A nurse is teaching a client who is at 38 weeks of gestation about a contraction stress test. Which of the following statements should the nurse include in the teaching?

"You will receive a dose of misoprostol to initiate contractions.

"I will apply an external fetal heart rate monitor during the test."

“I will give you a terbutaline injection after the test."

“I will apply an oxygen face mask during the test

Answer and Explanation

The Correct Answer is B

Rationale:

A. "You will receive a dose of misoprostol to initiate contractions.": Misoprostol is used for cervical ripening and induction of labor, not for a contraction stress test. A CST uses nipple stimulation or low-dose oxytocin to produce mild contractions. Using misoprostol would create strong, prolonged contractions that could endanger the fetus.

B. "I will apply an external fetal heart rate monitor during the test.": A contraction stress test evaluates how the fetal heart rate responds to contractions. External fetal monitoring is required to record the fetal heart pattern and contraction frequency, allowing the provider to assess for late decelerations that indicate uteroplacental insufficiency. This reflects accurate and essential teaching for the procedure.

C. "I will give you a terbutaline injection after the test.": Terbutaline is a tocolytic used to stop contractions, but it is not routinely administered after a CST. The contractions produced during a CST are mild and temporary, and terbutaline is only given if excessive contractions occur, which is not expected in normal testing.

D. "I will apply an oxygen face mask during the test.": Oxygen is not routinely administered during a CST because the goal is to observe how the fetus tolerates normal physiologic contractions. Oxygen is used only if fetal distress occurs, so including it in routine teaching suggests an incorrect understanding of the procedure.

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Correct Answer is C

Explanation

Rationale:

A. WBC count 10,000/mm³ (5,000 to 10,000/mm³): This value is at the upper limit of normal. Mild elevations can occur during early pregnancy due to physiological changes and do not typically require immediate reporting unless accompanied by signs of infection.

B. Fasting blood glucose 80 mg/dL (74 to 106 mg/dL): This value falls within the normal fasting glucose range for adults and is not concerning during early pregnancy. No intervention or reporting is necessary for this result.

C. Hematocrit 30% (37% to 47%): This value is below the normal range, indicating anemia. Early pregnancy anemia can increase the risk of maternal fatigue, preterm birth, and low birth weight. The nurse should report this finding to the provider for further evaluation and possible iron supplementation.

D. RBC count 6 million/mm³ (4.2 to 6.1 million/mm³): This value is within the normal range for red blood cells. It does not indicate any immediate concern and does not require reporting to the provider.

A. Place the client in supine position. B. Ensure the client has a full bladder. C. Obtain a creatinine level. D. Weigh the client.

Correct Answer is D

Explanation

Rationale:

A. Place the client in supine position: The supine position is not ideal for paracentesis. The procedure is typically performed with the client sitting upright on the edge of the bed or in a high Fowler’s position, allowing fluid to collect in the lower abdomen and reducing the risk of organ puncture.

B. Ensure the client has a full bladder: A full bladder increases the risk of bladder puncture during paracentesis. Clients are usually asked to void before the procedure to minimize this risk and promote safety.

C. Obtain a creatinine level: While kidney function may be relevant to overall health, measuring creatinine is not required specifically for paracentesis. The procedure focuses on removing ascitic fluid and assessing for infection or other complications, not directly on renal function.

D. Weigh the client: Weighing the client before the procedure establishes a baseline to evaluate the amount of fluid removed and monitor changes in fluid status. Pre- and post-procedure weights help assess effectiveness and detect complications such as hypotension or fluid shifts.

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A nurse is teaching a client who is at 38 weeks of gestation about a contraction stress test. Which of the following statements should the nurse include in the teaching?

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