A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit.

The fetal heart rate has been normal.

Contractions are 10 to 15 minutes apart, 20 to 30 seconds in duration, and of mild intensity.

Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission). Membranes are intact.

The nurse should expect the woman to be:

Discharged home with a sedative.

Admitted and prepared for cesarean birth.

Admitted for extended observation.

Discharged home to await the onset of true labor.

Answer and Explanation

The Correct Answer is A

Choice A rationale
Mild contractions and minimal cervical dilation suggest false labor. Administering a sedative helps the patient rest and wait for true labor onset. Sedatives can include sleep-inducing medications.
Choice B rationale
Cesarean birth is not indicated for a primigravida with mild contractions and minimal cervical dilation. This intervention is reserved for more serious obstetric complications.
Choice C rationale
Extended observation is unnecessary for mild contractions and unchanged cervical status. It is more appropriate for patients showing signs of true labor or complications.
Choice D rationale
True labor onset requires regular, increasing intensity contractions and cervical changes. Discharging the patient allows her to await true labor onset at home comfortably.

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Correct Answer is C

Explanation

Choice A rationale
Drinking as much as desired, even in the second trimester, can lead to fetal alcohol spectrum disorders. No safe amount of alcohol is known during pregnancy.
Choice B rationale
Despite being in the second trimester, no level of alcohol consumption is considered safe during pregnancy, as it poses a risk to fetal development.
Choice C rationale
The safest course is to abstain from alcohol throughout pregnancy as no specific amount has been deemed safe and it can cause irreversible harm to fetal development.
Choice D rationale
Even limiting alcohol consumption to three times a week poses a risk to fetal health, as any amount can potentially cause developmental issues.

A. Document the findings and tell the mother that the monitor indicates fetal well-being. B. Call the midwife or doctor right away to tell them. C. Take the mother’s vital signs and tell her that bed rest is required to conserve oxygen. D. Reposition the mother and check the monitor for changes in the fetal tracing.

Correct Answer is A

Explanation

Choice A rationale
Accelerations with moderate variability indicate fetal well-being and responsiveness to the uterine environment, requiring documentation of normal findings and reassurance to the mother.
Choice B rationale
There is no need to immediately call the midwife or doctor, as accelerations with moderate variability are positive indicators of fetal health and do not suggest any issues.
Choice C rationale
Taking maternal vital signs and advising bed rest is unnecessary because the observed accelerations and variability show that the fetus is not experiencing distress, negating the need for such interventions.
Choice D rationale
Repositioning the mother and checking the monitor for changes is unnecessary, given that accelerations with moderate variability already indicate a well-oxygenated and responsive fetus, not requiring any adjustments.

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Naxlex Comprehensive Predictor Exams

A woman who is 14 weeks pregnant tells the nurse that she always had a glass of wine with dinner before she became pregnant. She has abstained during her first trimester and would like to know if it is safe for her to have a drink with dinner now. The nurse would tell her:

Correct Answer is C

Explanation

The nurse caring for a client in labor observes the external fetal monitor tracing showing that there are accelerations with moderate variability. Which of the following actions is most appropriate?

Correct Answer is A

Explanation

The nurse should realize that the most common and potentially harmful maternal complication of epidural anesthesia is:

A pregnant client at 22 weeks’ gestation has a hematocrit of 35%. Pre-pregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change?

A woman at 40 weeks gestation calls the labor unit to see whether or not she should go to the hospital to be evaluated. Which of the following statements by the woman indicates that she is probably in labor and should proceed to the hospital?

The nurse caring for the laboring woman should know that meconium is produced by:

As relates to the structure and function of the placenta, the nurse should be aware that.

The fetal monitor tracing shown is associated with:

The most common cause of decreased variability in the FHR that lasts 20 minutes or less is: