A nurse is assessing a fetal heart rate (FHR) tracing for a client who is in active labor.
The nurse notes that the baseline FHR is 150 bpm with absent variability and recurrent variable decelerations with slow return to baseline.
What category of FHR tracing does this represent?
Category I.
Category II.
Category III.
Category IV.
The Correct Answer is C
Category III. This category of FHR tracing represents an abnormal pattern that is predictive of fetal acidemia and requires prompt evaluation and intervention. A category III pattern is defined by any of the following criteria:
• Absent baseline FHR variability and any of the following:
➤ Recurrent late decelerations
➤ Recurrent variable decelerations
➤ Bradycardia
• Sinusoidal pattern
Choice A is wrong because category I is a normal pattern that is predictive of normal fetal acid-base balance at the time of observation. A category I pattern is defined by all of the following criteria:
• Baseline rate of 110 to 160 bpm
• Moderate baseline FHR variability
• No late or variable decelerations
• Early decelerations may be present or absent
• Accelerations may be present or absent
Choice B is wrong because category II is an indeterminate pattern that is not predictive of abnormal fetal acid-base balance but requires continued surveillance and reevaluation. A category II pattern includes all FHR tracings that are not category I or III.
Choice D is wrong because there is no category IV in the NICHD classification system for FHR tracings.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Negative CST.A negative CST means that there are no late or significant variable decelerations of the fetal heart rate (FHR) during three uterine contractions in 10 minutes.
This indicates that the fetus is well oxygenated and can tolerate the stress of labor contractions.
Choice A is wrong because a positive CST means that there are late decelerations of the FHR with 50% or more of the contractions.
This suggests that the fetus is at risk of hypoxia and may need early delivery.
Choice C is wrong because an unsatisfactory CST means that there are fewer than three contractions in 10 minutes or the tracing is not interpretable.
This does not provide enough information to assess the fetal well-being.
Choice D is wrong because an equivocal CST means that there are either intermittent late decelerations or significant variable decelerations.
This indicates that the fetus may have some degree of compromise and may need further testing.
Normal ranges for FHR are 110 to 160 beats per minute, and for uterine contractions are 2 to 5 per 10 minutes.
Correct Answer is B
Explanation
Lecithin/sphingomyelin (L/S) ratio.
This is a test that measures the amount of two phospholipids in the amniotic fluid that are important for the production of surfactant, a substance that helps the lungs expand and prevents them from collapsing.A higher L/S ratio indicates more surfactant and greater fetal lung maturity.The normal range for L/S ratio is 2:1 or higher at term.
Choice A is wrong because alpha-fetoprotein (AFP) is a protein produced by the fetus that can be measured in the amniotic fluid or maternal blood.It is used to screen for neural tube defects and other abnormalities, not for fetal lung maturity.
Choice C is wrong because Kleihauer-Betke test is a blood test that detects fetal red blood cells in the maternal circulation.It is used to diagnose fetomaternal hemorrhage, a condition where fetal blood leaks into the mother’s blood, not for fetal lung maturity.
Choice D is wrong because indirect Coombs’ test is a blood test that detects antibodies in the mother’s blood that may attack the fetal red blood cells.It is used to screen for Rh incompatibility or other blood group sensitization, not for fetal lung maturity.
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