ob practice questions remediation

3. Inspect her perineal area.

A multigravida in the active phase of labor says, "I feel all wet. I think I wet myself." What should the nurse do first? 1 Give her the bedpan. 2 Change the bed linens. 3 Inspect her perineal area. 4 Take an oral temperature.

4. Increased bloody show, irritability, and shaking Increased bloody show, irritability, and shaking are some of the classic signs of the transition phase of the first stage of labor. The increase in bloody show is related to the complete dilation of the cervix, the irritability is related to the intensity of contractions, and the shaking is believed to be a vasomotor response. Facial redness and an urge to push are associated with the start of the second stage of labor. A bulging perineum, crowning, and caput signal that birth is imminent. Less intense, less frequent contractions may signal uterine hypotonicity, which may occur throughout the first stage of labor.

Nursing assessment of a client in labor reveals that she is entering the transition phase of the first stage of labor. Which clinical manifestations support this conclusion? 1 Facial redness and an urge to push 2 Bulging perineum, crowning, and caput 3 Less intense, less frequent contractions 4 Increased bloody show, irritability, and shaking

1. Deep breathe slowly Slow, deep breathing expands the spaces between the ribs and raises the abdominal muscles, giving the uterus room to expand and preventing painful pressure of the uterus against the abdominal wall. Pelvic rocking is used to relieve pressure from back labor. Panting is used to halt or delay the expulsion of the infant's head before complete dilation has occurred. Patterned, paced breathing is used during the transition phase of the first stage; the client has not yet reached this phase.

A client and her partner are working together to achieve an unmedicated birth. The client's cervix is now dilated to 7 cm, and the presenting part is low in the midpelvis. What should the nurse instruct the client to do that will alleviate discomfort during contractions? 1 Deep-breathe slowly. 2 Perform pelvic rocking. 3 Use the panting technique. 4 Begin patterned, paced breathing.

4. Client's contractions will become longer and more frequent. This is an accurate description of contractions as labor progresses through the active portion of the first stage of labor. Nausea and vomiting occurs in the transition phase of the first stage of labor. More profuse bloody show and uncontrollable shaking of the legs occur in the transition phase of the first stage of labor.

A client in active labor is admitted to the birthing room. A vaginal examination reveals that her cervix is dilated 6 to 7 cm. In light of this finding, what does the nurse expect? 1 Client may experience nausea and vomiting. 2 Client's bloody show will become more profuse. 3 Client will experience uncontrollable shaking of her legs. 4 Client's contractions will become longer and more frequent.

1. "What activities does your job entail?" More information is needed before the nurse can give a professional response. Although it is important to ascertain the client's feelings about continuing to work, at this time she is seeking information. Although it is true that most women work throughout their pregnancies, more information is needed before the nurse can respond. It is misinformation to state that usually women quit work at the start of the third trimester.

A client on her first prenatal clinic visit is at 6 weeks' gestation. She asks how long she may continue to work and when she should plan to quit. How should the nurse respond? 1 "What activities does your job entail?" 2 "How do you feel about continuing to work?" 3 "Most women work throughout their pregnancies." 4 "Usually women quit work at the start of their third trimester."

4. Massaging their abdomens gently with their fingertips Effleurage is a gentle massage of the abdomen that is effective during the first stage of labor because it distracts the client from the discomfort of the contractions. Rocking gently on the knees, known as the pelvic rock, is used during pregnancy to relieve backache. Practicing panting to avoid pushing during labor is a technique of breathing. Taking deep breaths before imagined contractions is also a technique of breathing.

During a childbirth class the nurse determines that the women understand how to use effleurage correctly when they are observed doing what? 1 Rocking gently on their knees 2 Practicing panting to avoid pushing during labor 3 Taking deep breaths before imagined contractions 4 Massaging their abdomens gently with their fingertips

4. "Many women are able to first feel light movement between 18 and 20 weeks." Fetal movement can be felt after 18 weeks and usually by 20 weeks in a primigravida. Fetal movement is normally not felt before 18 weeks' gestation, when the uterus has risen into the abdomen. Fetal movement should continue to be felt at 24 weeks' gestation, but normally is felt 4 to 6 weeks before this time.

A 23-year-old primigravida is at her first prenatal appointment today. Ultrasound indicates that she is at 9 weeks' gestation. She asks when she can first expect to feel her baby move. What is the best response by the nurse? 1 "You should be able to feel the baby move any day now." 2 "You should feel your first light movement of the baby around 24 weeks." 3 "Most women can first detect movement of their babies by 12 to 14 weeks." 4 "Many women are able to first feel light movement between 18 and 20 weeks."

