Quiz 2 Chap 6, 8, 9
A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse?
"It assists in identifying the location of the placenta and fetus."
A nurse in a prenatal clinic is instructing a client about an amniocentesis, which is scheduled at 15 weeks of gestation. Which of the following should be included in the teaching?
"This test requires the presence of amniotic fluid."
A nurse is caring for a client during a nonstress test (NST). At the end of a 30-min period of observation, the nurse notes the following findings: The fetal heart rate baseline is 120/min with minimal variability and no accelerations. There are two decelerations of 15/min in the fetal heart rate during a period of fetal movement, each lasting 20 seconds. Which of the following interpretations of these findings should the nurse make?
A nonreactive test (should have two accelerations minimum in 20 min 15x15)
A nurse is teaching a client who is at 15 weeks of gestation and is to undergo an amniocentesis. The nurse should explain that the purpose of this test is to identify which of the following conditions? SATA
Anomalies in fetal chromosomes Neural tube defects Fetal gender
Rhogam is prescribed for a woman following an amniocentesis. Which statement by the woman indicates the woman understands the purpose of the medication?
This medication will prevent me from producing antibodies to RH positive antigens in my baby's blood
Which of the following indications is not a reason to perform a first trimester ultrasound?
To determine fetal gender
What is the main role of the nurse for a pregnant client?
To prioritize the client's needs
A nurse is caring for a client who is in active labor when the client's membranes rupture. The fetal monitor tracing shows late decelerations. Which of the following actions should the nurse take first?
Turn the client onto her side
A nurse is observing the electronic fetal heart rate monitor tracing for a client who is at 40 weeks of gestation and is in labor. The nurse should suspect a problem with the umbilical cord when she observes which of the following patterns?
Variable decelerations
A nurse is caring for a client who is in the first stage of labor, undergoing external fetal monitoring, and receiving IV fluids. The nurse observes variable decelerations in the fetal heart rate on the monitor strip. Which of the following is a correct interpretation of this finding?
Variable decelerations are due to umbilical cord compression
A nurse is caring for a client who is in the first stage of labor, undergoing external fetal monitoring, and receiving IV fluid. The nurse observes variable decelerations in the fetal heart rate on the monitor strip. Which of the following is a correct interpretation of this finding?
Variable decelerations are due to umbilical cord compressions
Complete the following sentences by using the list of options: The midwife is explaining to the patient how to palpate contractions during labor. The uterus should feel
soft resting tone
The mother is at a gestational age of 40-weeks, the nurse knows the fetus is descending in the cervical when the compression on the head shows what?
Early deceleration
The nurse is caring for a patient who is exhibiting the decelerations circled in the following picture. Which does the nurse assess related to the decelerations pictured? (picture shows early deceleration)
Early decelerations caused by head compression
A nurse is teaching a client who is at 23 weeks of gestation and will return to the facility in 2 days for an amniocentesis. Which of the following instructions should the nurse give the client?
Empty her bladder immediately prior to the procedure (prevents possible puncture)
A nurse is caring for a client who is to undergo a biophysical profile (BPP). The client asks the nurse what is being evaluated during this test. Which of the following should the nurse include? SATA
Fetal breathing Fetal motion Amniotic fluid volume
The nurse is caring for a client who is 10 weeks pregnant. The client asks the nurse when they should be able to feel the baby moving, how should the nurse respond?
Fetal movement is normally felt at 15-20 weeks
Where should the nurse place the TOCO?
Fundus
What are the complications of amniocentesis?
Hemorrhage Infection Preterm labor Bladder Injury Placenta, fetal or cord puncture
A nurse is providing teaching to a client who is at 30 weeks of gestation and is to have a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching?
I will have to lie on my back during the test."
A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client?
It is a screening test for spinal defects in the fetus (tests NTDs neural tube defects)
A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client? a. This test assesses fetal lung maturity
It is a screening test for spinal defects in the fetus (tests NTDs neural tube defects)
The nurse is reading the fetal heart rate and notices a late deceleration. What is the correct interpretation of this assessment finding?
Late decelerations are due to uteroplacental insufficiency/poor placental perfusion
Which of the following components of the fetal heart rate tracing would reassure the nurse of a well oxygenated baby and the absence of fetal acidemia?
