A nurse is assessing a client who is 8 hours postpartum.
Where should the nurse expect to find the fundus?

At a non-palpable depth.

Just below the umbilicus.

At the umbilicus.

Just above the symphysis pubis.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Immediately postpartum, the fundus is typically palpable. It gradually descends into the pelvic cavity over the following days.

Choice B rationale

By 6 to 12 hours postpartum, the fundus is usually located at the level of the umbilicus or slightly below it. It descends approximately one fingerbreadth (1 cm) per day.

Choice C rationale

In the immediate postpartum period, within the first few hours after delivery, the nurse should expect to find the fundus at the level of the umbilicus. This indicates that the uterus is contracting to control bleeding at the placental site.

Choice D rationale

Immediately after delivery, the fundus is typically higher than the symphysis pubis. It descends into the abdomen as the uterus contracts and the placental site begins to heal. .

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Correct Answer is D

Explanation

Choice A rationale

An increase in baseline variability is generally considered a reassuring sign of fetal well-being, indicating a responsive central nervous system and adequate oxygenation. While important to monitor, it is not a specific periodic pattern to observe immediately following membrane rupture due to potential cord compression. Normal baseline variability ranges from 6 to 25 beats per minute.

Choice B rationale

Non-periodic accelerations are abrupt increases in fetal heart rate above the baseline, typically lasting less than 30 seconds. They are usually a reassuring sign, often occurring with fetal movement or stimulation. While their presence is noted, they are not the primary periodic pattern to observe immediately after membrane rupture for potential complications.

Choice C rationale

Early decelerations are gradual decreases in fetal heart rate that mirror the uterine contractions. They are thought to be caused by fetal head compression and are generally considered benign. While their presence is documented, they are not the most concerning pattern immediately after membrane rupture, which raises the risk of cord issues.

Choice D rationale

Variable decelerations are abrupt decreases in fetal heart rate that are variable in timing and shape in relation to uterine contractions. They are often caused by umbilical cord compression, which is a significant risk factor immediately following the rupture of membranes, as the fluid cushion around the cord is reduced. Prompt identification is crucial for intervention.

A. Changes in the cervix. B. Station of the presenting part. C. Rupture of the membranes. D. Pattern of contractions.

Correct Answer is A

Explanation

Choice A rationale

True labor is characterized by progressive cervical changes, including effacement (thinning) and dilation (opening) of the cervix. These changes are the most definitive signs that a woman is in true labor, as contractions can sometimes be Braxton Hicks contractions, which do not cause cervical change.

Choice B rationale

The station of the presenting part (how far down the baby's head is in the pelvis) can change during true labor as the baby descends. However, a single assessment of station does not definitively indicate true labor, as the baby may have been in a lower position prior to the onset of labor. Cervical changes are a more reliable indicator.

Choice C rationale

Rupture of the membranes (water breaking) can occur before or during true labor, but it is not always the first sign of labor. Some women experience contractions for a period before their membranes rupture, and some may not have their membranes rupture until late in labor or require artificial rupture. Therefore, it is not the most definitive sign of true labor.

Choice D rationale

A pattern of regular contractions that increase in frequency, duration, and intensity is a strong indication of true labor. However, some women may experience irregular contractions (Braxton Hicks) that can be mistaken for early labor. The key differentiator is whether these contractions are causing cervical change, making cervical assessment the most definitive sign.

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A nurse is assessing a client who is 8 hours postpartum.Where should the nurse expect to find the fundus?

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Naxlex Comprehensive Predictor Exams

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

Correct Answer is D

Explanation

A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not.”. Which of the following should the nurse recognize as a sign of true labor?

Correct Answer is A

Explanation

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A nurse is assessing a client who is 8 hours postpartum.
Where should the nurse expect to find the fundus?