A nurse assisting in the care of a client, places the tocodynamometer (TOCO) transducer on a client's fundus and secures it in place. The client asks the nurse to explain the purpose of the monitoring device. Which of the following responses should the nurse make?
"This monitor gives me information related to fetal heart rate fluctuations during your labor."
"This monitor measures the intensity and frequency of your contractions so I can observe labor progress."
"This monitor allows me to observe your labor progress. By observing the pattern, I can tell how strong your contractions are."
"This monitor provides me with information related to the duration and frequency of your contractions."
The Correct Answer is D
A. "This monitor gives me information related to fetal heart rate fluctuations during your labor." – Incorrect; the TOCO does not monitor fetal heart rate; the fetal heart rate is detected using a Doppler or fetal scalp electrode.
B. "This monitor measures the intensity and frequency of your contractions so I can observe labor progress." – Incorrect; the TOCO can measure frequency and duration, but not intensity (which requires an intrauterine pressure catheter).
C. "This monitor allows me to observe your labor progress. By observing the pattern, I can tell how strong your contractions are." – Incorrect; TOCO does not measure contraction strength, only duration and frequency.
D. "This monitor provides me with information related to the duration and frequency of your contractions." – Correct; a TOCO detects and records contraction frequency and duration, but not intensity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Notify social services. – Incorrect; while reporting may be necessary, the nurse must first gather more information.
B. Ask the parents what caused the bruises. – Correct; the nurse should first assess by asking the parents in a nonjudgmental manner to determine if the bruises are accidental or suspicious for abuse.
C. Ask the toddler what caused the bruises. – Incorrect; toddlers may have limited verbal skills, and their responses may not be reliable.
D. Notify the provider. – Incorrect; while the provider should be informed, the nurse must first assess before escalating concerns.
Correct Answer is A
Explanation
A. Gravidity (G): The total number of pregnancies, including the current one. She has had 3 prior pregnancies and is currently pregnant, making her G4. Term (T): Number of term births (37 weeks or later). She has had two sets of twins delivered at 37 and 38 weeks, so T2. Preterm (P): Number of preterm births (between 20 and 36 weeks 6 days). She has one son born at 34 weeks, so P1. Abortions (A): Number of pregnancies ending in miscarriage or abortion before 20 weeks. She has no history of miscarriage or abortion, so A0. Living (L): Number of living children. She has two sets of twins (4 children) and her 9-year-old son (1 child), making a total of L5.
B. Gravidity (G): The total number of pregnancies, including the current one. She has had 3 prior pregnancies and is currently pregnant, making her G4. Term (T): Number of term births (37 weeks or later). She has had two sets of twins delivered at 37 and 38 weeks, so T2. Preterm (P): Number of preterm births (between 20 and 36 weeks 6 days). She has one son born at 34 weeks, so P1. Abortions (A): Number of pregnancies ending in miscarriage or abortion before 20 weeks. She has no history of miscarriage or abortion, so A0. Living (L): Number of living children. She has two sets of twins (4 children) and her 9-year-old son (1 child), making a total of L5.
C. Gravidity (G): The total number of pregnancies, including the current one. She has had 3 prior pregnancies and is currently pregnant, making her G4. Term (T): Number of term births (37 weeks or later). She has had two sets of twins delivered at 37 and 38 weeks, so T2. Preterm (P): Number of preterm births (between 20 and 36 weeks 6 days). She has one son born at 34 weeks, so P1. Abortions (A): Number of pregnancies ending in miscarriage or abortion before 20 weeks. She has no history of miscarriage or abortion, so A0. Living (L): Number of living children. She has two sets of twins (4 children) and her 9-year-old son (1 child), making a total of L5.
D. Gravidity (G): The total number of pregnancies, including the current one. She has had 3 prior pregnancies and is currently pregnant, making her G4. Term (T): Number of term births (37 weeks or later). She has had two sets of twins delivered at 37 and 38 weeks, so T2. Preterm (P): Number of preterm births (between 20 and 36 weeks 6 days). She has one son born at 34 weeks, so P1. Abortions (A): Number of pregnancies ending in miscarriage or abortion before 20 weeks. She has no history of miscarriage or abortion, so A0. Living (L): Number of living children. She has two sets of twins (4 children) and her 9-year-old son (1 child), making a total of L5.
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