp stimulation. No action is needed beyond continued monitoring.
- B: A late deceleration is a fall in rate after the contraction peak.
- C: Oxygen is not needed for a reassuring tracing.
- D: Cord compression produces variable decelerations, which are falls, not rises.
Question 2 · Hard
Four hours after a caesarean, a woman's pulse rises from 86 to 124/min and BP falls from 118/74 to 94/56 mmHg. Urine output was 20 mL/h for 2 hours. The fundus is firm, lochia is scant and the abdomen is becoming distended. What is most likely?
1. ANormal recovery after spinal anaesthesia
2. BParalytic ileus after surgery
3. CConcealed intra-abdominal bleeding
4. DPostpartum uterine atony
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Answer: C · Concealed intra-abdominal bleeding
Rising pulse, falling BP and low urine output show hypovolaemia. With a firm uterus and scant lochia, the bleeding is hidden, and a distending abdomen suggests bleeding into the abdomen. The nurse calls the obstetric team urgently, gives oxygen, starts fluids and sends blood for cross-match. She may need a return to theatre.
- A: Spinal anaesthesia does not cause rising tachycardia and low urine output hours later.
- B: Ileus causes distension but not shock.
- D: The fundus is firm, so atony is not the cause.
Question 3 · Medium
Breastfeeding is contraindicated when the newborn has which condition?
1. AClassic galactosaemia
2. BCleft lip alone
3. CLow birth weight
4. DPhysiological jaundice
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Answer: A · Classic galactosaemia
Babies with classic galactosaemia cannot break down galactose, which comes from lactose in breast milk. They need a lactose-free formula, or they develop liver failure, cataracts and sepsis. Physiological jaundice is treated with more frequent feeding. Babies with cleft lip or low birth weight benefit from breast milk with feeding support.
- B: Many babies with cleft lip alone breastfeed well.
- C: Low birth weight babies benefit greatly from breast milk.
- D: Physiological jaundice is helped by frequent breastfeeding.
Question 4 · Medium
A woman taking a combined oral contraceptive pill forgot yesterday's pill and remembers this morning. What should the nurse advise?
1. AUse condoms for 7 days and skip the missed pill
2. BTake emergency contraception straight away
3. CTake the missed pill now and continue as usual
4. DStop the pack and start a new pack tomorrow
Show answerHide answer
Answer: C · Take the missed pill now and continue as usual
When one active pill is missed (less than 48 hours late), the woman takes it as soon as she remembers, even if that means two pills in one day. She continues the pack as usual. Protection is maintained, so no extra contraception or emergency pill is usually needed. Rules are stricter if two or more pills are missed.
- A: Skipping the pill reduces protection.
- B: Emergency contraception is not usually needed for one missed pill.
- D: Restarting a pack leaves an unprotected gap.
Question 5 · Easy
The fourth stage of labour, when the risk of haemorrhage is highest and close observation is needed, is:
1. AThe time from full dilatation to the birth
2. BThe time from the birth to the placenta's delivery
3. CThe first 6 weeks after the birth
4. DThe first 1-2 hours after the placenta is delivered
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Answer: D · The first 1-2 hours after the placenta is delivered
The fourth stage is the first 1-2 hours after delivery of the placenta, when the mother's body begins to recover. Most primary postpartum haemorrhages start in this period. The nurse checks fundal tone, lochia, pulse and blood pressure frequently, and supports skin-to-skin contact and the first breastfeed. The bladder is checked because a full bladder stops the uterus contracting.
- A: This is the second stage of labour.
- B: This is the third stage of labour.
- C: Six weeks is the whole puerperium, not the fourth stage.
Question 6 · Easy
A woman takes a traditional levonorgestrel progestogen-only pill. Her protection is lost if she takes a pill late by more than:
1. A3 hours
2. B24 hours
3. C48 hours
4. D12 hours
Answer and explanation in LearnFree account
Question 7 · Easy
Uterine tachysystole during labour is defined as:
1. AMore than 3 contractions in 10 minutes in active labour
2. BAny contraction lasting longer than 60 seconds
3. CContractions felt as strong as when palpating the forehead
4. DMore than 5 contractions in 10 minutes, averaged over 30 minutes
Answer and explanation in LearnFree account
Question 8 · Medium
A loop of umbilical cord is lying outside the vagina while the team prepares for emergency birth. How should the nurse manage the cord itself?
1. AHandle the cord as little as possible
2. BPush the cord back into the uterus
3. CPull the cord gently to check pulsation
4. DClamp the loop to stop it bleeding
Answer and explanation in LearnFree account
Question 9 · Medium
A woman had gestational diabetes treated with insulin. She is now well and breastfeeding. Which follow-up test should the nurse make sure she knows about?
1. ADaily capillary glucose checks for the next year
2. BA 75 g glucose tolerance test at 4-12 weeks after birth
3. CNo testing, as gestational diabetes resolves after birth
4. DAn HbA1c test within 48 hours of giving birth
Answer and explanation in LearnFree account
Question 10 · Hard
