A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?

Administer Rho(D) immune globulin.

Monitor fetal heart rate

Assess maternal vital signs

Obtain an order for an ultrasound exam.

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Monitor fetal heart rate.

This is because cramping and vaginal bleeding after amniocentesis are signs of possible complications such as miscarriage, preterm labor, or injury to the fetus.

Monitoring fetal heart rate can help assess the well-being of the fetus and detect any signs of distress.

Choice A is wrong because administering Rho(D) immunoglobulin is only necessary if the mother has Rh-negative blood and the baby has Rh-positive blood, which can cause Rh sensitization.

This is not given routinely to all women who have amniocentesis.

Choice C is wrong because assessing maternal vital signs is not the first priority when there is a risk of fetal compromise.

Maternal vital signs can be affected by many factors and are not specific indicators of fetal health.

Choice D is wrong because obtaining an order for an ultrasound exam is not the first action to take.

An ultrasound exam can help confirm the diagnosis of complications such as placental abruption or fetal demise, but it requires time and equipment that might delay immediate intervention.

Monitoring fetal heart rate can be done quickly and easily at the bedside.

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Correct Answer is A

Explanation

The test involves an ultrasound and a nonstress test.

A biophysical profile (BPP) is a way to check on the overall fetal health by observing the fetus’s heart rate, breathing, movement, muscle tone, and the amount of amniotic fluid surrounding the fetus in the uterus.

It is typically performed after 28 weeks of pregnancy, especially for high-risk pregnancies or if there is a chance of complications.

Choice B is wrong because a contraction stress test is not part of a BPP.

A contraction stress test measures how the fetus’s heart rate changes during contractions induced by oxytocin or nipple stimulation.

It is a different test from a nonstress test, which measures the fetus’s heart rate while moving and at rest without any stimulation.

Choice C is wrong because a Doppler ultrasound is not part of a BPP.

A Doppler ultrasound uses sound waves to measure the blood flow in the umbilical cord and other blood vessels.

It is a different type of ultrasound from the one used in a BPP, which uses sound waves to create images of the fetus and the amniotic fluid.

Choice D is wrong because it combines two incorrect components from choices B and C. A BPP does not involve a Doppler ultrasound or a contraction stress test.

A. Cord compression B. Fetal hypoxia C. Normal placental function D. Adequate fetal oxygenation

Correct Answer is A

Explanation

This finding indicates that the umbilical cord is being compressed, which can reduce the blood flow and oxygen supply to the fetus.

Variable decelerations are abrupt decreases in the fetal heart rate (FHR) that vary in shape, duration, and degree of fall below the baseline.

They are seen as W- or U-shaped waves on the monitor.

Choice B is wrong because fetal hypoxia is not indicated by variable decelerations, but by late decelerations, which are gradual decreases in the FHR that begin after the peak of the contraction and return to baseline after the contraction ends.

Late decelerations are associated with uteroplacental insufficiency, which means that the placenta is not delivering enough oxygen to the fetus.

Choice C is wrong because normal placental function is not indicated by variable decelerations, but by reassuring FHR patterns, such as moderate variability (6 to 25 beats per minute) and accelerations (increases in the FHR above the baseline).

Normal placental function ensures adequate fetal oxygenation and well-being.

Choice D is wrong because adequate fetal oxygenation is not indicated by variable decelerations, but by reassuring FHR patterns, such as moderate variability and accelerations.

Adequate fetal oxygenation means that the fetus is not experiencing hypoxia or distress.

Normal ranges for FHR are 110 to 160 beats per minute at term and 120 to 160 beats per minute before term.

Normal ranges for uterine contractions are 2 to 5 contractions in 10 minutes, lasting less than 90 seconds each.

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A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later. Which of the following actions should the nurse take first?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing a client for a biophysical profile (BPP). The nurse should instruct the client that the test involves which of the following procedures?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?