Intrapartum Care: A Comprehensive Guide for Midwives

Question 1

Which of the following is NOT a medically necessary reason to induce labor?

Accepted Answer

Elective induction at 39 weeks gestation

Answer

Severe pre-eclampsia

Answer

Intrauterine fetal demise

Answer

Oligohydramnios

Question 2

In the first stage of labor, what primarily determines the rate of cervical dilation?

Accepted Answer

(A) Strength and frequency of uterine contractions

Answer

(B) Maternal pushing efforts

Answer

(C) Pressure from the amniotic sac

Answer

(D) Descent of the fetal head

Question 3

Which of the following is NOT an early sign of imminent delivery during the first stage of labor?

Accepted Answer

Nausea and vomiting

Answer

Increased bloody show

Answer

Urinary frequency

Answer

Restlessness and agitation

Question 4

Which of the following is the period that follows immediately after birth, rather than a stage of labor?

Accepted Answer

Postpartum period

Answer

Latent phase

Answer

Active phase

Answer

Second stage

Question 5

What is the most reliable indicator of the start of the second stage of labor?

Accepted Answer

The mother feels an irresistible urge to push

Answer

Cervical dilation of 5 centimeters

Answer

The amniotic membranes have ruptured

Answer

The contractions last for 60 seconds and occur every 5 minutes

Question 6

Which of these is a common early sign of labor?

Accepted Answer

Lightening

Answer

No periods

Answer

More baby movements

Answer

Feeling sick and being sick

Question 7

Which of the following is not a recognized stage of labor in midwifery?

Accepted Answer

Plateau phase

Answer

Latent phase

Answer

Active phase

Answer

Second stage

Question 8

Which of the following findings would NOT be expected during an assessment for impending abruption placenta?

Accepted Answer

Normal fetal heart rate and pattern

Answer

Sudden onset of severe abdominal pain

Answer

Dark red or brown vaginal bleeding

Answer

Increased uterine tenderness

Question 9

Which of the following is a non-drug method of pain relief during childbirth that midwives often use?

Accepted Answer

Acupressure

Answer

Pudendal block

Answer

Epidural

Answer

Nitrous oxide

Question 10

What is the most common reason for inducing labor?

Accepted Answer

Pregnancy lasting beyond 42 weeks

Answer

Breech presentation

Answer

Premature rupture of membranes

Answer

Intrauterine growth restriction

Question 11

Which of the following is NOT typically a sign that labor is about to begin?

Accepted Answer

Persistent heartburn and indigestion

Answer

Lightening

Answer

Bloody show

Answer

Increased vaginal discharge

Question 12

Which of the following scenarios necessitates a cesarean section as the optimal delivery method?

Accepted Answer

A woman with a previous cesarean section scar, currently in labor with a breech presentation.

Accepted Answer

A woman with placenta previa and active bleeding.

Answer

A healthy woman at term with an uncomplicated singleton cephalic presentation.

Answer

A woman with gestational diabetes and a large baby, now 42 weeks pregnant.

Question 13

During the third stage of labor, which signs indicate placental abruption?

Accepted Answer

Vaginal bleeding, uterine tenderness, and fetal distress

Answer

Rupture of membranes, uterine contractions, and maternal hypotension

Answer

Fetal bradycardia, maternal tachycardia, and uterine rigidity

Answer

Placenta previa, postpartum hemorrhage, and uterine inversion

Question 14

In pregnancies extending beyond 42 weeks, which factor primarily prompts the decision to induce labor?

Accepted Answer

Reducing the risk of stillbirth

Answer

Preventing placental abruption

Answer

Managing pregnancy-induced hypertension

Answer

Addressing concerns about fetal macrosomia

Question 15

Which of the following is a medical indication for an elective cesarean section?

Accepted Answer

Breech presentation at term

Accepted Answer

Previous classical cesarean section

Answer

Nulliparity

Answer

Gestational age of 37 weeks

Question 16

In midwifery, which of the following best describes the first stage of labor?

Accepted Answer

Cervical dilation from 0 cm to 4 cm, with regular contractions

Answer

Placenta delivery after the baby's birth

Answer

Fetal head crowning until baby delivery

Answer

Full cervical dilation of 10 cm, marking labor's end

Question 17

A woman in labor requests an epidural. She is anxious and has concerns about the procedure. Which nursing intervention is most appropriate to address her concerns?