3. Chorionic villus sampling Chorionic villus sampling may be performed between 10 and 12 weeks' gestation. The nonstress test, which is not invasive, is a technique used for antepartum evaluation of the fetus; it does not reveal fetal defects. Amniocentesis may be performed after 14 weeks' gestation, when sufficient amniotic fluid is available. Direct access to the fetal circulation with percutaneous umbilical blood sampling may be performed during the second and third trimesters.

A 37-year-old woman agrees to have a prenatal test done in order to diagnose fetal defects. There is a history of Down syndrome in her family. Which invasive prenatal test provides the earliest diagnosis and rapid test results? 1 Nonstress test 2 Amniocentesis 3 Chorionic villus sampling 4 Percutaneous umbilical blood sampling

2 An NST indicates that the fetus is healthy because there is an active pattern of fetal heart rate acceleration with movement. The result is positive and desired; immediate birth is not required. Further testing is needed. If the pregnancy continues, another test of fetal well-being will probably be done. The results were positive, not inconclusive.

A 42-year-old client at 39 weeks' gestation has a reactive nonstress test (NST). What should the nurse explain to the client about the positive result? 1 Immediate birth is indicated. 2 This is the desired response at this stage of gestation. 3 Further testing is unnecessary with this desired outcome. 4 The result is inconclusive, indicating the need for further evaluation.

4. "Medication may interfere with the baby's first breaths; keep breathing." Analgesia crosses the placental barrier; when birth is imminent, it can cause respiratory depression in the newborn. The client is exhibiting fear and panic; a backrub at this time will not be effective and will probably be rejected. Stating that the client will get a shot when she reaches the birthing room is incorrect and provides false reassurance. Although acknowledging that the client is in pain is an empathic response, an explanation of why medication cannot be given is more appropriate in this situation.

A client in active labor is rushed from the emergency department to the labor and birth suite screaming, "Knock me out!" Examination reveals that her cervix is dilated 9 cm and 100% effaced. What should the nurse say while trying to calm the client? 1 "I'll rub your back—that will help ease your pain." 2 "You'll get a shot when you reach the birthing room." 3 "I'm sure you're in pain, but try to bear with it for the baby's sake." 4 "Medication may interfere with the baby's first breaths; keep breathing."

4. "If the heart reacts well, my baby should do OK when I give birth." The nonstress test is used to evaluate the response of the fetus to movement and activity. A reactive test indicates that the fetus is healthy. No injections of any kind are used during a nonstress test; it involves only the use of a fetal monitor to record the fetal heart rate during periods of activity. The nonstress test will not influence the activity of the fetus because no exogenous stimulus is used. Early labor is unlikely because the nonstress test is noninvasive.

A client is scheduled for a nonstress test in the 37th week of gestation. The nurse explains the procedure. Which statement demonstrates that the client understands the teaching? 1 "I'll need to have an IV so the medication can be injected before the test." 2 "My baby may get very restless after I have this test." 3 "I hope this test doesn't cause my labor to start too early." 4 "If the heart reacts well, my baby should do OK when I give birth."

3. Performs it 3 days after intercourse took place

A false-negative home pregnancy test may result if the woman does what when performing the test? 1 Saturates the test strip 2 Performs it in the first void of the morning 3 Performs it 3 days after intercourse took place 4 Performs it while taking a prescribed tranquilizer

3. "It will be administered during a contraction, when the uterine blood vessels are constricted." Giving the medication during a contraction, when the uterine vessels are constricted, keeps the medication within the maternal vascular system for several seconds and decreases the impact on the fetus. The other options are incorrect because none of these responses involves administration during a contraction.

A laboring client expresses concern about the effect that an intravenous analgesic may have on her fetus. What is the best response by the nurse to reassure the client? 1 "I'll dilute the medication so it won't have an immediate impact on the baby." 2 "I'll just give a half-dose of the medication while the uterus is in its relaxed phase." 3 "It will be administered during a contraction, when the uterine blood vessels are constricted." 4 "It will be administered in the proximal port of your IV so that you have immediate pain relief."

1. The amount of lochia rubra is moderate Red, distinctly blood-tinged vaginal flow (lochia rubra) is expected during the first few postpartum days and indicates that involution is progressing as it should. Clots indicate uterine atony, which prevents involution of the uterus. The status of the episiotomy is unrelated to the status of the uterus. Uterine cramps during breastfeeding are evidence that the uterus is undergoing appropriate involution.

