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| show | This deceleration pattern is associated with uteroplacental insufficiency. The nurse
must act quickly to improve placental blood flow and fetal oxygen supply.
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| Which maternal condition should be considered a contraindication for the application of internal monitoring devices? | show 🗑
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| show | Fetoscope
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| Proper placement of the tocotransducer for electronic fetal monitoring is | show 🗑
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| show | Variability
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| Which method of intrapartum fetal monitoring is the most appropriate when a woman has a history of hypertension during pregnancy? | show 🗑
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| Why is continuous electronic fetal monitoring generally used when oxytocin is administered? | show 🗑
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| The nurse is concerned that a patient’s uterine activity is too intense and that her obesity is preventing accurate assessment of the actual intrauterine pressure. Based on this information, which action should the nurse take? | show 🗑
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| show | Right lower
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| In which situation would a baseline fetal heart rate of 160 to 170 bpm be considered a normal finding? | show 🗑
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| When the deceleration pattern of the fetal heart rate mirrors the uterine contraction, which nursing action is indicated? | show 🗑
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| When the mother’s membranes rupture during active labor, the fetal heart rate should be observed for the occurrence of which periodic pattern? | show 🗑
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| The fetal heart rate baseline increases 20 bpm after vibroacoustic stimulation. The best interpretation of this is that the fetus is showing | show 🗑
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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? | show 🗑
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| show | Securely apply the tocotransducer with a strap or belt.
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| Which statement correctly describes the nurse’s responsibility related to electronic monitoring? | show 🗑
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| 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? | show 🗑
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| Which of the following therapeutic applications provides the most accurate information related to uterine contraction strength? | show 🗑
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| show | Cord compression
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| The patient presenting at 38 weeks’ gestation, gravida 1, para 0, vaginal exam 4 cm, 100% effaced, +1 station vertex. What is the most likely intervention for this fetal heart rate pattern? | show 🗑
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| show | +4 meconium-stained amniotic fluid on artificial rupture of membranes (AROM)
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| show | Reposition to left side-lying position.
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| show | maintain the normal assessment routine
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| To clarify the fetal condition when baseline variability is absent, the nurse should first | show 🗑
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| show | Obese patient whose contractions are 3 to 6 minutes apart, lasting 20 to 50 seconds
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| Which of the following is the priority intervention for the patient in a left side-lying position whose monitor strip shows a deceleration that extends beyond the end of the contraction? | show 🗑
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| show | position patient in a knee-chest position.
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| 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 | show 🗑
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| A patient at 41 weeks’ gestation is undergoing an induction of labor with an IV administration of oxytocin (Pitocin). The fetal heart rate starts to demonstrate a recurrent pattern of late decelerations with moderate variability. What is the nurse’s prior | show 🗑
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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 care, at what interval will the nurse intermittently auscultate (IA) the | show 🗑
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| The nurse is monitoring a patient in labor and notes this fetal heart rate pattern on the electronic fetal monitoring strip (see figure). Which is the most appropriate nursing action? | show 🗑
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| The nurse is monitoring a patient in labor and notes this fetal heart rate pattern on the electronic fetal monitoring strip (see figure). Which is the most appropriate nursing action at this time? | show 🗑
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| show | Baseline tachycardia
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| show | All of the above
a.Oxytocin (Pitocin)
b. Misoprostol (Cytotec)
c. Dinoprostone (Cervidil)
d. Methylergonovine maleate (Methergine)
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| show | a.baroreceptors.
b. adrenal glands.
c. chemoreceptors.
e. automatic nervous system
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| 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.) | show 🗑
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| The nurse is preparing supplies for an amnioinfusion on a patient with intact membranes. Which supplies should the nurse gather? (Select all that apply.) | show 🗑
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| The nurse is explaining the physiology of uterine contractions to a group of nursing students. Which statement best explains the maternal-fetal exchange of oxygen and waste products during a contraction? | show 🗑
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| The nurse is directing an unlicensed assistive personnel (UAP) to obtain maternal vital signs between contractions. Which statement is the appropriate rationale for assessing maternal vital signs between contractions rather than at another interval? | show 🗑
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| show | respiratory alkalosis.
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| Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet? | show 🗑
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| The laboring patient asks the nurse how the labor contractions cause the cervix to dilate. The nurse responds that labor contractions facilitate cervicle dilation by | show 🗑
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| show | Increased blood volume
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| The nurse is assessing the duration of a patient’s labor contractions. Which method does the nurse implement to assess the duration of labor contractions? | show 🗑
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| Which physiologic event is the key indicator of the commencement of true labor? | show 🗑
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| show | Flexion
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| show | lightening
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| A patient just delivered her baby via the vaginal route. The patient asks the nurse why the baby’s head is not round, but oval. Which explanation should the nurse provide the patient? | show 🗑
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| show | Active phase
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| show | The patient is requesting pain medication.
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| show | The acme
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| A patient in labor presents with a breech presentation. The nurse understands that a breech presentation is associated with | show 🗑
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| The primary difference between the labor of a nullipara and that of a multipara is | show 🗑
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| Which maternal factor may inhibit fetal descent during labor? | show 🗑
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| Which assessment finding would cause a concern for a patient who had delivered vaginally? | show 🗑
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| show | Notify the health care provider.
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| show | Bloody mucus drainage from vagina
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| If a notation on the patient’s health record states that the fetal position is LSP, this indicates that the | show 🗑
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| To determine if the patient is in true labor, the nurse would assess for changes in | show 🗑
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| The health care provider for a laboring patient makes the following entry into the patient’s record: 3/50%+.. What instruction will the nurse implement with the patient? | show 🗑
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| show | On her left side
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| The primiparous patient at 39 weeks’ gestation states to the nurse, “I can breathe easier now.” What is the nurse’s most appropriate response? | show 🗑
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| The nurse assesses a laboring patient’s contraction pattern and notes the frequency at every 3 to 4 minutes, duration 50 to 60 seconds, and the intensity is is moderate by palpation. What is the most accurate documentation for this contraction pattern? | show 🗑
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| A laboring patient states to the nurse, “I have to push!” What is the next nursing action? | show 🗑
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| After birth of the placenta the patient states, “All of a sudden I feel very cold.” What is the most appropriate nursing action at this time? | show 🗑
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| A 28-year-old gravida 1, para 0 patient who is at term calls the labor and birth unit stating that she thinks she is in labor. She states that she does have some vaginal discharge and feels wet; however, it is not bloody in nature. She relates a contracti | show 🗑
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| A patient asks the nurse how she can tell if labor is real. Which information should the nurse provide to this patient? (Select all that apply.) | show 🗑
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| The nurse who elects to practice in the area of obstetrics often hears discussion regarding the four Ps. What are the four Ps that interact during childbirth? (Select all that apply.) | show 🗑
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| show | Offer the patient a warm blanket.
Place an ice pack on the perineum.
Massage the uterus if it is boggy.
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| show | gush of blood appears.
The uterus rises upward in the abdomen.
The cord descends further from the vagina.
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| The clinical nurse educator is providing instruction to a group of new nurses during labor orientation. Which information regarding the factors that have a role in the initiation of labor should the educator include in this teaching session? (Select all t | show 🗑
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