Deck 19: Fetal Health Surveillance During Labour

Question 1

Which is a cause of early decelerations?

A) Transient fetal head compression
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Spontaneous rupture of membranes

Answer 1

Transient fetal head compression

Question 2

Which fetal heart rate (FHR)finding would concern the nurse during labour?

A) Accelerations with fetal movement
B) Early decelerations
C) An average FHR of 126 beats/min
D) Late decelerations

Answer 2

Late decelerations

Question 3

Which is a legal responsibility of the perinatal nurse?

A) Correctly interpreting fetal heart rate (FHR)patterns,initiating appropriate nursing interventions,and documenting the outcomes
B) Greeting the patient on arrival,assessing her,and starting an intravenous (IV)line
C) Applying the external fetal monitor and notifying the care provider
D) Making sure that the woman is comfortable and orientated to the unit

Answer 3

Correctly interpreting fetal heart rate (FHR)patterns,initiating appropriate nursing interventions,and documenting the outcomes

Question 4

Which characterizes a normal uterine activity pattern in labour?

A) Contractions every 2 to 5 minutes
B) Contractions lasting about 2 minutes
C) Contractions about 1 minute apart
D) A contraction intensity of about 1000 mm Hg with relaxation at 50 mm Hg

Question 5

When providing care for the labouring woman,which fetal heart rate (FHR)deviation should the nurse understand that amnioinfusion is used to treat?

A) Variable decelerations
B) Late decelerations
C) Fetal bradycardia
D) Fetal tachycardia

Question 6

Which is true in relation to accelerations with fetal movement?

A) They are considered normal.
B) They are caused by umbilical cord compression.
C) They warrant close observation.
D) They are caused by uteroplacental insufficiency.

Question 7

When is fetal bradycardia most common?

A) Intra-amniotic infection
B) Fetal anemia
C) Prolonged umbilical cord compression
D) Treatment with atropine

Question 8

Which is a cause of variable fetal heart rate (FHR)decelerations?

A) Altered fetal cerebral blood flow
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Fetal hypoxemia

Question 9

What should the nurse assess for when caring for the woman in labour who experiences maternal hypotension?

A) Early decelerations
B) Fetal dysrhythmias
C) Fetal hypoxemia
D) Spontaneous rupture of membranes

Question 10

A new patient and her partner arrive on the labour,delivery,recovery,and postpartum unit for the birth of their first child.You apply the electronic fetal monitor (EFM)to the woman.Her partner asks you to explain what is printing on the graph,referring to the EFM strip.He wants to know what the baby's heart rate should be.What is the basis of the nurse's response?

A) Labour support people do not need to know about EFM interpretation.
B) The top line graphs the baby's heart rate,which is between 110 and 160 but fluctuates somewhat.
C) The top line graphs the baby's heart rate,and the bottom line lets the nurse know how strong the contractions are.
D) Arrange for the health care provider to explain interpretation to the patient's partner.

Question 11

When caring for a labouring woman,the nurse is aware that which can lead to an increase in maternal cardiac output?

A) Change in position
B) Oxytocin administration
C) Regional anaesthesia
D) Intravenous analgesic

Question 12

While evaluating an external monitor tracing of a woman in active labour whose labour is being induced,the nurse notes that the fetal heart rate (FHR)begins to decelerate at the onset of several contractions and returns to baseline before each contraction ends.What should the nurse do?

A) Change the woman's position.
B) Discontinue the oxytocin infusion.
C) Insert an internal monitor.
D) Document the finding in the patient's record.

Question 13

What three measures should the nurse implement to provide intrauterine resuscitation? Select the response that best indicates the priority of actions that should be taken.

A) Call the provider,reposition the mother,and perform a vaginal examination.
B) Reposition the mother,increase intravenous (IV)fluid,and preform a vaginal examination.
C) Administer oxygen to the mother,increase IV fluid,and notify the care provider.
D) Perform a vaginal examination,reposition the mother,and provide oxygen via face mask.

Question 14

According to standard professional thinking,how often should nurses auscultate the fetal heart rate (FHR)?

A) Every hour in the active phase of the first stage of labour in the absence of risk factors
B) Every 20 minutes in the second stage,regardless of whether risk factors are present
C) Before and after ambulation and rupture of membranes
D) More often in a woman's first pregnancy

Question 15

As a perinatal nurse,you realize that which accompanies a fetal heart rate that demonstrates late decelerations?

A) Hypotension
B) Cord compression
C) Maternal drug use
D) Hypoxemia

Question 16

What should the nurse who is providing care for the labouring woman understand about late fetal heart rate (FHR)decelerations?

A) Altered cerebral blood flow
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Meconium fluid

Question 17

While evaluating an external monitor tracing of a woman in active labour,the nurse notes that the fetal heart rate (FHR)for five sequential contractions begins to decelerate late in the contraction,with the nadir of the decelerations occurring after the peak of the contraction.What is the nurse's priority intervention?

