A fetal monitor shows variable decelerations. The nurse understands this is most often caused by:
Head compression
Cord compression
Placental insufficiency
Normal fetal sleep patterns
The Correct Answer is B
A. Head compression typically causes early decelerations, not variable decelerations. Early decelerations are gradual decreases in fetal heart rate that mirror uterine contractions and are considered a benign sign of fetal descent through the birth canal.
B. Cord compression is the most common cause of variable decelerations. These are abrupt decreases in fetal heart rate that may vary in timing, shape, and duration, often occurring independently of uterine contractions. Variable decelerations result from umbilical cord compression, which can temporarily reduce blood flow and oxygen to the fetus. Interventions focus on relieving the compression, such as repositioning the mother, providing oxygen, or increasing intravenous fluids.
C. Placental insufficiency is associated with late decelerations, which are gradual decreases in fetal heart rate that begin after the contraction starts and return to baseline after the contraction ends. Late decelerations indicate uteroplacental compromise and may signal fetal hypoxia, which is more serious than variable decelerations.
D. Normal fetal sleep patterns can cause brief, mild decreases in baseline heart rate, but these are generally not abrupt, variable decelerations seen on monitoring. Sleep-related changes are gradual and last 20–40 minutes, unlike the abrupt pattern of variable decelerations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The MSAFP test is a screening test used during the second trimester (typically 15–20 weeks) to assess the risk of neural tube defects, such as spina bifida and anencephaly, in the fetus. Elevated AFP levels are associated with open neural tube defects.
B. MSAFP alone does not assess various markers of fetal well-being. While AFP may be part of multiple-marker screening tests (e.g., triple or quad screen), those tests assess risk for chromosomal abnormalities, not overall fetal well-being.
C. Rh incompatibility is identified through maternal blood type and antibody screening (indirect Coombs test), not through the MSAFP test.
D. Fetal lung maturity is assessed later in pregnancy using amniotic fluid studies (e.g., lecithin-to-sphingomyelin ratio), not by maternal serum AFP testing.
Correct Answer is A
Explanation
A. Subinvolution of the uterus is the most common cause of late postpartum hemorrhage, which occurs more than 24 hours after delivery (often 1–6 weeks postpartum). It is commonly related to retained placental fragments or infection, leading to failure of the uterus to return to its normal size and tone, resulting in excessive bleeding.
B. Cervical lacerations typically cause early postpartum hemorrhage immediately after birth and are associated with a firm uterus and continuous bleeding, not late PPH.
C. Uterine inversion is a rare, acute obstetric emergency that occurs shortly after delivery and causes early postpartum hemorrhage, severe pain, and shock.
D. Defective vascularity of the placenta is not a typical cause of late postpartum hemorrhage; placental abnormalities are more commonly associated with antepartum or early postpartum bleeding.
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