While evaluating a fetal heart tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) begins to decelerate after the peak of the contraction. What is the nurse's first priority?

Assist with amnioinfusion.

Insert a scalp electrode for internal monitoring.

Notify the health care provider.

Change to left lateral position.

Answer and Explanation

The Correct Answer is D

A. This is incorrect as the first priority. Amnioinfusion is typically used to treat variable decelerations caused by cord compression by introducing fluid into the amniotic sac. However, early decelerations are not caused by cord compression; they are usually benign and related to fetal head compression, so amnioinfusion is not indicated initially.

B. This is incorrect as the first step. A fetal scalp electrode provides more accurate FHR monitoring, but it does not address the underlying cause of early decelerations. Internal monitoring is not necessary if the decelerations are normal and reassuring.

C. This is incorrect as the immediate first action. Early decelerations are generally benign and do not indicate fetal compromise. Notifying the provider is important if patterns change or become nonreassuring, but immediate interventions focus on maternal positioning and monitoring.

D. Early decelerations typically occur due to fetal head compression during contractions and are benign. The first priority is non-invasive maternal positioning, such as placing the woman in a left lateral position, to optimize uteroplacental perfusion and fetal oxygenation. This intervention is simple, safe, and helps ensure continued reassuring fetal status.

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Correct Answer is B

Explanation

A. December 7, 2025: This date is over a year late, likely due to miscalculation in applying Naegele’s Rule.

B. To calculate the expected date of birth (EDB), use Naegele’s Rule, which estimates a 40-week gestation from the first day of the last menstrual period:

Start with the LMP: March 14, 2024
Add 1 year: March 14, 2025
Subtract 3 months: December 14, 2024
Add 7 days: December 21, 2024

This calculation assumes a 28-day menstrual cycle and provides a standard method for estimating the due date.

C. December 17, 2024: This is four days early, possibly due to an arithmetic error in adding 7 days.

D. November 17, 2024: This is too early, likely due to subtracting months incorrectly or misinterpreting the rule.

A. A reactive test B. A positive test C. A negative test D. A nonreactive test

Correct Answer is D

Explanation

A. A reactive NST is defined as having two or more accelerations of the fetal heart rate (FHR) at least 15 beats per minute above the baseline, lasting at least 15 seconds within a 20-minute window for a fetus ≥32 weeks gestation. Accelerations indicate a healthy, well-oxygenated fetus with an intact autonomic nervous system. In this scenario, there are no accelerations, which means the NST does not meet the criteria for a reactive result.

B. A positive test is terminology associated with a contraction stress test (CST), not an NST. A positive CST indicates the presence of late decelerations with uterine contractions, suggesting uteroplacental insufficiency. Since the test in question is an NST, this terminology does not apply.

C. A negative test is also specific to a CST, indicating no late decelerations with contractions. Using this terminology for an NST is incorrect.

D. A nonreactive NST occurs when the fetal heart rate does not demonstrate the required accelerations over a 20–40 minute period or shows minimal or absent variability. In this case, the baseline FHR is 120/min (within normal range), but the minimal variability, absence of accelerations, and the presence of variable decelerations suggest the fetus may not be receiving adequate oxygenation or that neurological responsiveness is not optimal at this time. Variable decelerations often indicate umbilical cord compression, which can compromise fetal oxygenation transiently.

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While evaluating a fetal heart tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) begins to decelerate after the peak of the contraction. What is the nurse's first priority?

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Naxlex Comprehensive Predictor Exams

A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was March 14, 2024. What is the client's expected date of birth (EDB)?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

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While evaluating a fetal heart tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) begins to decelerate after the peak of the contraction. What is the nurse's first priority?

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