Exam (elaborations)
Chapter 17 Intrapartum Fetal Surveillance
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Chapter 17 Intrapartum Fetal Surveillance
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Chapter 17: Intrapartum Fetal SurveillanceTest Bank
MULTIPLE CHOICE
1. 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. Continue to monitor these early decelerations, which occur as the fetal head is
compressed during a contraction.
b. This deceleration pattern is associated with uteroplacental insufficiency, so the
nurse acts quickly to improve placental blood flow and fetal oxygen supply.
c. This pattern reflects variable decelerations. No interventions are necessary at this
time.
d. Document this reassuring fetal heart rate pattern, but decrease the rate of the
intravenous fluid.
ANS: B
Feedback
A These are late decelerations, not early; therefore interventions are necessary.
B This is a description of a late deceleration. Oxygen should be given via snug
facemask. Position the woman on her left side to increase placental blood flow.
C Variable decelerations are caused by cord compression. A vaginal examination
should be performed to identify this potential emergency.
D This is not a reassuring pattern, so the intravenous rate should be increased to
increase the mother’s blood volume.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 375-376
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
2. Which maternal condition is considered a contraindication for the application of
internal monitoring devices?
a. Unruptured membranes
b. Cervix is dilated to 4 cm
c. External monitors are currently being used
d. Fetus has a known heart defect
ANS: A
Feedback
A To apply internal monitoring devices, the membranes must be ruptured.
B Cervical dilation of 4 cm permits the insertion of fetal scalp electrodes and
intrauterine catheter.
C The external monitor can be discontinued after the internal ones are applied.
D A compromised fetus should be monitored with the most accurate monitoring
devices.
, PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 371
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
3. Which method of assessing the fetal heart rate requires the use of a gel?
a. Fetoscope
b. Tocodynamometer
c. Doppler
d. Scalp electrode
ANS: C
Feedback
A The fetoscope does not require the use of gel because ultrasonic transmission is
not used.
B Tocodynamometer does not require the use of gel. This device monitors uterine
contractions.
C Doppler is the only listed method involving ultrasonic transmission of fetal heart
rates; it requires use of a gel.
D The scalp electrode is attached to the fetal scalp; gel is not necessary.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 370
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
4. How does the available staff influence the selection of either continuous electronic or
intermittent auscultation as the fetal-monitoring method?
a. There must be a 1:1 nurse-to-patient ratio regardless of the method used.
b. Staffing patterns do not influence fetal monitoring choices.
c. Use of intermittent auscultation requires a lower nurse-to-patient ratio.
d. More nurses are needed when electronic fetal monitoring is used because of
increased medical interventions.
ANS: C
Feedback
A A one-to-one ratio is needed during the second stage of labor or if a high-risk
condition exists, regardless of the monitoring method used.
B Staffing patterns do plan a role in maintaining safe monitoring practice of the
labor patient.
C Intermittent auscultation is more staff-intensive.
D Less nursing time is needed with electronic monitoring, giving the nurse more
time for teaching and supporting the laboring woman.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 367
OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment
5. The nurse knows that proper placement of the tocotransducer for electronic fetal monitoring is
a. Over the uterine fundus
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