Maternal-Newborn chapter 14 test bank ACTUAL 55 QUESTIONS WITH DETAILED VERIFIED ANSWERS AND RATIONALE /A+ GRADE ASSURD

Maternal-Newborn chapter 14
test bank ACTUAL 55
QUESTIONS WITH DETAILED
VERIFIED ANSWERS AND
RATIONALE /A+ GRADE
ASSURD
Which method of intrapartum fetal monitoring is
the most appropriate when a woman has a history
of hypertension during pregnancy?
A: continuous auscultation with a fetoscope
B: continuous electronic fetal monitoring
C: intermittent assessment with a Doppler
transducer
D: intermittent electronic fetal monitoring for 15
minutes each hour - ANSWER-B: continuous
electronic fetal monitoring
RATIONALE: Maternal hypertension may reduce
placental blood flow through vasospasm of the
spiral arteries. Reduced placental perfusion is best
assessed with continuous electronic fetal
monitoring to identify patterns associated with this
condition. It is not practical to provide continuous
auscultation with a fetoscope. This fetus needs
continuous monitoring because it is at high risk for
complications.
Why is continuous electronic fetal monitoring
usually used when oxytocin is administered?
A: fetal chemoreceptors are stimulated
B: the mother may become hypotensive
C: maternal fluid volume deficit may occur
D: uteroplacental exchange may be compromised -
ANSWER-D: uteroplacental exchange may be
compromised
RATIONALE: The uterus may contract more firmly
and the resting tone may be increased with
oxytocin use. This response reduces the entrance of
freshly oxygenated maternal blood into the
intervillous spaces, depleting fetal oxygen reserves.
Oxytocin affects the uterine muscles. Hypotension
is not a common side effect of oxytocin. All laboring
women are at risk for fluid volume deficit; oxytocin
administration does not increase the risk.
The nurse evaluates a pattern on the fetal monitor
that appears similar to early decelerations. 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?
A: this pattern reflects variable decelerations. no
interventions are necessary at this time.
B: document this Category I fetal heart rate pattern
and decrease the rate of the IV fluid
C: continue to monitor these early decelerations,
which occur as the fetal head is compressed during
a contraction
D: this deceleration pattern is associated with
uteroplacental insufficiency. the nurse must act
quickly to improve placental blood flow and fetal
oxygen supply. - ANSWER-D: this deceleration
pattern is associated with uteroplacental
insufficiency. the nurse must act quickly to improve
placental blood flow and fetal oxygen supply.
RATIONALE: 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 patient 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
normal pattern, rather it is a Category III tracing,
predictive of abnormal fetal acid status at the time
of observation. The IV rate should be increased in
order to add to the mother's blood volume. These
are late decelerations, not early; therefore
interventions are necessary.
Which maternal condition should be considered a
contraindication for the application of internal
monitoring devices?
A: unruptured membranes
B: cervix dilated to 4 cm
C: fetus has known heart defect
D: maternal HIV - ANSWER-A: unruptured
membranes
RATIONALE: 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. An internal
electrode should not be placed if the patient has
hemophilia, maternal HIV, or genital herpes.