A nurse is planning care for a client who is to undergo a nonstress test. Which of the following actions should the nurse include in the plan of care?
Maintain the client NPO throughout the procedure.
Place the client in a supine position,
Instruct the client to massage the abdomen to stimulate fetal movement
Instruct the client to press the provided button each time fetal movement is detected
The Correct Answer is D
The correct answer is D.
A. Maintain the client NPO throughout the procedure: It is not necessary to maintain the client NPO (nothing by mouth) for a nonstress test. The test primarily involves monitoring fetal heart rate in response to the baby's movements and does not require fasting.
B. Place the client in a supine position: Placing the client in a left lateral position is often preferred for NST to optimize uterine blood flow and fetal oxygenation. The supine position can compromise blood flow to the uterus and is generally avoided, especially in later pregnancy.
C. Instruct the client to massage the abdomen to stimulate fetal movement: While the goal of the NST is to monitor fetal movements, instructing the client to actively stimulate fetal movement through abdominal massage is not a standard part of the procedure. Fetal movements should occur naturally.
D. Instruct the client to press the provided button each time fetal movement is detected: This is the correct action. During a nonstress test, the client is typically provided with a button to press whenever she feels fetal movement. This helps correlate fetal movements with changes in the fetal heart rate on the monitor, providing valuable information about the baby's well-being.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "This medication promotes softening of the cervix."
A. Dinoprostone is a prostaglandin E2 analogue that is used to ripen the cervix by promoting softening and effacement. This is an important step in preparing the cervix for labor induction or augmentation.
B. Dinoprostone does not cause relaxation of the uterine muscles. Instead, it specifically works on the cervix to make it more favorable for labor.
C. Dinoprostone is not used to treat preeclampsi
A. It is primarily used for cervical ripening in the context of labor induction or augmentation.
D. Dinoprostone is not used to treat genital herpes simplex virus. It is specifically employed for its effects on cervical ripening and preparing the cervix for labor.
Correct Answer is D
Explanation
A. Resting tone of 15 mmHg:A resting tone of 15 mmHg is generally acceptable and indicates normal uterine resting pressure, which should be between 5 and 20 mmHg.
B. Frequency of every two minutes. A frequency of every two minutes can be acceptable during labor, especially if the contractions are not too long or intense. The key consideration is the duration and intensity of the contractions.
C. Intensity of 60 to 90 mmHg: This intensity is typically acceptable for labor induction and signifies effective contractions. There’s no indication to stop oxytocin based solely on this intensity range.
D. Duration of 90 to 120 seconds:A contraction lasting 90 to 120 seconds is concerning and indicates potential uterine hyperstimulation, warranting the discontinuation of oxytocin to protect both the mother and fetus from adverse effects.
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