A nurse is assisting with performing Leopold maneuvers on a client who is in labor. Which of the following techniques should the nurse use to identify the fetal lie?
Apply palms of both hands to one side of uterus.
Stand facing client's feet with fingertips outlining cephalic prominence.
Palpate the fundus of the uterus.
Perform deep palpation of the uterus
The Correct Answer is C
A. Apply palms of both hands to one side of the uterus: This step helps identify the fetal position (whether the baby is facing left or right), not the fetal lie.
B. Stand facing the client's feet with fingertips outlining cephalic prominence. This maneuver helps determine fetal engagement, not fetal lie.
C. Palpate the fundus of the uterus. The fetal lie refers to whether the fetus is positioned longitudinally or transversely, and this is assessed by palpating the fundus to feel which part of the fetus is located there (e.g., head or buttocks).
D. Perform deep palpation of the uterus. Deep palpation helps identify the presenting part (what part of the fetus is entering the pelvis), not fetal lie.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Weakened uterine contractions: Terbutaline is a tocolytic medication used to relax the uterus and reduce or stop preterm uterine contractions.
B. Maternal glucose 63 mg/dL: Terbutaline can cause hyperglycemia, not hypoglycemia. Therefore, a glucose level of 63 mg/dL would not be an expected finding.
C. Enhanced fetal lung surfactant: Betamethasone, not terbutaline, is used to enhance fetal lung maturity by increasing surfactant production.
D. Fetal heart rate 100/min:Terbutaline can cause tachycardia, so a fetal heart rate of 100/min (bradycardia) would be unexpected.
Correct Answer is B
Explanation
A. Decreased maternal heart rate: Maternal heart rate usually stays the same or may increase slightly due to the physical exertion of labor, but it does not decrease as a sign of labor progression.
B. Increased intensity and frequency of contractions: The active phase of labor is characterized by more frequent and intense contractions that lead to continued cervical dilation and effacement.
C. Decreased cervical dilation: Cervical dilation increases during labor, particularly in the active phase. Decreased dilation is a sign of dysfunctional labor, not normal progress.
D. Decreased intensity and frequency of contractions: Decreasing contraction intensity and frequency would indicate a stall in labor or ineffective labor, not normal progress.
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