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Quizzes > Health & Medicine

Intrapartum NCLEX Questions: Test Labor and Delivery Skills

Quick, free intrapartum NCLEX quiz to check your skills. Instant results.

Editorial: Review CompletedCreated By: Fiona TagulaoUpdated Aug 25, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for NCLEX intrapartum questions quiz on a coral background.

This quiz helps you practice intrapartum NCLEX questions on labor, birth, and fetal monitoring. Work through realistic scenarios, spot priorities, and check safe actions with instant feedback. For more targeted review, explore our labor and delivery quiz, postpartum nclex questions, and maternity hesi practice questions.

What is the normal duration of the active phase of labor for a primigravida?
1 to 3 hours
15 to 20 hours
10 to 14 hours
4 to 8 hours
The active phase of labor for a first-time mother typically lasts between 4 and 8 hours as cervical dilation progresses from 4 to 10 centimeters at an average rate of 1.2 cm per hour. This phase is characterized by regular, strong contractions. Variation can occur, but durations beyond this put both mother and fetus at increased risk of complications.
Leopold maneuvers are used primarily to assess which aspect of the fetus?
Fetal heart rate pattern
Uterine contraction strength
Presentation and position
Placental location
Leopold maneuvers involve external palpation of the maternal abdomen to determine fetal presentation (head or breech) and position (orientation in the pelvis). They do not assess the fetal heart rate or uterine contractions directly. Placental location is determined via ultrasound.
Early decelerations on the fetal monitor are most commonly caused by which factor?
Head compression
Uteroplacental insufficiency
Umbilical cord compression
Maternal hypotension
Early decelerations mirror the contraction pattern and are caused by fetal head compression, which increases intracranial pressure and triggers a vagal response. They are usually benign and resolve as the head accommodates. They differ from late decelerations, which indicate uteroplacental insufficiency, and variable decelerations caused by cord compression.
Which maternal position is best to relieve hypotension after an epidural placement?
Right lateral tilt
Trendelenburg
Supine flat
Left lateral tilt
A left lateral tilt helps relieve aortocaval compression by the gravid uterus, improving venous return and cardiac output to correct hypotension. Trendelenburg can exacerbate respiratory compromise and is not first-line. Supine positioning worsens compression, and right lateral tilt is less effective.
Which finding best differentiates true labor from Braxton Hicks contractions?
Contractions relieved by walking
Irregular contraction pattern
Contraction intensity remains constant
Cervical dilation and effacement
True labor is confirmed by progressive cervical dilation and effacement, whereas Braxton Hicks contractions do not cause cervical change. Irregular contractions and relief with activity are characteristic of false labor. Contraction intensity increasing over time also suggests true labor.
When administering oxytocin for induction, the nurse's priority assessment is:
IV site patency
Uterine contraction frequency and duration
Maternal blood pressure
Fetal position
Oxytocin titration requires close monitoring of uterine activity to prevent tachysystole (more than five contractions in 10 minutes) and uterine rupture. While maternal BP and IV patency are important, preventing hyperstimulation is the immediate priority. Fetal position does not change with induction.
Which sign indicates correct placement of a vacuum extraction cup on the fetal head?
Cervical dilation of 8 cm
Maternal urge to push is relieved
Fetal heart rate acceleration
Formation of a chignon (scalp edema)
A chignon, or a localized swelling of the fetal scalp under the suction cup, confirms correct cup placement and adequate vacuum seal. FHR changes and maternal sensations are not reliable placement indicators. Cervical dilation must be complete before cup application.
What is the first maneuver a nurse should anticipate for managing shoulder dystocia?
Fundal pressure
McRoberts maneuver
Episiotomy
Gaskin maneuver
The McRoberts maneuver, involving hyperflexion of the maternal thighs to the abdomen, is the initial step to widen the pelvic outlet and free the impacted shoulder. Fundal pressure can worsen impaction, and episiotomy does not resolve shoulder entrapment. The Gaskin maneuver is used if McRoberts fails.
Oxytocin for labor induction is contraindicated in which of the following conditions?
Postdate pregnancy
Mild preeclampsia
Placenta previa
Gestational diabetes
Oxytocin-induced contractions can cause placental separation and hemorrhage in placenta previa. Gestational diabetes, postdate pregnancy, and mild preeclampsia are not absolute contraindications. Always confirm placental location by ultrasound before augmentation.
Late decelerations on the fetal monitor are most indicative of:
Uteroplacental insufficiency
Maternal hyperventilation
Head compression
Umbilical cord prolapse
Late decelerations are uniform, gradual decreases in FHR that begin after the peak of a contraction, indicating uteroplacental insufficiency and fetal hypoxia risk. Immediate interventions include repositioning, oxygen administration, and fluid bolus. Umbilical cord issues cause variable decels, and head compression causes early decels.
Which pattern best defines uterine tachysystole?
Contractions lasting longer than 60 seconds
More than five contractions in 10 minutes averaged over 30 minutes
Uterine resting tone below 10 mm Hg
Contraction interval of 5 minutes
Uterine tachysystole is defined as more than five contractions in 10 minutes, averaged over a 30-minute window, which can compromise fetal oxygenation. Contractions longer than 90 seconds or inadequate resting tone also require intervention but are separate definitions. A 5-minute interval is normal early labor.
An order is written for an amnioinfusion of 500 mL of normal saline over 20 minutes. What infusion rate (mL/hr) should the nurse set on the pump?
1500 mL/hr
1000 mL/hr
2000 mL/hr
500 mL/hr
To calculate infusion rate: divide total volume by time in hours. 20 minutes equals 0.333 hours, so 500 mL ÷ 0.333 hours ? 1500 mL/hr. Accurate pump settings ensure therapeutic amnioinfusion to relieve variable decelerations.
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Study Outcomes

