The practical nurse (PN) is monitoring a client who was admitted for induction of labor. As the client's labor progresses to the second stage, the fetal heart rate falls to 100 beats/minute following each contraction.
Which intervention should the PN implement first?

Administer oxygen at 10 L/face mask.

Discontinue oxytocin infusion.

Observe perineum for cord prolapse.

Reposition the client laterally.

Answer and Explanation

The Correct Answer is D

Fetal heart rate (FHR) is one of the essential indicators of fetal well-being during labor. A fall in FHR following each contraction is known as recurrent deceleration and can be an indication of fetal distress. In this case, the PN should first reposition the client laterally, as this may help to alleviate compression of the umbilical cord and improve fetal oxygenation.
A.   Administering oxygen at 10 L/face mask may be necessary, but it is not the first intervention to be implemented in this scenario.
B.   Discontinuing oxytocin infusion may be necessary, but it is not the first intervention to be implemented in this scenario.
C.   Observing perineum for cord prolapse is not necessary in this scenario.

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Correct Answer is B

Explanation

Detoxification can be a difficult and potentially dangerous process, and it's important for the client to receive proper monitoring and medication management during this time. The hospital is equipped to provide this level of care and support. The practical nurse should explain this to the client and emphasize the importance of receiving proper care during detoxification.

A. Uses the pregnancy food pyramid when making meal choices. B. Recognizes the dangers of alcohol use during pregnancy. C. Achieves the desired weight gain for each trimester. D. Prepares a diet history for use in analyzing her own diet.

Correct Answer is B

Explanation

The priority goal for the practical nurse (PN) in the antepartum clinic is to ensure that the client recognizes the dangers of alcohol use during pregnancy. Alcohol consumption during pregnancy can lead to fetal alcohol syndrome and other developmental disorders. It is important for the client to understand the risks associated with alcohol use and to avoid it during pregnancy. The other goals are also important but recognizing the dangers of alcohol use takes priority.

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The practical nurse (PN) is monitoring a client who was admitted for induction of labor. As the client's labor progresses to the second stage, the fetal heart rate falls to 100 beats/minute following each contraction. Which intervention should the PN implement first?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The practical nurse (PN) notes several nutritional goals in a standardized plan of care used in the antepartum clinic. Which client goal takes priority?

Correct Answer is B

Explanation

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The practical nurse (PN) is monitoring a client who was admitted for induction of labor. As the client's labor progresses to the second stage, the fetal heart rate falls to 100 beats/minute following each contraction.
Which intervention should the PN implement first?