Chapter 18: Fetal Assessment During Labor
1. What is the most likely cause for early decelerations in the fetal heart rate (FHR)
pattern?
a. Altered fetal cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Spontaneous rupture of membranes
2.Early decelerations are the fetus' response to fetal head compression; these are
considered benign, and interventions are not necessary. Variable decelerations are
associated with umbilical cord compression. Late decelerations are associated with
uteroplacental insufficiency. Spontaneous rupture of membranes has no bearing on the
FHR unless the umbilical cord prolapses, which would result in variable or prolonged
bradycardia.
Which clinical finding or intervention might be considered the rationale for fetal
tachycardia to occur?
a. Maternal fever
b. Umbilical cord prolapse
c. regional anesthesia
d. Magnesium sulfate administration
3.Fetal tachycardia can be considered an early sign of fetal hypoxemia and may also
result from maternal or fetal infection. Umbilical cord prolapse, regional anesthesia, and
the administration of magnesium sulfate will each more likely result in fetal bradycardia,
not tachycardia.
While evaluating an external monitor tracing of a woman in active labor, the nurse notes
that the FHR for five sequential contractions begins to decelerate late in the contraction,
with the nadir of the decelerations occurring after the peak of the contraction. What is
the nurse's first priority?
a. Change the woman's position.
b. Notify the health care provider.
c. Assist with amnioinfusion
,d. Insert a scalp electrode.
4. Late FHR decelerations may be caused by maternal supine hypotension syndrome.
These decelerations are usually corrected when the woman turns onto her side to
displace the weight of the gravid uterus from the vena cava. If the fetus does not
respond to primary nursing interventions for late decelerations, then the nurse should
continue with subsequent intrauterine resuscitation measures and notify the health care
provider. An amnioinfusion may be used to relieve pressure on an umbilical cord that
has not prolapsed. The FHR pattern associated with this situation most likely will reveal
variable decelerations. Although a fetal scalp electrode will provide accurate data for
evaluating the well-being of the fetus, it is not a nursing intervention that will alleviate
late decelerations nor is it the nurse's first priority.
What is the most likely cause for variable FHR decelerations?
a. Altered fetal cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Fetal hypoxemia
5. Variable FHR decelerations can occur at any time during the uterine contracting
phase and are caused by compression of the umbilical cord. Altered fetal cerebral blood
flow results in early decelerations in the FHR. Uteroplacental insufficiency results in late
decelerations in the FHR. Fetal hypoxemia initially results in tachycardia and then
bradycardia if hypoxia continues.
The nurse providing care for a high-risk laboring woman is alert for late FHR
decelerations. Which clinical finding might be the cause for these late decelerations?
a. Altered cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Meconium fluid
6. Uteroplacental insufficiency results in late FHR decelerations. Altered fetal cerebral
blood flow results in early FHR decelerations. Umbilical cord compression results in
variable FHR decelerations. Meconium-stained fluid may or may not produce changes
in the FHR, depending on the gestational age of the fetus and whether other causative
factors associated with fetal distress are present.
, Which alteration in the FHR pattern would indicate the potential need for an
amnioinfusion?
a. Variable decelerations
b. Late decelerations
c. Fetal bradycardia
d. Fetal tachycardia
7. Amnioinfusion is used during labor to either dilute meconium-stained amniotic fluid or
supplement the amount of amniotic fluid to reduce the severity of variable FHR
decelerations caused by cord compression. Late decelerations are unresponsive to
amnioinfusion. Amnioinfusion is not appropriate for the treatment of fetal bradycardia
and has no bearing on fetal tachycardia.
Which FHR finding is the most concerning to the nurse who is providing care to a
laboring client?
a. Accelerations with fetal movement
b. Early decelerations
c. Average FHR of 126 beats per minute
d. Late decelerations
8. Late decelerations are caused by uteroplacental insufficiency and are associated with
fetal hypoxemia. Late FHR decelerations are considered ominous if they are persistent
and left uncorrected. Accelerations with fetal movement are an indication of fetal well-
being. Early decelerations in the FHR are associated with head compression as the
fetus descends into the maternal pelvic outlet; they are not generally a concern during
normal labor. An FHR finding of 126 beats per minute is normal and not a concern.
What three measures should the nurse implement to provide intrauterine resuscitation?
a. Call the provider, reposition the mother, and perform a vaginal examination.
b. Turn the client onto her side, provide oxygen (O2) via face mask, and increase
intravenous (IV) fluids.
