A nurse is preparing to auscultate fetal heart tones for a client who is pregnant. Using Leopold maneuvers, the nurse palpates a round, firm, movable part in the fundal portion of the uterus and a long, smooth surface on the mother's right side. In which of the following maternal quadrants should the nurse auscultate fetal heart tones?

Right upper quadrant

Left lower quadrant

Right lower quadrant

Left upper quadrant

Answer and Explanation

The Correct Answer is A

Choice A rationale: Auscultating fetal heart tones in the right upper quadrant is not appropriate based on the information provided by Leopold maneuvers, which indicates the fetal back is on the right side of the mother's abdomen, and the fetal head is in the fundal portion of the uterus.
Choice B rationale: During Leopold maneuvers, the nurse palpated a round, firm, movable part in the fundal portion of the uterus. This finding corresponds to the fetal head, which is typically located at the top of the uterus (fundus). Additionally, the nurse palpated a long, smooth surface on the mother's right side. This finding indicates the fetal back, which typically lies along the right side of the mother's abdomen, suggesting that the fetus's back is positioned anteriorly (toward the mother's front). The location of the fetal heart is typically best heard over the back of the fetus. Therefore, the nurse should auscultate the fetal heart tones in the maternal quadrant corresponding to the back of the fetus, which is the left lower quadrant.
Choice C rationale: The information from Leopold maneuvers does not indicate the fetal back is in the right lower quadrant. The nurse should not auscultate fetal heart tones in this area.
Choice D rationale: Auscultating fetal heart tones in the left upper quadrant is not appropriate based on the information provided by Leopold maneuvers, which indicates the fetal head is in the fundal portion of the uterus and the fetal back is on the right side of the mother's abdomen. The fetal heart is usually best heard over the back of the fetus, which is not in the left upper quadrant.

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Correct Answer is ["B","C","D","E"]

Explanation

Choice A rationale: Cephalopelvic disproportion is a condition where the baby's head is too large or the mother's pelvis is too small for a vaginal delivery. Amniocentesis does not provide information about this condition.
Choice B rationale: Amniocentesis can be used to detect neural tube defects such as spina bifida and anencephaly.
Choice C rationale: Rh incompatibility occurs when the mother is Rh-negative, and the fetus is Rh-positive. This can lead to hemolytic disease of the newborn (HDN) if untreated. While Rh incompatibility can be detected through blood tests (maternal blood), amniocentesis is typically not used to diagnose this condition.
Choice D rationale: Amniocentesis can be used to determine the fetal gender by analyzing the DNA in the amniotic fluid. This is not the primary purpose of amniocentesis, but it can certainly identify the gender, especially in cases where this information is needed for medical reasons, such as gender-linked genetic disorders.
Choice E rationale: Amniocentesis is commonly used to screen for chromosomal abnormalities such as Down syndrome (trisomy 21) and other genetic conditions.

A. Maternal pelvis is gynecoid. B. Fetal lie is longitudinal. C. Fetal position is persistent occiput posterior. D. Fetal attitude is in general flexion.

Correct Answer is C

Explanation

Choice A rationale: A gynaecoid-shaped pelvis is considered the most favorable for childbirth and is not a contributing cause of difficult, prolonged labor.
Choice B rationale: The fetal lie refers to the orientation of the baby's spine in relation to the mother's spine. A longitudinal lie (baby's spine parallel to the mother's spine) is the typical and preferred position for birth and is not a cause of difficult, prolonged labor.
Choice C rationale: A persistent occiput posterior (OP) position, where the baby's head faces the mother's abdomen instead of her back, is a known contributing factor to difficult and prolonged labor. The baby's position in the birth canal can affect the progress and ease of labor.
Choice D rationale: Fetal attitude refers to the position of the baby's body parts in relation to each other. General flexion, where the baby's head is flexed forward and the limbs are flexed, is the normal attitude for birth and does not contribute to difficult, prolonged labor.

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who is at 15 weeks of gestation and is about to undergo an amniocentesis. The nurse should reinforce that this test can identify which of the following traits or problems? (Select all that apply.)

Correct Answer is ["B","C","D","E"]

Explanation

A nurse is assisting with the care of a client who is in labor. The client's labor is difficult and prolonged and she reports a severe backache. Which of the following factors is a contributing cause of difficult, prolonged labor?

Correct Answer is C

Explanation

A nurse is caring for a client who is 1 day postpartum. The client tells the nurse, "The baby has been breathing funny, fast and slow, off and on." Which of the following responses should the nurse make?

A nurse is assisting in the care of a client who is scheduled for a cesarean birth based on the fetal lungs having reached maturity. Which of the following findings indicates that the fetal lungs are mature?

A nurse is collecting data from a client who is at 18 weeks of gestation and tells the nurse that she felt light fluttering in her stomach the previous day. The nurse should use which of the following terms to document this finding?

A nurse is caring for a client who is pregnant and undergoing a nonstress test. The nurse records the FHR as 130 to 150/min, with no fetal movement for 15 min. Which of the following actions should the nurse take?

A nurse is reinforcing teaching about dietary intake with a client who is breastfeeding her newborn. Which of the following information should the nurse include in the teaching?

A nurse is caring for a client who is at 34 weeks of gestation and has a suspected placenta previa. Which of the following actions should the nurse take?

A nurse is reviewing the medical record of a client who experienced a vaginal birth 2 hr ago. The nurse should identify which of the following findings places the client at risk for a postpartum hemorrhage.

A nurse is assisting with the care of a client who is in labor. Immediately after the delivery of a newborn, which of the following actions should the nurse take first?