After birth, a woman's pads are weighed to estimate blood loss. Three soaked pads weigh 180 g, 220 g and 150 g; a dry pad weighs 20 g. The under-buttock drape weighs 400 g; dry, it weighs 50 g. What is her estimated blood loss?
1. A490 mL
2. B840 mL
3. C950 mL
4. D890 mL
Answer and explanation in LearnFree account
Question 11 · Hard
A labouring woman's oxytocin infusion contains 10 IU in 1000 mL of normal saline, and the pump is running at 18 mL/h. What dose is she receiving?
1. A3 milliunits/min
2. B18 milliunits/min
3. C30 milliunits/min
4. D0.3 milliunits/min
Answer and explanation in LearnFree account
Question 12 · Medium
A woman on oxytocin has 6 contractions in 10 minutes, averaged over 30 minutes. The fetal heart baseline is 140 with moderate variability and no decelerations. The nurse should:
1. AIncrease the rate to shorten the labour
2. BReduce or stop the oxytocin as per protocol
3. CContinue the same rate as the tracing is normal
4. DCall the team to prepare for caesarean
Answer and explanation in LearnFree account
Question 13 · Easy
When shoulder dystocia is recognised, the first manoeuvre usually tried is:
1. AMcRoberts manoeuvre
2. BWood's screw manoeuvre
3. CZavanelli manoeuvre
4. DFundal pressure
Answer and explanation in LearnFree account
Question 14 · Easy
The most effective method of emergency contraception, which can be used up to 5 days after unprotected intercourse, is:
1. AA levonorgestrel pill
2. BA progestogen-only pill
3. CA copper intrauterine device
4. DA combined oral pill
Answer and explanation in LearnFree account
Question 15 · Medium
Two hours after a forceps birth, a woman reports severe pain and pressure in her perineum. The fundus is firm and lochia is moderate, but her pulse is 112/min and there is a tense, bluish swelling beside the labia. The nurse suspects:
1. AAn episiotomy infection
2. BNormal perineal oedema
3. CA vulval haematoma
4. DUterine atony
Answer and explanation in LearnFree account
Question 16 · Hard
After a forceps birth, a tear runs through the vaginal wall and perineal muscles and through more than half of the external anal sphincter. The internal sphincter and anal lining are intact. How is this tear classified?
1. ASecond degree
2. BThird degree, 3b
3. CThird degree, 3c
4. DThird degree, 3a
Answer and explanation in LearnFree account
Question 17 · Medium
How should an oxytocin infusion for induction of labour be set up?
1. AAs an IM injection repeated every 30 minutes
2. BAs a secondary line on a pump, joined to the main line near the cannula
3. CAs the only IV fluid, allowed to drip by gravity
4. DAdded to the main 1000 mL bag running at the maintenance rate
Answer and explanation in LearnFree account
Question 18 · Hard
On a postnatal ward, four mothers call at the same time. Which one should the nurse see first?
1. ADay 3: hard, warm, tender breasts, temperature 37.6 °C
2. BDay 1 after caesarean: sudden breathlessness, chest pain and SpO2 89%
3. CDay 1, para 5: cramping pain during feeds, fundus firm
4. DDay 4: tearful and anxious but caring for her baby
Answer and explanation in LearnFree account
Question 19 · Hard
A woman in labour has had ruptured membranes for 22 hours. Now: temperature 38.8 °C, pulse 116/min, a tender uterus and foul-smelling liquor. The fetal heart baseline is 170 bpm with minimal variability. What is most likely, and what is needed?
1. AEpidural fever; continue to monitor hourly
2. BNormal labour fever; give oral fluids only
3. CIntra-amniotic infection; report for IV antibiotics
4. DPlacental abruption; prepare for blood transfusion
Answer and explanation in LearnFree account
Question 20 · Medium
A fully breastfeeding mother, 3 weeks after birth, wants a hormonal method of contraception. Which method is most suitable now?
1. ACombined vaginal ring
2. BProgestogen-only pill
3. CCombined contraceptive patch
4. DCombined oral pill
Answer and explanation in LearnFree account
Question 21 · Medium
On the first day after delivery, a breastfeeding mother has sore, cracked nipples. What should the nurse do first?
1. AGive formula until the nipples heal
2. BClean the nipples with soap before each feed
3. CWatch a feed and correct the baby's attachment
4. DAdvise her to stop breastfeeding for 2 days
Answer and explanation in LearnFree account
Question 22 · Medium
A woman in active labour received IM pethidine 2 hours ago. Birth is now imminent. Which effect in the newborn should the nurse be ready to manage?
1. AHypertonia
2. BNeonatal jaundice
3. CRespiratory depression
4. DHypoglycaemia
Answer and explanation in LearnFree account
Question 23 · Easy
During a vaginal examination in labour, a fetal station of 0 means the presenting part is level with the:
1. ASacral promontory
2. BIschial spines
3. CPelvic inlet
4. DPelvic outlet
Answer and explanation in LearnFree account
Question 24 · Medium
A woman who plans to have another baby next year asks about DMPA injections. Which information is most important for her?
1. AIt must be stopped while she is breastfeeding
2. BIt needs to be injected every month
3. CFertility may take many months to return after stopping
4. DIt protects her against sexually transmitted infections
Answer and explanation in LearnFree account
Question 25 · Medium
During a shoulder dystocia, a staff member offers to push on the top of the uterus. Why should this be stopped?
1. AIt slows the fetal heart rate through vagal reflexes
2. BIt drives the shoulder harder against the pubic bone
3. CIt raises the risk of cord prolapse
4. DIt lifts the fetal head back into the birth canal
Answer and explanation in LearnFree account

