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A nurse caring for a patient in labor is evaluating the fetal heart monitor.Which finding would indicate fetal distress?

The fetal heart rate decreases after the start of a contraction and returns to the baseline 60 seconds after the end of the contraction.

There is a six to ten beat-to-beat variability in the fetal heart rate.

The fetal heart rate accelerates five to seven beats just prior to the beginning of a contraction.

The fetal heart rate decreases at the start of the contraction and returns to baseline by the end of the contraction.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A and it indicates fetal distress because it is a sign of late deceleration. Late decelerations are due to uteroplacental insufficiency as the result of decreased blood flow and oxygen to the fetus during the uterine contractions. This causes hypoxemia and can lead to fetal acidosis and neurological damage.

Choice B is wrong because it indicates a normal variability in the fetal heart rate, which reflects a healthy autonomic nervous system. A normal fetal heart rate is 120-160 beats per minute.

Choice C is wrong because it indicates an early acceleration in the fetal heart rate, which is a benign finding that may occur with fetal movement or stimulation.

Choice D is wrong because it indicates an early deceleration in the fetal heart rate, which is a normal response to fetal head compression during contractions.

It does not indicate fetal distress.

Normal ranges for fetal heart rate patterns are:

• Baseline: 120-160 beats per minute

• Variability: 6-25 beats per minute

• Accelerations: at least 15 beats per minute above baseline for at least 15 seconds

• Decelerations: none or early (mirror contractions)

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Correct Answer is D

Explanation

The correct answer is choice D. Leaning slightly backwards when walking can increase the curvature of the lower spine and worsen back pain.

The other choices are helpful methods to alleviate back pain during pregnancy.

Choice A is correct because pelvic tilt exercises can strengthen the abdominal muscles and reduce the strain on the lower back.

Choice B is correct because wearing shoes with low heels can improve posture and balance and prevent excessive arching of the lower back.

Choice C is correct because sleeping on the side with a pillow beneath the knees can support the spine and pelvis and relieve pressure on the lower back.

Normal ranges for back pain during pregnancy vary depending on the individual, but some common factors that can affect it are weight gain, hormonal changes, center of gravity shift, stress and muscle separation.

A. She lives with two dogs at home. B. She works as a part-time oncology nurse. C. She is lacto-ova vegetarian. D. She commutes to work on a train.

Correct Answer is B

Explanation

The correct answer is choice B. She works as a part-time oncology nurse.This is because oncology nurses are exposed toteratogenic agents, which are substances that can cause abnormalities in an exposed fetus.Teratogenic agents can cross the placenta and alter fetal morphology or function.Examples of teratogenic agents are lead, methyl mercury, polychlorinated biphenyls, lithium, vitamin K antagonists, tobacco, rubella, cytomegalovirus, ionizing agents, hyperthermia, diabetes, and some drugs.

Choice A is wrong because living with two dogs at home does not pose a high risk for exposure to teratogenic agents.Dogs can be beneficial for pregnant women as they provide companionship and exercise.

Choice C is wrong because being a lacto-ova vegetarian does not pose a high risk for exposure to teratogenic agents.Lacto-ova vegetarians can get adequate nutrition from plant-based foods, dairy products, and eggs.

Choice D is wrong because commuting to work on a train does not pose a high risk for exposure to teratogenic agents.Trains are a safe and convenient mode of transportation for pregnant women.

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A nurse caring for a patient in labor is evaluating the fetal heart monitor.Which finding would indicate fetal distress?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a class for women in the second trimester of pregnancy, the nurse discusses methods to alleviate back pain. Which statement by a class member would indicate the need for additional instruction?

Correct Answer is D

Explanation

A patient comes to the antepartal clinic for her visit and provides the nurse with information. What piece of information places this patient at high risk for exposure to teratogenic agents?

Correct Answer is B

Explanation

A client asks a nurse about breastfeeding, and the nurse discusses the topic with her. Which statement by the client indicates she needs further instruction?

A patient had an episiotomy during her delivery. Which nursing action should be included in her plan of care for the first 12 hours?

A 23-year-old primigravida who appears to be in her third trimester of pregnancy comes to the labor and delivery unit reporting acute abdominal pain. She has had no prenatal care. Which assessment should the nurse do first?

The physician prescribes prostaglandin (PGE2) gel for a patient being admitted for induction of labor. Which finding would best indicate that the prostaglandin gel is effective?

A patient’s amniotic fluid is meconium-stained. Which action should the nurse plan to take?

A nurse is caring for a patient who is 40 weeks pregnant. Which finding would indicate the need for a cesarean delivery?

A patient has been instructed to increase the protein in her diet. Which statement by the patient shows a need for further instruction?

A patient states, “My water just broke.” The nurse verifies that her membranes have ruptured spontaneously. Which action should the nurse take next?