1. What is the most likely cause for early decelerations in the fetal heart rate (FHR)
pattern?
a. Altered fetal cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Spontaneous rupture of membranes
2.Early decelerations are the fetus' response to fetal head compression; these are
considered benign, and interventions are not necessary. Variable decelerations are
associated with umbilical cord compression. Late decelerations are associated with
uteroplacental insufficiency. Spontaneous rupture of membranes has no bearing on the
FHR unless the umbilical cord prolapses, which would result in variable or prolonged
bradycardia.
Which clinical finding or intervention might be considered the rationale for fetal
tachycardia to occur?
a. Maternal fever
b. Umbilical cord prolapse
c. regional anesthesia
d. Magnesium sulfate administration
3.Fetal tachycardia can be considered an early sign of fetal hypoxemia and may also
result from maternal or fetal infection. Umbilical cord prolapse, regional anesthesia, and
the administration of magnesium sulfate will each more likely result in fetal bradycardia,
not tachycardia.
While evaluating an external monitor tracing of a woman in active labor, the nurse notes
that the FHR for five sequential contractions begins to decelerate late in the contraction,
with the nadir of the decelerations occurring after the peak of the contraction. What is
the nurse's first priority?
a. Change the woman's position.
b. Notify the health care provider.
c. Assist with amnioinfusion
,d. Insert a scalp electrode.
4. Late FHR decelerations may be caused by maternal supine hypotension syndrome.
These decelerations are usually corrected when the woman turns onto her side to
displace the weight of the gravid uterus from the vena cava. If the fetus does not
respond to primary nursing interventions for late decelerations, then the nurse should
continue with subsequent intrauterine resuscitation measures and notify the health care
provider. An amnioinfusion may be used to relieve pressure on an umbilical cord that
has not prolapsed. The FHR pattern associated with this situation most likely will reveal
variable decelerations. Although a fetal scalp electrode will provide accurate data for
evaluating the well-being of the fetus, it is not a nursing intervention that will alleviate
late decelerations nor is it the nurse's first priority.
What is the most likely cause for variable FHR decelerations?
a. Altered fetal cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Fetal hypoxemia
5. Variable FHR decelerations can occur at any time during the uterine contracting
phase and are caused by compression of the umbilical cord. Altered fetal cerebral blood
flow results in early decelerations in the FHR. Uteroplacental insufficiency results in late
decelerations in the FHR. Fetal hypoxemia initially results in tachycardia and then
bradycardia if hypoxia continues.
The nurse providing care for a high-risk laboring woman is alert for late FHR
decelerations. Which clinical finding might be the cause for these late decelerations?
a. Altered cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Meconium fluid
6. Uteroplacental insufficiency results in late FHR decelerations. Altered fetal cerebral
blood flow results in early FHR decelerations. Umbilical cord compression results in
variable FHR decelerations. Meconium-stained fluid may or may not produce changes
in the FHR, depending on the gestational age of the fetus and whether other causative
factors associated with fetal distress are present.
, Which alteration in the FHR pattern would indicate the potential need for an
amnioinfusion?
a. Variable decelerations
b. Late decelerations
c. Fetal bradycardia
d. Fetal tachycardia
7. Amnioinfusion is used during labor to either dilute meconium-stained amniotic fluid or
supplement the amount of amniotic fluid to reduce the severity of variable FHR
decelerations caused by cord compression. Late decelerations are unresponsive to
amnioinfusion. Amnioinfusion is not appropriate for the treatment of fetal bradycardia
and has no bearing on fetal tachycardia.
Which FHR finding is the most concerning to the nurse who is providing care to a
laboring client?
a. Accelerations with fetal movement
b. Early decelerations
c. Average FHR of 126 beats per minute
d. Late decelerations
8. Late decelerations are caused by uteroplacental insufficiency and are associated with
fetal hypoxemia. Late FHR decelerations are considered ominous if they are persistent
and left uncorrected. Accelerations with fetal movement are an indication of fetal well-
being. Early decelerations in the FHR are associated with head compression as the
fetus descends into the maternal pelvic outlet; they are not generally a concern during
normal labor. An FHR finding of 126 beats per minute is normal and not a concern.
What three measures should the nurse implement to provide intrauterine resuscitation?
a. Call the provider, reposition the mother, and perform a vaginal examination.
b. Turn the client onto her side, provide oxygen (O2) via face mask, and increase
intravenous (IV) fluids.
