A nurse is discussing intermittent fetal heart monitoring with a newly licensed nurse. Which of the following statements should the nurse include?

"Count the fetal heart rate for 15 seconds to determine the baseline."

"Auscultate the fetal heart rate every 5 minutes during the active phase of the first stage of labor."

"Auscultate the fetal heart rate every 30 minutes during the second stage of labor."

"Count the fetal heart rate after a contraction to determine baseline changes."

Answer and Explanation

The Correct Answer is D

A. "Count the fetal heart rate for 15 seconds to determine the baseline." The fetal heart rate (FHR) should be counted for a full minute to determine the baseline, not just for 15 seconds.

B. "Auscultate the fetal heart rate every 5 minutes during the active phase of the first stage of labor." The fetal heart rate is typically auscultated every 30 minutes in low-risk clients during the first stage of labor.

C. "Auscultate the fetal heart rate every 30 minutes during the second stage of labor." The fetal heart rate should be auscultated every 15 minutes during the second stage of labor, not every 30 minutes.

D. "Count the fetal heart rate after a contraction to determine baseline changes." It is important to assess the fetal heart rate after a contraction to determine if there are any decelerations or baseline changes that may indicate fetal distress.

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Correct Answer is B

Explanation

A. Determine the size of the fetus: Although Leopold’s maneuvers can give an idea of fetal size, the primary purpose is to assess the fetal position.

B. Determine the position of the fetus: Leopold's maneuvers are used to determine the position and presentation of the fetus in utero, aiding in delivery management.

C. Determine the size of the woman's pelvis: Pelvimetry, not Leopold’s maneuvers, is used to assess the size of the pelvis.

D. Determine the fundal height: Fundal height is measured separately to assess fetal growth, not with Leopold’s maneuvers.

A. Fetal head compression B. Uteroplacental insufficiency C. Cord compression D. Maternal hypertension

Correct Answer is A

Explanation

A. Fetal head compression. Early decelerations are typically caused by fetal head compression during contractions. This is usually a benign finding and indicates that labor is progressing.

B. Uteroplacental insufficiency. Uteroplacental insufficiency causes late decelerations, not early decelerations. Late decelerations are more concerning and indicate fetal distress.

C. Cord compression. Cord compression causes variable decelerations, not early decelerations. Variable decelerations can occur at any time during a contraction.

D. Maternal hypertension. Maternal hypertension is not a direct cause of early decelerations. It may contribute to uteroplacental insufficiency, which causes late decelerations.

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A nurse is discussing intermittent fetal heart monitoring with a newly licensed nurse. Which of the following statements should the nurse include?

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Naxlex Comprehensive Predictor Exams

Leopold's maneuvers are performed to:

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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