NU 321 Sherpath 4: Fetal Assessment Methods

Match the FHR classification with its corresponding description.

Category 1 - Tracing with moderate variability and absent late decelerations

Category II - Tracing with recurrent late decelerations and no accelerations

Category III - Tracing with absent baseline variability and recurrent late decelerations

For which reason are Leopold maneuvers performed prior to intermittent auscultation of FHR?

a. Identifying fetal presentation

b. Determining contraction intensity

c. Assessing fetal movement

d. Evaluating contraction frequency

a. Identifying fetal presentation

Which clinical finding of the client in labor must be assessed prior to fetal electrocardiograph (fECG)?

a. Complete cervical effacement

b. Rupture of membranes

c. Transverse fetal lie

d. Posterior placental attachment

b. Rupture of membranes

Which monitoring device would require access to the fetal presenting part?

a. Ultrasound transducer

b. Spiral electrode

c. Tocotransducer

d. Intrauterine pressure catheter (IUPC)

b. Spiral electrode

Which statement is accurate about the use of integrated abdominal monitoring?

a. It interprets the intensity of contraction.

b. Contractions can be evaluated at home using this.

c. Frequent readjustment is required during its use.

d. It provides monitoring during hydrotherapy.

d. It provides monitoring during hydrotherapy

Which location would the nurse position the tocotransducer on a pregnant client?

a. Across the area of maximal FHR intensity

b. Covering the umbilicus

c. Above the symphysis pubis

d. Directly over the fundus

d. Directly over the fundus

Which condition would cause alteration in fetal circulation? Select all that apply

a. Partial placental separation

b. Occipital posterior presentation

c. Fetal head compression

d. Umbilical cord prolapse

e. Complete placental abruption

a. Partial placental separation

c. Fetal head compression

d. Umbilical cord prolapse

e. Complete placental abruption

Which description would the nurse give the average uterine resting tone during labor?

a. Boggy palpation

b. Rigid board-like

c. Easily indented

d. Moderate resistance

c. Easily indented

In the presence of which labor characteristic would the nurse use intermittent auscultation?

a. Progression of labor without oxytocin

b. Spontaneous ROM

c. Augmentation of uterine contractions

d. Sufficient dilation of the cervix

a. Progression of labor without oxytocin

Which maternal factor may cause weak, absent, or false ultrasound transducer signals? Select all that apply

a. Maternal obesity

b. Placental attachment

c. Previous c-section

d. Retroverted uterus

e. Fundal height

a. Maternal obesity

b. Placental attachment

Which measurement is used to identify the intensity of uterine contractions?

a. The frequency of fetal accelerations

b. The calculation of Montevideo units (MVUs)

c. The number of contractions in a 10-minute window

d. The tracing recorded by the tocotransducer

b. The calculation of Montevideo units (MVUs)

Which information regarding electronic fetal monitoring would the nurse provide to a woman in labor?

a. The lower tracing shows the FHR.

b. It is necessary to maintain a supine position.

c. The fetus is only monitored between contractions.

d. The monitor does not restrict movement.

d. The monitor does not restrict movement

Which baseline fetal heart rate (FHR) measurement would be considered normal?

a. Baseline greater than 100 beats/min

b. Baseline between 60 and 100 beats/min

c. Baseline greater than 160 beats/min

d. Baseline between 110 and 160 beats/min

d. Baseline between 110 and 160 beats/min

Which inference would the nurse draw if moderate fetal heart rate (FHR) variability is present?

a. The fetus is anemic.

b. The fetus is premature.

c. There is a normal acid-base balance.

d. The fetus is in a sleep cycle.

c. There is a normal acid-base balance

Which complication may cause fetal bradycardia? Select all that apply.

a. Magnesium sulfate infusion

b. Maternal infection

c. Maternal hypothermia

d. Fetal anemia

e. Maternal hypoglycemia

f. Cocaine or amphetamines

a. Magnesium sulfate infusion

c. Maternal hypothermia

e. Maternal hypoglycemia

Which characteristic of fetal heart rate (FHR) would be observed with an acceleration? Select all that apply

a. Peaks at least 10 beats/min above the baseline at term.

