A nurse is evaluating the understanding of a client who is at risk for pre-term labor and has been instructed to perform daily home uterine activity monitoring (HUAM).

Which of the following statements by the client indicates a need for further teaching?

“I should empty my bladder before applying the monitor.”

“I should lie on my back with my knees bent while using the monitor.”

“I should press the event marker every time I feel a contraction.”

“I should use the monitor for at least 1 hour twice a day.”

Answer and Explanation

The Correct Answer is B

Lying on one’s back with knees bent while using the monitor is not recommended for women at risk of preterm labor, as it can put pressure on the inferior vena cava, a major vein leading back to the heart. This can cause low blood pressure and reduce blood flow to the uterus and the baby. A better position is to lie on one’s side with a pillow at the back for support.

Choice A is correct because emptying the bladder before applying the monitor can reduce interference from urine contractions and make the readings more accurate.

Choice C is correct because pressing the event marker every time one feels a contraction can help record the frequency and duration of uterine activity.

Choice D is correct because using the monitor for at least 1 hour twice a day can provide sufficient data on uterine contractions and help detect early signs of preterm labor.

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Correct Answer is C

Explanation

True labor contractions cause cervical dilation and effacement.

This means that the cervix opens up and thins out to prepare for the baby’s passage through the birth canal.

Cervical changes can be measured by a pelvic exam.

Choice A is wrong because true labor contractions are regular and do not subside with rest.False labor contractions are irregular and may stop when you change position or activity level.

Choice B is wrong because false labor contractions are usually felt in the front of the abdomen, not in the lower back.True labor contractions may start in the back and radiate to the abdomen.

Choice D is wrong because false labor contractions do not increase in intensity with ambulation.True labor contractions may become stronger and closer together when you walk.

Normal ranges for cervical dilation and effacement vary depending on the stage of labor, but generally, full dilation is 10 cm and full effacement is 100%.

A. Assess fetal heart rate and activity B. Perform a nitrazine test on the fluid C. Administer oxytocin (Pitocin) IV infusion D. Place the client in Trendelenburg position

Correct Answer is A

Explanation

Assess fetal heart rate and activity.

The nurse should identify that a client who reports a sudden gush of fluid from her vagina is at risk forpremature rupture of membranes (PROM), which can lead toinfection,cord prolapse, andfetal distress.Therefore, the priority action is to assess the fetal heart rate and activity to monitor for signs of hypoxia or distress.

Choice B is wrong because performing a nitrazine test on the fluid is not the first action.A nitrazine test can confirm the presence of amniotic fluid by detecting its alkaline pH, but it is not as urgent as assessing the fetal well-being.

Choice C is wrong because administering oxytocin (Pitocin) IV infusion is contraindicated in this situation.Oxytocin is used to induce or augment labor, but it can causeuterine hyperstimulation,fetal distress, andplacental abruptionif given to a client who has PROM.

Choice D is wrong because placing the client in Trendelenburg position is not recommended for a client who has PROM.Trendelenburg position can increase the risk ofcord prolapseandaspirationin this situation.

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A nurse is evaluating the understanding of a client who is at risk for pre-term labor and has been instructed to perform daily home uterine activity monitoring (HUAM). Which of the following statements by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who is at 27 weeks of gestation and has pre-term labor about the signs and symptoms of true labor versus false labor. Which of the following information should the nurse include in the teaching?

Correct Answer is C

Explanation

A nurse is caring for a client who is at 33 weeks of gestation and has pre-term labor. The client reports a sudden gush of fluid from her vagina. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

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A nurse is evaluating the understanding of a client who is at risk for pre-term labor and has been instructed to perform daily home uterine activity monitoring (HUAM).

Which of the following statements by the client indicates a need for further teaching?