Labor and Delivery skills quiz

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? a. change the woman's position b. assist with amnioinfusion c. insert a scalp electrode d. notify the health care provider

a. change the woman's position

How should the nurse document the duration of contractions based on the strip below? a. 45 seconds b. 90 seconds c. 60 seconds d. 120 seconds

c. 60 seconds

how should the nurse interpret the variability of this fetal heart tracing? a. early decelerations b. variable decelerations c. late decelerations

c. late decelerations

what is the most likely cause of the following fetal heart rate pattern? a. uteroplacental insufficiency b. cord compression c. prolapsed cord d. head compression

d. head compression

during labor, a fetus displays an average FHR of 135 bp, over a 10 minute period. which statement best describes the status of this fetus? a. bradycardia b. tachycardia c. hypoxia d. normal baseline heart rate

d. normal baseline heart rate

In which situation would the nurse be called on to stimulate the fetal scalp? a. as part of fetal scalp blood sampling b. in response to tocolysis c. in preparation for fetal oxygen saturation monitoring d. to elicit an acceleration in the FHR

d. to elicit an acceleration in the FHR

how should the nurse interpret the variability of this fetal heart tracing? a. early decelerations b. late decelerations c. variable decelerations

a. early decelerations

How should the nurse interpret the variability of this fetal heart tracing? a. no variability b. marked variability c. minimal variability d. moderative variability

a. no variability

A nurse is monitoring the contractions of the 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

1c, 2a, 3b, 4d

Which FHR finding is the most concerning to the nurse who is providing care to a laboring client? a. late decelerations b. average FHR of 126 bpm c. early decelerations d. accelerations with fetal movement

a. late decelerations

how should the nurse interpret the variability of this fetal heart tracing? a. moderate variability b. minimal variability c. marked variability d. no variability

a. moderate variability

During a nonstress test (NST), a nurse notes 3 fetal heart rate increases of 20 bpm, each lasting 20 seconds. these increases occur only with fetal movement. what does this finding suggest? a. the fetus is not in distress at this time b. the test is inconclusive at the time c. the client should undergo an oxytocin challenge test d. the fetus is nonreactive and hypoxic

a. the fetus is not in distress at this time

what is the most likely cause of variable FHR decelerations? a. umbilical cord compression b. fetal hypoxemia c. altered fetal cerebral blood flow d. uteroplacental insufficiency

a. umbilical cord compression

what is the most likely cause of the following fetal heart rate pattern? a. uteroplacental insufficiency b. prolapsed cord c. cord compression d. head compression

a. uteroplacental insufficiency

Which alteration in the FHR pattern would indicate the potential need for an amnioinfusion? a. Variable decelerations b. Late decelerations c. Fetal bradycardia d. Fetal tachycardia

a. variable decelerations

what is the most likely cause of the following fetal heart rate pattern? a. head compression b. cord compression c. uteroplacental insufficiency d. prolapsed cord

b. cord compression

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? a. late decelerations b. early decelerations c. prolonged decelerations d. variable decelerations

b. early decelerations

how should the nurse document the frequency of contractions based on the strip below? a. every 3 minutes b. every 2 minutes c. every 1 minute d. every 4 minutes

b. every 2 minutes

the nurse is evaluating the EFM tracing of the client who is in active labor. suddenly, the FHR drops from its baseline for 125 down to 80 bpm. the mother is repositioned, and the nurse provides oxygen, increases IV fluids, and performs a vaginal examination. the cervix has not changed. five minutes have passes, and the FHR ramiains in the 80s. what additional nursing measures should the nurse take next? a. insert a foley catheter b. immediately notify the care provider c. start administering pitocin d. call for help

b. immediately notify the care provider

Which characteristic correctly matches the type of deceleration with its likely cause? a. variable deceleration - head compression b. late deceleration - uteroplacental insufficiency c. early deceleration - umbilical cord compression d. prolonged deceleration - unknown cause

b. late deceleration - uteroplacental insufficiency

How should the nurse interpret the variability of this fetal heart tracing? a. no variability b. marked variability c. minimal variability d. moderate variability

b. marked variability

The nurse observes a sudden increase in variability on the ERM tracing. which class of medications may cause this finding? a. barbiturates b. methamphetamines c. narcotics d. tranquilizers

b. methamphetamines

How should the nurse interpret the variability of this fetal heart tracing? a. moderate variability b. minimal variability c. marked variability d. no variability

b. minimal variability

Umbilical cord prolapse occurs after spontaneous rupture of the membranes. what should the nurse do immediately? a. ask the client to begin pushing b. place the client in a Trendelenburg position c. administer oxytocin intravenously d. cover the cord with sterile towels

b. place the client in a Trendelenburg position

What is the most likely cause if the following fetal heart rate pattern? a. cord compression b. prolapsed cord c. head compression d. uteroplacental insufficiency

b. prolapsed cord

how should the nurse interpret the variability of this fetal heart tracing? a. nonreactive NST b. reactive NST

b. reactive NST

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? a. umbilical cord compression b. uteroplacental insufficiency c. altered cerebral blood flow d. meconium fluid

b. uteroplacental insufficiency

Which client would not be a suitable candidate for internal EFM? a. client whose cervix is dilated 4 to 5 cm b. woman whose fetus is well engaged in the pelvis c. client who still has intact membranes d. pregnant woman who has a comorbidity of obesity

c. client who still has intact membranes

Which statement best describes a normal uterine activity pattern in labor? a. contraction intensity of approximately 500 mmHg with relaxation at 50 mmHg b. contractions lasting approximately 2 minutes c. contractions every 2 to 5 minutes d. contractions approximately 1 minute apart

c. contractions every 2 to 5 minutes

while performing continuous electronic monitoring of a client in labor, the nurse should document which information about uterine contractions? a. dilation, duration, and frequency b. dilation, effacement, position c. duration, frequency, and intensity d. frequency, duration, maternal position

c. duration, frequency, and intensity

which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur? a. umbilical cord prolapse b. magnesium sulfate administration c. maternal fever d. regional anesthesia

c. maternal fever

What is the correct placement of the tocotransducer for effective EFM? a. inside the uterus b. over the mother's lower abdomen c. over the uterine fundus d. on the fetal scalp

c. over the uterine fundus

In which clinical situation would the nurse most likely anticipate fetal bradycardia? a. fetal anemia b. tocolytic treatment using terbutaline c. prolonged umbilical cord compression d. intraamniotic infection

c. prolonged umbilical cord compression

How should the nurse interpret the variability of this fetal heart tracing? a. early decelerations b. late decelerations c. variable decelerations

c. variable decelerations