Test Bank For Foundations of Maternal Newborn and Women
Health Nursing 8th Edition By Murray Sharon (),
9780323827386, Chapter 1-28 , All Chapters with Answers and
Rationals
The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the
deceleration begins near the acme of the contraction and continues well beyond the end of the
contraction. Which nursing action indicates the proper evaluation of this situation?
a. This pattern reflects variable decelerations. No interventions are necessary at this time.
b. Document this reassuring fetal heart rate pattern but decrease the rate of the intravenous (IV)
fluid.
c. Continue to monitor these early decelerations, which occur as the fetal head is compressed during
a contraction.
d. This deceleration pattern is associated with uteroplacental insufficiency, so the nurse acts quickly to
improve placental blood flow and fetal oxygen supply. - ANSWER: ANS: D
A pattern similar to early decelerations, but the deceleration begins near the acme of the contraction
and continues well beyond the end of the contraction, describes a late deceleration. Oxygen should
be given via a snug face mask. Position the client on her left side to increase placental blood flow.
Variable decelerations are caused by cord compression. A vaginal examination should be performed
to identify this potential emergency. This is not a reassuring pattern, so the IV rate should be
increased to increase the mother's blood volume. These are late decelerations, not early; therefore,
interventions are necessary.
Which maternal condition should be considered a contraindication for the application of internal
monitoring devices?
a. Unruptured membranes
b. Cervix dilated to 4 cm
c. Fetus has known heart defect
d. External monitors currently being used - ANSWER: ANS: A
To apply internal monitoring devices, the membranes must be ruptured. Cervical dilation of 4 cm
would permit the insertion of fetal scalp electrodes and an intrauterine catheter. A compromised
fetus should be monitored with the most accurate monitoring devices. The external monitor can be
discontinued after the internal ones are applied.
The nurse is instructing a nursing student on the application of fetal monitoring devices. Which
method of assessing the fetal heart rate requires the use of a gel?
a. Doppler
b. Fetoscope
c. Scalp electrode
d. Tocodynamometer - ANSWER: ANS: A
Doppler is the only listed method involving ultrasonic transmission of fetal heart rates; it requires the
use of a gel. The fetoscope does not require gel because ultrasonic transmission is not used. The scalp
electrode is attached to the fetal scalp; gel is not necessary. The tocodynamometer does not require
gel. This device monitors uterine contractions.
Proper placement of the tocotransducer for electronic fetal monitoring is:
a. inside the uterus.
b. on the fetal scalp.
c. over the uterine fundus.
d. over the mother's lower abdomen. - ANSWER: ANS: C
The tocotransducer monitors uterine activity and should be placed over the fundus, where the most
intensive uterine contractions occur. The tocotransducer is for external use. The tocotransducer
, monitors uterine contractions. The most intensive uterine contractions occur at the fundus; this is the
best placement area.
Which can be determined only by electronic fetal monitoring?
a. Variability
b. Tachycardia
c. Bradycardia
d. Fetal response to contractions - ANSWER: ANS: A
Beat-to-beat variability cannot be determined by auscultation because auscultation provides only an
average fetal heart rate (FHR) as it fluctuates. Tachycardia can be determined by any of the FHR
monitoring techniques. Bradycardia can be determined by any of the FHR monitoring techniques. The
fetal response to the contractions is usually noted by an increase or decrease in fetal heart rate.
These can be determined by any of the FHR monitoring techniques.
Which is the most appropriate method of intrapartum fetal monitoring when a woman has a history
of hypertension during pregnancy?
a. Continuous auscultation with a fetoscope
b.Continuous electronic fetal monitoring
c. Intermittent assessment with a Doppler transducer
d. Intermittent electronic fetal monitoring for 15 minutes each hour - ANSWER: ANS: B
Maternal hypertension may reduce placental blood flow through vasospasm of the spiral arteries.
