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Quizzes > Health & Medicine > Human Anatomy & Medicine

Ready to Master Management of Normal Labor and Delivery? Take the Quiz!

Think you can ace these labor and delivery management questions? Start the normal labor and delivery quiz now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art style illustration of pregnant mother silhouette, fetus, stethoscope and medical icons on golden yellow background

This labor and delivery quiz helps you practice normal labor management, key interventions, and fetal monitoring. Work through real cases, review the stages of labor, and spot gaps before a check‑off or exam; for more practice, see our obstetrics review and induction practice .

What marks the beginning of the first stage of labor?
Delivery of the fetus
Rupture of membranes
Complete cervical dilation
Onset of regular uterine contractions
The first stage of labor begins with the onset of regular, painful uterine contractions and ends with full cervical dilation. It encompasses both the latent and active phases of cervical change. Rupture of membranes may occur at any point but does not define the stage.
What is the maximum duration of the latent phase of labor in a nulliparous woman?
24 hours
8 hours
20 hours
12 hours
In nulliparous women, the latent phasedefined as cervical dilation up to 4 cmcan last up to 20 hours. Prolongation beyond this may be considered a labor abnormality requiring evaluation. Multiparous women typically have shorter latent phases.
Which event defines the end of the third stage of labor?
Full cervical dilation
Episiotomy repair
Delivery of the placenta
Rupture of membranes
The third stage of labor lasts from the birth of the baby until the expulsion of the placenta. Active management aims to shorten this stage and reduce postpartum hemorrhage risk. Rupture of membranes and cervical dilation occur during earlier stages.
The second stage of labor is defined as the interval from:
Onset of regular contractions to full dilation
Delivery of the fetus to placenta expulsion
Full dilation to delivery of the fetus
Rupture of membranes to delivery
The second stage of labor begins at complete (10 cm) cervical dilation and ends with the delivery of the baby. It involves maternal expulsive efforts. The first stage covers dilation, and the third stage covers placental delivery.
Which hormone is the primary driver of uterine contractions during labor?
Oxytocin
Prostaglandin E2
Progesterone
Relaxin
Oxytocin, secreted by the posterior pituitary, is the principal hormone stimulating the myometrium to contract in labor. Prostaglandins also play a supportive role by ripening the cervix, but oxytocin is key for contraction frequency and intensity.
A vertex presentation describes which fetal attitude in labor?
Buttocks first
Face presenting
Chin flexed on the chest
Head extended backward
Vertex presentation refers to the fetal head being well flexed so that the occiput (vertex) leads through the birth canal. Extreme extension results in face or brow presentations. Breech is buttocks first.
The term station in labor refers to the relationship between the presenting part and:
Symphysis pubis
Sacral promontory
Ischial spines
Pelvic inlet
Station measures the position of the fetal presenting part relative to the maternal ischial spines. Zero station means the head is at the level of the spines; negative values are above, positive values are below.
What is the normal progression of cervical dilation in the active phase of labor?
2 cm per hour in nulliparas
3 cm per hour in nulliparas
0.5 cm per hour in nulliparas
1 cm per hour in nulliparas
In the active phase (after ~6 cm dilation), the cervix dilates at about 1 cm per hour in nulliparous women. Multiparous women may dilate slightly faster. Slower rates may prompt evaluation for augmentation.
Which finding is most consistent with arrest of active-phase labor for a nulliparous woman?
No dilation in 1 hour with inadequate contractions
No cervical change in 2 hours with adequate contractions
1 cm dilation in 2 hours
Fetal head at +1 station
Active-phase labor arrest in nulliparas is defined by no cervical dilation over 2 hours despite adequate uterine activity. Inadequate contractions may warrant augmentation rather than arrest diagnosis.
Which partogram alert line parameter indicates slowing descent in the active phase?
Less than 1 cm descent per hour
Station above ?3 after full dilation
More than 1 cm descent per hour
Head at 0 station for 2 hours
A descent slower than 1 cm per hour in the active phase is concerning for prolonged second stage and triggers further assessment. The partogram tracks such deviations from normal labor progress.
For labor augmentation, an initial oxytocin infusion rate is typically started at:
20 mU/min
12 mU/min
10 mU/min
56 mU/min
Oxytocin infusion for augmentation usually starts at 12 milliunits per minute, titrating up every 3040 minutes. Higher starting rates increase the risk of tachysystole without added benefit.
Which analgesic technique provides the most effective labor pain relief?
Nitrous oxide
Systemic opioids
Local infiltration
Epidural analgesia
Epidural analgesia provides the most consistent and profound labor pain relief. It allows titration of local anesthetics and opioids and can be extended for operative delivery if needed.
