A nurse is caring for a client at 30 weeks gestation who is in preterm labor. The provider orders dexamethasone IM. The nurse recognizes the primary purpose of this medication is to:

Prevent neonatal hypoglycemia

Enhance fetal lung maturity

Reduce the risk of intraventricular hemorrhage in the fetus

Stop uterine contractions

Answer and Explanation

The Correct Answer is B

A. While preterm infants are at increased risk for hypoglycemia due to limited glycogen stores and immature metabolic regulation, dexamethasone does not directly prevent hypoglycemia. Its pharmacologic action is not related to neonatal blood sugar management.

B. Dexamethasone is a corticosteroid given to pregnant clients at risk of preterm birth, typically between 24 and 34 weeks gestation. The medication crosses the placenta and stimulates fetal lung epithelial cells to produce surfactant, a substance that reduces alveolar surface tension, enabling the lungs to remain open for effective gas exchange after birth. By accelerating lung development, dexamethasone significantly reduces the risk of respiratory distress syndrome (RDS), intraventricular hemorrhage, necrotizing enterocolitis, and neonatal mortality. The most benefit is observed when delivery occurs 24–48 hours after the first dose but within 7 days of administration.

C. While corticosteroid therapy can have secondary benefits, including a reduction in intraventricular hemorrhage, this is not the primary purpose of dexamethasone administration. The main goal remains enhancing fetal lung maturity.

D. Dexamethasone is not a tocolytic and does not suppress preterm labor contractions. Tocolytic medications, such as magnesium sulfate, nifedipine, or indomethacin, are used for short-term suppression of uterine activity to allow time for corticosteroids to enhance fetal lung maturity.

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Correct Answer is D

Explanation

A. Fetal hypoxia is typically indicated by abnormal FHR patterns, such as late decelerations, decreased or absent variability, bradycardia, or prolonged decelerations. In this scenario, the FHR shows a normal baseline, moderate variability, and accelerations, all of which suggest adequate oxygenation and fetal well-being.

B. Tachycardia is defined as a baseline FHR greater than 160 beats per minute. Causes of fetal tachycardia can include maternal fever, infection, medications, or fetal hypoxia, but this fetus has a baseline of 135 bpm, which is within the normal range of 110–160 bpm, so tachycardia is not present.

C. Bradycardia is defined as a baseline FHR less than 110 beats per minute. Causes of bradycardia can include prolonged cord compression, maternal hypotension, or congenital heart conditions, but this fetus has a baseline of 135 bpm, ruling out bradycardia.

D. This fetus exhibits a reassuring FHR pattern characterized by a normal baseline indicating adequate cardiac function, moderate variability reflecting an intact autonomic nervous system and good oxygenation, presence of accelerations demonstrating a responsive, well-oxygenated fetus, and absence of decelerations, indicating there is no evidence of uteroplacental compromise or cord compression.

A. All women, regardless of risk factors B. Women who have had a sexually transmitted infection (STI) C. Women who have had more than one sexual partner D. Woman who are monogamous with their partner

Correct Answer is A

Explanation

A. Routine prenatal HIV screening is recommended for all pregnant women, regardless of identified risk factors. Universal testing helps identify undiagnosed HIV early, allowing for timely antiretroviral therapy, which significantly reduces the risk of maternal-to-child transmission. This approach avoids missed diagnoses that can occur when testing is based only on perceived risk.
B. Women with a history of STIs are at increased risk for HIV and should be tested; however, limiting testing only to this group would miss many cases. Therefore, this option is incomplete and not the most appropriate answer.
C. Having multiple sexual partners increases the risk for HIV infection, but prenatal HIV testing is not limited to women with this risk factor. Universal screening is recommended instead.
D. Even women who are monogamous may be at risk if their partner is infected or has other risk factors. For this reason, monogamy does not eliminate the need for prenatal HIV testing.

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A nurse is caring for a client at 30 weeks gestation who is in preterm labor. The provider orders dexamethasone IM. The nurse recognizes the primary purpose of this medication is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During labor a fetus displays an average fetal heart rate (FHR) of 135 beats per minute over a 10-minute period with moderate variability, accelerations are present, and no decelerations are noted by the nurse. Which statement best describes the status of this fetus?

Correct Answer is D

Explanation

Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)?

Correct Answer is A

Explanation

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