Question 1

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

Accepted Answer

A)  Every hour in the active phase of the first stage of labour in the absence of risk factors 
B)  Every 20 minutes in the second stage,regardless of whether risk factors are present 
C)  Before and after ambulation and rupture of membranes 
D)  More often in a woman's first pregnancy 
A)  Every hour in the active phase of the first stage of labour in the absence of risk factors 
B)  Every 20 minutes in the second stage,regardless of whether risk factors are present 
C)  Before and after ambulation and rupture of membranes 
D)  More often in a woman's first pregnancy C

Question 2

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

Accepted Answer

A)  Accelerations with fetal movement 
B)  Early decelerations 
C)  An average FHR of 126 beats/min 
D)  Late decelerations 
A)  Accelerations with fetal movement 
B)  Early decelerations 
C)  An average FHR of 126 beats/min 
D)  Late decelerations D

Question 3

Which is a cause of early decelerations?

Accepted Answer

A)  Transient fetal head compression 
B)  Umbilical cord compression 
C)  Uteroplacental insufficiency 
D)  Spontaneous rupture of membranes 
A)  Transient fetal head compression 
B)  Umbilical cord compression 
C)  Uteroplacental insufficiency 
D)  Spontaneous rupture of membranes A

Question 4

Which is a reason that a nurse might be directed to stimulate the fetal scalp?

Accepted Answer

A)  As part of fetal scalp blood sampling 
B)  In preparation for tocolysis 
C)  To implement fetal oxygen saturation monitoring 
D)  To elicit an acceleration in the fetal heart rate (FHR) 
A)  As part of fetal scalp blood sampling 
B)  In preparation for tocolysis 
C)  To implement fetal oxygen saturation monitoring 
D)  To elicit an acceleration in the fetal heart rate (FHR)

Question 5

The nurse caring for a woman in labour understands that which is related to prolonged decelerations?

Accepted Answer

A)  They are a continuing pattern of benign decelerations that do not require intervention. 
B)  They constitute a baseline change when they last longer than 5 minutes. 
C)  They can be gradual or abrupt and are at least 15 beats/min below the baseline. 
D)  They require the usual fetal monitoring by the nurse. 
A)  They are a continuing pattern of benign decelerations that do not require intervention. 
B)  They constitute a baseline change when they last longer than 5 minutes. 
C)  They can be gradual or abrupt and are at least 15 beats/min below the baseline. 
D)  They require the usual fetal monitoring by the nurse.

Question 6

What should the nurse know when assisting a patient with pushing and positioning during labour?

Accepted Answer

A)  Encourage the woman's cooperation in avoiding the supine position. 
B)  Advise the woman to avoid the semi-Fowler position. 
C)  Encourage the woman to hold her breath and tighten her abdominal muscles to produce a vaginal response. 
D)  Instruct the woman to open her mouth and close her glottis,letting air escape after the push. 
A)  Encourage the woman's cooperation in avoiding the supine position. 
B)  Advise the woman to avoid the semi-Fowler position. 
C)  Encourage the woman to hold her breath and tighten her abdominal muscles to produce a vaginal response. 
D)  Instruct the woman to open her mouth and close her glottis,letting air escape after the push.

Question 7

Which is true in relation to accelerations with fetal movement?

Accepted Answer

A)  They are considered normal. 
B)  They are caused by umbilical cord compression. 
C)  They warrant close observation. 
D)  They are caused by uteroplacental insufficiency. 
A)  They are considered normal. 
B)  They are caused by umbilical cord compression. 
C)  They warrant close observation. 
D)  They are caused by uteroplacental insufficiency.

Question 8

Which should the nurse be aware of when using intermittent auscultation (IA)to record the fetal heart rate (FHR)?

Accepted Answer

A)  The uterus is palpated for absence of activity. 
B)  The frequency and duration of contractions are measured in seconds for consistency. 
C)  Contraction intensity is given a number of 1 to 7 by the nurse and patient together. 
D)  The resting tone between contractions is described as either placid or turbulent. 
A)  The uterus is palpated for absence of activity. 
B)  The frequency and duration of contractions are measured in seconds for consistency. 
C)  Contraction intensity is given a number of 1 to 7 by the nurse and patient together. 
D)  The resting tone between contractions is described as either placid or turbulent.

Question 9

While evaluating an external monitor tracing of a woman in active labour whose labour 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.What should the nurse do?

Accepted Answer

A)  Change the woman's position. 
B)  Discontinue the oxytocin infusion. 
C)  Insert an internal monitor. 
D)  Document the finding in the patient's record. 
A)  Change the woman's position. 
B)  Discontinue the oxytocin infusion. 
C)  Insert an internal monitor. 
D)  Document the finding in the patient's record.

Question 10

Which deceleration pattern is considered a normal finding in fetal heart monitoring?

Accepted Answer

A)  Early decelerations 
B)  Late decelerations 
C)  Variable decelerations 
D)  Prolonged decelerations 
A)  Early decelerations 
B)  Late decelerations 
C)  Variable decelerations 
D)  Prolonged decelerations

Question 11

Which characterizes a normal uterine activity pattern in labour?

Accepted Answer

A)  Contractions every 2 to 5 minutes 
B)  Contractions lasting about 2 minutes 
C)  Contractions about 1 minute apart 
D)  A contraction intensity of about 1000 mm Hg with relaxation at 50 mm Hg 
A)  Contractions every 2 to 5 minutes 
B)  Contractions lasting about 2 minutes 
C)  Contractions about 1 minute apart 
D)  A contraction intensity of about 1000 mm Hg with relaxation at 50 mm Hg

Question 12

What is an advantage of external electronic fetal monitoring?

