The nurse notices a decreased fetal heart rate (FHR) on the fetal monitor tracing and contacts the charge nurse. The charge nurse completes a vaginal exam and can feel a portion of the umbilical cord in the vagina.

Which emergency interventions will the charge nurse implement? Select all that apply.

Prepare the client for emergency cesarean delivery

Position the client in a knee-chest position and call for help

Locate and insert a vacuum suction catheter into the vagina and push the infant back into the uterus

Keep a gloved hand in the vagina and push upward on the presenting part to keep it off the cord

Contact the provider and report a prolapsed umbilical cord

Answer and Explanation

Correct Answer : A,B,D,E

A.   Preparing the client for emergency cesarean delivery is often necessary when a prolapsed umbilical cord is identified.

B.   Positioning the client in a knee-chest position helps alleviate pressure on the umbilical cord, improving fetal oxygenation.
C.   Inserting a vacuum suction catheter into the vagina and pushing the infant back into the uterus is not a recommended intervention for a prolapsed umbilical cord; this action may cause harm to the fetus.
D.   Keeping a gloved hand in the vagina and pushing upward on the presenting part helps relieve pressure on the umbilical cord.
E.   Contacting the provider and reporting a prolapsed umbilical cord is essential for prompt communication and decision-making.

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Correct Answer is B

Explanation

A. Late decelerations typically start after the contraction has reached its peak and return to baseline after the contraction ends, not during the contraction.
B. Early decelerations coincide with the contraction and return to baseline by the end of the contraction. They are typically considered benign and related to head compression.
C. Accelerations are brief increases in the FHR above the baseline and are usually associated with fetal movement.
D. Variable decelerations are abrupt decreases in the FHR, often unrelated to contractions, and have an erratic pattern.

A. Count the interval from the end of one contraction to the beginning of the next one B. Count the interval from the beginning of one contraction to its end C. Count the number of contractions that occur in 10 minutes D. Count the interval between the acmes of two consecutive contractions

Correct Answer is B

Explanation

A. The interval from the end of one contraction to the beginning of the next one is the frequency, not the duration.
B. Counting the interval from the beginning to the end of one contraction provides the duration of that contraction.
C. Counting the number of contractions in 10 minutes gives the frequency, not the duration.

D. Counting the interval between the acmes (peaks) of two consecutive contractions is not a standard method for determining the duration of contractions. The duration is usually measured from the beginning to the end of a single contraction.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse is caring for a client in labor. Which process will the nurse use to determine the duration of contractions?

Correct Answer is B

Explanation

The nurse assesses the postpartum client's fundal height and tone in the first 24 hours. Which action will the nurse take to correctly assess the uterine fundus?

A nurse is providing care for a client experiencing postpartum hemorrhage. Which medications may be prescribed by the provider? Select all that apply.

A nurse is planning home care for a 9-year-old child following an acute exacerbation of asthma. Which of the following of Erikson’s developmental stages should the nurse consider in the planning?

The nurse is assisting a pregnant patient into bed after the patient reports a gush of fluid from the vagina. Which action will the nurse take first?

The nurse is caring for a laboring client. The nurse observes that there are variable decelerations. What is the nurse's priority action?

A postpartum client has continuous seepage of bright red blood from the vagina. The nurse completes an assessment and finds a firm uterus, 1 cm below the umbilicus, and midline. What does the nurse suspect is the reason for the bleeding?