A nurse caring for a client who gave birth to a healthy neonate evaluates the client's uterine tone 8 hours after delivery. How does the nurse determine that the uterus is demonstrating appropriate involution? 1 The amount of lochia rubra is moderate 2 Numerous clots are being passed vaginally 3 Bleeding from the episiotomy has stopped 4 Uterine cramps are absent during breastfeeding

2. Crown-to-rump measurement until 11 weeks Crown-to-rump measurement is used to determine the age of the embryo until 11 weeks. Occipital frontal diameter is not an ultrasound measurement used at term. Biparietal diameter at term will be approximately 9.8 cm. Diagonal conjugate is not used as an ultrasound measurement; it is the estimated size of the maternal pelvic outlet. The actual size of the pelvis as it relates to fetal size is best determined with ultrasonography.

A nurse is caring for a client during an ultrasonogram. Which parameters does the nurse expect to be used in the determination of pregnancy dates? 1 Occipital frontal diameter at term 2 Crown-to-rump measurement until 11 weeks 3 Biparietal diameter of 12 cm or more at term 4 Diagonal conjugate between 26 and 37 weeks

3. Left occipitoanterior (LOA) In the LOA position, the small parts are on the right, the smooth back is on the left, and the head is in the pelvis. The LSP position is a breech position, and therefore the fetal head will not be in the pelvic area; the data reveal a hard, round, movable object in the pubic area, which indicates that the fetus is in the vertex position. The RSP position is a breech position, and therefore the fetal head will not be in the pelvic area. In the ROA position, the small parts will be on the left and the smooth back on the right.

A nurse performs Leopold's maneuvers on a pregnant client and documents the following data: soft, firm mass in the fundus; several small parts on the right side; hard, round, movable object in pubic area; and cephalic prominence on right side. Applying these findings, which fetal position does the nurse identify? 1 Left sacroposterior (LSP) 2 Right sacroposterior (RSP) 3 Left occipitoanterior (LOA) 4 Right occipitoanterior (ROA)

4. "After birth, the vagina gradually decreases in size and returns to its pre-pregnancy state." During the postpartum period, normal anatomic and physiological changes occur. After a birth, the vagina gradually decreases in size; however, does not return to its pre-pregnancy state. The capacity of the bladder increases postpartum, which may lead to a decreased urge to void. The uterus returns to a nonpregnant state after birth in a process known as involution. The uterus involutes to approximately 350 g by two weeks after birth. During labor, the cervix dilates to approximately 10 cm; the dilation decreases to 2 to 3 cm by the second or third postpartum day.

A nursing student is learning about expected postpartum anatomic and physiologic changes. Which statement made by the nursing student indicates a need for further learning? 1 "The capacity of the bladder increases postpartum." 2 "The uterus involutes to approximately 350 g by two weeks after birth." 3 "The cervical dilation decreases to 2 to 3 cm by the second or third postpartum day." 4 "After birth, the vagina gradually decreases in size and returns to its pre-pregnancy state."

2

A pregnant client is being prepared for a pelvic examination. She reports that she is always tired and feels sick to her stomach, especially in the morning. What is the ideal response by the nurse? 1 "Tell me how you feel the rest of the day." 2 "Let's discuss ways to resolve these common problems." 3 "Perhaps you should ask your healthcare provider about it." 4 "Both of those problems are common in pregnant women. Don't worry about it."

3. Anterior pituitary gland

A primigravida asks the nurse, "I've got this blotchy skin on my face, my nipples are darker, and there's this dark line down the middle of my stomach. What causes that?" The nurse explains that the gland that causes these expected changes during pregnancy is the what? 1 Adrenal gland 2 Thyroid gland 3 Anterior pituitary gland 4 Posterior pituitary gland

3. Greenish-tinged amniotic fluid Greenish amniotic fluid is common in a breech presentation because the contracting uterus exerts pressure on the fetus's lower colon, forcing the expulsion of meconium. Mild bloody show is expected; a heavier flow is a deviation from the expected response and not a common finding with breech presentations. Fetal heart rate irregularities are not specific to a breech presentation. Severe back pain is more likely to occur when the fetus is in a cephalic presentation and the occiput is in the posterior position.

