Nokea
Observation of a fetal heart rate pattern indicates an increase in heart rate from the prior baseline rate of 152 bpm. Which physiologic mechanisms would account for this situation?
- A. Inhibition of epinephrine
- B. Inhibition of norepinephrine
- C. Stimulation of the vagus nerve
- D. Sympathetic stimulation
Correct Answer: D
Rationale: The correct answer is D: Sympathetic stimulation. Sympathetic stimulation increases heart rate by releasing norepinephrine, which acts on beta-adrenergic receptors in the heart. This leads to an increase in heart rate. Choices A and B are incorrect because inhibition of epinephrine or norepinephrine would not cause an increase in heart rate. Choice C is incorrect because stimulation of the vagus nerve would actually decrease heart rate by releasing acetylcholine, which acts on muscarinic receptors in the heart.
You may also like to solve these questions
Which maternal condition should be considered a contraindication for the application of internal monitoring devices?
- A. Unruptured membranes
- B. intravenous (IV) fluid.
- C. Fetus has known heart defect
- D. must act quickly to improve placental blood flow and fetal oxygen supply
Correct Answer: A
Rationale: The correct answer is A: Unruptured membranes. Internal monitoring devices are inserted through the cervix and into the uterus, which can introduce bacteria and increase the risk of infection if the membranes are not ruptured. This can lead to serious complications for both the mother and the baby.
Choice B (intravenous fluid) is incorrect because IV fluids are commonly used during labor to maintain hydration and provide necessary nutrients.
Choice C (Fetus has known heart defect) is incorrect because internal monitoring devices are used to assess fetal heart rate and detect any abnormalities, making this condition a reason for monitoring rather than a contraindication.
Choice D (must act quickly to improve placental blood flow and fetal oxygen supply) is incorrect because internal monitoring devices are usually used for continuous monitoring and do not require immediate intervention to be placed.
What is the condition where the umbilical cord vessels cross the cervix?
- A. placenta previa
- B. placenta cervix
- C. velamentous insertion
- D. vasa previa
Correct Answer: D
Rationale: The correct answer is D: vasa previa. This condition occurs when the umbilical cord vessels cross the cervix, making them vulnerable to compression during labor. This can lead to fetal blood vessel rupture and potentially life-threatening bleeding. Placenta previa (A) is when the placenta partially or fully covers the cervix, unrelated to the cord position. Placenta cervix (B) is not a recognized medical term. Velamentous insertion (C) is when the blood vessels of the umbilical cord insert into the fetal membranes before reaching the placenta, also not directly related to cord position over the cervix.
Why is continuous electronic fetal monitoring generally used when oxytocin is administered?
- A. Fetal chemoreceptors are stimulated
- B. The mother may become hypotensive
- C. Maternal fluid volume deficit may occur.
- D. Uteroplacental exchange may be compromised
Correct Answer: D
Rationale: The correct answer is D because oxytocin can cause increased uterine contractions, potentially impacting uteroplacental exchange and reducing oxygen delivery to the fetus. This can lead to fetal distress, making continuous electronic fetal monitoring crucial to detect any signs of distress promptly.
A: Fetal chemoreceptors being stimulated is not directly related to the need for continuous monitoring with oxytocin administration.
B: Maternal hypotension is a potential side effect of oxytocin but does not directly necessitate continuous fetal monitoring.
C: Maternal fluid volume deficit is a concern with oxytocin, but it does not directly link to the need for continuous fetal monitoring.
What is a complication of uterine rupture?
- A. DIC
- B. nuchal cord
- C. polyhydramnios
- D. oligohydramnios
Correct Answer: A
Rationale: The correct answer is A: DIC (Disseminated Intravascular Coagulation). Uterine rupture can lead to severe bleeding, causing DIC. This is because the release of blood into the abdomen triggers the body's clotting system, resulting in the consumption of clotting factors and platelets. This can lead to widespread clotting in small blood vessels and ultimately result in bleeding disorders.
Summary:
- B: Nuchal cord is when the umbilical cord is wrapped around the baby's neck, not directly related to uterine rupture.
- C: Polyhydramnios is excessive amniotic fluid, not a direct complication of uterine rupture.
- D: Oligohydramnios is decreased amniotic fluid, not a direct complication of uterine rupture.
A nurse is examining a G1P0 who is 10 weeks gestation. The nurse notes a bluish coloration of her cervix. The nurse should document this finding as which positive sign?
- A. Quickening
- B. Goodell’s sign
- C. Chadwick’s sign
- D. Hegar’s sign
Correct Answer: C
Rationale: The correct answer is C: Chadwick's sign. Chadwick's sign refers to the bluish coloration of the cervix due to increased vascularity in early pregnancy. This is a positive sign of pregnancy, indicating the presence of hormonal changes and increased blood flow to the cervix. Quickening is the first fetal movements felt by the mother, typically around 18-20 weeks gestation. Goodell's sign refers to the softening of the cervix, not discoloration. Hegar's sign is the softening of the lower uterine segment, also not related to discoloration. Chadwick's sign specifically describes the bluish discoloration of the cervix due to increased blood flow, making it the correct answer in this scenario.