A 38-week pregnant patient is being prepared for a version.
Which of the following assessments is most important during and after this procedure?

Assess for contractions.

Check the amniotic fluid volume.

Assess the fetal heart rate.

Monitor for vaginal bleeding.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While monitoring for contractions is important, the most critical assessment is the fetal heart rate. Contractions can occur during and after the procedure, but their presence alone is not as indicative of fetal well-being or distress as a change in the fetal heart rate. The contractions themselves are expected and a direct result of the manipulation of the uterus.

Choice B rationale

Checking the amniotic fluid volume is typically done via ultrasound prior to the procedure to ensure there's enough fluid for the fetus to be mobile. A version is contraindicated if there is insufficient fluid (oligohydramnios). However, this is a pre-procedure assessment, and a real-time assessment during and after the procedure is focused on the fetal response.

Choice C rationale

During a version, the fetus is manually repositioned, which can cause transient umbilical cord compression or placental abruption. Monitoring the fetal heart rate is paramount to detect signs of fetal distress, such as bradycardia or persistent decelerations, which would necessitate immediate cessation of the procedure. This assessment is the most direct indicator of fetal tolerance.

Choice D rationale

Monitoring for vaginal bleeding is important post-procedure to detect a placental abruption, which is a potential complication. However, changes in the fetal heart rate are often the earliest and most direct sign of fetal compromise and should be monitored continuously, both during and immediately after the procedure. Vaginal bleeding may be a later sign.

Nursing Test Bank

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Correct Answer is ["A","D","E"]

Explanation

Choice A rationale

An ultrasound for cervical length is a crucial diagnostic tool for assessing preterm labor. A shortened cervix, typically less than 2.5 cm, is a significant risk factor for preterm birth. Measuring the cervical length helps to determine the probability of progressing to true labor and guides subsequent interventions, such as cerclage or progesterone therapy.

Choice B rationale

Amniocentesis, the sampling of amniotic fluid, is primarily used for genetic testing, assessing fetal lung maturity, or diagnosing fetal infection. It is not a standard procedure for a patient with intermittent back pain and pelvic pressure at 28 weeks gestation, as it carries risks, including inducing labor and infection, and isn't the first-line diagnostic for this presentation.

Choice C rationale

A glucose tolerance test is a screening tool for gestational diabetes, typically performed between 24 and 28 weeks of gestation. While the patient is at this gestational age, the test is not directly related to the symptoms of back pain and pelvic pressure, which are more indicative of potential preterm labor. The test wouldn't be a priority in this specific context.

Choice D rationale

A fetal fibronectin (fFN) swab is a diagnostic test used to predict the likelihood of preterm birth. The presence of fFN, a protein that acts as a "glue" for the fetal sac, in cervical or vaginal secretions between 22 and 34 weeks gestation suggests an increased risk of preterm labor within the next one to two weeks. It is a key tool in managing preterm labor.

Choice E rationale

Encouraging fluids and rest is a common initial intervention for a patient with symptoms of preterm labor. Dehydration can sometimes trigger uterine contractions, so rehydration may help to stop them. Resting can also reduce uterine irritability. This non-pharmacological approach is often the first step before more aggressive treatments are considered. *.

Correct Answer is ["0.25"]

Explanation

Step 1 is: 12.5 mg ÷ (50 mg ÷ 1 mL) = 0.25 mL. The final calculated answer is 0.25 mL.

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A 38-week pregnant patient is being prepared for a version. Which of the following assessments is most important during and after this procedure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a patient who is 28 weeks pregnant and complaining of intermittent back pain and pelvic pressure. Which of the following should the nurse expect to be done? Select all that apply.

Correct Answer is ["A","D","E"]

Explanation

The nurse-midwife orders fentanyl 12.5 mg IV now for the laboring mother. Fentanyl from the pharmacy comes in 50 mg/ml vials. How many ml would the nurse draw up for the injection?

Correct Answer is ["0.25"]

Explanation

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A 38-week pregnant patient is being prepared for a version.
Which of the following assessments is most important during and after this procedure?