A primigravida client is admitted to the birthing unit in active labor. The fetus is in a breech presentation. Which physiologic response does the nurse expect during this client's labor? 1 Heavy vaginal bleeding 2 Fetal heart rate irregularities 3 Greenish-tinged amniotic fluid 4 Severe back pain with contractions

3. Transition The transition phase is the most difficult phase of labor. Characterized by restlessness, irritability, nausea, and increased bloody show, it continues from 8 to 10 cm of dilation. The latent phase is early labor (1 to 4 cm of dilation). It is relatively easy to tolerate, and the client generally is in control and not too uncomfortable. The active phase lasts from about 4 to 6 cm of dilation. It is difficult, but is not accompanied by nausea, irritability, or an increase in bloody show. The early active phase lasts from about 4 to 6 of cm dilation. It is difficult, but is not accompanied by nausea, irritability, or an increase in bloody show.

A vaginal examination reveals that a client in labor is dilated 8 cm. Soon afterward she becomes nauseated and has the hiccups. The bloody show increases. Which phase of labor does the nurse determine the client is entering? 1 Latent 2 Active 3 Transition 4 Early active

2. Hemodilution The increase in circulating blood volume during pregnancy is reflected in lower hemoglobin and hematocrit readings (physiological anemia of pregnancy). Infection does not lead to a lower hematocrit. The history reveals no prenatal problems, and weight gain is adequate. In the absence of other significant signs and symptoms, concealed bleeding is unlikely.

A woman's pregnancy has been uneventful, and she has gained 25 lb (11.3 kg). At term her hemoglobin level is 10.6 g/dL (106 mmol/L) and her hematocrit is 31%. What is the physiologic reason for these hemoglobin and hematocrit levels? 1 Infection 2 Hemodilution 3 Nutritional deficits 4 Concealed bleeding

1. Gently guiding the head downward After the newborn's head has rotated externally, the nurse gently guides the head downward for the birth of the anterior shoulder. Gradually flexing the head toward the mother's thigh, gently putting pressure on the head by pulling upward, and gradually extending the head above the mother's symphysis pubis are all contraindicated.

After being transported to the hospital by the ambulance, a pregnant woman is brought into the emergency department on a stretcher. During the assessment the nurse notes that the fetus's head has emerged. How should the nurse assist the mother in the birth of the fetus' anterior shoulder? 1 Gently guiding the head downward 2 Gradually flexing the head toward the mother's thigh 3 Gently putting pressure on the head by pulling upward 4 Gradually extending the head above the mother's symphysis pubis

4. Placing the client in the semi-Fowler position to increase cervical pressure Placing the client in the semi-Fowler position forces the heavy uterus to put pressure on the blood vessels at the site of the separating placenta, controlling bleeding to some extent. There is no indication that the clotting mechanism is disturbed. Performing a rectal examination is contraindicated with placenta previa; it may further dislodge the placenta. Enemas are contraindicated in any client admitted with vaginal bleeding.

Early in the ninth month of pregnancy a client experiences painless vaginal bleeding and is admitted to the hospital. What should the client's plan of care include? 1 Giving vitamin K to promote clotting t2 Performing a rectal examination to assess cervical dilation 3 Administering an enema to prevent contamination during birth 4 Placing the client in the semi-Fowler position to increase cervical pressure

1. Stop the oxytocin (Pitocin) infusion. The contraction pattern indicates hyperstimulation of the uterus. Stopping the oxytocin infusion permits relaxation of the uterus and perfusion of the placenta. Oxygen cannot reach the placenta until the uterus is relaxed, so administering oxygen will not help. Increasing the rate of delivery of the main line fluid does not affect hyperstimulation of the uterus. Insertion of an intrauterine pressure catheter will only provide measurement of the internal uterine pressure and will not affect uterine contractions.

The electronic fetal monitor displays contractions every 2 minutes and lasting 95 seconds. What is the nurse's highest priority intervention at this time? 1 Stop the oxytocin (Pitocin) infusion. 2 Administer oxygen at 8 to 10 L/min. 3 Increase the main line fluid delivery rate to 150 mL/hr. 4 Prepare the client for insertion of an intrauterine pressure catheter.

3

The membranes of a client who is at 39 weeks' gestation have ruptured spontaneously. Examination in the emergency department reveals that her cervix is dilated 4 cm and 75% effaced, and the fetal heart rate is 136 beats/min. She and her partner are admitted to the birthing unit. What is the nurse's primary intervention upon the client's arrival to the unit? 1 Settle the client in bed and attach an external fetal monitor. 2 Have the client undress while taking her history from her partner. 3 Introduce the staff nurses to the couple and try to make them feel welcome. 4 Ask the couple to wait in the examining room while notifying the healthcare provider.