A) Change the woman's position.
B) Notify the care provider.
C) Assist with amnioinfusion.
D) Insert a scalp electrode.

Question 18

Which best assesses fetal well-being during labour?

A) The response of the fetal heart rate (FHR)to labour
B) Maternal pain control
C) Accelerations in the FHR
D) An FHR above 110 beats/min

Question 19

Which is a common cause of decreased variability in the fetal heart rate (FHR)that lasts 30 minutes or less?

A) Altered cerebral blood flow
B) Fetal hypoxemia
C) Umbilical cord compression
D) Fetal sleep cycles

Question 20

The nurse is evaluating the fetal monitor tracing of a patient who is in active labour.Suddenly the fetal heart rate (FHR)drops from its baseline of 125 down to 80.The nurse repositions the mother,provides oxygen,increases intravenous (IV)fluid,and performs a vaginal examination.The cervix has not changed.Five minutes have passed,and the FHR remains in the 80s.What additional nursing measures should the nurse take?

A) Call for help.
B) Insert a Foley catheter.
C) Start oxytocin.
D) Notify the care provider immediately.

Question 21

Which deceleration pattern is considered a normal finding in fetal heart monitoring?

A) Early decelerations
B) Late decelerations
C) Variable decelerations
D) Prolonged decelerations

Question 22

Which is recommended for routine use during labour?

A) Intermittent auscultation
B) Continuous external monitoring
C) Fetal pulse oximetry
D) Fetal scalp blood pH

Question 23

What is an advantage of external electronic fetal monitoring?

A) The ultrasound transducer can accurately measure variability in the fetal heart rate.
B) The tocotransducer can measure and record the frequency,regularity,intensity,and approximate duration of uterine contractions (UCs).
C) The tocotransducer is especially valuable for measuring uterine activity during the first stage of labour.
D) Once correctly applied by the nurse,the transducer need not be repositioned even when the woman changes positions.

Question 24

What should the nurse know when assisting a patient with pushing and positioning during labour?

A) Encourage the woman's cooperation in avoiding the supine position.
B) Advise the woman to avoid the semi-Fowler position.
C) Encourage the woman to hold her breath and tighten her abdominal muscles to produce a vaginal response.
D) Instruct the woman to open her mouth and close her glottis,letting air escape after the push.

Question 25

Which correctly matches the type of deceleration with its likely cause?

A) Early deceleration-umbilical cord compression
B) Late deceleration-uteroplacental inefficiency
C) Variable deceleration-head compression
D) Prolonged deceleration-cause unknown

Question 26

The nurse caring for a woman in labour understands that which is related to prolonged decelerations?

A) They are a continuing pattern of benign decelerations that do not require intervention.
B) They constitute a baseline change when they last longer than 5 minutes.
C) They can be gradual or abrupt and are at least 15 beats/min below the baseline.
D) They require the usual fetal monitoring by the nurse.

Question 27

Which should nurses be aware of with regard to accelerations in the fetal heart rate?

A) They are indications of fetal well-being when they are periodic.
B) They are greater and longer in preterm gestations.
C) They are usually seen with breech presentations when they are episodic.
D) They may visibly resemble the shape of the uterine contraction.

Question 28

The nurse caring for the woman in labour knows that which medication may increase fetal tachycardia?

A) Narcotics
B) Barbiturates
C) Methamphetamines
D) Tranquilizers

Question 29

When using intermittent auscultation (IA)for fetal heart rate,what should the nurse be aware of?

A) The nurse can be expected to cover only two or three patients when IA is the primary method of fetal assessment.
B) The best course is to use the descriptive terms associated with electronic fetal monitoring (EFM)when documenting results.
C) If the heartbeat cannot be found immediately,a shift must be made to EFM.
D) A doptone can be used to find the fetal heartbeat.

Question 30

Which is a reason that a nurse might be directed to stimulate the fetal scalp?

A) As part of fetal scalp blood sampling
B) In preparation for tocolysis
C) To implement fetal oxygen saturation monitoring
D) To elicit an acceleration in the fetal heart rate (FHR)

Question 31

Which should the nurse be aware of when using intermittent auscultation (IA)to record the fetal heart rate (FHR)?

A) The uterus is palpated for absence of activity.
B) The frequency and duration of contractions are measured in seconds for consistency.
C) Contraction intensity is given a number of 1 to 7 by the nurse and patient together.
D) The resting tone between contractions is described as either placid or turbulent.

Question 32

When assessing the relative advantages and disadvantages of internal and external electronic fetal monitoring,nurses should be aware that which applies to both types?

A) They can be used when membranes are intact.
B) They measure the frequency,duration,and intensity of uterine contractions.
C) They rely on the woman to indicate when uterine activity (UA)is occurring.
D) They can be used during the antepartum and intrapartum periods.

Question 33

How would the nurse chart a fetal heart rate (FHR)of 135 beats/min over a 10-minute period during labour?

A) Bradycardia
B) A normal baseline heart rate
C) Tachycardia
D) Hypoxia