External fetal monitoring cannot detect the of uterine contractions (choose one word).
Intensity.
Frequency.
Duration.
Timing.
The Correct Answer is A
Choice A rationale
External fetal monitoring, typically performed with a tocotransducer placed on the maternal abdomen, records the frequency and duration of uterine contractions but cannot accurately measure the absolute strength or intensity. The intensity of contractions is best determined by internal monitoring using an intrauterine pressure catheter (IUPC), which measures the fluid pressure inside the uterus in millimeters of mercury.
Choice B rationale
Frequency of uterine contractions, defined as the time from the beginning of one contraction to the beginning of the next, is readily and accurately detected by the external tocotransducer. The device senses the change in the shape of the abdomen during a contraction, allowing for precise measurement of how often contractions are occurring.
Choice C rationale
Duration of uterine contractions, which is the time from the start of a contraction to the end of that same contraction, is effectively measured by the external tocotransducer. The device picks up the mechanical changes in the abdominal wall and clearly delineates the start and end points of each contractile episode.
Choice D rationale
Timing, specifically the interval between contractions or the frequency, is clearly detected by the external fetal monitor. While the monitor shows when a contraction begins and ends, the word 'intensity' is the precise physiological parameter that the external monitor is incapable of quantifying with accuracy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A fundal height 3 cm below the umbilicus at 20 weeks of gestation is not considered higher than normal. At approximately 20 weeks, the fundus should be reliably palpable right at the level of the umbilicus, which serves as a clinical landmark. A fundus that is higher than the umbilicus at this point might suggest an error in dating, multiple gestation, or polyhydramnios, but the described finding is the opposite.
Choice B rationale
A fundal height 3 cm below the umbilicus at 20 weeks is not typically a sign of impending complications, but it does suggest the uterus is measuring smaller than expected for the gestational age. Clinical assessment of fundal height is often used to screen for intrauterine growth restriction (IUGR) or oligohydramnios, which would require further diagnostic investigation like an ultrasound, but this specific finding is low, not high.
Choice C rationale
The fundus is generally expected to be palpable at the umbilicus (approximately 20 cm from the symphysis pubis) when the client is at 20 weeks of gestation. A finding of 3 cm below the umbilicus is significantly lower than this established norm. Fundal height measurement is a simple, quick method to estimate gestational age and assess fetal growth.
Choice D rationale
At 20 weeks of gestation, the uterine fundus should be at the level of the umbilicus. If the fundus is palpated 3 cm below the umbilicus, it is considered lower than expected for gestational age, suggesting that the uterus is smaller than anticipated. This finding warrants further investigation, such as ultrasound, to confirm the gestational age and rule out conditions like intrauterine growth restriction or oligohydramnios.
Correct Answer is B
Explanation
Choice A rationale
Acrocyanosis, a benign bluish discoloration of the hands and feet, is a normal finding in the immediate newborn period due to immature peripheral circulation and is not a specific adverse effect of narcotic analgesics given during maternal labor, which primarily affects the central nervous system.
Choice B rationale
Narcotic analgesics, such as opioids, cross the placenta and can depress the fetal respiratory center, leading to newborn respiratory depression (respiratory rate < 30 breaths/min or shallow breathing) upon delivery, especially if administered close to the time of birth, requiring careful monitoring and possible reversal agents.
Choice C rationale
Bradycardia in a newborn, defined as a heart rate < 100 beats/minute, is often a sign of hypoxia or distress, but it is not the primary or most common adverse effect of maternally administered narcotics; respiratory depression is the principal concern related to opioid use in labor.
Choice D rationale
Tachypnea in a newborn, a respiratory rate > 60 breaths/minute, is commonly associated with conditions like transient tachypnea of the newborn (TTN) or respiratory distress syndrome (RDS) and is the opposite of the CNS-depressant effect of narcotic analgesics, which instead typically cause a decreased respiratory rate.
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