Labor and Delivery Quiz
A nurse is evaluating the external fetal monitoring strip of a client who is in labor. She notes decreases in the fetal heart rate (FHR) that start with the beginning of the client's contraction and return to baseline before the end of the contraction. What term does the nurse use to document this finding? Show answer choices Prolonged decelerations Late decelerations Variable decelerations Early decelerations
Early decelerations
A nurse is monitoring the contractions of a client in the first stage of labor. Order the phases of a uterine contraction from the beginning of contraction to its conclusion. All options must be used. a. Acme. b. Decrement. c. Increment. d. Relaxation. Show answer choices 1a, 2b, 3d, 4c 1a, 2d, 3b, 4c 1c, 2a, 3b, 4d 1b, 2a, 3c, 4d 1a, 2b, 3c, 4d
1c, 2a, 3b, 4d
While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the 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. What is the nurse's first priority? Show answer choices Notify the health care provider. Assist with amnioinfusion Insert a scalp electrode. Change the woman's position.
Change the woman's position.
Which client would not be a suitable candidate for internal EFM? Show answer choices Pregnant woman who has a comorbidity of obesity Client whose cervix is dilated to 4 to 5 cm Client who still has intact membranes Woman whose fetus is well engaged in the pelvis
Client who still has intact membranes
Which statement best describes a normal uterine activity pattern in labor? Show answer choices Contractions lasting approximately 2 minutes Contraction intensity of approximately 500 mm Hg with relaxation at 50 mm Hg Contractions every 2 to 5 minutes Contractions approximately 1 minute apart
Contractions every 2 to 5 minutes
The nurse is evaluating the EFM tracing of the client who is in active labor. Suddenly, the FHR drops from its baseline of 125 down to 80 beats per minute. The mother is repositioned, and the nurse provides oxygen, increased IV fluids, and performs a vaginal examination. The cervix has not changed. Five minutes have passed, and the FHR remains in the 80s. What additional nursing measures should the nurse take next? Show answer choices Insert a Foley catheter. Start administering Pitocin. Call for help. Immediately notify the care provider.
Immediately notify the care provider
Which characteristic correctly matches the type of deceleration with its likely cause? Show answer choices Variable deceleration—head compression Early deceleration—umbilical cord compression Prolonged deceleration—unknown cause Late deceleration—uteroplacental insufficiency
Late deceleration-uteroplacental insufficiency
Which FHR finding is the most concerning to the nurse who is providing care to a laboring client? Show answer choices Average FHR of 126 beats per minute Early decelerations Accelerations with fetal movement Late decelerations
Late decelerations
Which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur? Show answer choices Magnesium sulfate administration Regional anesthesia Maternal fever Umbilical cord prolapse
Maternal fever
The nurse observes a sudden increase in variability on the ERM tracing. Which class of medications may cause this finding? Show answer choices Barbiturates Narcotics Methamphetamines Tranquilizers
Methamphetamines
During labor a fetus displays an average FHR of 135 beats per minute over a 10-minute period. Which statement best describes the status of this fetus? Show answer choices Tachycardia Hypoxia Normal baseline heart rate Bradycardia
Normal baseline heart rate
Umbilical cord prolapse occurs after spontaneous rupture of the membranes. What should the nurse do immediately? Show answer choices Administer oxytocin intravenously. Place the client in a Trendelenburg position. Cover the cord with sterile towels. Ask the client to begin pushing.
Place the client in a Trendelenburg position.
In which clinical situation would the nurse most likely anticipate a fetal bradycardia? Show answer choices Prolonged umbilical cord compression Fetal anemia Tocolytic treatment using terbutaline Intraamniotic infection
Prolonged umbilical cord compression
During a nonstress test (NST), a nurse notes three fetal heart rate (FHR) increases of 20 beats/minute, each lasting 20 seconds. These increases occur only with fetal movement. What does this finding suggest? Show answer choices The fetus is nonreactive and hypoxic. The fetus is not in distress at this time. The test is inconclusive and must be repeated. The client should undergo an oxytocin challenge test.
The fetus is not in distress at this time.
In which situation would the nurse be called on to stimulate the fetal scalp? Show answer choices As part of fetal scalp blood sampling In response to tocolysis In preparation for fetal oxygen saturation monitoring To elicit an acceleration in the FHR
To elicit an acceleration in the FHR
What is the most likely cause for variable FHR decelerations? Show answer choices Umbilical cord compression Uteroplacental insufficiency Fetal hypoxemia Altered fetal cerebral blood flow
Umbilical cord compression
The nurse providing care for a high-risk laboring woman is alert for late FHR decelerations. Which clinical finding might be the cause for these late decelerations? Show answer choices Altered cerebral blood flow Uteroplacental insufficiency Meconium fluid Umbilical cord compression
Uteroplacental insufficiency
While performing continuous electronic monitoring of a client in labor, the nurse should document which information about uterine contractions? Show answer choices Frequency, duration, maternal position Dilation, duration, and frequency Dilation, effacement, position Duration, frequency, and intensity
duration, frequency, and intensity
What is the correct placement of the tocotransducer for effective EFM? Show answer choices On the fetal scalp Inside the uterus Over the uterine fundus Over the mother's lower abdomen
over the uterine fundus
Which alteration in the FHR pattern would indicate the potential need for an amnioinfusion? Show answer choices Fetal bradycardia Fetal tachycardia Late decelerations Variable decelerations
variables decelerations