  1. Understand the stages of labor -

    Identify the physiological changes and cervical progression in the first, second, and third stages of labor as presented in NCLEX intrapartum questions.

  2. Apply appropriate nursing interventions -

    Implement evidence-based nursing actions for pain management, maternal positioning, and fetal monitoring during each phase of labor.

  3. Interpret maternal and fetal assessments -

    Analyze vital signs, uterine activity, and fetal well-being data to make informed decisions in intrapartum NCLEX questions.

  4. Analyze fetal heart rate patterns -

    Differentiate between reassuring and nonreassuring heart rate tracings to determine timely nursing responses in intrapartum scenarios.

  5. Evaluate and manage intrapartum complications -

    Recognize signs of common complications - such as shoulder dystocia, preeclampsia, and hemorrhage - and select appropriate interventions.

  6. Enhance NCLEX intrapartum exam readiness -

    Reinforce test-taking strategies and review detailed rationales to boost confidence and accuracy on nclex intrapartum exam questions.

Cheat Sheet

  1. Stages and Phases of Labor -

    Mastering the four stages of labor (latent, active, transition, second, third, and fourth) is essential for answering nclex intrapartum questions confidently. Review typical dilation rates (1.2 cm/hr nullipara, 1.5 cm/hr multipara in active phase) and use the Friedman curve as a reference. Knowing phase-specific interventions (e.g., amniotomy in active phase) helps you select best-practice NCLEX intrapartum exam questions responses.

  2. Cardinal Movements & Leopold's Maneuvers -

    Use the mnemonic "Every Damn Fetus In Rotterdam Eats Raisins" (Engagement, Descent, Flexion, Internal rotation, Extension, External rotation, Expulsion) to recall cardinal movements during birth. Pair this with the four Leopold's maneuvers to assess fetal lie, presentation, and position externally - key skills tested in intrapartum nclex questions. Practicing palpation on models enhances accuracy for both real-world and NCLEX questions intrapartum scenarios.

  3. Fetal Heart Rate Monitoring & Deceleration Patterns -

    Apply the VEAL-CHOP mnemonic (Variable - Cord compression, Early - Head compression, Accelerations - Okay, Late - Placental insufficiency) to interpret electronic fetal monitoring strips. Distinguish early from late decelerations, then choose appropriate interventions like repositioning or oxygen - common clinical scenarios in nclex intrapartum questions. Familiarity with reactive NST criteria (≥2 accelerations in 20 min) also boosts your confidence on exam day.

  4. Pain Management Strategies -

    Compare systemic analgesics (e.g., IV fentanyl) with regional techniques (epidural, combined spinal-epidural) and know timing rules - opioids should be given at least two hours before delivery to reduce neonatal respiratory depression. Recognize contraindications (e.g., coagulopathy for epidurals) and side effects like hypotension, which are frequently tested in nclex intrapartum questions. Remember the "FAST" mnemonic for epidural assessment: Foley, Allergies, Skin, Tone.

  5. Emergency Interventions: Shoulder Dystocia & Cord Prolapse -

    Memorize the HELPERR steps for shoulder dystocia (Head”down position, Episiotomy, Legs McRoberts, Pressure suprapubic, Enter maneuvers, Remove posterior arm, Roll patient) to tackle critical intrapartum nclex questions. For prolapsed cord, immediate interventions like Trendelenburg or knee - chest position and manual elevation of the presenting part are lifesaving - key content in NCLEX intrapartum exam questions. Quick recall of these algorithms ensures prompt, evidence-based care.

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