A nurse is interpreting the results of a contraction stress test (CST) for a client who is at 38 weeks of gestation.
The nurse notes that there are no late or significant variable decelerations of the fetal heart rate (FHR).
How should the nurse document this finding?
Positive CST
Negative CST
Unsatisfactory CST
Suspicious CST
The Correct Answer is B
Negative CST. A negative CST means that the fetal heart rate does not slow down (decelerate) after a contraction, which indicates that the baby can tolerate the stress of labor.
This is a normal and reassuring result.
Choice A is wrong because a positive CST means that the fetal heart rate slows down and stays slow after more than half of the contractions, which indicates that the baby may be at risk for problems during labor.
This is an abnormal and concerning result.
Choice C is wrong because an unsatisfactory CST means that there are not enough contractions to produce a reliable result.
This may happen if the medication or nipple stimulation does not induce enough contractions, or if there are other factors that interfere with the test, such as maternal movement or fetal sleep.
Choice D is wrong because a suspicious CST means that the results are unclear or inconsistent. This may happen if the fetal heart rate slows down after some but not all of the contractions, or if there are other types of decelerations that are not clearly related to the contractions.
A suspicious CST may need to be repeated in a couple of days.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Place the device over the fetal back for 3 seconds.This is because vibroacoustic stimulation (VAS) is the application of a vibratory sound stimulus to the abdomen of a pregnant woman to induce fetal heart rate (FHR) accelerations.The presence of FHR accelerations reliably predicts the absence of fetal metabolic acidemia.VAS is typically used during a nonstress test (NST) to assess fetal well-being.The device should be placed over the fetal back for 3 seconds, as this is the optimal duration and location to elicit a fetal response.
Choice B is wrong because holding the device firmly against the maternal abdomen for 10 seconds may be too long and too strong for the fetus, and may cause discomfort or distress.
Choice C is wrong because moving the device around the maternal abdomen until fetal movement is detected may not be effective or efficient, as the device may not reach the optimal location or duration to stimulate the fetus.
Choice D is wrong because applying the device intermittently over the fundus for 15 seconds may not target the fetal auditory system, which is located near the fetal back, and may also be too long and too strong for the fetus.
Normal ranges for FHR are between 110 and 160 beats per minute, and FHR accelerations are defined as an increase of at least 15 beats per minute above baseline for at least 15 seconds.
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.
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