Continuous fetal heart rate monitoring is indicated when:
Membrane rupture
Maternal fever >38C
Patient requests epidural
Labor is uncomplicated
Maternal fever suggests possible chorioamnionitis, a risk factor for fetal compromisecontinuous monitoring is recommended. Epidural anesthesia alone does not require continuous fetal monitoring unless other risk factors exist.
Which factor is NOT included in the Bishop score for assessing cervical favorability?
Fetal weight estimation
Cervical effacement
Fetal station
Cervical dilation
The Bishop score assesses cervical dilation, effacement, consistency, position, and fetal station. Fetal weight estimation is important for management but is not part of the Bishop scoring system.
Which maternal position can facilitate fetal descent in the second stage?
Supine with legs extended
Upright squatting
Left lateral decubitus
Lithotomy without hips flexion
Upright and squatting positions use gravity to aid fetal descent and can shorten the second stage of labor. Supine positions may reduce pelvic dimensions and impede progress.
When augmenting labor with oxytocin, what is the maximum recommended contraction frequency?
8 contractions per 10 minutes
3 contractions per 10 minutes
4 contractions per 10 minutes
6 contractions per 10 minutes
No more than 5 contractions in a 10-minute window (averaged over 30 minutes) should occur to avoid tachysystole, and 4 per 10 minutes is considered safe. Excessive contractions risk fetal distress.
What is the most appropriate immediate management of a prolapsed umbilical cord?
Administer tocolytics and observe
Apply fundal pressure
Initiate oxytocin infusion
Perform emergent cesarean delivery
A prolapsed cord is an obstetric emergency requiring immediate relief of cord compression. Elevating the presenting part and prepping for an emergent cesarean section is critical to prevent fetal hypoxia.
During shoulder dystocia, the McRoberts maneuver involves:
Delivering the posterior arm
Performing a symphysiotomy
Flexing maternal hips against abdomen
Applying suprapubic pressure
The McRoberts maneuver entails hyperflexing the mothers thighs onto her abdomen to widen the pelvic outlet and reduce the angle of pelvic inclination. It is the first-line response to shoulder dystocia.
Which finding is diagnostic of chorioamnionitis in labor?
Maternal heart rate >100 bpm
Leukocytosis alone
Fever of 38.5C with uterine tenderness
Fetal tachycardia alone
Clinical chorioamnionitis is diagnosed with maternal fever ?38C plus one of the following: uterine tenderness, maternal or fetal tachycardia, or foul-smelling amniotic fluid. Fever and tenderness together strongly suggest infection.
Which medication is first-line for preventing postpartum hemorrhage immediately after delivery?
Misoprostol
Oxytocin
Methergine (methylergonovine)
Carboprost tromethamine
Active management of the third stage mandates prophylactic oxytocin to contract the uterus and reduce bleeding. Methylergonovine and prostaglandins are used if bleeding persists or oxytocin is contraindicated.
In the setting of prolonged second stage, what is the maximum recommended duration for a multiparous woman before considering operative delivery?
1 hour
3 hours
2 hours
4 hours
In multiparous women, a second-stage duration of up to 2 hours is generally acceptable before evaluating for operative vaginal delivery or cesarean. Extended durations increase maternal and fetal risks.
What is the recommended management for a category III fetal heart rate tracing?
Oxygen and maternal repositioning only
Increase oxytocin infusion
Continue observation
Immediate intrauterine resuscitation and prepare for urgent delivery
Category III tracings (absent variability with recurrent decelerations or bradycardia) require immediate intrauterine resuscitation measures and prompt preparation for operative delivery to prevent hypoxic injury.
Which uterine rupture sign is most conclusive during labor?
Sudden cessation of contractions
Maternal tachycardia alone
Vaginal bleeding
Fetal heart rate bradycardia and loss of station
Complete uterine rupture often presents with fetal heart rate abnormalities (late decelerations or bradycardia), loss of presenting part station, and possible palpation of fetal parts abdominally. Maternal signs are less specific.
A patient with prolonged latent labor has been contracting for 24 hours with minimal dilation. The next step is to:
Initiate oxytocin augmentation
Stop all interventions and observe
Proceed to cesarean delivery
Administer analgesics and wait 12 more hours
Prolonged latent phase (beyond 20 hours in nulliparas) without significant dilation warrants augmentation, typically with oxytocin, to promote progression. Cesarean is reserved if augmentation fails or there is fetal/maternal compromise.
Which of the following is the most common initial presentation of amniotic fluid embolism?
Postpartum hemorrhage only
Hypertension and bradycardia
Uterine atony without hemodynamic changes
Acute maternal hypotension and respiratory distress
Amniotic fluid embolism typically presents abruptly with hypotension, respiratory distress, and coagulopathy. Early recognition and critical care support are essential due to high mortality.
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Study Outcomes

