What is the cause of early decelerations in the fetal heart rate (FHR) of a laboring woman?

Cerebral compression

Cord compression

Uteroplacental insufficiency

Spontaneous rupture of membranes

Answer and Explanation

The Correct Answer is A

Choice A reason: Cerebral compression is the cause of early decelerations, as it reflects the fetal head compression during uterine contractions. Early decelerations are decreases in the FHR that begin and end with the onset and end of a contraction, respectively. They are symmetrical and mirror the shape of the contraction. Early decelerations are normal and benign, as they indicate that the fetus is responding to the increased intracranial pressure and maintaining adequate oxygenation.

Choice B reason: Cord compression is not the cause of early decelerations but of variable decelerations. Variable decelerations are abrupt and irregular decreases in the FHR that vary in onset, duration, and depth. They are usually caused by the umbilical cord being compressed or occluded by the fetal body, the maternal pelvis, or the uterine contractions. Variable decelerations can indicate fetal distress or hypoxia, especially if they are severe, frequent, or prolonged.

Choice C reason: Uteroplacental insufficiency is not the cause of early decelerations, but of late decelerations. Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They are symmetrical and have a gradual onset and recovery. They are usually caused by the reduced blood flow and oxygen delivery to the placenta and the fetus due to maternal or fetal factors. Late decelerations can indicate fetal distress or hypoxia, and require immediate intervention.

Choice D reason: Spontaneous rupture of membranes is not the cause of early decelerations, but it can be a risk factor for cord compression and variable decelerations. Spontaneous rupture of membranes is the breaking of the amniotic sac and the release of the amniotic fluid, which usually occurs during labor or shortly before it. Spontaneous rupture of membranes can cause the umbilical cord to prolapse or slip into the vagina, where it can be compressed or kinked by the fetal head or the contractions.

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Correct Answer is B

Explanation

Choice A reason: This is incorrect because primary dysmenorrhea is menstrual pain that is not associated with any underlying condition. It usually begins with the onset of menstruation and lasts for a few days. It does not cause pain during intercourse or infertility.

Choice B reason: This is correct because endometriosis is a condition where the endometrial tissue that normally lines the uterus grows outside the uterus, such as on the ovaries, fallopian tubes, or pelvic organs. It causes chronic inflammation, scarring, and adhesions that can result in severe pain during menstruation and intercourse, as well as infertility.

Choice C reason: This is incorrect because secondary dysmenorrhea is menstrual pain that is caused by an underlying condition, such as fibroids, pelvic inflammatory disease, or adenomyosis. It usually develops later in life and lasts longer than primary dysmenorrhea. It may or may not cause pain during intercourse or infertility, depending on the condition.

Choice D reason: This is incorrect because PMS stands for premenstrual syndrome, which is a group of physical and emotional symptoms that occur before menstruation. It may include mood swings, irritability, bloating, headaches, or breast tenderness. It does not cause severe pain during menstruation or intercourse, or infertility.

A. point out that inappropriate sexual behavior caused the infection. B. position the woman in a semi-Fowler position. C. tell her that antibiotics need to be taken until pelvic pain is relieved. D. explain to the woman that infertility is a likely outcome of this type of infection.

Correct Answer is B

Explanation

Choice A reason: Pointing out that inappropriate sexual behavior caused the infection is not helpful, as it may make the woman feel guilty, ashamed, or defensive. The nurse should avoid blaming or judging the woman and focus on providing education and support.

Choice B reason:Positioning the patient in asemi-Fowler position(head of the bed elevated 30–45 degrees) helps promote drainage of pelvic exudate and reduces the risk of abscess formation or further spread of infection. This is a key nursing intervention for patients withacute pelvic inflammatory disease (PID).

Choice C reason: Telling her that antibiotics need to be taken until pelvic pain is relieved is incorrect, as it may lead to incomplete treatment and recurrence of the infection. The nurse should instruct the woman to take the full course of antibiotics as prescribed, regardless of the symptoms.

Choice D reason:While infertility is apotential complicationof PID, it is not a guaranteed outcome. The nurse should provideaccurate informationabout risks but avoid causing unnecessary alarm. The focus should be onprompt treatment and prevention of complications.

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What is the cause of early decelerations in the fetal heart rate (FHR) of a laboring woman?

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Naxlex Comprehensive Predictor Exams

A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to:

Correct Answer is B

Explanation

When providing care to a young single woman just diagnosed with acute pelvic inflammatory disease, the nurse should:

Correct Answer is B

Explanation

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