Question 1

A nurse might be called on to stimulate the fetal scalp:

Accepted Answer

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 fetal heart rate (FHR) . D

Question 2

Perinatal nurses are legally responsible for:

Accepted Answer

A)  Correctly interpreting fetal heart rate (FHR)  patterns,initiating appropriate nursing interventions,and documenting the outcomes.
B)  Greeting the client on arrival,assessing her,and starting an intravenous line.
C)  Applying the external fetal monitor and notifying the care provider.
D)  Making sure that the woman is comfortable. A

Question 3

During labor a fetus with an average heart rate of 135 beats/min over a 10-minute period would be considered to have:

Accepted Answer

A)  Bradycardia.
B)  A normal baseline heart rate.
C)  Tachycardia.
D)  Hypoxia. B

Question 4

Which deceleration of the fetal heart rate would NOT require the nurse to change the maternal position?

Accepted Answer

A)  Early decelerations
B)  Late decelerations
C)  Variable decelerations
D)  It is always a good idea to change the woman's position.

Question 5

You are evaluating the fetal monitor tracing of your client,who is in active labor. Suddenly you see the fetal heart rate (FHR) drop from its baseline of 125 down to 80. You reposition the mother,provide oxygen,increase intravenous (IV) fluid,and perform a vaginal examination. The cervix has not changed. Five minutes have passed,and the fetal heart rate remains in the 80s. What additional nursing measures should you take?

Accepted Answer

A)  Scream for help.
B)  Insert a Foley catheter.
C)  Start pitocin.
D)  Notify the care provider immediately.

Question 6

In assisting with the two factors that have an effect on fetal status (i.e.,pushing and positioning),nurses should:

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.

Question 7

External fetal monitoring cannot detect the ____________________ of uterine contractions.

Accepted Answer

The answer of External fetal monitoring cannot detect the ____________________...

Question 8

The nurse caring for the woman in labor should understand that increased variability of the fetal heart rate might be caused by:

Accepted Answer

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

Question 9

The nurse providing care for the laboring woman should understand that late fetal heart rate (FHR) decelerations are caused by:

Accepted Answer

A)  Altered cerebral blood flow.
B)  Umbilical cord compression.
C)  Uteroplacental insufficiency.
D)  Meconium fluid.

Question 10

The nurse caring for the woman in labor should understand that maternal hypotension can result in:

Accepted Answer

A)  Early decelerations.
B)  Fetal dysrhythmias.
C)  Uteroplacental insufficiency.
D)  Spontaneous rupture of membranes.

Question 11

The nurse providing care for the laboring woman should understand that accelerations with fetal movement:

Accepted Answer

A)  Are reassuring.
B)  Are caused by umbilical cord compression.
C)  Warrant close observation.
D)  Are caused by uteroplacental insufficiency.

Question 12

The nurse caring for a woman in labor understands that prolonged decelerations:

Accepted Answer

A)  Are a continuing pattern of benign decelerations that do not require intervention.
B)  Constitute a baseline change when they last longer than 5 minutes.
C)  Usually are isolated events that end spontaneously.
D)  Require the usual fetal monitoring by the nurse.

Question 13

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

Accepted Answer

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

Question 14

When using intermittent auscultation (IA) to assess uterine activity,nurses should be aware that:

Accepted Answer

A)  The examiner's hand should be placed over the fundus before,during,and after contractions.
B)  The frequency and duration of contractions is measured in seconds for consistency.
C)  Contraction intensity is given a judgment number of 1 to 7 by the nurse and client together.
D)  The resting tone between contractions is described as either placid or turbulent.

Question 15

What correctly matches the type of deceleration with its likely cause?

Accepted Answer

A)  Early deceleration-umbilical cord compression
B)  Late deceleration-uteroplacental inefficiency
C)  Variable deceleration-head compression
D)  Prolonged deceleration-cause unknown

Question 16

When using intermittent auscultation (IA) for fetal heart rate,nurses should be aware that:

Accepted Answer

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

Question 17

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

Accepted Answer

A)  Every 15 minutes in the active phase of the first stage of labor 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.

Question 18

A new client and her partner arrive on the labor,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. Your best response is:

Accepted Answer

A)  "Don't worry about that machine;that's my job."
B)  "The top line graphs the baby's heart rate. Generally the heart rate is between 110 and 160. The 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 doctor will explain all of that later."

Question 19

A normal uterine activity pattern in labor is characterized by:

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.

Question 20

As a perinatal nurse you realize that a fetal heart rate that is tachycardic,is bradycardic,or has late decelerations or loss of variability is nonreassuring and is associated with:

Accepted Answer

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

Exam 17: Fetal Assessment During Labor