29 more Labour, delivery and postpartum care questions

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Labour, delivery and postpartum care

During labour, the fetal heart rate rises 15 beats/min above baseline for 15 seconds after the fetus moves. What does this finding tell the nurse?

Four hours after a caesarean, a woman's pulse rises from 86 to 124/min and BP falls from 118/74 to 94/56 mmHg. Urine output was 20 mL/h for 2 hours. The fundus is firm, lochia is scant and the abdomen is becoming distended. What is most likely?

Breastfeeding is contraindicated when the newborn has which condition?

A woman taking a combined oral contraceptive pill forgot yesterday's pill and remembers this morning. What should the nurse advise?

The fourth stage of labour, when the risk of haemorrhage is highest and close observation is needed, is:

A woman takes a traditional levonorgestrel progestogen-only pill. Her protection is lost if she takes a pill late by more than:

Uterine tachysystole during labour is defined as:

A loop of umbilical cord is lying outside the vagina while the team prepares for emergency birth. How should the nurse manage the cord itself?

A woman had gestational diabetes treated with insulin. She is now well and breastfeeding. Which follow-up test should the nurse make sure she knows about?

After birth, a woman's pads are weighed to estimate blood loss. Three soaked pads weigh 180 g, 220 g and 150 g; a dry pad weighs 20 g. The under-buttock drape weighs 400 g; dry, it weighs 50 g. What is her estimated blood loss?

A labouring woman's oxytocin infusion contains 10 IU in 1000 mL of normal saline, and the pump is running at 18 mL/h. What dose is she receiving?

A woman on oxytocin has 6 contractions in 10 minutes, averaged over 30 minutes. The fetal heart baseline is 140 with moderate variability and no decelerations. The nurse should:

When shoulder dystocia is recognised, the first manoeuvre usually tried is:

The most effective method of emergency contraception, which can be used up to 5 days after unprotected intercourse, is:

Two hours after a forceps birth, a woman reports severe pain and pressure in her perineum. The fundus is firm and lochia is moderate, but her pulse is 112/min and there is a tense, bluish swelling beside the labia. The nurse suspects:

After a forceps birth, a tear runs through the vaginal wall and perineal muscles and through more than half of the external anal sphincter. The internal sphincter and anal lining are intact. How is this tear classified?

How should an oxytocin infusion for induction of labour be set up?

On a postnatal ward, four mothers call at the same time. Which one should the nurse see first?

A woman in labour has had ruptured membranes for 22 hours. Now: temperature 38.8 °C, pulse 116/min, a tender uterus and foul-smelling liquor. The fetal heart baseline is 170 bpm with minimal variability. What is most likely, and what is needed?

A fully breastfeeding mother, 3 weeks after birth, wants a hormonal method of contraception. Which method is most suitable now?

On the first day after delivery, a breastfeeding mother has sore, cracked nipples. What should the nurse do first?

A woman in active labour received IM pethidine 2 hours ago. Birth is now imminent. Which effect in the newborn should the nurse be ready to manage?

During a vaginal examination in labour, a fetal station of 0 means the presenting part is level with the:

A woman who plans to have another baby next year asks about DMPA injections. Which information is most important for her?

During a shoulder dystocia, a staff member offers to push on the top of the uterus. Why should this be stopped?