A nurse is caring for a client who is having a nonstress test. The fetal heart rate (FHR) baseline is 145 bpm, there is moderate variability, but there have been no accelerations or fetal movement. Which of the following actions should the nurse complete next?
Encourage the client to walk around without the monitoring unit for 30 minutes, then resume monitoring.
Immediately report the situation to the client’s provider and prepare the client for induction of labor.
Perform vibroacoustic stimulation on the maternal abdomen.
Reposition the client into a supine position and begin the test again.
The Correct Answer is C
Choice A rationale
Walking may not stimulate fetal activity and could delay necessary intervention. Monitoring should continue to provide accurate data on the fetal heart rate.
Choice B rationale
Immediate induction is not warranted without further diagnostic tests and failed stimulation attempts. Reporting to the provider is premature.
Choice C rationale
Vibroacoustic stimulation uses sound waves to prompt fetal activity. This test assesses fetal well-being by observing changes in the fetal heart rate with stimuli.
Choice D rationale
Repositioning the client to a supine position can decrease blood flow to the fetus, potentially causing fetal distress. Fetal heart rate monitoring should continue in a left lateral or semi-Fowler's position.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice B rationale
Fetal macrosomia, defined as birth weight above 4,000 grams, can complicate labor due to increased risk of shoulder dystocia, prolonged labor, and cesarean delivery. Proper management of macrosomia is critical for maternal and neonatal outcomeChoice s.
Choice A rationale
Small for gestational age (SGA) fetuses, although growth-restricted, typically do not pose mechanical issues in labor. The primary concerns involve potential preterm birth, low birth weight, and associated neonatal complications, not labor obstruction.
Choice C rationale
Intrauterine growth restriction (IUGR) fetuses are smaller than expected for gestational age but do not generally cause labor obstruction. IUGR primarily raises concerns about fetal well-being and potential complications, not mechanical labor issues.
Choice D rationale
Fetal anemia, although serious, does not typically affect the mechanical aspects of labor progression. It can lead to fetal hypoxia and distress, requiring close monitoring and potentially earlier delivery, but not labor complications related to size.
Correct Answer is A
Explanation
Choice A rationale
Amniocentesis detects anomalies in fetal chromosomes by analyzing amniotic fluid cells. It identifies genetic disorders like Down syndrome. Normal karyotype excludes major chromosomal abnormalities.
Choice B rationale
Rh incompatibility is identified by maternal blood tests, not amniocentesis. Blood type and antibody screening determine Rh status and risk of hemolytic disease in the fetus.
Choice C rationale
Cephalopelvic disproportion is assessed clinically and via ultrasound. It involves the pelvis and fetal head sizes, not amniocentesis.
Choice D rationale
Amniocentesis can detect infections, but this is not its primary purpose. Polymerase chain reaction (PCR) identifies bacterial or viral DNA/RNA.
Choice E rationale
Amniocentesis detects neural tube defects like spina bifida by measuring alpha-fetoprotein (AFP) levels in amniotic fluid. Elevated AFP suggests neural tube defects.
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