Reduced placental perfusion is best assessed with continuous electronic fetal monitoring to identify
patterns associated with this condition. It is not practical to provide continuous auscultation with a
fetoscope. This fetus needs continuous monitoring because it is at high risk for complications.
Why is continuous electronic fetal monitoring generally used when oxytocin is administered?
a. Fetal chemoreceptors are stimulated.
b. The mother may become hypotensive.
c. Maternal fluid volume deficit may occur.
d. Uteroplacental exchange may be compromised. - ANSWER: ANS: D
The uterus may contract more firmly and the resting tone may be increased with oxytocin use. This
response reduces the entrance of freshly oxygenated maternal blood into the intervillous spaces,
depleting fetal oxygen reserves. Oxytocin affects the uterine muscles. Hypotension is not a common
side effect of oxytocin. All laboring women are at risk for fluid volume deficit; oxytocin administration
does not increase the risk.
The nurse is concerned that a client's uterine activity is too intense and that her obesity is preventing
accurate assessment of the actual intrauterine pressure. Based on this information, which action
should the nurse take?
a. Reposition the tocotransducer.
b. Reposition the Doppler transducer.
c. Obtain an order from the health care provider for a spiral electrode.
d. Obtain an order from the health care provider for an intrauterine pressure catheter. - ANSWER:
ANS: D
An intrauterine pressure catheter can measure actual intrauterine pressure. The tocotransducer
measures the uterine pressure externally; this would not be accurate with an obese client, even with
repositioning. A Doppler auscultates the FHR. A scalp electrode (or spiral electrode) measures the
fetal heart rate (FHR).
If the position of a fetus in a cephalic presentation is right occiput anterior, the nurse should assess
the fetal heart rate in which quadrant of the maternal abdomen?
a. Right upper
b. Left upper
c. Right lower
d. Left lower - ANSWER: ANS: C
If the fetus is in a right occiput anterior position, the fetal spine will be on the mother's right side. The
best location to hear the fetal heart rate is through the fetal shoulder, which would be in the right
Health Nursing 8th Edition By Murray Sharon (),
9780323827386, Chapter 1-28 , All Chapters with Answers and
Rationals
The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the
deceleration begins near the acme of the contraction and continues well beyond the end of the
contraction. Which nursing action indicates the proper evaluation of this situation?
a. This pattern reflects variable decelerations. No interventions are necessary at this time.
b. Document this reassuring fetal heart rate pattern but decrease the rate of the intravenous (IV)
fluid.
c. Continue to monitor these early decelerations, which occur as the fetal head is compressed during
a contraction.
d. This deceleration pattern is associated with uteroplacental insufficiency, so the nurse acts quickly to
improve placental blood flow and fetal oxygen supply. - ANSWER: ANS: D
A pattern similar to early decelerations, but the deceleration begins near the acme of the contraction
and continues well beyond the end of the contraction, describes a late deceleration. Oxygen should
be given via a snug face mask. Position the client on her left side to increase placental blood flow.
Variable decelerations are caused by cord compression. A vaginal examination should be performed
to identify this potential emergency. This is not a reassuring pattern, so the IV rate should be
increased to increase the mother's blood volume. These are late decelerations, not early; therefore,
interventions are necessary.
Which maternal condition should be considered a contraindication for the application of internal
monitoring devices?
a. Unruptured membranes
b. Cervix dilated to 4 cm
c. Fetus has known heart defect
d. External monitors currently being used - ANSWER: ANS: A
To apply internal monitoring devices, the membranes must be ruptured. Cervical dilation of 4 cm
would permit the insertion of fetal scalp electrodes and an intrauterine catheter. A compromised
fetus should be monitored with the most accurate monitoring devices. The external monitor can be
discontinued after the internal ones are applied.
