A nurse is assisting with the care of a client who is in the latent phase of labor and just had an amniotomy. Which of the following findings indicates that the fetus is at risk?

Recurrent variable deceleration of the FHR

Uterine contractions every 6 min

Uterine contractions lasting 30 to 45 seconds

Moderate variability of the FHR

Answer and Explanation

The Correct Answer is A

A.   Recurrent variable decelerations of the fetal heart rate (FHR) are concerning and can indicate fetal distress.
B.   Uterine contractions every 6 minutes may not provide effective progress in labor, but it is not indicative of fetal distress.
C.   Uterine contractions lasting 30 to 45 seconds are within the normal range for labor.
D.   Moderate variability of the FHR is a reassuring sign and indicates that the fetus is tolerating labor well.

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Correct Answer is A

Explanation

A. Ice packs can help reduce swelling and inflammation associated with engorgement by constricting blood vessels and reducing blood flow to the area, which can alleviate pain and discomfort.
B. Avoiding the use of a breast pump may exacerbate engorgement. It is appropriate to use a pump if needed for comfort or to facilitate breastfeeding.
C. While purified lanolin can help soothe sore nipples, it does not address the inflammation and swelling of engorgement.
D. A well-fitting, supportive bra is important, but it should not be too tight. It should provide adequate support without constricting the breasts.

A. "I will make sure that just the nipple is in my baby's mouth." B. "I will lay my baby on a pillow at the level of my breast." C. "I will nurse my baby for 5 to 10 minutes on each breast." D. "I will apply vitamin E oil to my nipples after each feeding."

Correct Answer is B

Explanation

A: The baby should take in both the areola and nipple for effective breastfeeding, not just the nipple.
B: This position helps ensure that the baby's mouth is at the same level as the breast, which promotes proper latch and feeding.
C: The duration of breastfeeding can vary, and it's often recommended to nurse until the baby is satisfied rather than setting a specific time limit.
D: Applying vitamin E oil after each feeding is not a standard practice and is not necessary for successful breastfeeding.

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A nurse is assisting with the care of a client who is in the latent phase of labor and just had an amniotomy. Which of the following findings indicates that the fetus is at risk?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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