A nurse is evaluating the results of a contraction stress test (CST) for a pregnant client who had a nonreactive or nonreassuring result on a nonstress test (NST).
The nurse notes that there are no late decelerations of the fetal heart rate (FHR) after three contractions in a 10-minute period.
How should the nurse interpret this finding?
Positive or abnormal
Negative or normal
Equivocal or suspicious
Unsatisfactory or incomplete
The Correct Answer is B
Negative or normal. This means that there are no late decelerations of the fetal heart rate (FHR) after three contractions in a 10-minute period, which indicates that the baby can tolerate the stress of labor contractions.
Choice A is wrong because positive or abnormal results mean that there are late decelerations of the FHR after three contractions in a 10-minute period, which suggests that the baby may be at risk of hypoxia or injury during labor.
Choice C is wrong because equivocal or suspicious results mean that there are either variable decelerations or late decelerations after fewer than half of the contractions, which require further testing or monitoring.
Choice D is wrong because unsatisfactory or incomplete results mean that there are either fewer than three contractions in a 10-minute period or poor quality of the FHR tracing, which prevent an accurate interpretation of the test.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Lecithin/sphingomyelin (L/S) ratio.
This is a test that measures the amount of two phospholipids in the amniotic fluid that are important for the production of surfactant, a substance that helps the lungs expand and prevents them from collapsing.A higher L/S ratio indicates more surfactant and greater fetal lung maturity.The normal range for L/S ratio is 2:1 or higher at term.
Choice A is wrong because alpha-fetoprotein (AFP) is a protein produced by the fetus that can be measured in the amniotic fluid or maternal blood.It is used to screen for neural tube defects and other abnormalities, not for fetal lung maturity.
Choice C is wrong because Kleihauer-Betke test is a blood test that detects fetal red blood cells in the maternal circulation.It is used to diagnose fetomaternal hemorrhage, a condition where fetal blood leaks into the mother’s blood, not for fetal lung maturity.
Choice D is wrong because indirect Coombs’ test is a blood test that detects antibodies in the mother’s blood that may attack the fetal red blood cells.It is used to screen for Rh incompatibility or other blood group sensitization, not for fetal lung maturity.
Correct Answer is A
Explanation
Prepare the client for an amnioinfusion.An amnioinfusion is a procedure that adds fluid to the uterus during labor to relieve cord compression and improve fetal condition.Variable decelerations on the fetal monitor tracing are a sign of cord compression and fetal distress.If repositioning and oxygen administration do not resolve the decelerations, an amnioinfusion may be indicated.
Choice B is wrong because applying an internal fetal scalp electrode does not address the cause of variable decelerations, which is cord compression.
An internal fetal scalp electrode is used to monitor the fetal heart rate more accurately, but it does not improve fetal oxygenation or prevent cord compression.
Choice C is wrong because administering IV fluid bolus to the client may help increase maternal blood volume and placental perfusion, but it does not directly increase amniotic fluid volume or relieve cord compression.
Choice D is wrong because discontinuing oxytocin infusion if present may reduce uterine contractions and decrease cord compression, but it may also prolong labor and increase the risk of infection or fetal compromise.Oxytocin infusion should only be discontinued if there are signs of uterine hyperstimulation or fetal intolerance.
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