A nurse is teaching a client who is at 41 weeks of gestation about a nonstress test. Which of the following information should the nurse include in the teaching?
"You should massage one of your nipples to stimulate contractions of your uterus."
"You will have a Doppler transducer applied to your abdomen during the test.
"You should avoid eating or drinking for 4 hours before the test."
"You will need blood work before and after the test."
The Correct Answer is B
A. "You should massage one of your nipples to stimulate contractions of your uterus.": Nipple stimulation is used to induce contractions during a contraction stress test, not a nonstress test. For a nonstress test, the goal is to assess fetal heart rate in response to fetal movements without inducing contractions.
B. "You will have a Doppler transducer applied to your abdomen during the test.": A nonstress test involves placing a Doppler transducer on the maternal abdomen to monitor fetal heart rate and a tocodynamometer to detect uterine activity. The test is noninvasive and monitors fetal heart rate accelerations in response to movement.
C. "You should avoid eating or drinking for 4 hours before the test.": Fasting is not required for a nonstress test. In fact, some providers encourage eating beforehand to promote fetal activity, which helps obtain accurate heart rate accelerations.
D. "You will need blood work before and after the test.": Blood work is not required for a nonstress test. The test relies solely on external monitoring of the fetal heart rate and maternal contractions, making it noninvasive and straightforward.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Progestin oral contraceptive: Progestin-only oral contraceptives (often called the “mini-pill”) are safe to use immediately postpartum for breastfeeding clients because they do not affect milk production. They provide effective contraception without the risks associated with estrogen-containing methods.
B. Vaginal etonogestrel/ethinyl estradiol contraceptive ring: Combination estrogen-progestin contraceptives, such as the vaginal ring, are generally not recommended immediately postpartum for breastfeeding clients because estrogen can reduce milk supply and may increase the risk of thromboembolism.
C. Transdermal estrogen/progesterone patch: Similar to other estrogen-containing methods, the transdermal patch is not recommended immediately postpartum for breastfeeding clients due to potential interference with lactation and increased thromboembolism risk.
D. Injectable synthetic progestin: Injectable progestin (e.g., depot medroxyprogesterone acetate) is safe for breastfeeding, but it is not ideal for immediate postpartum use if the client wishes for rapid return to fertility later, since its effects can last for several months. It may also have delayed effects on bone density with long-term use.
Correct Answer is A
Explanation
A. Perform bimanual fundal massage: Excessive vaginal bleeding postpartum often indicates uterine atony. Performing a bimanual fundal massage helps stimulate uterine contraction, which can reduce hemorrhage. This is a primary and immediate intervention in postpartum bleeding management.
B. Weigh perineal pads: Weighing pads helps quantify blood loss but does not actively stop hemorrhage. While important for assessment and documentation, it is not the first action when the client is actively bleeding.
C. Initiate oxygen at 2 L/min via nasal cannula: Administering oxygen may support tissue oxygenation but does not address the underlying cause of postpartum hemorrhage. Oxygen is supportive care and should not replace interventions to control bleeding.
D. Administer terbutaline: Terbutaline is a uterine relaxant used to treat preterm labor, which would worsen postpartum bleeding by inhibiting uterine contraction. It is contraindicated in cases of active postpartum hemorrhage.
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