Deck 18: Intrapartal Nursing Assessment

Question 1

A laboring client asks the nurse,"Why does the physician want to use an intrauterine pressure catheter (IUPC)during my labor?" The nurse would accurately explain that the best rationale for using an IUPC is:

A)The IUPC can be used throughout the birth process.
B)A tocodynamometer is subject to artifacts.
C)The IUPC provides more accurate data than does the tocodynamometer.
D)The tocodynamometer can only be used after the cervix is dilated 2 cm.

Answer 1

The IUPC provides more accurate data than does the tocodynamometer.

Question 2

The fetal heart rate pattern associated with abruptio placentae,uterine hyperstimulation,umbilical cord compression,and maternal hypotension is known as fetal:

A)Sinusoidal pattern.
B)Variable deceleration.
C)Tachycardia.
D)Bradycardia.

Answer 2

Bradycardia.

Question 3

A nurse is analyzing several fetal heart rate patterns.The pattern that would be of most concern to the nurse would be:

A)Moderate long-term variability.
B)Early decelerations.
C)Late decelerations.
D)Accelerations.

Answer 3

Late decelerations.

Question 4

During maternal assessment,the nurse determines the fetus to be in a left occiput anterior (LOA)position.Auscultation of the fetal heart rate should begin in the:

A)Right upper quadrant.
B)Left upper quadrant.
C)Right lower quadrant.
D)Left lower quadrant.

Question 5

Before performing Leopold's maneuver,the nurse would: (Select all that apply. )

A)Have the client empty her bladder.
B)Place the client in Trendelenburg position.
C)Have the client lie on her back with her feet on the bed and knees bent.
D)Turn the client to her left side.

Question 6

Upon assessing the FHR tracing,the nurse determines that there is increased variability.The increased variability would be caused by: (Select all that apply. )

A)Early mild hypoxia.
B)Fetal stimulation.
C)Alterations in placental blood flow.
D)Fetal sleep cycle.

Question 7

Persistent early decelerations are noted.The nurse's first action would be to:

A)Turn the mom on her left side and give oxygen.
B)Check for prolapsed cord.
C)Do nothing.This is a benign pattern.
D)Prepare for immediate forceps or cesarean delivery.

Question 8

After several hours of labor,the electronic fetal monitor (EFM)shows repetitive variable decelerations in the fetal heart rate.You would interpret the decelerations to be consistent with:

A)Breech presentation.
B)Uteroplacental insufficiency.
C)Compression of the fetal head.
D)Umbilical cord comprehension.

Question 9

A nurse is analyzing fetal cord blood results.If the fetal blood pH is less than 7.25,the nurse can conclude that the fetus was:

A)Acidotic and hypoxic.
B)Alkalotic and hypoxic.
C)Well oxygenated.
D)Alkalotic but well oxygenated.

Question 10

The nurse is analyzing a fetal heart rate (FHR)monitor strip.The nurse notes that some early decelerations are present.The nurse explains to the client that early decelerations are most often related to:

A)Umbilical cord compression.
B)Fetal head compression.
C)Uteroplacental insufficiency.
D)Fetal hypoxia.

Question 11

The nurse is admitting a client to the birthing unit.What question should the nurse ask to gain a better understanding of the psychosocial status of the client?

A)"How did you decide to have your baby at this hospital?"
B)"Who will be your labor support person?"
C)"Have you chosen names for your baby yet?"
D)"What feeding method will you use for your baby?"

Question 12

After noting meconium-stained amniotic fluid,fetal heart rate decelerations,and a fetal blood pH of 7.20,the physician diagnoses a severely depressed fetus.The appropriate nursing action at this time would be to:

A)Increase the mother's oxygen rate.
B)Turn the mother to the left lateral position.
C)Prepare the mother for a forceps or cesarean birth.
D)Increase the intravenous infusion rate.

Question 13

The nurse has just palpated contractions,and compares the consistency to that of the forehead.The intensity of these contractions would be identified as:

A)Mild.
B)Moderate.
C)Strong.
D)Weak.

Question 14

The nurse auscultates the FHR and determines a rate of 112 bpm.Which action is appropriate?

A)Inform the maternal client that the rate is normal.
B)Reassess the FHR in 5 minutes because the rate is low.
C)Report the FHR to the doctor immediately.
D)Turn the maternal client on her side and administer oxygen.

Question 15

A fetus that is not in any stress would respond to a fetal scalp stimulation test by showing which of the following changes on the monitor strip?

A)Late decelerations
B)Early decelerations
C)Accelerations
D)Increased long-term variability