Question 1

What is the most likely cause for early decelerations in the fetal heart rate (FHR)pattern?

Accepted Answer

Early decelerations in the fetal heart rate pattern are most commonly associated with altered fetal cerebral blood flow, often due to head compression during contractions.

Question 2

Which definition of an acceleration in the fetal heart rate (FHR)is accurate?

Accepted Answer

An acceleration in the fetal heart rate (FHR) is characterized by a visually apparent and abrupt increase from the baseline FHR. This is considered a sign of fetal well-being, as it often indicates a healthy and responsive fetal autonomic nervous system.

Question 3

What is a distinct advantage of external electronic fetal monitoring (EFM)?

Accepted Answer

External electronic fetal monitoring, particularly the toco transducer, is valuable for measuring uterine activity during the first stage of labor, as it can non-invasively monitor contractions.

Question 4

In which clinical situation would the nurse most likely anticipate a fetal bradycardia?

Accepted Answer

Prolonged umbilical cord compression can lead to a reduction in fetal oxygenation and subsequent fetal bradycardia. Intraamniotic infection, fetal anemia, and tocolytic treatment using terbutaline may impact fetal heart rate, but a bradycardia is not the most likely outcome.

Question 5

A new client and her partner arrive on the labor,delivery,recovery,and postpartum (LDRP)unit for the birth of their first child.The nurse applies 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 nurse's best response?

Accepted Answer

The nurse's best response is to explain that the baby's heart rate will fluctuate in response to what is happening during labor, providing reassurance and information to the partner.

Question 6

In which situation would the nurse be called on to stimulate the fetal scalp?

Accepted Answer

Stimulating the fetal scalp is a technique used to elicit an acceleration in the fetal heart rate (FHR), which can be an indicator of fetal well-being during labor. This method is used when there is a concern about the fetus based on the FHR pattern observed on the monitor.

Question 7

Which nursing intervention would result in an increase in maternal cardiac output?

Accepted Answer

Changing the mother's position can shift blood flow and help increase cardiac output by alleviating pressure on major vessels or improving venous return. Oxytocin administration can have cardiovascular effects but primarily stimulates uterine contractions. Regional anesthesia and IV analgesics can result in vasodilation and decreased blood pressure, which can lower cardiac output.

Question 8

The nurse who provides care to clients in labor must have a thorough understanding of the physiologic processes of maternal hypotension.Which outcome might occur if the interventions for maternal hypotension are inadequate?

Accepted Answer

Inadequate interventions for maternal hypotension can lead to uteroplacental insufficiency, which can result in decreased fetal perfusion and oxygenation. This can lead to fetal distress, hypoxia, and even death if not addressed promptly.

Question 9

While evaluating an external monitor tracing of a woman in active labor,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 first priority?

Accepted Answer

Late decelerations of the fetal heart rate (FHR) are associated with uteroplacental insufficiency and can indicate that the fetus is not receiving enough oxygen. The first priority in managing late decelerations is to improve fetal oxygenation, which can often be achieved by changing the woman's position to enhance blood flow to the placenta.

Question 10

Which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur?

Accepted Answer

Maternal fever can lead to fetal tachycardia as the increased maternal temperature can lead to stress on the fetus and an increase in the fetal heart rate.

Question 11

Which information related to a prolonged deceleration is important for the labor nurse to understand?

Accepted Answer

Understanding that a disruption to the fetal oxygen supply causes prolonged decelerations is important for the labor nurse, as it may prompt the nurse to take intervention measures such as administering oxygen to the mother, modifying the mother's position, or preparing for delivery. Option A is incorrect because prolonged decelerations typically present a pattern of decelerations that last longer than 2 minutes but less than 10 minutes and require intervention. Option B is incorrect because a baseline change would refer to a new pattern of fetal heart rate baseline that lasts for at least 2 hours, not to a single prolonged deceleration. Option D is incorrect because prolonged decelerations require close monitoring and intervention by the nurse.

Question 12

During labor a fetus displays an average fetal heart rate (FHR)of 135 beats per minute over a 10-minute period.Which statement best describes the status of this fetus?

Accepted Answer

The average fetal heart rate of 135 beats per minute over a 10-minute period is within the normal baseline range of 110-160 beats per minute. Therefore, the status of this fetus is a normal baseline heart rate.

Question 13

Part of the nurse's role is assisting with pushing and positioning.Which guidance should the nurse provide to her client in active labor?

