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When evaluating the patient's progress, the nurse knows that four of the five fetal factors that interact to regulate the heart Nrate Rare I(SeGlect Bal.l CthatM apply.) U S N T O
- A. baroreceptors.
- B. adrenal glands.
- C. chemoreceptors.
- D. uterine activity.
Correct Answer: A
Rationale: The correct answer is A: baroreceptors. Baroreceptors are sensory receptors that detect changes in blood pressure and play a role in regulating heart rate. They are one of the fetal factors that interact to regulate heart rate. Adrenal glands (B) primarily regulate stress response, chemoreceptors (C) detect changes in oxygen and carbon dioxide levels, and uterine activity (D) refers to contractions during labor, which are not directly related to regulating fetal heart rate. Thus, A is correct as it directly influences heart rate regulation.
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Decelerations that mirror the contractions are present with each contraction on the monitor strip of a multipara who received epidural anesthesia 20 minutes ago. The nurse should
- A. maintain the normal assessment routine
- B. administer O at 8 to 10 L/minute by face mask.
- C. increase the IV flow rate from 125 to 150 mL/hour.
- D. assess the maternal blood pressure for a systolic pressure below 100 mm Hg.
Correct Answer: A
Rationale: The correct answer is A: maintain the normal assessment routine. Decelerations mirroring contractions in a multipara with epidural anesthesia likely indicate normal physiologic response to labor. There is no indication of fetal distress. Administering O2 (B) is unnecessary as there is no indication of maternal hypoxemia. Increasing IV flow rate (C) is not necessary if there are no signs of hypovolemia. Assessing maternal blood pressure (D) for hypotension is not relevant without other signs of maternal compromise. Maintaining the normal assessment routine ensures ongoing monitoring and evaluation of both mother and baby without unnecessary interventions.
What is the condition in which the umbilical cord vessels branch prior to insertion into the placenta?
- A. placenta previa
- B. placenta cervix
- C. velamentous insertion
- D. vasa previa
Correct Answer: C
Rationale: The correct answer is C: velamentous insertion. In this condition, the umbilical cord vessels branch before reaching the placenta, making them vulnerable to compression and rupture. Placenta previa (A) refers to the placenta covering the cervix, not cord insertion. Placenta cervix (B) is not a recognized term. Vasa previa (D) is when fetal vessels traverse the fetal membranes overlying the cervix, not related to branching of umbilical cord vessels before insertion into the placenta.
Which of the following therapeutic applications provides the most accurate information related to uterine contraction strength?
- A. External fetal monitoring (EFM)
- B. Internal fetal monitoring
- C. Intrauterine pressure catheter (IUP
- D. Maternal comments based on perception
Correct Answer: C
Rationale: The correct answer is C: Intrauterine pressure catheter (IUP). This device directly measures the pressure within the uterus, providing precise data on uterine contraction strength. It is considered the gold standard for assessing uterine activity.
A: External fetal monitoring (EFM) measures fetal heart rate and uterine contractions but doesn't provide direct information on contraction strength.
B: Internal fetal monitoring measures fetal heart rate and uterine contractions internally but focuses on fetal well-being, not contraction strength.
D: Maternal comments based on perception are subjective and not reliable for accurately assessing uterine contraction strength.
What is the nursing intervention for prolapsed cord?
- A. Turn the person to the side.
- B. Give the person oxygen.
- C. Lift the presenting part off the cord.
- D. Increase the oxytocin.
Correct Answer: C
Rationale: The correct nursing intervention for prolapsed cord is to lift the presenting part off the cord to relieve pressure and improve blood flow to the fetus. This step prevents further compression of the blood vessels in the cord. Turning the person to the side (A) is not specific to addressing a prolapsed cord. Giving oxygen (B) may be necessary, but it does not directly address the issue of cord prolapse. Increasing oxytocin (D) can worsen the situation by causing stronger contractions, potentially further compressing the cord. Therefore, the most appropriate action is to lift the presenting part off the cord (C) to protect the blood flow to the fetus.
The fetal heart rate baseline increases 20 bpm after vibroacoustic stimulation. The best interpretation of this is that the fetus is showing
- A. a worsening hypoxi
- B. progressive acidosis.
- C. an expected respons
- D. parasympathetic stimulation.
Correct Answer: C
Rationale: The correct answer is C. After vibroacoustic stimulation, an increase in fetal heart rate baseline indicates an expected response, showing the fetus is healthy and responding appropriately to the stimulus. This increase is a sign of fetal well-being and does not suggest worsening hypoxia (choice A) or progressive acidosis (choice B). Additionally, parasympathetic stimulation (choice D) would typically lead to a decrease in heart rate, not an increase as observed in this scenario. Therefore, choice C is the best interpretation based on the positive response of the fetal heart rate to the stimulation, indicating a healthy and expected reaction.