NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance

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2/5/2019 (7) ✅ NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance (14) https://docs.google.com/forms/d/1Gk3HgY3VRxypK-wF_KiNsb5m72kwcOqk0ZP3TgP2F0o/edit 1/9 (7) ✅ NR327 Exam 2 Revie... w Questions #7 Intrapartum Fetal Surveillance (14) * Required 1. Email address * 2. 1. 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? * Mark only one oval. 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. 3. 2. Which maternal condition should be considered a contraindication for the application of internal monitoring devices? * Mark only one oval. a. Unruptured membranes b. Cervix dilated to 4 cm c. Fetus has known heart defect d. External monitors currently being used 4. 3. 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? * Mark only one oval. a. Doppler b. Fetoscope c. Scalp electrode d. Tocodynamometer https://www.coursehero.com/file/37570062/7-NR327-Exam-2-Review-Questions-7-Intrapartum-Fetal-Surveillance-14pdf/ This study resource was shared via CourseHero.com2/5/2019 (7) ✅ NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance (14) https://docs.google.com/forms/d/1Gk3HgY3VRxypK-wF_KiNsb5m72kwcOqk0ZP3TgP2F0o/edit 2/9 5. 4. 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? * Mark only one oval. a. Naloxone (Narcan) b. Terbutaline (Brethine) c. Ephedrine d. Diphenhydramine (Benadryl) 6. 5. Proper placement of the tocotransducer for electronic fetal monitoring is: * Mark only one oval. a. inside the uterus. b. on the fetal scalp. c. over the uterine fundus. d. over the mother's lower abdomen. 7. 6. Which can be determined only by electronic fetal monitoring? * Mark only one oval. a. Variability b. Tachycardia c. Bradycardia d. Fetal response to contractions 8. 7. Which is the most appropriate method of intrapartum fetal monitoring when a woman has a history of hypertension during pregnancy? * Mark only one oval. a. Continuous auscultation with a fetoscope b. Continuous electronic fetal monitoring c. Intermittent assessment with a Doppler transducer d. Intermittent electronic fetal monitoring for 15 minutes each hour 9. 8. Why is continuous electronic fetal monitoring generally used when oxytocin is administered? * Mark only one oval. a. Fetal chemoreceptors are stimulated. b. The mother may become hypotensive. c. Maternal fluid volume deficit may occur. d. Uteroplacental exchange may be compromised. https://www.coursehero.com/file/37570062/7-NR327-Exam-2-Review-Questions-7-Intrapartum-Fetal-Surveillance-14pdf/ This study resource was shared via CourseHero.com2/5/2019 (7) ✅ NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance (14) https://docs.google.com/forms/d/1Gk3HgY3VRxypK-wF_KiNsb5m72kwcOqk0ZP3TgP2F0o/edit 3/9 10. 9. 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? * Mark only one oval. 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. 11. 10. 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? * Mark only one oval. a. Right upper b. Left upper c. Right lower d. Left lower 12. 11. In which situation would a baseline fetal heart rate of 160 to 170 bpm be considered a normal finding? * Mark only one oval. a. The fetus is at 30 weeks of gestation. b. The mother has a history of fast labors. c. The mother has been given an epidural block. d. The mother has mild preeclampsia but is not in labor. 13. 12. When the deceleration pattern of the fetal heart rate mirrors the uterine contraction, which nursing action is indicated? * Mark only one oval. a. Reposition the client. b. Apply a fetal scalp electrode. c. Record this reassuring pattern. d. Administer oxygen by nasal cannula. 14. 13. When the mother's membranes rupture during active labor, the fetal heart rate should be observed for the occurrence of which periodic pattern? * Mark only one oval. a. Early decelerations b. Variable decelerations c. Nonperiodic accelerations d. Increase in baseline variability https://www.coursehero.com/file/37570062/7-NR327-Exam-2-Review-Questions-7-Intrapartum-Fetal-Surveillance-14pdf/ This study resource was shared via CourseHero.com2/5/2019 (7) ✅ NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance (14) https://docs.google.com/forms/d/1Gk3HgY3VRxypK-wF_KiNsb5m72kwcOqk0ZP3TgP2F0o/edit 4/9 15. 