Accepted Answer

Start an IV, administer fluids, and provide clear information about the epidural procedure.

Answer

Explain that an epidural is not an option and that she must try other pain relief methods first.

Answer

Tell her to wait until labor is further along before requesting an epidural.

Answer

Call the anesthesiologist immediately to administer the epidural.

Question 18

In the active phase of labor's first stage, a woman experiences intense pain. Which pain management technique provides the most effective relief?

Accepted Answer

Continuous epidural infusion

Answer

Intramuscular injection of opioids

Answer

Transcutaneous electrical nerve stimulation (TENS)

Answer

Inhalation of nitrous oxide

Question 19

Which of the following is NOT a sign that delivery is about to happen?

Accepted Answer

Elevated temperature

Answer

Involuntary bearing down

Answer

Cervical dilatation of 10 cm

Answer

Show (bloody vaginal discharge)

Question 20

Which clinical sign is most indicative of placental abruption?

Accepted Answer

Vaginal bleeding with clots

Answer

Uterine tenderness

Question 21

Which placental complication is characterized by sudden, severe abdominal pain?

Accepted Answer

Placental abruption

Answer

Placental previa

Answer

Uterine rupture

Answer

Preeclampsia

Question 22

Which of the following is **not** a common sign of impending labor?

Accepted Answer

Loss of appetite

Answer

Lightening, or dropping of the baby's head into the pelvis

Answer

Increased vaginal discharge, known as show

Answer

Back pain

Question 23

During labor, which condition commonly necessitates the use of forceps delivery?

Accepted Answer

Cephalopelvic disproportion with fetal macrosomia

Answer

Breech presentation with a vertex positioned above the ischial spine

Answer

Prolonged second stage of labor due to maternal exhaustion

Question 24

Which sign during labor suggests a potential malposition of the fetus?

Accepted Answer

Presenting part not engaged in the pelvis

Answer

Fetal heart rate over 160 beats per minute

Answer

Severe back pain experienced by the mother

Question 25

When a healthcare provider suspects fetal distress, what is the most common reason for inducing labor?

Accepted Answer

Fetal distress

Answer

Maternal hypertension

Answer

Preterm premature rupture of membranes (PPROM)

Answer

Gestational diabetes

Question 26

During vaginal delivery, when is the ideal time to perform an episiotomy to minimize perineal tearing?

Accepted Answer

When the baby's head is crowning and the perineum is fully stretched with little to no natural tearing

Answer

Right after the baby's head is delivered

Answer

Before the second stage of labor begins to prevent any tearing

Answer

When the cervix is fully dilated to help deliver the baby's shoulders

Question 27

During the second stage of labor, which of the following is NOT a valid reason for using instruments to assist with delivery?

Accepted Answer

The mother is exhausted

Answer

The baby's head is in a persistent occipitoposterior position

Answer

The baby's head is not descending despite strong uterine contractions

Question 28

Which of the following is **NOT** a potential benefit of induction of labor that should be discussed with the woman?

Accepted Answer

Eliminating the need for pain relief during labor

Answer

Reducing the risk of post-term pregnancy

Answer

Improving the chances of a successful vaginal birth

Question 29

Which of the following is a known risk factor for increased likelihood of perineal trauma during labor?

Accepted Answer

Prolonged second stage of labor

Accepted Answer

Maternal obesity

Answer

Pre-eclampsia

Answer

Adequate hydration

Question 30

Which of the following is NOT a potential complication during the third stage of labor?

Accepted Answer

Eclampsia

Answer

Retained placenta

Answer

Postpartum hemorrhage

Answer

Uterine rupture

Question 31

During childbirth, what is the main reason for performing an episiotomy?

Accepted Answer

To prevent perineal tearing when the baby's head is delivered.

Answer

To make it easier to use forceps or a vacuum.

Answer

To lower the risk of bleeding after birth.

Answer

To protect the baby's head from injury.

Question 32

Evaluate the evidence regarding the use of continuous electronic fetal monitoring during labor, considering its accuracy, indications, potential benefits, and risks.

