What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern?

Spontaneous rupture of membranes.

Fetal head compression.

Umbilical cord compression.

Utero-placental insufficiency.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Spontaneous rupture of membranes (SROM) can sometimes be associated with variable decelerations due to potential cord compression if the presenting part is not well applied, but it is not the most likely cause of early decelerations. Early decelerations reflect a physiological response to fetal head compression.

Choice B rationale

Fetal head compression during a contraction leads to vagal nerve stimulation, causing a transient decrease in the fetal heart rate. This deceleration is typically gradual in onset and recovery, mirroring the contraction pattern, and is considered a benign finding.

Choice C rationale

Umbilical cord compression typically results in variable decelerations, which are abrupt decreases in FHR that are not necessarily associated with uterine contractions. The shape and timing of variable decelerations differ significantly from the gradual, consistent pattern of early decelerations.

Choice D rationale

Utero-placental insufficiency usually manifests as late decelerations, which are gradual decreases in FHR that begin after the peak of the contraction and recover after the contraction ends. This pattern indicates fetal hypoxia and is a concerning finding, distinct from early decelerations.

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Correct Answer is B

Explanation

Choice A rationale

Cocaine is a stimulant that typically causes fetal tachycardia (an elevated fetal heart rate) due to its sympathomimetic effects, increasing maternal and subsequently fetal heart rate and blood pressure. It does not usually lead to fetal bradycardia.

Choice B rationale

Prolonged umbilical cord compression can lead to fetal bradycardia because it restricts oxygenated blood flow to the fetus. The baroreceptors in the fetus respond to decreased oxygen by slowing the heart rate in an attempt to conserve oxygen and maintain perfusion to vital organs.

Choice C rationale

Fetal anemia, a decrease in red blood cell count, can lead to fetal tachycardia as the heart attempts to compensate for reduced oxygen-carrying capacity by increasing cardiac output. Bradycardia is not a typical initial response to fetal anemia.

Choice D rationale

Terbutaline is a tocolytic medication used to relax the smooth muscle of the uterus and prevent preterm labor. Its side effects often include maternal and fetal tachycardia due to its beta-adrenergic agonist activity.

A. Blood pressure. B. Uterine tone. C. Deep tendon reflexes. D. Amount of lochia.

Correct Answer is A

Explanation

Choice A rationale

Methergine (methylergonovine) is an oxytocic medication that causes vasoconstriction and increases blood pressure. It is contraindicated in clients with hypertension. Therefore, assessing the client's blood pressure before administration is crucial to ensure safety. Normal adult blood pressure is typically less than 120/80 mmHg.

Choice B rationale

Assessing uterine tone is important in managing postpartum hemorrhage, as a boggy uterus contributes to bleeding. However, before administering a medication that affects blood pressure, the blood pressure itself is the priority assessment due to the contraindications of Methergine in hypertensive clients.

Choice C rationale

Deep tendon reflexes are assessed in the postpartum period, particularly for clients with preeclampsia who are at risk for magnesium sulfate toxicity. While important, it is not the priority assessment before administering Methergine, which has a direct impact on blood pressure.

Choice D rationale

Assessing the amount of lochia is essential for monitoring postpartum bleeding. However, before administering Methergine, which can significantly increase blood pressure, ensuring the client does not have a contraindication related to hypertension is the most critical immediate assessment. .

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What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern?

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Naxlex Comprehensive Predictor Exams

In which clinical situation would the nurse most likely anticipate a fetal bradycardia?

Correct Answer is B

Explanation

Methergine is prescribed for a woman to treat postpartum hemorrhage.Before administration of this medication, the priority nursing assessment is to check the:

Correct Answer is A

Explanation

A nurse is caring for a 37-year-old gravida para client who is at 14 weeks of gestation.The client asks, "Why are you taking my blood pressure? It's always been normal.”. Which of the following responses should the nurse make?

A nurse is caring for a client who is being admitted to the labor and delivery unit.Client reports mild abdominal pain and light vaginal bleeding.Reports last menstrual period was 11 weeks ago.

Which of the following are common methods used for the induction of labor in obstetric practice? (Select All that Apply)

A multigravida client at 31 weeks gestation is admitted with confirmed pre-term labor.As the nurse continues to monitor the client now receiving magnesium sulfate, which assessment findings will the nurse prioritize and report immediately to the RN or health care provider?

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes.What is the nurse's highest priority?

A patient who is 36 weeks pregnant tells you she has been counting her baby's kicks and is concerned because within a 4-hour period the baby has only kicked 32 times.What nursing intervention is correct?

A nurse is caring for a client who is 1 hour postpartum following a vaginal birth.The client has saturated a perineal pad within 10 minutes.Which of the following actions should the nurse take first?

When performing a Non-Stress test, the nurse interprets the finding of two accelerations of the fetal heart rate of 15 beats per minute above the baseline rate of 135 beats per minute lasting for 15 seconds in 20 minutes.This should be documented as: