Nokea
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.
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What medication is used for cervical ripening?
- A. amniotomy
- B. Hemabate
- C. misoprostol
- D. progesterone
Correct Answer: C
Rationale: The correct answer is C: misoprostol. Misoprostol is used for cervical ripening in obstetrics due to its ability to soften and dilate the cervix, making it favorable for induction of labor. It is a prostaglandin E1 analogue that helps prepare the cervix for childbirth. Amniotomy (A) is the artificial rupture of membranes and does not directly aid in cervical ripening. Hemabate (B) is a medication used to treat postpartum hemorrhage, not for cervical ripening. Progesterone (D) is a hormone that helps maintain pregnancy and is not used for cervical ripening.
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.
When assessing a prenatal client at follow-up prenatal visits during the second trimester, the nurse should anticipate which assessments to be performed at each visit? Select all that apply.
- A. Cervical examination
- B. Weight, height, BMI
- C. Fetal ultrasound
- D. Fundal height
Correct Answer: B
Rationale: The correct answer is B: Weight, height, BMI. During each second-trimester prenatal visit, it is essential to monitor the client's weight, height, and BMI to ensure appropriate maternal and fetal health. Weight gain is a crucial indicator of fetal growth and maternal well-being. Height and BMI can provide insights into the client's nutritional status and overall health.
Explanation of why other choices are incorrect:
A: Cervical examination is typically not performed routinely during second-trimester prenatal visits unless there are specific concerns such as preterm labor risk.
C: Fetal ultrasound is usually scheduled at specific times during pregnancy, not necessarily at every second-trimester visit.
D: Fundal height measurement is important, but it is usually performed starting in the second trimester to assess fetal growth and position, not necessarily at every visit.
The nurse is reviewing an electronic fetal monitor tracing from a patient in active labor and notes the fetal heart rate gradually drops to 20 beats per minute (bpm) below the baseline and returns to the baseline well after the completion of the patient's contractions. How will the nurse document these findings?
- A. Late decelerations
- B. Early decelerations
- C. Variable decelerations
- D. Proximal decelerations
Correct Answer: B
Rationale: The correct answer is B: Early decelerations. Early decelerations occur in response to fetal head compression during contractions, resulting in a gradual decrease in the fetal heart rate that mirrors the timing of contractions. In this scenario, the fetal heart rate drops to 20 bpm below the baseline during contractions and returns to baseline after contractions, indicating a benign pattern. Late decelerations (choice A) occur after the peak of the contraction and are associated with uteroplacental insufficiency. Variable decelerations (choice C) are abrupt decreases in fetal heart rate without a consistent timing in relation to contractions, often due to cord compression. Proximal decelerations (choice D) are not a recognized classification of decelerations in fetal monitoring.
Decreased capillary refill, delay in milk production, and diminished peripheral pulses are signs of what complication?
- A. alteration in perfusion
- B. alteration in liver function
- C. alteration in kidney function
- D. alteration in uterine function
Correct Answer: C
Rationale: The correct answer is C, alteration in kidney function. Decreased capillary refill indicates poor perfusion due to impaired kidney function leading to reduced blood flow. Delay in milk production is not directly related to kidney or liver function. Diminished peripheral pulses can be a sign of decreased blood flow due to kidney dysfunction affecting circulation. Alteration in liver or uterine function would not typically present with these specific signs. Therefore, the signs listed are most indicative of a complication related to kidney function.