Accepted Answer

The supine position can decrease blood flow to the uterus, compress the inferior vena cava, and increase the risk of fetal hypoxia. Encouraging the woman to avoid this position can help promote optimal fetal oxygenation and blood flow. The semi-Fowler position (option B) may be helpful during certain stages of labor, so it would not necessarily need to be avoided. Option C is incorrect as holding one's breath and tightening abdominal muscles can increase intra-abdominal pressure and reduce fetal oxygenation. Option D is also incorrect as the woman should be instructed to exhale during the pushing phase to decrease intra-abdominal pressure and promote fetal oxygenation.

Question 14

The nurse providing care for a high-risk laboring woman is alert for late fetal heart rate (FHR)decelerations.Which clinical finding might be the cause for these late decelerations?

Accepted Answer

Uteroplacental insufficiency, or decreased blood flow to the placenta, can lead to late decelerations as the fetus is not getting enough oxygen. Altered cerebral blood flow and meconium fluid can also be concerning in labor but may not directly cause late decelerations. Umbilical cord compression can cause variable decelerations.

Question 15

What is the most likely cause for variable fetal heart rate (FHR)decelerations?

Accepted Answer

Variable decelerations in fetal heart rate are most commonly caused by umbilical cord compression, which can lead to changes in blood flow and oxygen delivery to the fetus.

Question 16

Which client would not be a suitable candidate for internal electronic fetal monitoring (EFM)?

Accepted Answer

Clients with intact membranes do not require internal EFM as it is not feasible to insert a fetal electrode without rupturing the membranes. External EFM can be used in this case.

Question 17

A nurse caring for a woman in labor should understand that absent or minimal variability is classified as either abnormal or indeterminate.Which condition related to decreased variability is considered benign?

Accepted Answer

Periodic fetal sleep state, also known as sleep cycles, is a normal variation in fetal heart rate that is considered benign. It occurs due to the fetal sleep-wake cycles and typically lasts 20-40 minutes. The other options listed (B, C, and D) are all potential causes of decreased variability that are considered abnormal or concerning.

Question 18

What are the legal responsibilities of the perinatal nurses?

Accepted Answer

Perinatal nurses have a legal responsibility to correctly interpret fetal heart rate patterns, initiate appropriate nursing interventions, and document the outcomes. This is critical for ensuring the safety and well-being of the mother and baby during labor and delivery. While greeting the client, starting an IV line, applying the external fetal monitor, and ensuring the woman is comfortable are also important responsibilities of perinatal nurses, they are not specifically related to their legal responsibilities.

Question 19

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

Accepted Answer

Late decelerations are typically associated with uteroplacental insufficiency, indicating that the placenta is not delivering enough oxygen to the fetus.

Question 20

Which fetal heart rate (FHR)finding is the most concerning to the nurse who is providing care to a laboring client?

Accepted Answer

Late decelerations indicate fetal distress and suggest inadequate uteroplacental perfusion. This is the most concerning finding as it can lead to fetal hypoxia and potential long-term neurological damage. Accelerations with fetal movement are reassuring and indicate fetal well-being. Early decelerations suggest head compression during contractions and are generally considered a normal finding. An average FHR of 126 beats per minute falls within the normal range of fetal heart rates.

Quiz 18: Fetal Assessment During Labor

What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern?

Which definition of an acceleration in the fetal heart rate (FHR) is accurate?

What is a distinct advantage of external electronic fetal monitoring (EFM) ?

In which clinical situation would the nurse most likely anticipate a fetal bradycardia?

In which situation would the nurse be called on to stimulate the fetal scalp?

Which nursing intervention would result in an increase in maternal cardiac output?

The nurse who provides care to clients in labor must have a thorough understanding of the physiologic processes of maternal hypotension.Which outcome might occur if the interventions for maternal hypotension are inadequate?

Which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur?

Which information related to a prolonged deceleration is important for the labor nurse to understand?

During labor a fetus displays an average fetal heart rate (FHR) of 135 beats per minute over a 10-minute period.Which statement best describes the status of this fetus?

Part of the nurse's role is assisting with pushing and positioning.Which guidance should the nurse provide to her client in active labor?

The nurse providing care for a high-risk laboring woman is alert for late fetal heart rate (FHR) decelerations.Which clinical finding might be the cause for these late decelerations?

What is the most likely cause for variable fetal heart rate (FHR) decelerations?

Which client would not be a suitable candidate for internal electronic fetal monitoring (EFM) ?

A nurse caring for a woman in labor should understand that absent or minimal variability is classified as either abnormal or indeterminate.Which condition related to decreased variability is considered benign?

What are the legal responsibilities of the perinatal nurses?

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

Which fetal heart rate (FHR) finding is the most concerning to the nurse who is providing care to a laboring client?