2. Cause decreased placental perfusion

The nurse instructs a pregnant woman in labor that she must avoid lying on her back. The nurse bases this instruction on the information that the supine position is primarily avoided because it can do what? 1 Prolong the course of labor 2 Cause decreased placental perfusion 3 Lead to transient episodes of hypertension 4 Interfere with free movement of the coccyx

2. Supine

The nurse is caring for a client in the first stage of labor. Which position is the least desirable for the client if she is experiencing lower back pain? 1 Sitting 2 Supine 3 Knee-chest 4 Left side-lying

1. "I'm not exactly sure how an epidural works." A description of the various anesthetic techniques and what they entail is essential to informed consent, even if the woman received information about analgesia and anesthesia earlier in her pregnancy. Nurses play a significant role in the informed consent process by clarifying and describing procedures or by acting as the woman's advocate and asking the primary healthcare provider for further explanation. There are three essential components of an informed consent. First, the procedure and its advantages and disadvantages must be thoroughly explained. Second, the woman must agree with the plan of labor pain management as explained to her. Third, her consent must be given freely without coercion or manipulation from the healthcare provider.

The nurse is preparing a client for epidural anesthesia. Which client statement would cause the nurse to stop the placement of the epidural catheter? 1 "I'm not exactly sure how an epidural works." 2 "I understand that the epidural might or might not take my pain away." 3 "I signed the consent form for an epidural at my last clinic appointment." 4 "I'm aware that the epidural could cause my contractions to slow down."

2. Each pregnancy is a unique experience that is stressful despite multiparity.

The nurse is preparing to counsel a client whose two previous pregnancies were uneventful, ending in term vaginal births of healthy children. What should the nurse consider regarding multiparas with previous uneventful pregnancies before beginning prenatal counseling? 1 Multiparas cope more successfully with pregnancy than do primigravidas. 2 Each pregnancy is a unique experience that is stressful despite multiparity. 3 This pregnancy will provoke a situational crisis because the client has two children at home. 4 Support people play a lesser role because the client has had two prior experiences with pregnancy.

1. "Breastfed infants have fewer infections." Maternal antibodies are transferred from the mother in breast milk, providing protection for a longer time than do antibodies transferred to the fetus by way of the placenta. The neonate is protected by the antibodies. The fetus' own antibody system is immature at birth. Women who breastfeed completely (day and night with no supplementary feedings) may avoid ovulation and resumption of the menstrual cycle. Use of formula or solid foods decreases breastfeeding frequency and can lead to ovulation. Ovulation generally occurs before menses, making it difficult to know when the menstrual cycle is resuming. Therefore, breastfeeding is considered one of the least reliable methods of contraception for the new mother. Because of the higher carbohydrate content of breast milk, which is digested rapidly, breastfed infants wake more frequently than formula-fed infants. Their feeding demands take more time to regulate than do the formula-fed infants'. Breast milk has 1.1 g protein/100 mL; cow's milk has 3.5 g/100 mL. Whole cow's milk is unsuitable for infants.

The nurse is teaching participants in a prenatal class regarding breastfeeding versus formula feeding. A client asks, "What is the primary advantage of breastfeeding?" Which response is most appropriate? 1 "Breastfed infants have fewer infections." 2 "Breastfeeding inhibits ovulation in the mother." 3 "Breastfed infants adhere more easily to a feeding schedule." 4 "Breastfeeding provides more protein than cow's milk formula does."

2. Hemoglobin: 10.8 g/dL (108 mmol/L) The hemoglobin level of a healthy individual is 12 to 16 g/dL (120 to 160 mmol/L). During pregnancy it may decrease as a result of an increased blood volume, especially during the second trimester. The hemodilution is greater than a concomitant increase in RBC production, causing physiological anemia. If the hemoglobin decreases to less than 11 g/dL (110 mmol/L), anemia, probably due to a deficiency of iron or folic acid, is diagnosed. Iron supplementation may need to be increased. The expected platelet level is 150,000 to 400,000 mm3 (150 × 109/L to 400 × 109/L). There should be no significant change in this level throughout pregnancy. The expected fasting blood glucose is 70 to 105 mg/dL (3.9 to 5.8 mmol/L); it begins to rise in the second trimester and peaks in the third trimester.

