Ch. 15

Question 1

Fetal bradycardia is most common during

Answer 1

Prolonged umbilical cord compression

Question 2

While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. The nurses first priority is to

Answer 2

Change the womans position

Question 3

The nurse caring for the laboring woman should understand that early decelerations are caused by

Answer 3

Altered fetal cerebral blood flow

Question 4

The nurse providing care for the laboring woman comprehends that accelerations with fetal movement

Answer 4

Are reassuring

Question 5

The nurse providing care for the laboring woman realizes that variable fetal heart rate (FHR) decelerations are caused by

Answer 5

Umbilical cord compression

Question 6

The nurse providing care for the laboring woman should understand that late fetal heart rate (FHR) decelerations are the result of

Answer 6

Uteroplacental insufficiency

Question 7

The nurse providing care for the laboring woman should understand that amnioinfusion is used to treat

Answer 7

Variable decelerations

Question 8

The nurse caring for the woman in labor should understand that maternal hypotension can result in

Answer 8

Uteroplacental insufficiency

Question 9

The nurse caring for a laboring woman is aware that maternal cardiac output can be increased by

Answer 9

Change in position

Question 10

While evaluating an external monitor tracing of a woman in active labor whose labor is being induced, the nurse notes that the fetal heart rate (FHR) begins to decelerate at the onset of several contractions and returns to baseline before each contraction ends. The nurse should

Answer 10

Document the finding in the clients record

Question 11

Which fetal heart rate (FHR) finding would concern the nurse during labor

Answer 11

Late decelerations

Question 12

The most common cause of decreased variability in the fetal heart rate (FHR) that lasts 30 minutes or less is

Answer 12

Fetal sleep cycles

Question 13

The baseline fetal heart rate (FHR) is the average rate during a 10-minute segment. Changes in FHR are categorized as periodic or episodic. These patterns include both accelerations and decelerations. The labor nurse is evaluating the patients most recent 10-minute segment on the monitor strip and notes a late deceleration. This is likely to be caused by which physiologic alteration

Answer 13

Placental abruption

Maternal supine hypotension

Question 14

A tiered system of categorizing FHR has been recommended by regulatory agencies. Nurses, midwives, and physicians who care for women in labor must have a working knowledge of fetal monitoring standards and understand the significance of each category. These categories include

Answer 14

Category I
Category II
Category III

Question 15

Increasing the infusion rate of nonadditive intravenous fluids can increase fetal oxygenation primarily by

Answer 15

Expanding maternal blood volume

Question 16

Why is continuous electronic fetal monitoring usually used when oxytocin is administered?

Answer 16

Uteroplacental exchange may be compromised

Question 17

The nurse knows that proper placement of the tocotransducer for electronic fetal monitoring is located

Answer 17

Over the uterine fundus

Question 18

Which maternal condition is considered a contraindication for the application of internal monitoring devices

Answer 18

Unruptured membranes

Question 19

The uterine contractions of a woman early in the active phase of labor are assessed by an internal uterine pressure catheter (IUPC). The nurse notes that the intrauterine pressure at the peak of the contraction ranges from 65 to 70 mm Hg and the resting tone range is 6 to 10 mm Hg. The uterine contractions occur every 3 to 4 minutes and last an average of 55 to 60 seconds. On the basis of this information, the nurse should

Answer 19

Document the findings because they reflect the expected contraction pattern for the active phase of labor

Question 20

In assisting with the two factors that have an effect on fetal status (i.e., pushing and positioning), nurses should

Answer 20

Encourage the womans cooperation in avoiding the supine position

Question 21

A nurse may be called on to stimulate the fetal scalp

Answer 21

To elicit an acceleration in the fetal heart rate (FHR)

Question 22

The nurse caring for a woman in labor understands that prolonged decelerations

Answer 22

Usually are isolated events that end spontaneously

Question 23

What correctly matches the type of deceleration with its likely cause

Answer 23

Late decelerationuteroplacental inefficiency

Question 24

Which deceleration of the fetal heart rate would not require the nurse to change the maternal position

Answer 24

Early decelerations

Question 25

Fetal well-being during labor is assessed by

Answer 25

The response of the fetal heart rate (FHR) to uterine contractions (UCs)

Question 26

You are evaluating the fetal monitor tracing of your client, who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother, provide oxygen, increase intravenous (IV) fluid, and perform a vaginal examination. The cervix has not changed. Five minutes have passed, and the fetal heart rate remains in the 80s. What additional nursing measures should you take?

Answer 26

Notify the care provider immediately

Question 27

What three measures should the nurse implement to provide intrauterine resuscitation? Select the response that best indicates the priority of actions that should be taken

Answer 27

Reposition the mother, increase intravenous (IV) fluid, and provide oxygen via face mask

Question 28

Perinatal nurses are legally responsible for

Answer 28

Correctly interpreting fetal heart rate (FHR) patterns, initiating appropriate nursing interventions, and documenting the outcomes

Question 29

As a perinatal nurse you realize that a fetal heart rate that is tachycardic, is bradycardic, or has late decelerations or loss of variability is nonreassuring and is associated with

Answer 29

Hypoxemia

Question 30

A new client and her partner arrive on the labor, delivery, recovery, and postpartum unit for the birth of their first child. You apply the electronic fetal monitor (EFM) to the woman. Her partner asks you to explain what is printing on the graph, referring to the EFM strip. He wants to know what the babys heart rate should be. Your best response is

Answer 30

The top line graphs the babys heart rate. Generally the heart rate is between 110 and 160. The heart rate will fluctuate in response to what is happening during labor.

Question 31

According to standard professional thinking, nurses should auscultate the fetal heart rate (FHR)

Answer 31

Before and after ambulation and rupture of membranes

Question 32

When using intermittent auscultation (IA) for fetal heart rate, nurses should be aware that

Answer 32

Ultrasound can be used to find the fetal heartbeat and reassure the mother if initial difficulty was a factor

Question 33

When using intermittent auscultation (IA) to assess uterine activity, the nurse should be cognizant that

Answer 33

The examiners hand should be placed over the fundus before, during, and after contractions

Question 34

What is an advantage of external electronic fetal monitoring

Answer 34

The tocotransducer is especially valuable for measuring uterine activity during the first stage of labor

Question 35

When assessing the relative advantages and disadvantages of internal and external electronic fetal monitoring, nurses comprehend that both

Answer 35

Can be used during the antepartum and intrapartum periods

Question 36

During labor a fetus with an average heart rate of 135 beats/min over a 10-minute period would be considered to have

Answer 36

A normal baseline heart rate

Question 37

The nurse caring for the woman in labor should understand that increased variability of the fetal heart rate may be caused by

Answer 37

Methamphetamines

Question 38

Commonly 45 seconds or more in the second stage of labor

Answer 38

Relaxation time

Question 39

Generally ranging from two to five contractions per 10 minutes of labor

Answer 39

Frequency

Question 40

Average of 10 mm Hg

Answer 40

Resting tone

Question 41

Peaking at 40 to 70 mm Hg in the first stage of labor

Answer 41

Strength

Question 42

Remaining fairly stable throughout the first and second stages

Answer 42

Duration