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A healthcare provider is assessing fetal heart tones for a pregnant client. The provider has determined the fetal position as left occipital anterior. To which of the following areas of the client's abdomen should the provider apply the ultrasound transducer to assess the point of maximum intensity of the fetal heart?
- A. Left upper quadrant
- B. Right upper quadrant
- C. Left lower quadrant
- D. Right lower quadrant
Correct Answer: C
Rationale: The correct answer is C, left lower quadrant. In the left occipital anterior fetal position, the fetus's back is on the left side of the mother's abdomen. To assess the point of maximum intensity of the fetal heart tones, the ultrasound transducer should be applied to the area closest to the fetal back, which is the left lower quadrant. Applying the transducer in this area allows for optimal detection of the fetal heart sounds. Choices A, B, and D are incorrect as they are not in proximity to the fetal back in the left occipital anterior position, leading to suboptimal detection of fetal heart tones.
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A healthcare professional is preparing to collect a blood specimen from a newborn via a heel stick. Which of the following techniques should the professional use to help minimize the pain of the procedure for the newborn?
- A. Apply a cool pack to the heel for 10 minutes prior to the puncture.
- B. Request a prescription for IM analgesic.
- C. Use a manual lancet to pierce the skin.
- D. Place the newborn skin-to-skin on the mother's chest.
Correct Answer: D
Rationale: The correct answer is D: Place the newborn skin-to-skin on the mother's chest. This technique promotes bonding, warmth, and comfort, which can help minimize the newborn's pain perception during the procedure. Skin-to-skin contact releases oxytocin, which has analgesic effects. It also provides emotional support and reduces stress for both the newborn and the mother.
A, applying a cool pack, may cause vasoconstriction and increase pain perception. B, requesting an IM analgesic, is not typically necessary for a routine heel stick and may have potential adverse effects. C, using a manual lancet, does not address the emotional and psychological aspects of pain perception in newborns.
When discussing intermittent fetal heart monitoring with a newly licensed nurse, which statement should a nurse include?
- A. Count the fetal heart rate for 15 seconds to determine the baseline.
- B. Auscultate the fetal heart rate every 5 minutes during the active phase of the first stage of labor.
- C. Count the fetal heart rate after a contraction to determine baseline changes.
- D. Auscultate the fetal heart rate every 30 minutes during the second stage of labor.
Correct Answer: C
Rationale: The correct answer is C because counting the fetal heart rate after a contraction helps determine baseline changes, which is essential for identifying fetal distress. This method allows for accurate assessment of fetal well-being in response to contractions. Choice A is incorrect as 15 seconds is not enough time to establish a baseline. Choice B is incorrect as auscultating every 5 minutes may not provide timely information during the active phase. Choice D is incorrect because auscultating every 30 minutes in the second stage may miss important changes in fetal status. Therefore, option C is the most appropriate choice for intermittent fetal heart monitoring.
A client who is pregnant is scheduled for a contraction stress test (CST). Which of the following findings are indications for this procedure? (Select all that apply)
- A. Decreased fetal movement
- B. Intrauterine growth restriction (IUGR)
- C. Postmaturity
- D. All of the Above
Correct Answer: D
Rationale: The correct answer is D, All of the Above.
1. Decreased fetal movement indicates fetal distress, necessitating CST.
2. IUGR implies potential placental insufficiency, requiring CST evaluation.
3. Postmaturity increases risk of placental insufficiency, warranting CST.
Other choices are incorrect as they do not directly indicate the need for CST in a pregnant client.
A nurse is caring for a client who is at 40 weeks of gestation and is in early labor. The client has a platelet count of 75,000/mm3 and is requesting pain relief. Which of the following treatment modalities should the nurse anticipate?
- A. Epidural analgesia
- B. Naloxone hydrochloride
- C. Attention-focusing
- D. Pudendal nerve block
Correct Answer: C
Rationale: The correct answer is C: Attention-focusing. At 40 weeks gestation with a platelet count of 75,000/mm3, epidural analgesia is contraindicated due to the risk of epidural hematoma. Naloxone hydrochloride is an opioid antagonist used for opioid overdose, not for labor pain relief. Pudendal nerve block is used for local anesthesia during the second stage of labor, not for early labor pain relief. Attention-focusing techniques can help the client manage pain without pharmacological interventions, ensuring safety for both the client and the baby.
When providing care for a client in preterm labor at 32 weeks of gestation, which medication should the nurse anticipate the provider will prescribe to hasten fetal lung maturity?
- A. Calcium gluconate
- B. Indomethacin
- C. Nifedipine
- D. Betamethasone
Correct Answer: D
Rationale: Step 1: Betamethasone is a corticosteroid that promotes fetal lung maturity by stimulating the production of surfactant, essential for lung function.
Step 2: At 32 weeks, the fetus may benefit from accelerated lung development to reduce respiratory distress.
Step 3: Calcium gluconate is used for hypocalcemia, not for fetal lung maturity.
Step 4: Indomethacin is a nonsteroidal anti-inflammatory drug used to delay preterm labor, not for lung maturity.
Step 5: Nifedipine is a calcium channel blocker to prevent preterm labor, not for fetal lung maturity.