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?

Place the device over the fetal back for 3 seconds

Hold the device firmly against the maternal abdomen for 10 seconds

Move the device around the maternal abdomen until fetal movement is detected

Apply the device intermittently over the fundus for 15 seconds

Answer and Explanation

The Correct Answer is A

Place the device over the fetal back for 3 seconds. This is because vibroacoustic stimulation (VAS) is the application of a vibratory sound stimulus to the abdomen of a pregnant woman to induce fetal heart rate (FHR) accelerations. The presence of FHR accelerations reliably predicts the absence of fetal metabolic acidemia. VAS is typically used during a nonstress test (NST) to assess fetal well-being. The device should be placed over the fetal back for 3 seconds, as this is the optimal duration and location to elicit a fetal response.

Choice B is wrong because holding the device firmly against the maternal abdomen for 10 seconds may be too long and too strong for the fetus, and may cause discomfort or distress.

Choice C is wrong because moving the device around the maternal abdomen until fetal movement is detected may not be effective or efficient, as the device may not reach the optimal location or duration to stimulate the fetus.

Choice D is wrong because applying the device intermittently over the fundus for 15 seconds may not target the fetal auditory system, which is located near the fetal back, and may also be too long and too strong for the fetus.

Normal ranges for FHR are between 110 and 160 beats per minute, and FHR accelerations are defined as an increase of at least 15 beats per minute above baseline for at least 15 seconds.

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Correct Answer is C

Explanation

Category III.This category of FHR tracing represents an abnormal pattern that is predictive of fetal acidemia and requires prompt evaluation and intervention.A category III pattern is defined by any of the following criteria:

• Absent baseline FHR variability and any of the following:

➤ Recurrent late decelerations

➤ Recurrent variable decelerations

➤ Bradycardia

• Sinusoidal pattern

Choice A is wrong because category I is a normal pattern that is predictive of normal fetal acid-base balance at the time of observation.A category I pattern is defined by all of the following criteria:

• Baseline rate of 110 to 160 bpm

• Moderate baseline FHR variability

• No late or variable decelerations

• Early decelerations may be present or absent

• Accelerations may be present or absent

Choice B is wrong because category II is an indeterminate pattern that is not predictive of abnormal fetal acid-base balance but requires continued surveillance and reevaluation.A category II pattern includes all FHR tracings that are not category I or III.

Choice D is wrong because there is no category IV in the NICHD classification system for FHR tracings.

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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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is C

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 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?

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 providing discharge instructions to a client who had a nonreactive nonstress test (NST) followed by a biophysical profile (BPP) with a score of 8/10. Which of the following statements by the client indicates an understanding of the teaching?

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 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 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?

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?