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 B

Explanation

Negative CST.A negative CST means that there are no late or significant variable decelerations of the fetal heart rate (FHR) during three uterine contractions in 10 minutes.

This indicates that the fetus is well oxygenated and can tolerate the stress of labor contractions.

Choice A is wrong because a positive CST means that there are late decelerations of the FHR with 50% or more of the contractions.

This suggests that the fetus is at risk of hypoxia and may need early delivery.

Choice C is wrong because an unsatisfactory CST means that there are fewer than three contractions in 10 minutes or the tracing is not interpretable.

This does not provide enough information to assess the fetal well-being.

Choice D is wrong because an equivocal CST means that there are either intermittent late decelerations or significant variable decelerations.

This indicates that the fetus may have some degree of compromise and may need further testing.

Normal ranges for FHR are 110 to 160 beats per minute, and for uterine contractions are 2 to 5 per 10 minutes.

A. NST provides more information about fetal status than CST B. NST is less time-consuming and more comfortable than CST C. NST has fewer contraindications and complications than CST D. NST has higher sensitivity and specificity than CST

Correct Answer is B

Explanation

NST is less time-consuming and more comfortable than CST.This is because NST does not require any external stimulation of the uterus, while CST involves giving oxytocin to induce contractions.NST also does not pose any risk of preterm labor or fetal distress, which are possible complications of CST.

Choice A is wrong because NST does not provide more information about fetal status than CST.In fact, CST can detect fetal hypoxia more accurately than NST.

Choice C is wrong because NST does not have fewer contraindications than CST.Both tests have similar contraindications, such as placenta previa, multiple gestation, and previous cesarean section.

Choice D is wrong because NST does not have higher sensitivity and specificity than CST.

Sensitivity refers to the ability of a test to correctly identify positive cases, while specificity refers to the ability of a test to correctly identify negative cases.

NST has a high sensitivity but a low specificity, meaning it can detect most fetuses with hypoxia but also has many false positives.CST has a low sensitivity but a high specificity, meaning it can miss some fetuses with hypoxia but also has few false negatives.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is pregnant and undergoing a contraction stress test (CST). The nurse observes three uterine contractions in 10 minutes, with no late or significant variable decelerations of the fetal heart rate (FHR). How should the nurse interpret this finding?

Correct Answer is B

Explanation

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?

Correct Answer is B

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 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?

A nurse is using vibroacoustic stimulation (VAS) to stimulate fetal movement during a nonstress test (NST). What action should the nurse take when applying VAS?

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?