14. In which situation would it be appropriate to obtain a fetal scalp blood sample to establish fetal well-being? * Mark only one oval. a. The fetus has developed tachycardia related to maternal fever. b. The mother has vaginal bleeding, and the baseline fetal heart rate is decreasing. c. The fetal heart tracing on a preterm fetus shows decreased baseline variability. d. The fetal heart tracing shows a persistent pattern of late decelerations, with normal baseline variability. 16. 15. The fetal heart rate baseline increases 20 bpm after vibroacoustic stimulation. The best interpretation of this is that the fetus is showing: * Mark only one oval. a. a worsening hypoxia. b. progressive acidosis. c. a reassuring response. d. parasympathetic stimulation. 17. 16. 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? * Mark only one oval. a. Lower the head of the bed. b. Place a wedge under the left hip. c. Change her position to the right side. d. Place the mother in Trendelenburg position. 18. 17. Increasing the infusion rate of nonadditive intravenous fluids can increase fetal oxygenation primarily by: * Mark only one oval. a. expanding the maternal blood volume. b. maintaining a normal maternal temperature. c. preventing normal maternal hypoglycemia. d. increasing the oxygen-carrying capacity of the maternal blood. 19. 18. Which nursing action is correct when initiating electronic fetal monitoring? * Mark only one oval. a. Lubricate the tocotransducer with an ultrasound gel. b. Securely apply the tocotransducer with a strap or belt. c. Inform the client that she should remain in the semi-Fowler position. d. Determine the position of the fetus before attaching the electrode to the maternal abdomen. https://www.coursehero.com/file/37570062/7-NR327-Exam-2-Review-Questions-7-Intrapartum-Fetal-Surveillance-14pdf/ This study resource was shared via CourseHero.com2/5/2019 (7) ✅ NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance (14) https://docs.google.com/forms/d/1Gk3HgY3VRxypK-wF_KiNsb5m72kwcOqk0ZP3TgP2F0o/edit 5/9 20. 19. Which statement correctly describes the nurse's responsibility related to electronic monitoring? * Mark only one oval. a. Report abnormal findings to the physician before initiating corrective actions. b. Teach the woman and her support person about the monitoring equipment and discuss any of their questions. c. Document the frequency, duration, and intensity of contractions measured by the external device. d. Inform the support person that the nurse will be responsible for all comfort measures when the electronic equipment is in place. 21. 20. 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? * Mark only one oval. a. Inhibition of epinephrine b. Inhibition of norepinephrine c. Stimulation of the vagus nerve d. Sympathetic stimulation 22. 21. Which of the following therapeutic applications provides the most accurate information related to uterine contraction strength? * Mark only one oval. a. External fetal monitoring (EFM) b. Internal fetal monitoring c. Intrauterine pressure catheter (IUPC) d. Maternal comments based on perception 23. 22. What is the most likely cause for this fetal heart rate pattern? * Mark only one oval. a. Administration of an epidural for pain relief during labor b. Cord compression c. Breech position of fetus d. Administration of meperidine (Demerol) for pain relief during labor 24. 23. Client is at 38 weeks' gestation, gravida 1, para 0, vaginal exam—4 cm, 100% effaced, +1 station vertex. What is the most likely intervention for this fetal heart rate pattern? * Mark only one oval. a. Continue oxytocin (Pitocin) infusion. b. Contact the anesthesia department for epidural administration. c. Change maternal position. d. Administer Narcan to client and prepare for immediate vaginal delivery. https://www.coursehero.com/file/37570062/7-NR327-Exam-2-Review-Questions-7-Intrapartum-Fetal-Surveillance-14pdf/ This study resource was shared via CourseHero.com2/5/2019 (7) ✅ NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance (14) https://docs.google.com/forms/d/1Gk3HgY3VRxypK-wF_KiNsb5m72kwcOqk0ZP3TgP2F0o/edit 6/9 25. 