Nokea
The nurse is educating a primigravida patient during her first prenatal clinic appointment about follow-up prenatal care. How often will follow-up prenatal clinic visits be scheduled if the patient has a low-risk pregnancy and develops no complications? Select all that apply.
- A. Every 2 weeks for the first 28 weeks
- B. Every 4 weeks until 30 weeks
- C. Every 4 weeks until 28 weeks
- D. Every 2 weeks after 28 completed weeks until 36 weeks gestation
Correct Answer: C
Rationale: Ballottement is a physical examination technique used to detect the presence of a floating fetus or other abnormalities. A gentle tap on the cervix causes a rebound or sensation, confirming fetal presence.
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When a Category II pattern of the fetal heart rate is noted and the patient is lying on her left side, which nursing action is indicated?
- A. Lower the head of the be
- B. Place a wedge under the left hip.
- C. Change her position to the right side
- D. Place the mother in Trendelenburg position
Correct Answer: C
Rationale: When a Category II pattern of fetal heart rate is noted, placing a wedge under the left hip of the pregnant patient is indicated. This position helps to improve blood flow to the placenta and can sometimes help to improve the fetal heart rate pattern. Placing the patient in a left lateral tilt can also be effective in improving circulation and oxygenation to the fetus. It is important to act promptly in response to abnormal fetal heart rate patterns to optimize the well-being of the baby. Lowering the head of the bed, changing the position to the right side, or placing the mother in Trendelenburg position are not appropriate actions in this situation.
A pregnant woman is being seen at her first prenatal visit. The RN should correct which action of a student nurse who is preparing the client for a pelvic examination?
- A. Asking the client if she needs something to drink
- B. Assembling the necessary equipment for the pelvic examination
- C. Positioning the client in the lithotomy position
- D. Explaining the procedure prior to the pelvic examination
Correct Answer: A
Rationale: Multipara is a term used for a woman who has given birth more than once, which is consistent with the birth history provided. Primigravida refers to a woman who is pregnant for the first time, and primipara refers to a woman who has had one pregnancy outcome.
To clarify the fetal condition when baseline variability is absent, the nurse should first
- A. monitor fetal oxygen saturation using fetal pulse oximetry.
- B. notify the physician so that a fetal scalp blood sample can be obtaine
- C. apply pressure to the fetal scalp with a glove finger using a circular motion.
- D. increase the rate of nonadditive IV fluid to expand the mother's blood volume
Correct Answer: C
Rationale: When baseline variability is absent in fetal monitoring, it may indicate fetal hypoxia or acidemia. The appropriate action to further evaluate the fetal condition would be to notify the physician so that a fetal scalp blood sample can be obtained. This blood sample can provide important information about the oxygenation status of the fetus, helping to guide the management and interventions needed to support the baby's well-being. Monitoring fetal oxygen saturation using fetal pulse oximetry (choice A) or performing other interventions such as applying pressure to the fetal scalp (choice D) or increasing IV fluids for the mother (choice E) would not provide as direct or specific information about the fetal condition as obtaining a blood sample would.
Proper placement of the tocotransducer for electronic fetal monitoring is
- A. Inside the uterus.
- B. On the fetal scalp.
- C. Over the uterine fundus.
- D. Over the mother's lower abdomen.
Correct Answer: C
Rationale: The tocotransducer is a device used for electronic fetal monitoring to measure uterine contractions. Proper placement of the tocotransducer is over the uterine fundus, which is the upper part of the uterus where contractions are most accurately detected. Placing the tocotransducer there allows for optimal monitoring of uterine activity during labor, ensuring accurate readings and appropriate interventions if necessary. Placing the tocotransducer inside the uterus, on the fetal scalp, or over the mother's lower abdomen would not provide accurate readings of uterine contractions.
With what is malnutrition during pregnancy associated?
- A. fetal growth restriction
- B. postterm birth
- C. uterine dystocia
- D. precipitous birth
Correct Answer: A
Rationale: Malnutrition during pregnancy can lead to fetal growth restriction.