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What is a sign of fetal distress?
- A. prolonged moderate variability
- B. accelerations
- C. repetitive late decelerations
- D. variable decelerations
Correct Answer: C
Rationale: Fetal distress can be indicated by repetitive late decelerations, which show a lack of oxygen during labor.
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What is the most likely cause for this fetal heart rate pattern?
- A. Administration of an epidural for pain relief during labor
- B. Cord compression
- C. Breech position of fetus
- D. Administration of meperidine (Demerol) for pain relief during labor
Correct Answer: B
Rationale: The fetal heart rate pattern described in the question, which likely includes decelerations, is indicative of cord compression. Cord compression occurs when there is pressure on the umbilical cord, leading to temporary reduction or blockage of blood flow and oxygen supply to the fetus. This can result in variable decelerations in the fetal heart rate pattern. Common scenarios that can cause cord compression include changes in fetal position, cord prolapse, or excessive uterine contractions. It is important to promptly address cord compression to prevent fetal distress and potential complications during labor and delivery. The other options listed may also influence fetal heart rate, but in this scenario, cord compression is the most likely cause based on the described heart rate pattern.
How often is oxytocin usually increased for induction or augmentation of labor?
- A. every 10 minutes
- B. every 30 minutes
- C. every 60 minutes
- D. every 90 minutes
Correct Answer: C
Rationale: Oxytocin is typically increased every 60 minutes during labor induction.
The nurse recognizes that fetal scalp stimulation may be prescribed to evaluate the response of the fetus to tactile stimulation. Which conditions contraindicate the use of fetal scalp stimulation? (Select all that apply.)
- A. Post-term fetus
- B. Maternal fever
- C. Placenta previa
- D. Induction of labor
Correct Answer: A
Rationale: A. Post-term fetus: Fetal scalp stimulation can be contraindicated in post-term fetuses due to the potential risks associated with uterine hyperstimulation and decreased fetal reserve in these pregnancies.
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.
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.