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 ["E"]
Explanation
The test result is nonreactive after 40 minutes.Vibroacoustic stimulation (VAS) is the application of a vibratory sound stimulus to the abdomen of a pregnant woman to induce fetal heart rate (FHR) accelerations.VAS is typically used during a nonstress test (NST) to elicit fetal movement and reactivity when the baseline FHR variability is minimal or the test result is nonreactive after 40 minutes.VAS can shorten the testing time and reduce the incidence of non-reactive cardiotocography.
Choice A is wrong because the fetus’s presentation does not affect the use of VAS.
Choice B is wrong because VAS is not indicated for a fetus that has not moved for 40 minutes, unless the NST result is also nonreactive.
Choice C is wrong because minimal baseline FHR variability is not a sufficient indication for VAS, unless the NST result is also nonreactive.
Choice D is wrong because a history of stillbirth does not affect the use of VAS.
Correct Answer is D
Explanation
Notify the provider and prepare for delivery.Oligohydramnios is a condition where the amniotic fluid volume is less than expected for gestational age and it is associated with maternal and fetal complications.
The nonstress test (NST) is a method of fetal surveillance that measures the fetal heart rate response to fetal movement.A reactive NST is defined as at least two accelerations of 15 beats per minute or more above the baseline, lasting 15 seconds or more, within a 20-minute period.
A nonreactive NST indicates fetal hypoxia or acidosis and requires further evaluation.An acoustic stimulator can be used to elicit fetal movement and accelerations, but it should not be repeated more than once in a 10-minute period.
Therefore, choice A is wrong because repeating the acoustic stimulation after 1 minute is too soon and may cause fetal distress.
Choice B is wrong because documenting the finding as a nonreactive NST is not enough to address the situation.Choice C is wrong because performing a contraction stress test (CST) is contraindicated in oligohydramnios because it may cause umbilical cord compression and fetal compromise.
The CST involves inducing uterine contractions with oxytocin or nipple stimulation and monitoring the fetal heart rate for signs of intolerance.
A negative CST means that there
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