A nurse is educating a 38-week pregnant client about the ordered contraction stress test. Which of the following is correct regarding the contraction stress test?
We administer oxytocin through the IV to identify whether you can tolerate the pain of labor.
Positive contraction stress tests are associated with good fetal outcomes.
A negative result is a good indicator of fetal well-being.
We are looking for a positive test which has been associated with an increased rate of fetal death, fetal growth restriction, lower Apgar scores, need for C-section, and need for neonatal resuscitation.
The Correct Answer is C
Choice A rationale
Administering oxytocin during a contraction stress test is to assess uteroplacental insufficiency, not to identify pain tolerance. The test evaluates fetal response to contractions.
Choice B rationale
Positive contraction stress tests are associated with poor fetal outcomes, indicating fetal distress during contractions due to inadequate placental perfusion.
Choice C rationale
A negative result in a contraction stress test indicates adequate placental function and fetal well-being, suggesting the fetus can tolerate labor without distress.
Choice D rationale
A positive test result suggests potential fetal compromise, including increased risk of fetal death, growth restriction, low Apgar scores, and need for C-section or resuscitation.
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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 C
Explanation
Choice A rationale
Administering oxytocin during a contraction stress test is to assess uteroplacental insufficiency, not to identify pain tolerance. The test evaluates fetal response to contractions.
Choice B rationale
Positive contraction stress tests are associated with poor fetal outcomes, indicating fetal distress during contractions due to inadequate placental perfusion.
Choice C rationale
A negative result in a contraction stress test indicates adequate placental function and fetal well-being, suggesting the fetus can tolerate labor without distress.
Choice D rationale
A positive test result suggests potential fetal compromise, including increased risk of fetal death, growth restriction, low Apgar scores, and need for C-section or resuscitation.
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