Accepted Answer

Continuous electronic fetal monitoring may result in false alarms and unnecessary interventions.

Answer

Continuous electronic fetal monitoring is the most reliable method for assessing fetal well-being during labor.

Answer

Continuous electronic fetal monitoring is recommended for all women in labor.

Answer

Continuous electronic fetal monitoring can decrease the likelihood of cesarean delivery.

Question 33

In the immediate postpartum period, how does a midwife assess and manage postpartum hemorrhage?

Accepted Answer

Assess vaginal bleeding, uterine tone, and vital signs; administer oxytocin and massage the uterus.

Answer

Assess the perineum for tears, administer antibiotics, and monitor the mother's temperature.

Answer

Monitor the mother's blood pressure and pulse, insert an IV line, and prepare for a possible blood transfusion.

Answer

Perform a cervical examination to check for retained placental fragments, administer ergometrine, and elevate the mother's legs.

Question 34

Why is it crucial to provide culturally sensitive intrapartum care, and what is the midwife's responsibility in ensuring its provision?

Accepted Answer

Providing culturally sensitive intrapartum care is essential to guarantee that all women receive safe and effective care.

Answer

Culturally sensitive intrapartum care is unnecessary because all women experience labor and birth similarly.

Answer

The midwife's role in providing culturally sensitive intrapartum care is solely to inquire about the woman's cultural beliefs and practices.

Answer

Midwives have no role in providing culturally sensitive intrapartum care.

Question 35

In intrapartum care, which approach aligns with active listening and effective communication principles?

Accepted Answer

Using open-ended questions, reflective statements, and summarizing to foster dialogue

Answer

Speaking assertively and interrupting frequently

Answer

Maintaining distance by avoiding eye contact and body language

Answer

Providing information without considering the woman's emotional state

Question 36

What is a potential drawback of using active management of labor (AML)?

Accepted Answer

Higher chance of postpartum infection

Answer

Shorter labor duration

Answer

Increased maternal satisfaction

Answer

Lower risk of Cesarean delivery

Question 37

What is the primary purpose of the Apgar score?

Accepted Answer

To assess the newborn's immediate health and vitality

Answer

To predict long-term developmental outcomes

Answer

To determine the need for immediate resuscitation

Answer

To evaluate the effectiveness of labor management

Question 38

Which of the following is NOT a risk factor for postpartum hemorrhage?

Accepted Answer

Well-controlled hypertension

Answer

Multiple previous pregnancies

Answer

Uterine atony

Answer

Retained placenta

Question 39

In cephalic presentations, the most common fetal position is:

Accepted Answer

Occipito-anterior (OA)

Answer

Occipito-posterior (OP)

Answer

Vertex presentation

Answer

Breech presentation

Question 40

The primary goal of intrapartum care is to:

Accepted Answer

Ensure a safe and healthy birth for both mother and baby

Answer

Manage pain during labor

Answer

Provide comfort and support to the mother

Answer

Prevent postpartum complications

Question 41

The purpose of performing an abdominal examination during labor is to:

Accepted Answer

Assess fetal position and presentation

Answer

Measure fundal height

Answer

Monitor maternal vital signs

Answer

Determine cervical dilation

Question 42

Which of the following is a potential complication during labor that requires immediate intervention?

Accepted Answer

Uterine rupture

Answer

Sustained elevated blood pressure

Answer

Prolonged second stage of labor

Answer

Superficial perineal laceration

Question 43

The first-line treatment for managing a nuchal cord is:

Accepted Answer

Gentle traction on the cord to release it

Answer

Immediate cesarean section

Answer

Pushing the cord over the fetal head

Answer

Fetal blood sampling

Question 44

Which statement best reflects the role of a midwife in supporting a woman's birthing plan?

Accepted Answer

Midwives encourage women to participate in making choices throughout labor and birth.

Answer

A birthing plan is legally binding, and midwives must always follow it exactly.

Answer

Midwives make decisions about labor and birth without considering the woman's wishes.

Answer

A birthing plan cannot be changed once labor has started.

Question 45

In a primigravida who has been in labor for 24 hours, which evidence-based intervention is most appropriate for managing prolonged labor?