Moderate variability
Select the specific attributes that are scored during biophysical profile BPP? SATA
NST Amniotic fluid Fetal breathing movements Fetal tone Fetal movement
A nurse in a clinic is caring for a client during a non-stress test. The nurse observes moderate variability. No accelerations or decelerations are present. What is the result of the NST?
Non-reactive test
A nurse is caring for a client who is having a nonstress test performed. The fetal heart rate (FHR) is 130-150/min, but there has been no fetal movement for 15 min. Which of the following actions should the nurse perform?
Offer the client a snack of orange juice and crackers
A nurse in the labor and delivery unit is caring for a client who is undergoing external fetal monitoring. The nurse observes that the fetal heart rate begins to slow after the start of a contraction and the lowest rate occurs after the peak of the contraction. Which of the following actions should the nurse take first?
Place the client in the lateral position (late deceleration associated with fetal hypoxemia due to insufficient placental perfusion.)
A nurse is reading a patient's chart with the following information: 32 year-old G3, P2, 0, 0, 2, at 34 weeks' gestation. FHR = 150bpm, fundal height is 31cm, AFI=28.7cm. This information would be consistent with which diagnosis?
Polyhydramnios
A nurse in a clinic is reviewing the medical records of a group of clients who are pregnant. The nurse should anticipate the provider will order a maternal serum alpha-fetoprotein (MSAFP) screening for which of the following clients?
All of the clients (maternal blood test recommended for all pregnant women. Tests spinal and abdominal wall defects in the fetus. Neural tube defects can happen due to teratogens or genetic issues)
The nurse understands that a healthy fetus at full term will have:
An acceleration of 15 beats per minute for 15 seconds in a 20- minute period (pre-term is 10x10)
A nurse is teaching a client who is at 15 weeks of gestation and is to undergo an amniocentesis. The nurse should explain that the purpose of this test is to identify which of the following conditions? SATA
Anomalies in fetal chromosomes Neural tube defects Fetal gender
A nurse is caring for a client who is in active labor and notes late decelerations in the FHR. Which of the following actions should the nurse take first?
Change the client's position
The woman who is 10 weeks pregnant agreed to have chorionic villus sampling to detect genetic disorder on her baby after receiving explanation from the doctor. The woman understands the procedure will involve what?
Collection of sample from an area in the placenta
You are precepting a new graduate nurse in the prenatal clinic and are explaining indications for ultrasound by trimester. For each indication for ultrasound, click to indicate which trimester the ultrasound would be performed in. Each row must have at least one, but may have more than one response option selected
Confirm fetal cardiac activity-> 1,2,3 Confirm placental location or position-> 2,3 Visualization during chorionic villus sampling-> 1 Estimate gestational age->1 Evaluate vaginal bleeding->1,2,3 Visualize for amniocentesis->2 Perform Doppler flow studies->3
A nurse receives report about a client who is in labor and is having contractions 4 min apart. Which of the following patterns should the nurse expect on the fetal monitoring tracing?
Contractions that last for 60 seconds each with a 3 min rest between contractions
A nurse is caring for a pregnant client. The client asks about kick counts. How should the nurse respond?
10 kicks every 2 hours, or 4 kicks every hour
The nurse is caring for a patient who is having contractions every 2-3 minutes and lasting 70-90 seconds. The FHR is 145bpm with minimal variability and repetitive late decelerations to 110s, lasting 60-100 seconds. What is an appropriate nursing intervention for this patient? (Next Gen, drop down, select 2)
Administer O2 at 10L/min via nonrebreather (POOF) Position patient on either side
The nurse knows that the FHR tracing indicates a category III abnormal fetal heart rate pattern when there is:
Absent variability
Which of the following are considered diagnostic tests? SATA
CVS PUBS Amniocentesis Blood sampling AFP
While assessing a pregnant patient, the nurse notes the fetal heart rate (FHR) is 125 with moderate variability, no accelerations, and no decelerations. Using the National Institute of Child Health and Human Development (NICHD) Criteria, which would the nurse record as the appropriate category related to the assessment findings?
Category I: Strongly predictive of a well-oxygenated, non-acidotic fetus. No action required
