A nurse is performing an external nonstress test for a client who is at 41 weeks of gestation and has oligohydramnios.

The nurse notes that there are no accelerations in the fetal heart rate tracing after applying an acoustic stimulator to the maternal abdomen for several seconds.

Which of the following actions should the nurse take?

Repeat the acoustic stimulation after 1 minute

Document the finding as a nonreactive NST

Perform a contraction stress test (CST)

Notify the provider and prepare for delivery

Answer and Explanation

The Correct Answer is D

Notify the provider and prepare for delivery. Oligohydramnios is a condition where the amniotic fluid volume is less than expected for gestational age and it is associated with maternal and fetal complications.

The nonstress test (NST) is a method of fetal surveillance that measures the fetal heart rate response to fetal movement. A reactive NST is defined as at least two accelerations of 15 beats per minute or more above the baseline, lasting 15 seconds or more, within a 20-minute period.

A nonreactive NST indicates fetal hypoxia or acidosis and requires further evaluation. An acoustic stimulator can be used to elicit fetal movement and accelerations, but it should not be repeated more than once in a 10-minute period.

Therefore, choice A is wrong because repeating the acoustic stimulation after 1 minute is too soon and may cause fetal distress.

Choice B is wrong because documenting the finding as a nonreactive NST is not enough to address the situation. Choice C is wrong because performing a contraction stress test (CST) is contraindicated in oligohydramnios because it may cause umbilical cord compression and fetal compromise.

The CST involves inducing uterine contractions with oxytocin or nipple stimulation and monitoring the fetal heart rate for signs of intolerance.

A negative CST means that there

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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 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.

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

Correct Answer is A

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 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?

(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 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 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 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?