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

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Melasma, also called the “mask of pregnancy,” is characterized by irregular, blotchy, brownish patches on the face, typically over the cheeks, nose, forehead, and upper lip. It occurs in response to hormonal changes during pregnancy, specifically elevated estrogen and progesterone, which increase melanocyte activity and melanin production in sun-exposed areas. Melasma is more common in women with darker skin tones and those with a family history of hyperpigmentation. It is considered a benign and reversible condition, often improving several months postpartum, though it may persist in some cases. Preventive strategies include limiting sun exposure, using broad-spectrum sunscreen, and wearing protective clothing, as ultraviolet light can worsen pigmentation.

B. Palmar erythema refers to reddening of the palms due to increased estrogen levels and enhanced peripheral vasodilation. While it is a normal pregnancy change, it does not affect the face and therefore does not describe the blotchy facial pigmentation observed in melasma.

C. Linea nigra is a dark vertical line that appears along the midline of the abdomen, extending from the pubic area to the umbilicus or higher. It develops from hormonal stimulation of melanocytes in the abdominal midline and is unrelated to facial hyperpigmentation.

D. Striae gravidarum, commonly called stretch marks, appear as reddish-purple streaks on the abdomen, breasts, hips, or thighs due to rapid skin stretching combined with hormonal effects on connective tissue. They are not blotchy brown patches on the face.

A. 4 B. 7 C. 5 D. 6

Correct Answer is D

Explanation

A. 4 is incorrect because the infant demonstrates more than minimal findings across several Apgar components, resulting in a higher score than 4.

B. 7 is incorrect because a score of 7 would require stronger respiratory effort (good cry) or a heart rate above 100 beats per minute, which are not present in this assessment.

C. 5 is incorrect because the infant earns more points based on reflex irritability and overall appearance, making the score higher than 5.

D. 6 is correct because the Apgar score is calculated as follows:

Heart rate of 90 beats per minute = 1 point
Weak cry = 1 point
Some flexion of extremities = 1 point
Prompt response to stimuli = 2 points
Pink body with blue extremities (acrocyanosis) = 1 point

The total Apgar score at 1 minute is 6.

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A fetal monitor shows variable decelerations. The nurse understands this is most often caused by:

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Naxlex Comprehensive Predictor Exams

A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding?

Correct Answer is A

Explanation

A nurse assesses a baby boy at 1 minute after birth and notes a heart rate of 90 beats per minute, some flexion of extremities, a weak cry, a prompt response to stimuli and a pink body but blue extremities. Which Apgar score does the nurse calculate based on the assessment?

Correct Answer is D

Explanation

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