Intrapartum Fetal Surveillance

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Maternity and Women's Health Care Today
The Nurse's Role in Maternity and Women's Health Care
Ethical, Social, and Legal Issues
Reproductive Anatomy and Physiology
Hereditary and Environmental Influences on Childbearing
Conception and Prenatal Development
Physiologic Adaptations to Pregnancy
Psychosocial Adaptations to Pregnancy
Nutrition for Childbearing
Antepartum Fetal Assessment
Perinatal Education
Processes of Birth
Nursing Care During Labor and Birth
Intrapartum Fetal Surveillance
Pain Management During Childbirth
Nursing Care During Obstetric Procedures
Postpartum Physiologic Adaptations
Postpartum Psychosocial Adaptations
Normal Newborn: Processes of Adaptation
Assessment of the Normal Newborn
Care of the Normal Newborn
Infant Feeding
Home Care of the Infant
The Childbearing Family with Special Needs
Complications of Pregnancy
Concurrent Disorders During Pregnancy
Intrapartum Complications
Postpartum Maternal Complications
High-Risk Newborn: Complications Associated with Gestational Age and Development
High-Risk Newborn: Acquired and Congenital Conditions
Family Planning
Infertility
Preventive Care for Women
Women's Health Problems
Infertility
Preventive Care for Women
Women's Health Problems

All Questions

Question 1

Free

Multiple Choice

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?

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This pattern reflects variable decelerations. No interventions are necessary at this time.

Document this reassuring fetal heart rate pattern but decrease the rate of the intravenous (IV) fluid.

Continue to monitor these early decelerations, which occur as the fetal head is compressed during a contraction.

This deceleration pattern is associated with uteroplacental insufficiency, so the nurse acts quickly to improve placental blood flow and fetal oxygen supply.

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Question 2

Free

Multiple Choice

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

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Unruptured membranes

Cervix dilated to 4 cm

Fetus has known heart defect

External monitors currently being used

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Question 3

Free

Multiple Choice

The nurse is instructing a nursing student on the application of fetal monitoring devices. Which method of assessing the fetal heart rate requires the use of a gel?

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Doppler

Fetoscope

Scalp electrode

Tocodynamometer

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Question 4

Free

Multiple Choice

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?

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Naloxone (Narcan)

Terbutaline (Brethine)

Ephedrine

Diphenhydramine (Benadryl)

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Question 5

Free

Multiple Choice

Proper placement of the tocotransducer for electronic fetal monitoring is:

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inside the uterus.

on the fetal scalp.

over the uterine fundus.

over the mother's lower abdomen.

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Question 6

Multiple Choice

Which can be determined only by electronic fetal monitoring?

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Variability

Tachycardia

Bradycardia

Fetal response to contractions

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Question 7

Multiple Choice

Which is the most appropriate method of intrapartum fetal monitoring when a woman has a history of hypertension during pregnancy?

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Continuous auscultation with a fetoscope

Continuous electronic fetal monitoring

Intermittent assessment with a Doppler transducer

Intermittent electronic fetal monitoring for 15 minutes each hour

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Question 8

Multiple Choice

Why is continuous electronic fetal monitoring generally used when oxytocin is administered?

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Fetal chemoreceptors are stimulated.

The mother may become hypotensive.

Maternal fluid volume deficit may occur.

Uteroplacental exchange may be compromised.

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Question 9

Multiple Choice

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?

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Reposition the tocotransducer.

Reposition the Doppler transducer.

Obtain an order from the health care provider for a spiral electrode.

Obtain an order from the health care provider for an intrauterine pressure catheter.

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Question 10

Multiple Choice

If the position of a fetus in a cephalic presentation is right occiput anterior, the nurse should assess the fetal heart rate in which quadrant of the maternal abdomen?

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Right upper

Left upper

Right lower

Left lower

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Question 11

Multiple Choice

In which situation would a baseline fetal heart rate of 160 to 170 bpm be considered a normal finding?

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The fetus is at 30 weeks of gestation.

The mother has a history of fast labors.

The mother has been given an epidural block.

The mother has mild preeclampsia but is not in labor.

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Question 12

Multiple Choice

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

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Reposition the client.

Apply a fetal scalp electrode.

Record this reassuring pattern.

Administer oxygen by nasal cannula.

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Question 13

Multiple Choice

When the mother's membranes rupture during active labor, the fetal heart rate should be observed for the occurrence of which periodic pattern?

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Early decelerations

Variable decelerations

Nonperiodic accelerations

Increase in baseline variability

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Question 14

Multiple Choice

In which situation would it be appropriate to obtain a fetal scalp blood sample to establish fetal well-being?

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The fetus has developed tachycardia related to maternal fever.

The mother has vaginal bleeding, and the baseline fetal heart rate is decreasing.

The fetal heart tracing on a preterm fetus shows decreased baseline variability.

The fetal heart tracing shows a persistent pattern of late decelerations, with normal baseline variability.

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Question 15

Multiple Choice

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

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a worsening hypoxia.

progressive acidosis.

a reassuring response.

parasympathetic stimulation.

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Question 16

Multiple Choice

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

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Lower the head of the bed.

Place a wedge under the left hip.

Change her position to the right side.

Place the mother in Trendelenburg position.

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Question 17

Multiple Choice

Increasing the infusion rate of nonadditive intravenous fluids can increase fetal oxygenation primarily by:

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expanding the maternal blood volume.

maintaining a normal maternal temperature.

preventing normal maternal hypoglycemia.

increasing the oxygen-carrying capacity of the maternal blood.

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Question 18

Multiple Choice

Which nursing action is correct when initiating electronic fetal monitoring?

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Lubricate the tocotransducer with an ultrasound gel.

Securely apply the tocotransducer with a strap or belt.

Inform the client that she should remain in the semi-Fowler position.

Determine the position of the fetus before attaching the electrode to the maternal abdomen.

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Question 19

Multiple Choice

Which statement correctly describes the nurse's responsibility related to electronic monitoring?

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Report abnormal findings to the physician before initiating corrective actions.

Teach the woman and her support person about the monitoring equipment and discuss any of their questions.

Document the frequency, duration, and intensity of contractions measured by the external device.

Inform the support person that the nurse will be responsible for all comfort measures when the electronic equipment is in place.

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Question 20

Multiple Choice

Observation of a fetal heart rate pattern indicates an increase in heart rate from the prior baseline rate of 152 bpm. Which physiologic mechanisms would account for this situation?

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Inhibition of epinephrine

Inhibition of norepinephrine

Stimulation of the vagus nerve

Sympathetic stimulation

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