Maternal Fetal Monitoring

Maternal Fetal Monitoring Related

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A pregnant patient at 28 weeks gestation reports dizziness and faintness when standing. What is the nurse's most appropriate recommendation?

  • A. Rise quickly from a seated position to avoid dizziness.
  • B. Instruct the patient to increase fluid intake and stand slowly.
  • C. Encourage the patient to rest in bed to prevent fainting.
  • D. Advise the patient to avoid standing for long periods.
Correct Answer: B

Rationale: The correct answer is B: Instruct the patient to increase fluid intake and stand slowly. This recommendation is appropriate because the patient is likely experiencing orthostatic hypotension due to the expanding uterus compressing blood vessels, leading to decreased blood flow to the brain when standing. Increasing fluid intake helps maintain blood volume, while standing slowly helps prevent sudden drops in blood pressure.

A: Rising quickly can worsen dizziness by further decreasing blood flow to the brain.
C: Resting in bed may not address the underlying issue of orthostatic hypotension and may lead to deconditioning.
D: Avoiding standing for long periods may be impractical and may not address the need to maintain adequate blood volume and prevent sudden drops in blood pressure.

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What is the primary purpose of performing an episiotomy during delivery?

  • A. to reduce the risk of perineal trauma
  • B. to promote faster delivery
  • C. to facilitate fetal descent
  • D. to provide immediate fetal oxygenation
Correct Answer: A

Rationale: The primary purpose of performing an episiotomy during delivery is to reduce the risk of perineal trauma. Episiotomy is a surgical incision made in the perineum to widen the vaginal opening during childbirth, which can help prevent severe tearing of the perineal tissue. This procedure is performed to provide controlled and precise incision, reducing the likelihood of extensive tears that may lead to complications such as infection or prolonged healing time. It is not done to promote faster delivery, facilitate fetal descent, or provide immediate fetal oxygenation. These choices do not accurately reflect the main goal of episiotomy, which is to minimize perineal trauma.

A nurse is preparing a laboring person for an epidural. What is the most important nursing intervention before the procedure?

  • A. Ensure informed consent is signed
  • B. Administer IV fluids
  • C. Monitor maternal vital signs
  • D. Administer pain relief
Correct Answer: A

Rationale: The correct answer is A: Ensure informed consent is signed. Before any procedure, it is crucial to obtain informed consent to ensure the individual understands the risks, benefits, and alternatives. This protects their autonomy and ensures they are making an informed decision. Administering IV fluids (B) is important but not as critical as obtaining consent. Monitoring vital signs (C) is essential but not the most important step before the procedure. Administering pain relief (D) should only be done after ensuring informed consent and assessing the individual's pain level.

The following four changes occur during pregnancy. Which of them usually increases the father’s interest and involvement in the pregnancy?

  • A. Learning the results of the pregnancy test.
  • B. Attending childbirth education classes.
  • C. Hearing the fetal heartbeat.
  • D. Meeting the obstetrician or midwife.
Correct Answer: C

Rationale: Hearing the fetal heartbeat is a significant moment that often increases the father’s interest and involvement in the pregnancy. The other options may also increase involvement but are less impactful.

What organ does the ductus venosus shunt blood away from in fetal circulation?

  • A. Liver
  • B. Heart
  • C. Lungs
  • D. Kidneys
Correct Answer: A

Rationale: Fetal blood bypasses the liver through the ductus venosus by carrying blood directly to the inferior vena cava.

A nurse is educating a pregnant patient about the signs of preterm labor. Which of the following should the nurse include in the teaching plan?

  • A. Frequent, regular contractions every 10 minutes or less.
  • B. Decreased fetal movement and back pain.
  • C. Mild cramping and occasional vaginal spotting.
  • D. Headaches and blurred vision, especially after physical activity.
Correct Answer: A

Rationale: The correct answer is A because frequent, regular contractions every 10 minutes or less are a classic sign of preterm labor, indicating the need for immediate medical attention. Decreased fetal movement and back pain (choice B) are not specific signs of preterm labor. Mild cramping and occasional vaginal spotting (choice C) could be normal in pregnancy or may indicate other issues, but they are not definitive signs of preterm labor. Headaches and blurred vision (choice D) are more indicative of preeclampsia, a separate condition from preterm labor. Therefore, choice A is the most accurate and specific sign to include in the teaching plan for preterm labor.

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