b. Lasts 15 seconds to 2 minutes

c. Occurs only with contractions

d. Peaks at least 15 beats/min above the baseline

e. Lasts more than 2 minutes

b. Lasts 15 seconds to 2 minutes

d. Peaks at least 15 beats/min above the baseline

Which frequency of fetal heart rate (FHR) assessment is recommended by the American College of Obstetrics and Gynecology for low-risk women during the second stage of labor?

a. Every 30 minutes

b. Every 60 minutes

c. Every 15 minutes

d. Every 5 minutes

c. Every 15 minutes

Which intervention would the nurse perform when an abnormal fetal heart rate (FHR) is identified? Select all that apply.

a. Changing maternal position

b. Administering a tocolytic

c. Administering maternal oxygen

d. Increasing intravenous (IV) fluids

e. Reducing or stopping uterine stimulants

a. Changing maternal position

b. Administering a tocolytic

d. Increasing intravenous (IV) fluids

e. Reducing or stopping uterine stimulants

Which outcome of fetal scalp stimulation would indicate the absence of fetal acidemia?

a. The absence of late fetal heart rate (FHR) decelerations

b. Acceleration of at least 15 beats/min for at least 15 seconds at term

c. Acceleration of at least 10 beats/min for at least 10 seconds at term

d. A change in fetal baseline by at least 15 beats/min

b. Acceleration of at least 15 beats/min for at least 15 seconds at term

Which condition would necessitate the initiation of amnioinfusion?

a. Recurrent variable decelerations

b. Recurrent early decelerations

c. Recurrent late decelerations

d. The presence of thick meconium

a. Recurrent variable decelerations

Which occurrence would necessitate the administration of tocolytic therapy by the nurse?

a. Uterine tachysystole

b. Recurrent variable decelerations

c. Fetal bradycardia

d. Presence of early decelerations

a. Uterine tachysystole

Which explanation would the nurse provide to a client asking about the lack of impact on the baby's heart rate during contractions?

a. The balance between the sympathetic and parasympathetic nervous systems prevents change.

b. The fetal nervous system is still immature and cannot accommodate the changes.

c. The sympathetic nervous system prevents the heart rate from increasing.

d. The parasympathetic nervous system prevents the heart rate from decreasing.

a. The balance between the sympathetic and parasympathetic nervous system prevents change

Which information would the nurse consider for determining the appropriate action after observing a sinusoidal pattern in the fetal heart rate (FHR) over the past 30 minutes?

a. It is a result of umbilical cord compression.

b. It indicates a normal acid-base balance.

c. It signifies that the client is close to pushing.

d. It is associated with severe fetal acidemia.

d. It is associated with severe fetal acidemia.

Which condition would the nurse suspect if the fetal heart monitor shows fetal bradycardia?

a. Maternal infection

b. Maternal hypertension

c. Fetal heart block

d. Fetal anemia

c. Fetal heart block

Match the type of fetal deceleration with its characteristic.

Gradual decrease in fetal heart rate (FHR) that occurs with the contraction --> Early deceleration

Abrupt decrease in FHR that is caused by cord compression

--> Variable deceleration

Gradual decrease in FHR that occurs after the contraction

--> Late deceleration

Decrease in FHR that lasts between 2 minutes and 10 minutes

--> Prolonged deceleration

Which action would the nurse perform after noting recurrent variable decelerations during fetal heart rate (FHR) assessment? Select all that apply

a. Resolving maternal hypotension

b. Assisting with assessment of cord prolapse

c. Discontinuing oxytocin

d. Administering intravenous (IV) fluids

e. Changing maternal position

b. Assisting with assessment of cord prolapse

c. Discontinuing oxytocin

e. Changing maternal position

Which intervention would the nurse use for an abnormal fetal heart rate (FHR) tracing during the second stage of labor? Select all that apply

a. Using open glottis pushing

b. Using fewer pushes during each contraction

c. Administering supplemental oxygen

d. Pushing with every other contraction

e. Increasing Pitocin for stronger contractions

a. Using open glottis pushing

b. Using fewer pushes during each contraction

d. Pushing with every other contraction

Which diagnosis would be made when the pH of fetal umbilical arterial cord gases is 7.1, with a Pco2 of 60, a Po2 of 25, and a base excess of 8 after birth?

a. Metabolic acidosis

b. Respiratory acidosis

c. Mixed acidosis

d. Normal values and no acidosis

b. Respiratory acidosis

Which assessment finding would alert the nurse to the possibility of uterine overdistension due to amnioinfusion?

a. Resolution of variable decelerations

b. The volume of fluid returned being equal to that infused

c. A resting tone greater than 40 mmHg

d. The volume of fluid returned being greater than that infused

c. A resting tone greater than 40 mmHg

Which information would the nurse give to a patient who received terbutaline?

a. "The use of this medication will speed up your contractions for faster labor."

b. "This medication will cause the baby to have accelerations, which are reassuring."

c. "This medication is used for pain management, and you will begin to feel relief."

d. "The purpose of this medication is to relax the uterus to allow for better blood flow to the baby."

d. "The purpose of this medication is to relax the uterus to allow for better blood flow to the baby."

