Question 1

The nurse admits a laboring patient at term. On review of the prenatal record, the patient's pregnancy has been unremarkable and she is considered low risk. In planning the patient's care, at what interval will the nurse intermittently auscultate (IA) the fetal heart rate during the first stage of labor?

Accepted Answer

A)  Every 10 minutes 
B)  Every 15 minutes 
C)  Every 30 minutes 
D)  Every 60 minutes

Question 2

The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation?

Accepted Answer

A)  This pattern reflects variable decelerations. No interventions are necessary at this time. 
B)  Document this reassuring fetal heart rate pattern but decrease the rate of the intravenous (IV) fluid. 
C)  Continue to monitor these early decelerations, which occur as the fetal head is compressed during a contraction. 
D)  This deceleration pattern is associated with uteroplacental insufficiency, so the nurse acts quickly to improve placental blood flow and fetal oxygen supply.

Question 3

The fetal heart rate baseline increases 20 bpm after vibroacoustic stimulation. The best interpretation of this is that the fetus is showing:

Accepted Answer

A)  a worsening hypoxia. 
B)  progressive acidosis. 
C)  a reassuring response. 
D)  parasympathetic stimulation.

Question 4

The nurse is concerned that a client's uterine activity is too intense and that her obesity is preventing accurate assessment of the actual intrauterine pressure. Based on this information, which action should the nurse take?

Accepted Answer

A)  Reposition the tocotransducer. 
B)  Reposition the Doppler transducer. 
C)  Obtain an order from the health care provider for a spiral electrode. 
D)  Obtain an order from the health care provider for an intrauterine pressure catheter.

Question 5

A client is receiving oxytocin (Pitocin) to induce labor. The uterine contractions have become persistently hypertonic and the infusion is stopped. The health care provider has prescribed a tocolytic to stop contractions. Which medication should the nurse be prepared to administer?

Accepted Answer

A)  Naloxone (Narcan) 
B)  Terbutaline (Brethine) 
C)  Ephedrine 
D)  Diphenhydramine (Benadryl)

Exam 14: Intrapartum Fetal Surveillance

The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation?

The fetal heart rate baseline increases 20 bpm after vibroacoustic stimulation. The best interpretation of this is that the fetus is showing:

The nurse is concerned that a client's uterine activity is too intense and that her obesity is preventing accurate assessment of the actual intrauterine pressure. Based on this information, which action should the nurse take?

A client is receiving oxytocin (Pitocin) to induce labor. The uterine contractions have become persistently hypertonic and the infusion is stopped. The health care provider has prescribed a tocolytic to stop contractions. Which medication should the nurse be prepared to administer?