  1. Understand Key Stages of Labor -

    Identify the defining features and clinical progression of the latent, active, and transitional phases as covered in our labor and delivery questions and answers quiz.

  2. Apply Maternal Comfort Strategies -

    Select and implement evidence-based techniques for pain relief and positioning to enhance maternal comfort during normal labor and delivery.

  3. Interpret Fetal Monitoring Data -

    Analyze common fetal heart rate patterns and tracings to determine appropriate interventions for optimizing fetal well-being.

  4. Evaluate Labor Management Decisions -

    Assess case-based scenarios with labor and delivery management questions to choose the best clinical actions at each stage of labor.

  5. Recall Essential Obstetric Interventions -

    Memorize key interventions - such as oxytocin augmentation, amniotomy, and second-stage pushing guidance - crucial for effective normal labor management.

  6. Analyze Quiz Performance -

    Review your scored responses on the normal labor and delivery quiz to identify knowledge gaps and strengthen clinical competencies.

Cheat Sheet

  1. Bishop Score for Cervical Readiness -

    The Bishop score evaluates dilation, effacement, station, cervical consistency, and position to predict induction success, with a score ≥8 considered favorable (ACOG guidelines). Use the mnemonic "DICE P" (Dilation, Incidence - effacement, Consistency, Engagement - station, Position) to recall each component. Clinically, a score below 6 often suggests need for cervical ripening methods such as prostaglandins.

  2. Stage Definitions and Progress Rates -

    Per ACOG's updated guidelines, the active phase of the first stage of labor begins at ≥6 cm dilation, with expected cervical change of at least 1.2 cm/hr in nulliparas and 1.5 cm/hr in multiparas. Use the WHO partograph to visually track dilation against time and identify protraction or arrest disorders promptly. When tackling normal labor and delivery quiz questions, this redefinition helps you spot abnormal progress scenarios swiftly.

  3. Fetal Monitoring Checkpoints -

    Continuous electronic fetal monitoring requires attention to baseline heart rate (110 - 160 bpm), variability (6 - 25 bpm is moderate), accelerations, and decelerations per ACOG 2017 guidelines. Recognize early, variable, and late decelerations and their uteroplacental implications to answer labor and delivery management questions correctly. Remember the phrase "VEAL CHOP" to match deceleration patterns to causes.

  4. Maternal Comfort and Analgesia Options -

    Combine nonpharmacologic measures (hydrotherapy, breathing techniques, counterpressure) with pharmacologic options (nitrous oxide, epidural) based on maternal preference and clinical status (WHO 2018). Nitrous oxide provides self-administered analgesia with a rapid onset and offset, while epidural analgesia offers superior pain control but requires hemodynamic monitoring. Reflect on patient scenarios in your labor and delivery questions and answers to choose the safest, most effective approach.

  5. Active Management of the Third Stage -

    Administer 10 IU oxytocin IM or IV within one minute of birth, practice controlled cord traction, and perform uterine massage to reduce postpartum hemorrhage by ~60% (Cochrane review). Monitor for uterine tone, lochia, and vital signs in the first hour to detect early bleeding. This protocol-driven approach is a frequent topic in labor and delivery management questions.

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