The nurse is instructing a nursing student on the application of fetal monitoring devices. Which
method of assessing the fetal heart rate requires the use of a gel?
a. Doppler
b. Fetoscope
c. Scalp electrode
d. Tocodynamometer - ANSWER: ANS: A
Doppler is the only listed method involving ultrasonic transmission of fetal heart rates; it requires the
use of a gel. The fetoscope does not require gel because ultrasonic transmission is not used. The scalp
electrode is attached to the fetal scalp; gel is not necessary. The tocodynamometer does not require
gel. This device monitors uterine contractions.
Proper placement of the tocotransducer for electronic fetal monitoring is:
a. inside the uterus.
b. on the fetal scalp.
c. over the uterine fundus.
d. over the mother's lower abdomen. - ANSWER: ANS: C
The tocotransducer monitors uterine activity and should be placed over the fundus, where the most
intensive uterine contractions occur. The tocotransducer is for external use. The tocotransducer
, monitors uterine contractions. The most intensive uterine contractions occur at the fundus; this is the
best placement area.
Which can be determined only by electronic fetal monitoring?
a. Variability
b. Tachycardia
c. Bradycardia
d. Fetal response to contractions - ANSWER: ANS: A
Beat-to-beat variability cannot be determined by auscultation because auscultation provides only an
average fetal heart rate (FHR) as it fluctuates. Tachycardia can be determined by any of the FHR
monitoring techniques. Bradycardia can be determined by any of the FHR monitoring techniques. The
fetal response to the contractions is usually noted by an increase or decrease in fetal heart rate.
These can be determined by any of the FHR monitoring techniques.
Which is the most appropriate method of intrapartum fetal monitoring when a woman has a history
of hypertension during pregnancy?
a. Continuous auscultation with a fetoscope
b.Continuous electronic fetal monitoring
c. Intermittent assessment with a Doppler transducer
d. Intermittent electronic fetal monitoring for 15 minutes each hour - ANSWER: ANS: B
Maternal hypertension may reduce placental blood flow through vasospasm of the spiral arteries.
Reduced placental perfusion is best assessed with continuous electronic fetal monitoring to identify
patterns associated with this condition. It is not practical to provide continuous auscultation with a
fetoscope. This fetus needs continuous monitoring because it is at high risk for complications.
Why is continuous electronic fetal monitoring generally used when oxytocin is administered?
a. Fetal chemoreceptors are stimulated.
b. The mother may become hypotensive.
c. Maternal fluid volume deficit may occur.
d. Uteroplacental exchange may be compromised. - ANSWER: ANS: D
The uterus may contract more firmly and the resting tone may be increased with oxytocin use. This
response reduces the entrance of freshly oxygenated maternal blood into the intervillous spaces,
depleting fetal oxygen reserves. Oxytocin affects the uterine muscles. Hypotension is not a common
side effect of oxytocin. All laboring women are at risk for fluid volume deficit; oxytocin administration
does not increase the risk.
The nurse is concerned that a client's uterine activity is too intense and that her obesity is preventing
accurate assessment of the actual intrauterine pressure. Based on this information, which action
should the nurse take?
a. Reposition the tocotransducer.
b. Reposition the Doppler transducer.
c. Obtain an order from the health care provider for a spiral electrode.
d. Obtain an order from the health care provider for an intrauterine pressure catheter. - ANSWER:
ANS: D
An intrauterine pressure catheter can measure actual intrauterine pressure. The tocotransducer
measures the uterine pressure externally; this would not be accurate with an obese client, even with
repositioning. A Doppler auscultates the FHR. A scalp electrode (or spiral electrode) measures the
fetal heart rate (FHR).
If the position of a fetus in a cephalic presentation is right occiput anterior, the nurse should assess
the fetal heart rate in which quadrant of the maternal abdomen?
a. Right upper
b. Left upper
c. Right lower
d. Left lower - ANSWER: ANS: C
If the fetus is in a right occiput anterior position, the fetal spine will be on the mother's right side. The
best location to hear the fetal heart rate is through the fetal shoulder, which would be in the right