Accepted Answer

Oxytocin augmentation

Answer

Cesarean delivery

Answer

Artificial rupture of membranes

Answer

Bed rest and hydration

Question 46

Which fetal monitoring parameter is most reliable for indicating fetal distress during labor?

Accepted Answer

Sustained fetal heart rate decelerations following a uterine contraction

Answer

Uterine contractions occurring more than four times every 10 minutes

Answer

Fetal heart rate above 160 beats per minute

Answer

Fetal salivary pH below 7.25

Question 47

During the active phase of labor, which intervention is commonly used to enhance labor progress when cervical dilation is prolonged?

Accepted Answer

Intravenous oxytocin

Answer

Epidural anesthesia

Answer

Artificial rupture of membranes

Answer

Cesarean delivery

Question 48

The optimal fetal heart rate during labor is:

Accepted Answer

110-140 beats per minute

Answer

120-180 beats per minute

Answer

100-140 beats per minute

Answer

130-170 beats per minute

Question 49

Which of the following is a major risk factor for postpartum hemorrhage?

Accepted Answer

Uterine atony

Answer

Shoulder dystocia

Answer

Preeclampsia

Answer

Oligohydramnios

Question 50

The most common position for electronic fetal monitoring during labor is:

Accepted Answer

Lateral

Answer

Lithotomy

Answer

Fowler's

Answer

Sims'

Question 51

The APGAR score primarily evaluates the newborn's:

Accepted Answer

Neurological status

Answer

Gestational age

Answer

Weight

Answer

Birth weight

Question 52

During labor, which fetal lie is most common?

Accepted Answer

Occipito-anterior

Answer

Breech

Answer

Transverse

Answer

Shoulder

Question 53

In the first stage of labor, which method of pain management is generally preferred?

Accepted Answer

Nitrous oxide

Answer

Epidural anesthesia

Answer

Pethidine injection

Answer

Intravenous fluid administration

Question 54

What is the main reason for performing a cervical examination during labor?

Accepted Answer

Assess cervical dilation and effacement

Answer

Determine fetal position

Answer

Evaluate the need for an episiotomy

Answer

Monitor labor progress

Question 55

In the event of a retained placenta, which action should be taken first?

Accepted Answer

Attempt manual removal

Answer

Administer oxytocin

Answer

Request an obstetrician's assistance

Answer

Perform uterine massage

Question 56

Which vital sign is crucial for monitoring during intrapartum care?

Accepted Answer

Blood pressure

Answer

Temperature

Answer

Weight

Answer

Height

Question 57

Which pain management technique utilizes a TENS machine?

Accepted Answer

Transcutaneous electrical nerve stimulation (TENS)

Answer

Epidural anaesthesia

Answer

Gas and air

Answer

Pudendal nerve block

Question 58

What is the main purpose of creating a birth plan?

Accepted Answer

To document the woman's preferences for her labor and birth

Answer

To guarantee a specific type of birth

Answer

To ensure that the woman receives all possible interventions

Answer

To limit the woman's choices

Question 59

Which of the following is NOT a fundamental principle of intrapartum care?

Accepted Answer

Routine episiotomy

Answer

Respect for women's autonomy

Answer

Evidence-based practice

Answer

Collaborative teamwork

Question 60

During labor assessment, the most critical parameter to monitor is:

Accepted Answer

Fetal heart rate

Answer

Cervical dilation

Answer

Uterine contractions

Answer

Vaginal bleeding

Question 61

Which pain management method is generally considered most effective for most women in labor?

Accepted Answer

Epidural

Answer

Pethidine

Answer

Transcutaneous electrical nerve stimulation (TENS)

Answer

Acupuncture

Question 62

The first stage of labor ends when:

Accepted Answer

The cervix is fully dilated

Answer

The fetal head is visible

Answer

The woman begins pushing

Answer

The amniotic sac ruptures

Question 63

If a uterine rupture is suspected, the most appropriate action for a midwife is to:

Accepted Answer

Prepare for an emergency cesarean section

Answer

Administer oxytocin

Answer

Reposition the woman

Answer

Massage the fundus

Question 64

The primary function of a partner or support person during labor is to:

Accepted Answer

Provide emotional and physical support

Answer

Make all decisions regarding care

Answer

Act as a birth advocate

Answer

Monitor the woman's progress