Question 1

Which maternal condition is considered a contraindication for the application of internal monitoring devices?

Accepted Answer

A)  Unruptured membranes 
B)  Cervix is dilated to 4 cm 
C)  External monitors are currently being used 
D)  Fetus has a known heart defect 
A)  Unruptured membranes 
B)  Cervix is dilated to 4 cm 
C)  External monitors are currently being used 
D)  Fetus has a known heart defect

Question 2

How does the available staff influence the selection of either continuous electronic or intermittent auscultation as the fetal-monitoring method?

Accepted Answer

A)  There must be a 1:1 nurse-to-patient ratio regardless of the method used. 
B)  Staffing patterns do not influence fetal monitoring choices. 
C)  Use of intermittent auscultation requires a lower nurse-to-patient ratio. 
D)  More nurses are needed when electronic fetal monitoring is used because of increased medical interventions. 
A)  There must be a 1:1 nurse-to-patient ratio regardless of the method used. 
B)  Staffing patterns do not influence fetal monitoring choices. 
C)  Use of intermittent auscultation requires a lower nurse-to-patient ratio. 
D)  More nurses are needed when electronic fetal monitoring is used because of increased medical interventions.

Question 3

When the deceleration pattern of the fetal heart rate mirrors the uterine contraction,which nursing action is indicated?

Accepted Answer

A)  Administer oxygen by nasal cannula. 
B)  Reposition the woman. 
C)  Apply a fetal scalp electrode. 
D)  Record this reassuring pattern. 
A)  Administer oxygen by nasal cannula. 
B)  Reposition the woman. 
C)  Apply a fetal scalp electrode. 
D)  Record this reassuring pattern.

Question 4

According to the NICHD Three-Tier System of Fetal Heart Rate Classification,Category III tracings include all FHR tracings not categorized as Category I or II.Which characteristics of the fetal heart belong in Category III? Select all that apply.

Accepted Answer

A)  Baseline rate of 110 to 160 bpm 
B)  Tachycardia 
C)  Absent baseline variability NOT accompanied by recurrent decelerations 
D)  Variable decelerations with other characteristics such as shoulders or overshoots 
E)  Absent baseline variability with recurrent variable decelerations
F) Bradycardia 
A)  Baseline rate of 110 to 160 bpm 
B)  Tachycardia 
C)  Absent baseline variability NOT accompanied by recurrent decelerations 
D)  Variable decelerations with other characteristics such as shoulders or overshoots 
E)  Absent baseline variability with recurrent variable decelerations
F) Bradycardia

Question 5

When using IA for FHR,nurses should be aware that

Accepted Answer

A)  They 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 EFM when documenting results. 
C)  If the heartbeat cannot be found immediately, a shift must be made to electronic monitoring. 
D)  Ultrasound can be used to find the fetal heartbeat and reassure the mother if initial difficulty was a factor. 
A)  They 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 EFM when documenting results. 
C)  If the heartbeat cannot be found immediately, a shift must be made to electronic monitoring. 
D)  Ultrasound can be used to find the fetal heartbeat and reassure the mother if initial difficulty was a factor.

Question 6

The baseline fetal heart rate (FHR)is the average rate during a 10-minute segment.Changes in FHR are categorized as periodic or episodic.These patterns include both accelerations and decelerations.The labor nurse is evaluating the patient's most recent 10-minute segment on the monitor strip and notes a late deceleration.This is likely to be caused by which physiologic alteration? Select all that apply.

Accepted Answer

A)  Spontaneous fetal movement 
B)  Compression of the fetal head 
C)  Placental abruption 
D)  Cord around the baby's neck 
E)  Maternal supine hypotension 
A)  Spontaneous fetal movement 
B)  Compression of the fetal head 
C)  Placental abruption 
D)  Cord around the baby's neck 
E)  Maternal supine hypotension

Question 7

When a nonreassuring pattern of the fetal heart rate is noted and the mother is lying on her left side,what nursing action is indicated?

Accepted Answer

A)  Lower the head of the bed. 
B)  Place the mother in a Trendelenburg position. 
C)  Change her position to the right side. 
D)  Place a wedge under the left hip. 
A)  Lower the head of the bed. 
B)  Place the mother in a Trendelenburg position. 
C)  Change her position to the right side. 
D)  Place a wedge under the left hip.

Exam 17: Intrapartum Fetal Surveillance

Which maternal condition is considered a contraindication for the application of internal monitoring devices?

How does the available staff influence the selection of either continuous electronic or intermittent auscultation as the fetal-monitoring method?

When the deceleration pattern of the fetal heart rate mirrors the uterine contraction,which nursing action is indicated?

According to the NICHD Three-Tier System of Fetal Heart Rate Classification,Category III tracings include all FHR tracings not categorized as Category I or II.Which characteristics of the fetal heart belong in Category III? Select all that apply.

When using IA for FHR,nurses should be aware that

When a nonreassuring pattern of the fetal heart rate is noted and the mother is lying on her left side,what nursing action is indicated?

Foundations of Maternity, Women’s Health, and Child Health Nursing

The Nurse’s Role in Maternity, Women’s Health, and Pediatric Nursing

The Childbearing and Child-Rearing Family

Communicating With Children and Families

Health Promotion for the Developing Child

Health Promotion for the Infant

Health Promotion during Early Childhood

Health Promotion for the School-Age Child

Health Promotion for the Adolescent

Hereditary and Environmental Influences on Development

Reproductive Anatomy and Physiology

Conception and Prenatal Development

Adaptations to Pregnancy

Nutrition for Childbearing

Prenatal Diagnostic Tests

Giving Birth

Pain Management for Childbirth

Nursing Care during Obstetric Procedures

Postpartum Adaptations

The Normal Newborn: Adaptation and Assessment

The Normal Newborn: Nursing Care

Newborn Feeding

The Childbearing Family With Special Needs

Pregnancy-Related Complications

Concurrent Disorders During Pregnancy

The Woman With an Intrapartum Complication

The Woman With a Postpartum Complication

The High-Risk Newborn: Problems Related to Gestational Age and Development

The High Risk Newborn: Acquired and Congenital Conditions

Management of Fertility and Infertility

Women’s Health Care

Physical Assessment of Children

Emergency Care of the Child

The Ill Child in the Hospital and Other Care Settings

The Child With a Chronic Condition or Terminal Illness

Principles and Procedures for Nursing Care of Children

Medication Administration and Safety for Infants and Children

Pain Management for Children

The Child With a Fluid and Electrolyte Alteration

The Child With an Infectious Disease

The Child With an Immunologic Alteration

The Child With a Gastrointestinal Alteration

The Child With a Genitourinary Alteration

The Child With a Respiratory Alteration

The Child With a Cardiovascular Alteration

The Child With a Hematologic Alteration

The Child With Cancer

The Child With an Alteration in Tissue Integrity

The Child With a Musculoskeletal Alteration

The Child With an Endocrine or Metabolic Alteration

The Child With a Neurologic Alteration

Psychosocial Problems in Children and Families

The Child With a Developmental Disability

The Child With a Sensory Alteration

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