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 C

Explanation

Choice A rationale: While gestational hypertension can have various implications for the mother and baby, it is not directly associated with an increased risk of postpartum hemorrhage.
Choice B rationale: The birth of a small-for-gestational-age newborn may have certain implications, but it is not directly associated with an increased risk of postpartum hemorrhage.
Choice C rationale: Precipitous birth, which refers to an extremely rapid labor and delivery lasting less than 3 hours, is a risk factor for postpartum hemorrhage. Rapid delivery can lead to incomplete uterine contractions and inadequate uterine tone, increasing the risk of excessive bleeding after birth.
Choice D rationale: A two-vessel umbilical cord, also known as a single umbilical artery, may be associated with certain fetal anomalies but is not directly related to an increased risk of postpartum hemorrhage.

A. Prone B. Upright C. Right side D. Left side

Correct Answer is B

Explanation

Choice A rationale: Placing the infant in the prone position (face down) after feeding is not recommended for a baby with gastroesophageal reflux. The prone position can increase the risk of aspiration if reflux occurs while the baby is lying down.
Choice B rationale: For an infant with gastroesophageal reflux, placing the baby in an upright position after feeding can help prevent or reduce reflux episodes. Keeping the infant in an upright position allows gravity to assist in keeping stomach contents down and reduces the likelihood of reflux into the esophagus.
Choice C rationale: Placing the infant on the right side after feeding is also not recommended for managing gastroesophageal reflux. The right side position may not be as effective in preventing reflux as the upright position.
Choice D rationale: Placing the baby on either side after feeding is also not recommended for managing gastroesophageal reflux. The upright position is more effective in preventing reflux episodes and promoting digestion. Side-lying positions after feeding may not provide the same benefits and can potentially increase the risk of reflux.

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Naxlex Comprehensive Predictor Exams

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.

Correct Answer is C

Explanation

A nurse is caring for an infant who has gastroesophageal reflux. The nurse should place the infant in which of the following positions after feeding?

Correct Answer is B

Explanation

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