Accepted Answer

A)  The ultrasound transducer can accurately measure variability in the fetal heart rate. 
B)  The tocotransducer can measure and record the frequency,regularity,intensity,and approximate duration of uterine contractions (UCs). 
C)  The tocotransducer is especially valuable for measuring uterine activity during the first stage of labour. 
D)  Once correctly applied by the nurse,the transducer need not be repositioned even when the woman changes positions. 
A)  The ultrasound transducer can accurately measure variability in the fetal heart rate. 
B)  The tocotransducer can measure and record the frequency,regularity,intensity,and approximate duration of uterine contractions (UCs). 
C)  The tocotransducer is especially valuable for measuring uterine activity during the first stage of labour. 
D)  Once correctly applied by the nurse,the transducer need not be repositioned even when the woman changes positions.

Question 13

When is fetal bradycardia most common?

Accepted Answer

A)  Intra-amniotic infection 
B)  Fetal anemia 
C)  Prolonged umbilical cord compression 
D)  Treatment with atropine 
A)  Intra-amniotic infection 
B)  Fetal anemia 
C)  Prolonged umbilical cord compression 
D)  Treatment with atropine

Question 14

When using intermittent auscultation (IA)for fetal heart rate,what should the nurse be aware of?

Accepted Answer

A)  The nurse can be expected to cover only two or three patients when IA is the primary method of fetal assessment. 
B)  The best course is to use the descriptive terms associated with electronic fetal monitoring (EFM)when documenting results. 
C)  If the heartbeat cannot be found immediately,a shift must be made to EFM. 
D)  A doptone can be used to find the fetal heartbeat. 
A)  The nurse can be expected to cover only two or three patients when IA is the primary method of fetal assessment. 
B)  The best course is to use the descriptive terms associated with electronic fetal monitoring (EFM)when documenting results. 
C)  If the heartbeat cannot be found immediately,a shift must be made to EFM. 
D)  A doptone can be used to find the fetal heartbeat.

Question 15

Which is recommended for routine use during labour?

Accepted Answer

A)  Intermittent auscultation 
B)  Continuous external monitoring 
C)  Fetal pulse oximetry 
D)  Fetal scalp blood pH 
A)  Intermittent auscultation 
B)  Continuous external monitoring 
C)  Fetal pulse oximetry 
D)  Fetal scalp blood pH

Question 16

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

Accepted Answer

A)  Altered cerebral blood flow 
B)  Fetal hypoxemia 
C)  Umbilical cord compression 
D)  Fetal sleep cycles 
A)  Altered cerebral blood flow 
B)  Fetal hypoxemia 
C)  Umbilical cord compression 
D)  Fetal sleep cycles

Question 17

A new patient and her partner arrive on the labour,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 baby's heart rate should be.What is the basis of the nurse's response?

Accepted Answer

A)  Labour support people do not need to know about EFM interpretation. 
B)  The top line graphs the baby's heart rate,which is between 110 and 160 but fluctuates somewhat. 
C)  The top line graphs the baby's heart rate,and the bottom line lets the nurse know how strong the contractions are. 
D)  Arrange for the health care provider to explain interpretation to the patient's partner. 
A)  Labour support people do not need to know about EFM interpretation. 
B)  The top line graphs the baby's heart rate,which is between 110 and 160 but fluctuates somewhat. 
C)  The top line graphs the baby's heart rate,and the bottom line lets the nurse know how strong the contractions are. 
D)  Arrange for the health care provider to explain interpretation to the patient's partner.

Question 18

When providing care for the labouring woman,which fetal heart rate (FHR)deviation should the nurse understand that amnioinfusion is used to treat?

Accepted Answer

A)  Variable decelerations 
B)  Late decelerations 
C)  Fetal bradycardia 
D)  Fetal tachycardia 
A)  Variable decelerations 
B)  Late decelerations 
C)  Fetal bradycardia 
D)  Fetal tachycardia

Question 19

Which best assesses fetal well-being during labour?

Accepted Answer

A)  The response of the fetal heart rate (FHR)to labour 
B)  Maternal pain control 
C)  Accelerations in the FHR 
D)  An FHR above 110 beats/min 
A)  The response of the fetal heart rate (FHR)to labour 
B)  Maternal pain control 
C)  Accelerations in the FHR 
D)  An FHR above 110 beats/min

Question 20

What should the nurse assess for when caring for the woman in labour who experiences maternal hypotension?

Accepted Answer

A)  Early decelerations 
B)  Fetal dysrhythmias 
C)  Fetal hypoxemia 
D)  Spontaneous rupture of membranes 
A)  Early decelerations 
B)  Fetal dysrhythmias 
C)  Fetal hypoxemia 
D)  Spontaneous rupture of membranes

Exam 19: Fetal Health Surveillance During Labour

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

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

Which is a cause of early decelerations?

Which is a reason that a nurse might be directed to stimulate the fetal scalp?

The nurse caring for a woman in labour understands that which is related to prolonged decelerations?

What should the nurse know when assisting a patient with pushing and positioning during labour?

Which is true in relation to accelerations with fetal movement?

Which should the nurse be aware of when using intermittent auscultation (IA)to record the fetal heart rate (FHR)?

While evaluating an external monitor tracing of a woman in active labour whose labour 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.What should the nurse do?

Which deceleration pattern is considered a normal finding in fetal heart monitoring?

Which characterizes a normal uterine activity pattern in labour?

What is an advantage of external electronic fetal monitoring?

When is fetal bradycardia most common?

When using intermittent auscultation (IA)for fetal heart rate,what should the nurse be aware of?

Which is recommended for routine use during labour?

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

When providing care for the labouring woman,which fetal heart rate (FHR)deviation should the nurse understand that amnioinfusion is used to treat?

Which best assesses fetal well-being during labour?

What should the nurse assess for when caring for the woman in labour who experiences maternal hypotension?

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