Nokea
In which situation would a baseline fetal heart rate of 160 to 170 bpm be considered a normal finding?
- A. The fetus is at 30 weeks of gestation.
- B. The mother has a history of fast labors.
- C. The mother has been given an epidural block.
- D. The mother has mild preeclampsia but is not in labor.
Correct Answer: A
Rationale: The correct answer is A because at 30 weeks of gestation, a fetal heart rate of 160 to 170 bpm is considered normal due to the fetus's stage of development. Fetal heart rates gradually decrease as gestation progresses. Choices B, C, and D are incorrect because they do not directly impact the fetal heart rate based on gestational age. Choice B, fast labors, does not affect the baseline fetal heart rate. Choice C, epidural block, may cause maternal hypotension but typically doesn't affect the fetal heart rate. Choice D, mild preeclampsia, may lead to fetal distress but does not directly influence the baseline fetal heart rate.
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The nurse admits a laboring patient at term. On review of the prenatal record, the patient's pregnancy has been unremarkable and she is considered low risk. In planning the patient's
- A. the fetal heart rate during the first stage of labor?
- B. Every 10 minutes
- C. Every 15 minutes
- D. Every 30 minutes
Correct Answer: C
Rationale: The correct answer is C: Every 15 minutes. This is the appropriate frequency for monitoring the fetal heart rate during the first stage of labor for a low-risk patient. Monitoring every 15 minutes allows for regular assessment of the baby's well-being without being overly invasive. Monitoring every 10 minutes (choice A) would be too frequent and may lead to unnecessary interventions. Monitoring every 30 minutes (choice D) would be too infrequent and could potentially miss important changes in the fetal heart rate. Choice B is not the correct answer because monitoring every 10 minutes is too frequent for a low-risk patient and could lead to unnecessary interventions and increased stress for the laboring patient.
Which clinical finding can be determined only by electronic fetal monitoring?
- A. Variability
- B. Tachycardia
- C. Bradycardia
- D. Fetal response to contractions
Correct Answer: D
Rationale: The correct answer is D because electronic fetal monitoring is the only method that can directly measure and display the fetal heart rate in response to contractions. Variability, tachycardia, and bradycardia can also be observed through electronic fetal monitoring, but fetal response to contractions specifically requires continuous monitoring of the fetal heart rate during contractions. Therefore, D is the only clinical finding that can be determined exclusively through electronic fetal monitoring. Variability (A), tachycardia (B), and bradycardia (C) can be identified through other means of monitoring and assessment as well.
The nurse is preparing supplies for an amnioinfusion on a patient with intact membranes. Which supplies should the nurse gather? (Select all that apply.)
- A. Extra underpads
- B. Solution of 3% normal saline
- C. Amniotic hook to perform an amniotomy
- D. Solid intrauterine pressure catheter with a pressure transducer on its tip
Correct Answer: A
Rationale: The correct answer is A: Extra underpads. For an amnioinfusion on a patient with intact membranes, extra underpads are necessary to absorb any excess fluid leakage during the procedure. The other choices are incorrect because:
B: Solution of 3% normal saline is not necessary for an amnioinfusion with intact membranes as there is no need for amniotic fluid replacement.
C: Amniotic hook to perform an amniotomy is not required when the patient's membranes are intact; this procedure involves rupturing the membranes.
D: Solid intrauterine pressure catheter with a pressure transducer on its tip is used for monitoring intrauterine pressure during labor, not for an amnioinfusion procedure.
How much blood loss must occur to define the loss as a postpartum hemorrhage?
- A. 250 mL
- B. 500 mL
- C. 750 mL
- D. 1,000 mL
Correct Answer: B
Rationale: The correct answer is B (500 mL) for defining postpartum hemorrhage. This amount is used as the threshold because it represents a significant loss that may lead to maternal complications. Excessive bleeding after childbirth can quickly become life-threatening, so it is crucial to define postpartum hemorrhage accurately. Choices A (250 mL), C (750 mL), and D (1,000 mL) are incorrect as they do not align with the standard definition of postpartum hemorrhage, which is typically considered when blood loss exceeds 500 mL.
What is a potential complication for the neonate due to precipitous labor?
- A. respiratory distress
- B. low birth weight
- C. prelabor rupture of membranes
- D. placenta previa
Correct Answer: A
Rationale: The correct answer is A: respiratory distress. During precipitous labor, the rapid delivery can cause the neonate to experience respiratory distress due to inadequate time for fluid clearance from the lungs, leading to transient tachypnea or respiratory distress syndrome. This complication can result in difficulty breathing and require immediate medical intervention.
Summary:
B: Low birth weight is not directly associated with precipitous labor.
C: Prelabor rupture of membranes is unrelated to the speed of labor.
D: Placenta previa is a condition involving the placenta's position, not typically related to the duration of labor.