Home MCQs Nursing Question #9143
Back to Questions
Nursing QUESTION #9143
Question 1
A woman is in active labor. Partograph shows: the descent curve of fetal head has crossed the ALERT line. Contractions are 3 in 10 minutes, each lasting 35 seconds. What is the nurse's PRIORITY action?
  • Rupture membranes artificially (ARM) to accelerate labor
  • Administer oxytocin augmentation immediately
  • Reassess within 1 hour as crossing alert line alone is not an emergency
  • Inform the medical officer and prepare for transfer if in peripheral setting✔️
Correct Answer Explanation

The Partograph is a WHO tool for monitoring labor progress:

Cervicograph lines:

  • Alert line: Progress expected at \(1\,\text{cm/hr}\) from active phase (4 cm). Crossing it = slow progress, increase vigilance.
  • Action line: 4 hours to the right of alert line. Crossing it = immediate obstetric action required.

Contractions: 3 in 10 minutes × 35 seconds = mild to moderate — not hyperstimulation (normal: 3–5 in 10 min, 40–60 sec)

When the alert line is crossed (not action line):

  • The situation requires reassessment and increased monitoring
  • In peripheral/basic EmOC settings: prepare for referral/transfer to a higher facility
  • In hospital: alert senior midwife/doctor, assess for cause of slow progress
  • Do NOT augment with oxytocin without medical assessment first
  • Crossing action line = immediate medical intervention needed

This question tests the distinction between alert line (warn and prepare) vs action line (act immediately).