A nurse is assessing a client who is at 39 weeks of gestation and determines that the fetus is in a left occipitoanterior position. On which of the following sites should the nurse place the external fetal monitor to hear the point of maximum impulse of the fetal heart rate?
Right upper quadrant
left upper quadrant
left lower quadrant.
right lower quadrant.
The Correct Answer is C
A. This would be appropriate if the fetus were in a breech presentation.
B. This is incorrect because the fetal back is in the lower left quadrant, not the upper quadrant.
C. In the Left Occipitoanterior (LOA) Position, the fetal occiput (back of the head) is facing the mother’s left side and anteriorly (toward the front of the uterus). The fetal back will be on the left side of the maternal abdomen, making the PMI in the left lower quadrant. The best location to place the fetal monitor is over the fetal back, closest to the head. Since the fetus is cephalic (head down) in LOA position, the heart sounds are heard in the left lower quadrant.
D. This would be appropriate if the fetus were in a right occipitoanterior (ROA) position, but in LOA, the back is on the left.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The client's cervical dilation and effacement indicate that she is in active labor and progressing rapidly. Because the client is already 8 cm dilated and has been in labor for only 1 hour, the nurse should recognize that the client is at risk for a rapid delivery, which can increase the risk of postpartum hemorrhage. The other options listed are not associated with cervical dilation and effacement during active labor.
Correct Answer is B
Explanation
Uterine atony is a condition in which the uterus is not contracting effectively following delivery, which can lead to postpartum hemorrhage. Oxytocin is the first-line medication used to stimulate uterine contractions, but if the client fails to respond to oxytocin, the nurse should anticipate the use of a second-line medication, such as methylergonovine. Terbutaline is a tocolytic medication used to stop contractions, not stimulate them. Betamethasone is a corticosteroid used to promote fetal lung maturity before preterm delivery. Hydralazine is a vasodilator used to treat hypertension, not uterine atony.
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