Question 1

A laboring client asks the nurse,"Why does the physician want to use an intrauterine pressure catheter (IUPC)during my labor?" The nurse would accurately explain that the best rationale for using an IUPC is:

Accepted Answer

The IUPC provides more accurate data than does the tocodynamometer. The IUPC can provide more precise and quantifiable data on the strength, frequency, and duration of contractions, which can help in monitoring labor progress, identifying abnormalities or complications, and guiding interventions. A tocodynamometer can be subject to artifacts, such as movement or pressure on the abdomen, and may not accurately reflect the activity of the uterus. The IUPC can be used throughout the birth process, including in the first stage of labor before the cervix is dilated 2 cm.

Question 2

The fetal heart rate pattern associated with abruptio placentae,uterine hyperstimulation,umbilical cord compression,and maternal hypotension is known as fetal:

Accepted Answer

Bradycardia is associated with abruptio placentae, uterine hyperstimulation, umbilical cord compression, and maternal hypotension.

Question 3

A nurse is analyzing several fetal heart rate patterns.The pattern that would be of most concern to the nurse would be:

Accepted Answer

Late decelerations are the most concerning fetal heart rate pattern as they indicate decreased oxygenation to the fetus and can be a sign of fetal distress. Moderate long-term variability, early decelerations, and accelerations are all normal fetal heart rate patterns.

Question 4

During maternal assessment,the nurse determines the fetus to be in a left occiput anterior (LOA)position.Auscultation of the fetal heart rate should begin in the:

Accepted Answer

In a left occiput anterior (LOA) position, the baby's head is down, and the back of the baby is facing the mother's left side, slightly towards the front of the mother's abdomen. Therefore, the best place to start auscultating the fetal heart rate would be in the left lower quadrant, closest to where the baby's back (and heart) is positioned.

Question 5

Before performing Leopold's maneuver,the nurse would: (Select all that apply. )

Accepted Answer

It is recommended for the client to empty her bladder prior to performing Leopold's maneuver as a full bladder may result in incorrect assessment. The client should be positioned lying on her back with her feet on the bed and knees bent to relax the abdominal muscles and provide better access for palpation. Trendelenburg position (head down, feet up) and turning the client to her left side are not necessary for performing Leopold's maneuver.

Question 6

Upon assessing the FHR tracing,the nurse determines that there is increased variability.The increased variability would be caused by: (Select all that apply. )

Accepted Answer

Increased variability is caused by early mild hypoxia, fetal stimulation, and alterations in placental blood flow.

Question 7

Persistent early decelerations are noted.The nurse's first action would be to:

Accepted Answer

The answer of Persistent early decelerations are noted.The nurse's first...

Question 8

After several hours of labor,the electronic fetal monitor (EFM)shows repetitive variable decelerations in the fetal heart rate.You would interpret the decelerations to be consistent with:

Accepted Answer

Repetitive variable decelerations in the fetal heart rate are often indicative of umbilical cord compression, which can lead to fetal distress and potentially compromise the baby's oxygen supply. It is important for healthcare providers to take appropriate action if this is identified on the EFM.

Question 9

A nurse is analyzing fetal cord blood results.If the fetal blood pH is less than 7.25,the nurse can conclude that the fetus was:

Accepted Answer

A fetal blood pH less than 7.25 indicates acidosis, which means there is an increased level of acidic substances in the blood, usually caused by hypoxia or lack of oxygen supply to the fetus. Therefore, the fetus is both acidotic and hypoxic.

Question 10

The nurse is analyzing a fetal heart rate (FHR)monitor strip.The nurse notes that some early decelerations are present.The nurse explains to the client that early decelerations are most often related to:

Accepted Answer

Early decelerations are caused by fetal head compression during the active phase of labor. This is a normal finding and often indicates fetal descent. Umbilical cord compression, uteroplacental insufficiency, and fetal hypoxia would cause variable or late decelerations on the fetal heart rate monitor strip.

Question 11

The nurse is admitting a client to the birthing unit.What question should the nurse ask to gain a better understanding of the psychosocial status of the client?

Accepted Answer

Asking about the client's support person can provide insight into their social support network and potential emotional needs during labor and delivery. The other options do not provide information on psychosocial status.

Question 12

After noting meconium-stained amniotic fluid,fetal heart rate decelerations,and a fetal blood pH of 7.20,the physician diagnoses a severely depressed fetus.The appropriate nursing action at this time would be to:

Accepted Answer

If the fetus is severely depressed, urgent intervention is necessary to prevent further harm. Forceps or cesarean birth may be necessary to expedite delivery and prevent further fetal distress. Increasing the mother's oxygen rate or turning her to the left lateral position may be appropriate interventions in some cases, but if the fetus is severely depressed, they may not be enough to promote fetal recovery. Increasing the intravenous infusion rate may also be beneficial, but it is not the most urgent intervention in this situation.

Question 13

The nurse has just palpated contractions,and compares the consistency to that of the forehead.The intensity of these contractions would be identified as:

Accepted Answer

When contractions are palpated and compared to the consistency of the forehead, they are identified as strong. This is because the forehead is firm to the touch, similar to how strong contractions feel.

Question 14

The nurse auscultates the FHR and determines a rate of 112 bpm.Which action is appropriate?

Accepted Answer

A FHR of 112 bpm falls within the normal range of 110-160 bpm. Therefore, there is no need for any immediate action or intervention. The nurse should inform the maternal client that the rate is normal.

Question 15

A fetus that is not in any stress would respond to a fetal scalp stimulation test by showing which of the following changes on the monitor strip?

Accepted Answer

A fetus that is not in any stress would respond to a fetal scalp stimulation test by showing accelerations on the monitor strip. Accelerations are an increase in the fetal heart rate above baseline, which indicates a healthy response to the stimulation. Late decelerations are associated with fetal distress, whereas early decelerations are a normal response to head compression during contractions. Increased long-term variability is also a sign of fetal distress.

Quiz 18: Intrapartal Nursing Assessment

A laboring client asks the nurse,"Why does the physician want to use an intrauterine pressure catheter (IUPC) during my labor?" The nurse would accurately explain that the best rationale for using an IUPC is: