Chapter 14: Intrapartum Fetal Surveillance

Chapter 14: Intrapartum Fetal Surveillance

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation?

ANS:  D

A pattern similar to early decelerations, but the deceleration begins near the acme of the contraction and continues well beyond the end of the contraction, describes a late deceleration. Oxygen should be given via a snug face mask. Position the client on her left side to increase placental blood flow. Variable decelerations are caused by cord compression. A vaginal examination should be performed to identify this potential emergency. This is not a reassuring pattern, so the IV rate should be increased to increase the mother’s blood volume. These are late decelerations, not early; therefore, interventions are necessary.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   265

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Physiologic Integrity

2. Which maternal condition should be considered a contraindication for the application of internal monitoring devices?

ANS:  A

To apply internal monitoring devices, the membranes must be ruptured. Cervical dilation of 4 cm would permit the insertion of fetal scalp electrodes and an intrauterine catheter. A compromised fetus should be monitored with the most accurate monitoring devices. The external monitor can be discontinued after the internal ones are applied.

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   261

OBJ:   Nursing Process Step: Planning        MSC:  Client Needs: Physiologic Integrity

3. The nurse is instructing a nursing student on the application of fetal monitoring devices. Which method of assessing the fetal heart rate requires the use of a gel?

ANS:  A

Doppler is the only listed method involving ultrasonic transmission of fetal heart rates; it requires the use of a gel. The fetoscope does not require gel because ultrasonic transmission is not used. The scalp electrode is attached to the fetal scalp; gel is not necessary. The tocodynamometer does not require gel. This device monitors uterine contractions.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   257

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Health Promotion and Maintenance

4. A client is receiving oxytocin (Pitocin) to induce labor. The uterine contractions have become persistently hypertonic and the infusion is stopped. The health care provider has prescribed a tocolytic to stop contractions. Which medication should the nurse be prepared to administer?

ANS:  B

A tocolytic drug, such as terbutaline (0.125 to 0.25 mg IV or 0.25 mg subcutaneously), may be given to reduce uterine activity. Narcan is a narcotic antagonist. Benadryl is an antihistamine. Ephedrine is a vasopressor used to increase blood pressure.

PTS:   1                    DIF:    Cognitive Level: Application           REF:   270

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Physiologic Integrity

5. Proper placement of the tocotransducer for electronic fetal monitoring is:

ANS:  C

The tocotransducer monitors uterine activity and should be placed over the fundus, where the most intensive uterine contractions occur. The tocotransducer is for external use. The tocotransducer monitors uterine contractions. The most intensive uterine contractions occur at the fundus; this is the best placement area.

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   261

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Health Promotion and Maintenance