24. The physician has ordered an amnioinfusion for the laboring client. What data supports the use of this therapeutic procedure? * Mark only one oval. a. Presenting part not engaged b. +4 meconium-stained amniotic fluid on artificial rupture of membranes (AROM) c. Breech position of fetus d. Twin gestation 26. 25. Which of the following is the priority intervention for a supine client whose monitor strip shows decelerations that begin after the peak of the contraction and return to the baseline after the contraction ends? * Mark only one oval. a. Increase IV infusion. b. Elevate lower extremities. c. Reposition to left side-lying position. d. Administer oxygen per face mask at 4 to 6 L/min. 27. 26. Decelerations that mirror the contractions are present with each contraction on the monitor strip of a multipara who received epidural anesthesia 20 minutes ago. The nurse should: * Mark only one oval. a. maintain the normal assessment routine. b. administer O2 at 8 to 10 L/min by face mask. c. increase the IV flow rate from 125 to 150 mL/hr. d. assess the maternal blood pressure for a systolic pressure below 100 mm Hg. 28. 27. To clarify the fetal condition when baseline variability is absent, the nurse should first: * Mark only one oval. a. monitor fetal oxygen saturation using fetal pulse oximetry. b. notify the physician so that a fetal scalp blood sample can be obtained. c. apply pressure to the fetal scalp with a glove finger using a circular motion. d. increase the rate of nonadditive IV fluid to expand the mother's blood volume. 29. 28. Which client is a candidate for internal monitoring with an intrauterine pressure catheter? * Mark only one oval. a. Obese client whose contractions are 3 to 6 minutes apart, lasting 20 to 50 seconds b. Gravida 1, para 0, whose contractions are 2 to 3 minutes apart, lasting 60 seconds c. Multigravida whose contractions are 2 minutes apart, lasting 60 to 70 seconds d. Gravida 2, para 1, in latent phase whose contractions are irregular and mild https://www.coursehero.com/file/37570062/7-NR327-Exam-2-Review-Questions-7-Intrapartum-Fetal-Surveillance-14pdf/ This study resource was shared via CourseHero.com2/5/2019 (7) ✅ NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance (14) https://docs.google.com/forms/d/1Gk3HgY3VRxypK-wF_KiNsb5m72kwcOqk0ZP3TgP2F0o/edit 7/9 30. 29. Which client has the priority need for fetal monitoring? * Mark only one oval. a. Primigravida at 38 weeks with spontaneous ROM b. Multigravida at 40 weeks with history of 10-hour labors c. Multigravida admitted for repeat elective cesarean section d. Primigravida at 39 weeks with meconium-stained amniotic fluid 31. 30. Which of the following is the priority intervention for the client in a left side-lying position whose monitor strip shows a deceleration that extends beyond the end of the contraction? * Mark only one oval. a. Administer O2 at 8 to 10 L/min. b. Decrease the IV rate to 100 mL/hr. c. Reposition the ultrasound transducer. d. Perform a vaginal exam to assess for cord prolapse. 32. 31. When a pattern of variable decelerations occur, the nurse should: * Mark only one oval. a. administer O2 at 8 to 10 L/min. b. place a wedge under the right hip. c. increase the IV fluids to 150 mL/hr. d. position client in a knee-chest position. 33. 32. The nurse observes the following data on an electronic fetal monitor attached to a client in the active phase of the first stage of labor: fetal heart rate baseline, 125 to 140 bpm, three accelerations over the course of 20 minutes, moderate variability. What is the priority action based on these findings? * Mark only one oval. a. Document the findings. b. Contact the health care provider. c. Increase the rate of the existing IV to 200 mL/hr as per the standing prescription. d. Place oxygen via a rebreather mask at 10 L/min as per the standing prescription. 34. 