Question 1

What is a distinct advantage of external EFM?

Accepted Answer

A)  The ultrasound transducer can accurately measure short-term variability and beat-to-beat changes in the FHR. 
B)  The tocotransducer can measure and record the frequency, regularity, intensity, and approximate duration of uterine contractions. 
C)  The tocotransducer is especially valuable for measuring uterine activity during the first stage of labor. 
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 short-term variability and beat-to-beat changes in the FHR. 
B)  The tocotransducer can measure and record the frequency, regularity, intensity, and approximate duration of uterine contractions. 
C)  The tocotransducer is especially valuable for measuring uterine activity during the first stage of labor. 
D)  Once correctly applied by the nurse, the transducer need not be repositioned even when the woman changes positions.

Question 2

The nurse who provides care to clients in labor must have a thorough understanding of the physiologic processes of maternal hypotension.Which outcome might occur if the interventions for maternal hypotension are inadequate?

Accepted Answer

A)  Early FHR decelerations 
B)  Fetal arrhythmias 
C)  Uteroplacental insufficiency 
D)  Spontaneous rupture of membranes 
A)  Early FHR decelerations 
B)  Fetal arrhythmias 
C)  Uteroplacental insufficiency 
D)  Spontaneous rupture of membranes

Question 3

The nurse is using intermittent auscultation (IA)to locate the fetal heartbeat.Which statement regarding this method of surveillance is accurate?

Accepted Answer

A)  The nurse can be expected to cover only two or three clients 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 immediately found, then a shift must be made to EFM. 
D)  Ultrasound can be used to find the FHR and to reassure the mother if the initial difficulty is a factor. 
A)  The nurse can be expected to cover only two or three clients 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 immediately found, then a shift must be made to EFM. 
D)  Ultrasound can be used to find the FHR and to reassure the mother if the initial difficulty is a factor.

Question 4

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description.

-Average of 10 mm Hg

Accepted Answer

A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time 
A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time

Question 5

What three measures should the nurse implement to provide intrauterine resuscitation?

Accepted Answer

A)  Call the provider, reposition the mother, and perform a vaginal examination. 
B)  Turn the client onto her side, provide oxygen (O₂) via face mask, and increase intravenous (IV) fluids. 
C)  Administer O₂ to the mother, increase IV fluids, and notify the health care provider. 
D)  Perform a vaginal examination, reposition the mother, and provide O₂ via face mask. 
A)  Call the provider, reposition the mother, and perform a vaginal examination. 
B)  Turn the client onto her side, provide oxygen (O₂) via face mask, and increase intravenous (IV) fluids. 
C)  Administer O₂ to the mother, increase IV fluids, and notify the health care provider. 
D)  Perform a vaginal examination, reposition the mother, and provide O₂ via face mask.

Question 6

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description.

-Generally ranging from two to five contractions per 10 minutes of labor

Accepted Answer

A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time 
A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time

Question 7

Which statement best describes a normal uterine activity pattern in labor?

Accepted Answer

A)  Contractions every 2 to 5 minutes 
B)  Contractions lasting approximately 2 minutes 
C)  Contractions approximately 1 minute apart 
D)  Contraction intensity of approximately 500 mm Hg with relaxation at 50 mm Hg 
A)  Contractions every 2 to 5 minutes 
B)  Contractions lasting approximately 2 minutes 
C)  Contractions approximately 1 minute apart 
D)  Contraction intensity of approximately 500 mm Hg with relaxation at 50 mm Hg

Question 8

The nurse observes a sudden increase in variability on the ERM tracing.Which class of medications may cause this finding?

Accepted Answer

A)  Narcotics 
B)  Barbiturates 
C)  Methamphetamines 
D)  Tranquilizers 
A)  Narcotics 
B)  Barbiturates 
C)  Methamphetamines 
D)  Tranquilizers

Question 9

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description.

-Remaining fairly stable throughout the first and second stages

Accepted Answer

A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time 
A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time

Question 10

What are the legal responsibilities of the perinatal nurses?

Accepted Answer

A)  Correctly interpreting FHR patterns, initiating appropriate nursing interventions, and documenting the outcomes 
B)  Greeting the client on arrival, assessing her status, and starting an IV line 
C)  Applying the external fetal monitor and notifying the health care provider 
D)  Ensuring that the woman is comfortable 
A)  Correctly interpreting FHR patterns, initiating appropriate nursing interventions, and documenting the outcomes 
B)  Greeting the client on arrival, assessing her status, and starting an IV line 
C)  Applying the external fetal monitor and notifying the health care provider 
D)  Ensuring that the woman is comfortable

Question 11

What is the correct placement of the tocotransducer for effective EFM?

Accepted Answer

A)  Over the uterine fundus 
B)  On the fetal scalp 
C)  Inside the uterus 
D)  Over the mother's lower abdomen 
A)  Over the uterine fundus 
B)  On the fetal scalp 
C)  Inside the uterus 
D)  Over the mother's lower abdomen

Question 12

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description.