The nurse reviews the blood test results of a client at 24 weeks' gestation. Which finding should be reported to the healthcare provider? 1 Platelets: 230,000 mm3 (230 × 109/L) 2 Hemoglobin: 10.8 g/dL (108 mmol/L) 3 Fasting blood glucose: 90 mg/dL (4.2 mmol/L) 4 White blood cell count: 10,000 mm3 (10 × 109/L)

4. It will prevent adequate blood flow to the fetus. When the pregnant woman lies supine, pressure of the uterus against the vena cava reduces circulation; decreased perfusion of the placenta results in decreased blood flow to the fetus. The supine position should not precipitate a headache, although it can lead to supine hypotension. Although the supine position can prolong labor, it is not the primary reason for a position change. As labor progresses toward the transition phase, nausea may occur; this is unrelated to the client's position.

Upon arriving in the birthing room the nurse finds the client lying on her back with her head on a pillow and the bed in a flat position. The nurse explains that it is important to avoid lying in the supine position because of what reason? 1 It may precipitate a severe headache. 2 It can impede the progression of labor. 3 It may cause nausea as labor progresses. 4 It will prevent adequate blood flow to the fetus.

4. Exposing as much skin as possible by turning the infant every 2 hours

What is a priority intervention for the infant undergoing phototherapy? 1 Covering the infant's face with a soft mask 2 Administering glucose water between breast or bottle feedings 3 Keeping the infant in the supine position with the genitals covered 4 Exposing as much skin as possible by turning the infant every 2 hours

1. Preparing the client for surgery

What is the priority nursing intervention for a laboring client with a sudden prolapse of the umbilical cord protruding from the vagina? 1 Preparing the client for surgery 2 Gently replacing the cord in the vaginal vault 3 Checking the fetal heart rate every 15 minutes 4 Starting oxygen at 10 L per minute via a tight face mask

3. An increase of 300 calories per day

What should a nurse include in nutritional planning for a newly pregnant woman of average height who weighs 145 lb (65.8 kg)? 1 A decrease of 100 calories per day 2 A decrease of 200 calories per day 3 An increase of 300 calories per day 4 An increase of 500 calories per day

3. Staphylococcus aureus Staphylococcus aureus is a resident organism of the skin; it is the causative agent of 95% of the infections that result in maternal mastitis. Escherichia coli is found in the lower intestinal tract; it is not associated with mastitis. Group B streptococcus rarely causes mastitis. Chlamydia trachomatis can cause neonatal pneumonia and conjunctivitis, not mastitis. Frequent hand washing by staff and clients may reduce the risk of infection.

Which microorganism causes maternal mastitis? 1 Escherichia coli 2 Group B streptococcus 3 Staphylococcus aureus 4 Chlamydia trachomatis

3. Elevate the lower extremities.

Which recommendation should the nurse provide a client with fluid retention during pregnancy? 1 Decrease fluid intake. 2 Maintain a high-sodium diet. 3 Elevate the lower extremities. 4 Ask the healthcare provider for a diuretic.

2. Increased production of estrogen Increased estrogen production during pregnancy causes hyperplasia of the vaginal mucosa, which leads to increased production of mucus by the endocervical glands. The mucus contains exfoliated epithelial cells. Increased (not decreased) metabolism leads to systemic changes, but does not increase vaginal discharge. The amount of secretion from the Bartholin glands, which lubricates the vagina during intercourse, remains unchanged during pregnancy. There is no additional supply of sodium chloride to the vaginal cells during pregnancy.

While conducting prenatal teaching, the nurse should explain to clients that there is an increase in vaginal secretions during pregnancy called leukorrhea. What causes this increase? 1 Decreased metabolic rate 2 Increased production of estrogen 3 Secretion from the Bartholin glands 4 Supply of sodium chloride to the vaginal cells

1. an acceleration pAn acceleration is an abrupt increase in FHR above the baseline of 15 beats/min for 15 seconds; if the acceleration persists for more than 10 minutes, it is considered a change in baseline rate. Early decelerations, not increases, occur. An early deceleration starts before the peak of the uterine contraction and returns to baseline when the uterine contraction ends. A sonographic motion is not a term used in fetal monitoring. A tachycardic FHR is one faster than 160 beats per minute.

While monitoring the fetal heart rate (FHR) of a client in labor, the nurse identifies an increase of 15 beats more than the baseline rate of 135 beats per minute that lasts 15 seconds. How should the nurse document this event? 1 An acceleration 2 An early increase 3 A sonographic motion 4 A tachycardic heart rate