A nurse on the labor and delivery unit is caring for a patient who is having induction of labor with oxytocin administered through a secondary IV line. Uterine contractions occur every 2
minutes, last 90 seconds, and are strong to palpation. The baseline fetal heart rate is 150/minute, with uniform decelerations beginning at the peak of the contraction and a return to baseline after the contraction is over.

Which of the following actions should the nurse take?

Increase the rate of infusion of the IV oxytocin,

Discontinue the infusion of the IV oxytocin.

Decrease the rate of infusion of the maintenance IV selution.

Slow the client's rate of breathing.

Answer and Explanation

The Correct Answer is B

A.   Incorrect. Increasing the rate of infusion of the IV oxytocin would worsen the uterine hyperstimulation and fetal distress that are indicated by the frequent, long, and strong contractions and uniform decelerations.
B.   Correct. Discontinuing the infusion of the IV oxytocin would stop the uterine hyperstimulation and allow the fetus to recover from hypoxia.
C.   Incorrect. Decreasing the rate of infusion of the maintenance IV solution would not affect the uterine hyperstimulation or fetal distress, as they are caused by the oxytocin, not by the fluid volume.
D.   Incorrect. Slowing the client's rate of breathing would not help with the uterine hyperstimulation or fetal distress, as they are not related to maternal hyperventilation or respiratory alkalosis.

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Correct Answer is C

Explanation

A) Fetal head compression: Fetal head compression would typically result in variable decelerations, not late decelerations.
B) Umbilical cord compression: Umbilical cord compression is associated with variable decelerations, not late decelerations.
C) Uteroplacental insufficiency: Late decelerations occur due to decreased blood flow and oxygen supply to the fetus, which can be caused by uteroplacental insufficiency. This condition can lead to fetal hypoxia during contractions.
D) Maternal bradycardia: Maternal bradycardia would not directly cause late decelerations in the fetal heart rate.

A. "This will determine if there is more than one fetus." B. "It assists in identifying the location of the placenta and fetus." C. "This is a screening tool for spina bifida." D. "It is useful for estimating fetal age."

Correct Answer is B

Explanation

Choice A: An ultrasound can indeed determine the number of fetuses if a client is carrying multiples, but this is not the primary reason for performing an ultrasound before amniocentesis.

Choice B: An ultrasound is typically done before an amniocentesis to visualize the location of the placenta and fetus. This information is important to ensure that the amniocentesis needle is safely inserted away from the placenta and the fetus.

Choice C: The primary purpose of an amniocentesis is to obtain a sample of amniotic fluid to screen for genetic conditions, not specifically for spina bifida.

Choice D: Fetal age can be estimated through an ultrasound, but this is not the primary reason for performing an ultrasound before an amniocentesis. The main goal of the procedure is to obtain a sample of amniotic fluid for genetic testing.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is in labor and has an external fetal monitor. The nurse observes late decelerations on the monitor strip and interprets them as indicating which of the following?

Correct Answer is C

Explanation

A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse?

Correct Answer is B

Explanation

A nurse is caring for a client who is in her first trimester of pregnancy and asks the nurse if she can continue to exercise during pregnancy. Which of the following responses by the nurse is appropriate?

A nurse is assessing a client who is in active labor and notes that the presenting part is at 0 station. Which of the following is the correct interpretation of this clinical finding?

A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse see first?

A nurse is caring for a client who is scheduled for a maternal serum alphafetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client?

A nurse in a prenatal clinic is caring for a client who states that she might be pregnant because she feels the baby moving. How does the nurse classify this statement by the client?

A nurse is caring for an antepartum client whose laboratory findings indicate a negative rubella titer. Which of the following is the correct interpretation of this data?

A nurse is completing a health history for a client who is at 6 weeks of gestation. The client informs the nurse that she smokes one pack of cigarettes per day. The nurse should advise the client that smoking places the client's newborn at risk for which of the following complications?