-Peaking at 40 to 70 mm Hg in the first stage of labor

Accepted Answer

A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time 
A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time

Question 13

The perinatal nurse realizes that an FHR that is tachycardic,bradycardic,has late decelerations,or loss of variability is nonreassuring and is associated with which condition?

Accepted Answer

A)  Hypotension 
B)  Cord compression 
C)  Maternal drug use 
D)  Hypoxemia 
A)  Hypotension 
B)  Cord compression 
C)  Maternal drug use 
D)  Hypoxemia

Question 14

The baseline 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 client's most recent 10-minute segment on the monitor strip and notes a late deceleration.Which is likely to have caused this change?
(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 15

In which clinical situation would the nurse most likely anticipate a fetal bradycardia?

Accepted Answer

A)  Intraamniotic infection 
B)  Fetal anemia 
C)  Prolonged umbilical cord compression 
D)  Tocolytic treatment using terbutaline 
A)  Intraamniotic infection 
B)  Fetal anemia 
C)  Prolonged umbilical cord compression 
D)  Tocolytic treatment using terbutaline

Question 16

What is the most likely cause for early decelerations in the fetal heart rate (FHR)pattern?

Accepted Answer

A)  Altered fetal cerebral blood flow 
B)  Umbilical cord compression 
C)  Uteroplacental insufficiency 
D)  Spontaneous rupture of membranes 
A)  Altered fetal cerebral blood flow 
B)  Umbilical cord compression 
C)  Uteroplacental insufficiency 
D)  Spontaneous rupture of membranes

Question 17

What is the most likely cause for variable FHR decelerations?

Accepted Answer

A)  Altered fetal cerebral blood flow 
B)  Umbilical cord compression 
C)  Uteroplacental insufficiency 
D)  Fetal hypoxemia 
A)  Altered fetal cerebral blood flow 
B)  Umbilical cord compression 
C)  Uteroplacental insufficiency 
D)  Fetal hypoxemia

Question 18

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description.

-Commonly 45 seconds or more in the second stage of labor

Accepted Answer

A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time 
A) Frequency 
B) Duration 
C) Strength 
D) Resting tone 
E) Relaxation time

Question 19

A new client and her partner arrive on the labor,delivery,recovery,and postpartum (LDRP)unit for the birth of their first child.The nurse applies 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 nurse's best response?

Accepted Answer

A)  "Don't worry about that machine; that's my job." 
B)  "The baby's heart rate will fluctuate in response to what is happening during labor." 
C)  "The top line graphs the baby's heart rate, and the bottom line lets me know how strong the contractions are." 
D)  "Your physician will explain all of that later." 
A)  "Don't worry about that machine; that's my job." 
B)  "The baby's heart rate will fluctuate in response to what is happening during labor." 
C)  "The top line graphs the baby's heart rate, and the bottom line lets me know how strong the contractions are." 
D)  "Your physician will explain all of that later."

Question 20

What physiologic change occurs as the result of increasing the infusion rate of nonadditive IV fluids?

Accepted Answer

A)  Maintaining normal maternal temperature 
B)  Preventing normal maternal hypoglycemia 
C)  Increasing the oxygen-carrying capacity of the maternal blood 
D)  Expanding maternal blood volume 
A)  Maintaining normal maternal temperature 
B)  Preventing normal maternal hypoglycemia 
C)  Increasing the oxygen-carrying capacity of the maternal blood 
D)  Expanding maternal blood volume

Exam 18: Fetal Assessment During Labor

What is a distinct advantage of external EFM?

The nurse who provides care to clients in labor must have a thorough understanding of the physiologic processes of maternal hypotension.Which outcome might occur if the interventions for maternal hypotension are inadequate?

The nurse is using intermittent auscultation (IA)to locate the fetal heartbeat.Which statement regarding this method of surveillance is accurate?

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description. -Average of 10 mm Hg

What three measures should the nurse implement to provide intrauterine resuscitation?

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description. -Generally ranging from two to five contractions per 10 minutes of labor

Which statement best describes a normal uterine activity pattern in labor?

The nurse observes a sudden increase in variability on the ERM tracing.Which class of medications may cause this finding?

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description. -Remaining fairly stable throughout the first and second stages

What are the legal responsibilities of the perinatal nurses?

What is the correct placement of the tocotransducer for effective EFM?

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description. -Peaking at 40 to 70 mm Hg in the first stage of labor

The perinatal nurse realizes that an FHR that is tachycardic,bradycardic,has late decelerations,or loss of variability is nonreassuring and is associated with which condition?

In which clinical situation would the nurse most likely anticipate a fetal bradycardia?

What is the most likely cause for early decelerations in the fetal heart rate (FHR)pattern?

What is the most likely cause for variable FHR decelerations?

Fetal well-being in labor can be measured by the response of the FHR to uterine contractions. Match the characteristic of normal uterine activity during labor with the correct description. -Commonly 45 seconds or more in the second stage of labor

What physiologic change occurs as the result of increasing the infusion rate of nonadditive IV fluids?

21st Century Maternity and Women’s Health Nursing

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Maximizing Comfort for the Laboring Woman

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