A nurse is caring for a client in active labor.

The nurse identifies tachysystole and late decelerations with each contraction.

The nurse performs intrauterine resuscitation interventions, including repositioning the client, initiating an IV fluid bolus, and applying oxygen.

After the stated interventions, the nurse continues to observe tachysystole and recurrent late decelerations.

Which medication does the nurse anticipate administering to reduce uterine activity?

Terbutaline.

Oxytocin.

Misoprostol.

Magnesium sulfate.

Answer and Explanation

The Correct Answer is A

Choice A rationale
Terbutaline is a beta-adrenergic agonist that works by relaxing the smooth muscles of the uterus, thereby reducing uterine contractions. It is commonly used in cases of tachysystole and recurrent late decelerations to decrease uterine activity and improve fetal oxygenation. Terbutaline’s mechanism of action involves stimulating beta-2 adrenergic receptors, which leads to an increase in cyclic AMP and subsequent relaxation of uterine smooth muscle.
Choice B rationale
Oxytocin is a hormone that stimulates uterine contractions and is typically used to induce or augment labor. Administering oxytocin in a situation where there is already tachysystole and recurrent late decelerations would exacerbate the problem by increasing uterine contractions, potentially leading to further fetal distress.
Choice C rationale
Misoprostol is a prostaglandin analog used to ripen the cervix and induce labor. Similar to oxytocin, it would not be appropriate in this scenario as it would increase uterine contractions, worsening the tachysystole and late decelerations.
Choice D rationale
Magnesium sulfate is primarily used as a tocolytic to prevent preterm labor and as a neuroprotective agent for the fetus in cases of preeclampsia. While it has some uterine relaxation properties, it is not the first-line treatment for reducing uterine activity in the context of tachysystole and late decelerations.

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Correct Answer is A

Explanation

Choice A rationale
This statement is incorrect because Stage 2 of labor does not involve the delivery of the placenta. Stage 2 starts with the complete dilation and effacement of the cervix and ends with the delivery of the fetus. The delivery of the placenta occurs in Stage 3 of labor.
Choice B rationale
This statement is correct. Stage 2 of labor begins with complete effacement and dilation of the cervix. This stage is characterized by the mother pushing and the eventual delivery of the baby.
Choice C rationale
This statement is also correct. Stage 2 starts when the cervix is fully dilated, allowing the mother to start pushing. This stage continues until the baby is born.
Choice D rationale
This statement is incorrect. Stage 2 ends with the delivery of the fetus, not the placenta. The delivery of the placenta is part of Stage 3 of labor.

A. Uterine contractions that cause variable decelerations. B. Regular uterine contractions that cause cervical change. C. Station of the presenting part. D. Rupture of the membranes resulting in uterine contractions.

Correct Answer is B

Explanation

Choice B rationale
Regular uterine contractions that cause cervical change are a definitive sign of true labor. True labor is characterized by contractions that become progressively stronger, more frequent, and more regular, leading to cervical dilation and effacement. This process indicates that the body is preparing for childbirth.
Choice A rationale
Uterine contractions that cause variable decelerations are not specific to true labor. Variable decelerations are typically associated with umbilical cord compression and can occur during both true and false labor.
Choice C rationale
The station of the presenting part refers to the position of the fetus in relation to the ischial spines of the pelvis. While it is an important aspect of labor progression, it is not a definitive sign of true labor.
Choice D rationale
Rupture of the membranes, or the breaking of the water, can occur before true labor begins. While it often indicates that labor is imminent, it is not a definitive sign of true labor on its own.

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Naxlex Comprehensive Predictor Exams

The labor and delivery nurse tells her client she has completed stage 1 of labor. Which of the following statements by the student nurse indicates confusion about the stages of labor?

Correct Answer is A

Explanation

A nurse is caring for a client who is 39 weeks gestation and having contractions. Which of the following should the nurse recognize as a sign of true labor?

Correct Answer is B

Explanation

The nurse is caring for a client in labor at term. The nurse reviews the external monitor tracing below. The nurse identifies that the deceleration pattern seen indicates which of the following?

A nurse is caring for a client who is pregnant. The client’s vital signs are as follows: Temperature 37.2°C (98.9°F), Pulse rate 80/min, Respiratory rate 16/min, Blood Pressure 120/69 mm Hg. What should the nurse monitor next?

A nurse on the labor and delivery unit is caring for a client following a vaginal examination by the provider which is documented as -2 station. Which of the following interpretations of this finding should the nurse make?

The OB provider is concerned about placental perfusion and intrauterine growth restriction (IUGR) after noting minimal fetal growth over the past month. What non-invasive antenatal test would the nurse anticipate the provider will order?

A nurse is preparing to administer Terbutaline 0.25 mg SQ to a client for tachysystole. Available is terbutaline injection 5 mg/mL. How many mL should the nurse administer? (Use a leading zero if it applies. Do not use a trailing zero.)

A client has received MSAFP test result. The client is requesting additional testing to determine whether the fetus has a chromosomal abnormality. Which of the following antenatal tests would the nurse anticipate the provider will order?

A nurse is caring for a client who is postoperative following a tracheostomy, and has copious and tenacious secretions. Which of the following is an acceptable method for the nurse to use to thin this client's secretions?