Which position indicates a cephalic presentation?

a. The buttocks present first.

b. The presenting part is the occiput.

c. The fetal lie is oblique.

d. The presenting part is a fetal leg.

b. The presenting part is the occiput

Which anteroposterior diameter is the most critical in allowing the fetal head to descend easily into the true pelvis?

a. Occipitofrontal diameter

b. Suboccipitobregmatic diameter

c. Biparietal diameter

d. Occipitomental diameter

b. Suboccipitobregmatic diameter

Which value indicates that the fetal presenting part is engaged in the pelvis?

a. Station -1

b. Station +3

c. Station 0

d. Station -4

c. Station 0

Which factor is determined by measuring the length of the diagonal conjugate?

a. If the labor will prolong

b. If the placenta can enter the pelvic inlet

c. If the presenting part can enter the birth canal

d. If there is a possibility for breech presentation

c. If the presenting part can enter the birth canal

Match the pelvis type with the corresponding effect on the labor process.

Is associated with birth in OA position --> Gynecoid

Increases the risk of a transverse arrest --> Platypelloid

Increases the risk of CPD --> Android

Is associated with birth in OP position --> Anthropoid

Which role does the cervix play in facilitating a successful vaginal delivery?

a. Helps the fetus rotate anteriorly

b. Permits passage of the fetus into the external world

c. Exerts downward pressure by contracting

d. Effaces and dilates to allow fetal descent into the vagina

d. Effaces and dilates to allow fetal descent into the vagina

Which fetal characteristic would facilitate a vaginal birth? Select all that apply

a. Arms crossed over the thorax

b. Sacrum positioned in the lower pelvis

c. Umbilical cord between the legs

d. Legs flexed at the knees

e. Extended fetal head

a. Arms crossed over the thorax

c. Umbilical cord between the legs

d. Legs flexed at the knees

Match the term related to fetal characteristics with the corresponding description.

Relation of presenting part to the maternal ischial spines --> Station

Relation of the fetal body parts to another --> Attitude

Relation of the long axis of the fetus to the long axis of the mother --> Lie

Part of fetus entering the pelvic inlet first --> Presentation

Which action of fetal fontanels helps promote a successful vaginal delivery?

a. Extension of the fetal head

b. Internal rotation of the fetus

c. Molding of the fetal head

d. Engagement of fetal head in the pelvis

c. Molding of the fetal head

Which characteristic describes the upper border of the true pelvis?

a. A curved passage with a short wall

b. Formed laterally by the iliopectineal lines along the innominate bones

c. Bounded by the posterior aspect of symphysis pubis

d. Ovid and diamond shaped

b. Formed laterally by the iliopectineal lines along the innominate bones

Which characteristic of the cervix indicates full dilation?

a. Diameter of 5 cm

b. Not palpable

c. Cervical mucus discharge

d. Cervical effacement

b. Not palpable

Which role do secondary powers play in labor?

a. Facilitating onset of labor

b. Promoting cervical dilation

c. Facilitating expulsion of the fetus

d. Promoting uterine contractions

c. Facilitating expulsion of the fetus

Which education would a nurse provide to a first-time pregnant client a few weeks before their expected birth?

a. "Your uterus will move upward and back before delivery."

b. "The baby's head will descend into your pelvis about four weeks before term."

c. "You should start to feel more pressure below your ribcage as delivery nears."

d. "Your breathing may become easier once lightening occurs."

d. "Your breathing may become easier once lightening occurs."

Which characteristic would be observed in stage 2 of labor?

a. Rapid cervical dilation occurs with regular uterine contractions.

b. The fetus descends passively through the birth canal, rotating to an anterior position.

c. The placenta has separated from the uterine wall.

d. There is an increase in fetal movement.

b. The fetus descends passively through the birth canal, rotating to an anterior position.

