A nurse is caring for a client who is undergoing an external nonstress test at 40 weeks of gestation and notes variable decelerations on the fetal monitor tracing that are unresponsive to interventions such as repositioning and oxygen administration.

Which of the following actions should the nurse take next?

Prepare the client for an amnioinfusion

Apply an internal fetal scalp electrode

Administer IV fluid bolus to the client

Discontinue oxytocin infusion if present

Answer and Explanation

The Correct Answer is A

Prepare the client for an amnioinfusion. An amnioinfusion is a procedure that adds fluid to the uterus during labor to relieve cord compression and improve fetal condition. Variable decelerations on the fetal monitor tracing are a sign of cord compression and fetal distress. If repositioning and oxygen administration do not resolve the decelerations, an amnioinfusion may be indicated.

Choice B is wrong because applying an internal fetal scalp electrode does not address the cause of variable decelerations, which is cord compression.

An internal fetal scalp electrode is used to monitor the fetal heart rate more accurately, but it does not improve fetal oxygenation or prevent cord compression.

Choice C is wrong because administering IV fluid bolus to the client may help increase maternal blood volume and placental perfusion, but it does not directly increase amniotic fluid volume or relieve cord compression.

Choice D is wrong because discontinuing oxytocin infusion if present may reduce uterine contractions and decrease cord compression, but it may also prolong labor and increase the risk of infection or fetal compromise. Oxytocin infusion should only be discontinued if there are signs of uterine hyperstimulation or fetal intolerance.

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Correct Answer is A

Explanation

Prepare the client for an amnioinfusion.An amnioinfusion is a procedure that adds fluid to the uterus during labor to relieve cord compression and improve fetal condition.Variable decelerations on the fetal monitor tracing are a sign of cord compression and fetal distress.If repositioning and oxygen administration do not resolve the decelerations, an amnioinfusion may be indicated.

Choice B is wrong because applying an internal fetal scalp electrode does not address the cause of variable decelerations, which is cord compression.

An internal fetal scalp electrode is used to monitor the fetal heart rate more accurately, but it does not improve fetal oxygenation or prevent cord compression.

Choice D is wrong because discontinuing oxytocin infusion if present may reduce uterine contractions and decrease cord compression, but it may also prolong labor and increase the risk of infection or fetal compromise.Oxytocin infusion should only be discontinued if there are signs of uterine hyperstimulation or fetal intolerance.

A. Discontinue oxytocin infusion and monitor the client for another 10 minutes B. Increase oxytocin infusion and monitor the client until four contractions occur in 10 minutes C. Stop oxytocin infusion and notify the provider of a positive CST result D. Maintain oxytocin infusion and monitor the client until a negative CST result is confirmed

Correct Answer is D

Explanation

Maintain oxytocin infusion and monitor the client until a negative CST result is confirmed.

A negative CST result means that there are no late decelerations of the FHR after three contractions in 10 minutes.This indicates that the fetus can tolerate the stress of labor and has adequate oxygenation.

Choice A is wrong because discontinuing oxytocin infusion and monitoring the client for another 10 minutes will not provide enough information about the fetal response to contractions.The test requires at least three contractions in 10 minutes to be valid.

Choice B is wrong because increasing oxytocin infusion and monitoring the client until four contractions occur in 10 minutes may cause uterine hyperstimulation, which can compromise fetal oxygenation and lead to fetal distress.

Choice C is wrong because stopping oxytocin infusion and notifying the provider of a positive CST result is not appropriate.A positive CST result means that there are late decelerations of the FHR after more than half of the contractions, indicating fetal hypoxia and placental insufficiency.

In this case, there are no late decelerations, so the test result is not positive.

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is caring for a client who is undergoing an oxytocin-stimulated contraction stress test (CST). The nurse observes three contractions in 10 minutes with no late decelerations of the fetal heart rate (FHR). Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is caring for a client in labor who has an internal fetal scalp electrode applied for continuous fetal heart rate (FHR) monitoring. The nurse notes a pattern of late decelerations on the FHR tracing. What is the priority nursing intervention?

A nurse is reviewing the findings of a biophysical profile (BPP) for a client who is at 40 weeks of gestation. The BPP score is 6 out of 10 points. Which of the following components are included in this score? (Select all that apply.)

A nurse is comparing nonstress test (NST) and contraction stress test (CST) for assessing fetal well-being. What is an advantage of NST over CST?

A nurse is interpreting the results of a contraction stress test (CST) for a client who is at 38 weeks of gestation. The nurse notes that there are no late or significant variable decelerations of the fetal heart rate (FHR). How should the nurse document this finding?

(Select all that apply) A nurse is performing a nonstress test (NST) for a client who is at 32 weeks of gestation and has gestational diabetes mellitus. The nurse uses vibroacoustic stimulation to elicit fetal movement and acceleration of FHR. What are the indications for using this method?

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?

A nurse is caring for a client who is scheduled for an amniocentesis at 35 weeks of gestation to assess fetal lung maturity. Which of the following laboratory tests will provide this information?