33. The nurse is reviewing an electronic fetal monitor tracing from a patient in active labor and notes the fetal heart rate gradually drops to 20 beats per minute (bpm) below the baseline and returns to the baseline well after the completion of the patient's contractions. How will the nurse document these findings? * Mark only one oval. a. Late decelerations b. Early decelerations c. Variable decelerations d. Proximal decelerations https://www.coursehero.com/file/37570062/7-NR327-Exam-2-Review-Questions-7-Intrapartum-Fetal-Surveillance-14pdf/ This study resource was shared via CourseHero.com2/5/2019 (7) ✅ NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance (14) https://docs.google.com/forms/d/1Gk3HgY3VRxypK-wF_KiNsb5m72kwcOqk0ZP3TgP2F0o/edit 8/9 35. 34. A patient at 41 weeks' gestation is undergoing an induction of labor with an IV administration of oxytocin (Pitocin). The fetal heart rate starts to demonstrate a recurrent pattern of late decelerations with moderate variability. What is the nurse's priority action? * Mark only one oval. a. Stop the infusion of Pitocin. b. Reposition the patient from her right to her left side. c. Perform a vaginal exam to assess for a prolapsed cord. d. Prepare the patient for an emergency cesarean section. 36. 35. 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? * Mark only one oval. a. Every 10 minutes b. Every 15 minutes c. Every 30 minutes d. Every 60 minutes 37. 36. The nurse is monitoring a client in labor and notes this fetal heart rate pattern on the electronic fetal monitoring strip (see figure). Which is the most appropriate nursing action? * Mark only one oval. a. Administer oxygen with a face mask at 8 to 10 L/min. b. Reposition the fetal monitor ultrasound transducer. c. Assist the client to the bathroom to empty her bladder . d. Continue to monitor the client and fetal heart rate patterns. 38. 37. The nurse is monitoring a client in labor and notes this fetal heart rate pattern on the electronic fetal monitoring strip (see figure). Which is the most appropriate nursing action? * Mark only one oval. a. Decrease the rate of the IV fluids. b. Document the fetal heart rate pattern. c. Explain to the client that the pattern is reassuring. d. Perform a vaginal exam to detect a prolapsed cord. 39. 38. Which medications could potentially cause hyperstimulation of the uterus during labor? (Select all that apply.) * Check all that apply. a. Oxytocin (Pitocin) b. Misoprostol (Cytotec) c. Dinoprostone (Cervidil) d. Methylergonovine maleate (Methergine) https://www.coursehero.com/file/37570062/7-NR327-Exam-2-Review-Questions-7-Intrapartum-Fetal-Surveillance-14pdf/ This study resource was shared via CourseHero.com2/5/2019 (7) ✅ NR327 Exam 2 Review Questions #7 Intrapartum Fetal Surveillance (14) https://docs.google.com/forms/d/1Gk3HgY3VRxypK-wF_KiNsb5m72kwcOqk0ZP3TgP2F0o/edit 9/9 Powered by 40. 39. When evaluating the client's progress, the nurse knows that four of the five fetal factors that interact to regulate the heart rate are (select all that apply): * Check all that apply. a. baroreceptors. b. adrenal glands. c. chemoreceptors. d. uterine activity. e. autonomic nervous system. 41. 40. The nurse recognizes that fetal scalp stimulation may be prescribed to evaluate the response of the fetus to tactile stimulation. Which conditions contraindicate the use of fetal scalp stimulation? (Select all that apply.) * Check all that apply. a. Post-term fetus b. Maternal fever c. Placenta previa d. Induction of labor e. Prolonged rupture of membranes 42. 41. The nurse is preparing supplies for an amnioinfusion on a client with intact membranes. Which supplies should the nurse gather? (Select all that apply.) * Check all that apply. a. Extra underpads b. Solution of 3% normal saline c. Amniotic hook to perform an amniotomy d. Solid intrauterine pressure catheter with a pressure transducer on its tip Send me a copy of my responses. https://www.coursehero.com/file/37570062/7-NR327-Exam-2-Review-Questions-7-Intrapartum-Fetal-Surveillance-14pdf/ This study resource was shared via CourseHero.com Powered by TCPDF (www.tcpdf.org) [Show More]

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