Match the cardinal movement with its corresponding description.

The biparietal diameter of the head passes through the pelvic inlet --> Engagement

The fetal head passes the pelvic inlet in occipitotransverse position --> Internal rotation

The head and shoulders are raised toward the mother's pubic bone --> Expulsion

The occiput passes under the lower border of the symphysis pubis --> Extension

Which fetal change facilitates respiration after birth?

a. Increased fetal oxygen concentration

b. Increased arterial pH

c. Decreased bicarbonate level

d. Decreased arterial CO2 pressure concentration

c. Decreased bicarbonate level

Which complication would the nurse monitor for during the labor of a client with obesity?

a. Pallor

b. Supine hypotension

c. Low cardiac output

d. Decreased WBC count

b. Supine hypotension

Which symptom may be observed in a client who is hyperventilating during labor?

a. Respiratory acidosis

b. Hypoxia

c. Hypercapnia

d. Increased intrathoracic pressure

b. Hypoxia

Which explanation does the gate-control theory provide for pain relief?

a. Neuromuscular and motor activity modify pain signals.

b. Pain signals are prevented from reaching the brain.

c. The stimulation of auditory input creates a pain-free environment.

d. Pain is selectively manipulated in nerve cell groupings in the cerebral cortex.

b. Pain signals are prevented from reaching the brain.

Which outcome may result from excessive anxiety during labor? Select all that apply

a. Slow progress of labor

b. Increased muscle tension

c. Increased uterine blood flow

d. Elevated pain perception

e. Decreased levels of blood glucose

a. Slow progress of labor

b. Increased muscle tension

d. Elevated pain perception

Which nerve pathway is involved in the transmission of visceral pain?

a. T10-T12 spinal nerve segments

b. Abdominal wall nerve segments

c. Rectal nerve segments

d. Peritoneal nerve segments

a. T10-T12 spinal nerve segments

Tub hydrotherapy is contraindicated in a patient with which condition?

a. 38 weeks of gestational age

b. Multiparous pregnancy

c. Preterm labor

d. Ruptured membranes

c. Preterm labor

Which mechanism enables an intradermal water block to be effective during labor?

a. Hindering the sensations of the myelinated sensory and motor fibers

b. Anesthetizing the pudendal nerve

c. Reducing the initial perception of pain

d. Introducing counterirritation

d. Introducing counterirritation

Which instruction would be given to a patient when using a cleansing breath technique?

a. "Breath IN-2-3-4/OUT-2-3-4 at half the normal breathing rate."

b. "Let's begin 3:1 patterned breathing by IN-OUT/IN-OUT/IN-OUT/IN-BLOW."

c. "Breathe in through the nose and breathe out through the mouth."

d. "Breathe IN-OUT/IN-OUT at twice the normal breathing rate."

c. "Breathe in through the nose and breathe out through the mouth."

Which criterion would the nurse consider before using touch therapy for labor pain management? Select all that apply

a. Who is allowed to touch the patient?

b. Does the patient have a prepared birth method?

c. Has the patient experienced any sexual abuse?

d. Is the patient allergic to any lubricants?

e. Do cultural beliefs prevent this method from being used?

a. Who is allowed to touch the patient?

b. Does the patient have a prepared birth method?

c. Has the patient experienced any sexual abuse?

e. Do cultural beliefs prevent this method from being used?

Which chemical messenger is released when acupressure is administered to a laboring patient?

a. Norepinephrine

b. Endorphins

c. Adrenaline

d. Cortisol

b. Endorphins

Which electrode placement during transcutaneous electrical nerve stimulation (TENS) is required for the pain management of a laboring patient?

a. Thoracic spine

b. Lower abdomen

c. Cervical spine

d. Flank region

a. Thoracic spine

Match the opioid agonist to the correct description.

Causes neurobehavioral changes that cannot be reversed with naloxone --> Meperidine (Demerol)

Acts for a short duration and requires frequent dosing --> Fentanyl (Sublimaze)

Pain relief onset begins within 1 minute --> Remifentanil (Ultiva)

Which finding is consistent with opioid abstinence syndrome?

a. Constricted pupils

b. Hypotonia

c. Constipation

d. Sweating

d. Sweating

Left off on Pharmacologic Pain Management and Nursing Care