What should a nurse know about the contraction stress test (CST) when providing care for the antepartum woman?
It sometimes uses vibroacoustic stimulation.
It is considered negative if no late decelerations are observed with the contractions.
It is an invasive test; however, contractions are stimulated.
It is more effective than nonstress test (NST) if the membranes have already been ruptured.
It is more effective than nonstress test (NST) if the membranes have already been ruptured.
The Correct Answer is B
Choice A reason: Vibroacoustic stimulation is a technique that uses sound to stimulate the fetus and elicit a response. It is sometimes used in conjunction with the nonstress test (NST), not the CST. The NST measures the fetal heart rate (FHR) in response to fetal movement, while the CST measures the FHR in response to uterine contractions.
Choice B reason: A negative CST result means that the FHR does not show any late decelerations during at least three contractions in a 10-minute period. Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They indicate uteroplacental insufficiency, which means that the placenta is not delivering enough oxygen and nutrients to the fetus. A negative CST result is reassuring and suggests that the fetus is well-oxygenated and can tolerate labor².
Choice C reason: The CST is not an invasive test, as it does not involve inserting any instruments or devices into the uterus or the fetus. However, it does require stimulating contractions, either by giving the pregnant woman oxytocin (a hormone that causes uterine contractions) or by having her rub her nipples (which also releases oxytocin). The contractions can be uncomfortable and may trigger preterm labor in some cases.
Choice D reason: The CST is not more effective than the NST if the membranes have already been ruptured. In fact, the CST is contraindicated (not recommended) in women who have ruptured membranes, as it can increase the risk of infection and bleeding. The NST is a safer and simpler alternative to the CST, as it does not require stimulating contractions. However, the NST may not be as reliable as the CST in detecting fetal compromise.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A: February 6-7 is incorrect. This is too late for the woman's fertile period, which occurs around the time of ovulation. Ovulation usually happens about 14 days before the next period starts, which would be around January 22 for a 28-day cycle¹.
Choice B:In a 28-day menstrual cycle, ovulation typically occurs around day 14 (counting from the first day of the last menstrual period). Since the first day of the last period is January 8, day 14 falls on January 22. The fertile window consists of the five days leading up to ovulation and the day of ovulation (January 17–22), as sperm can survive in the reproductive tract for up to 5 days, and the egg remains viable for about 24 hours after ovulation.January 22-23 is the most fertile period, with ovulation occurring around January 22 and the egg remaining viable for fertilization on January 23.
Choice C: January 30-31 is incorrect. This is after the woman's fertile period, which ends about a day after ovulation. Ovulation usually happens about 14 days before the next period starts, which would be around January 22 for a 28-day cycle.
Choice D: January 14-15 corresponds to cycle days 7-8, which is too early for ovulation in a typical 28-day cycle. Ovulation generally occurs around day 14 (January 22). The follicular phase (the first half of the cycle) is when the follicles in the ovary mature, and estrogen levels rise to trigger ovulation. At this point (January 14-15), the egg is not yet released, and the uterus is still preparing for ovulation, making conception unlikely.
Correct Answer is A
Explanation
Choice A reason: A previous birth of a large infant (macrosomia) is a risk factor for gestational diabetes mellitus (GDM). A large infant may indicate that the mother had high blood glucose levels during pregnancy, which can cause the fetus to grow larger than normal. Women who have had a large infant are more likely to develop GDM in subsequent pregnancies.
Choice B reason: Underweight before pregnancy is not a risk factor for GDM. In fact, being overweight or obese before pregnancy is a risk factor for GDM, as it increases insulin resistance and makes it harder for the body to use glucose effectively.
Choice C reason: A previous diagnosis of type 2 diabetes mellitus is not a risk factor for GDM. It is a contraindication for GDM, as it means that the woman already has diabetes before pregnancy. GDM is a condition that develops during pregnancy and usually resolves after delivery.
Choice D reason: Maternal age younger than 25 years is not a risk factor for GDM. In fact, being older than 25 years is a risk factor for GDM, as it increases the risk of insulin resistance and other metabolic changes that can affect glucose tolerance.
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