Chapter 17 Intrapartum Fetal Surveillance

Chapter 17  Intrapartum Fetal Surveillance

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse sees this pattern on the fetal monitor.

What action by the nurse is most appropriate?
a. Apply oxygen via face mask, and position the woman on her left side.
b. Document the findings in the chart along with maternal vital signs.
c. Prepare to start an infusion of oxytocin per unit protocol.
d. Decrease the rate of the woman’s IV maintenance fluids.

ANS: A
This tracing shows a late deceleration. The mother should be given oxygen and positioned on
her left side. The findings should be documented, but only after interventions have occurred.
Oxytocin would increase uterine activity (and increase stress on the fetus) so should not be
started, or if already running, discontinued. IV fluids should be increased.

PTS: 1 DIF: Cognitive Level: Analysis REF: Figure 17.10
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
To apply internal monitoring devices, the membranes must be ruptured. Cervical dilation of 4
cm permits the insertion of fetal scalp electrodes and intrauterine catheter. The external
monitor can be discontinued after the internal ones are applied. A compromised fetus should
be monitored with the most accurate monitoring devices.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 338 OBJ: Nursing Process: Planning

MSC: Client Needs: Physiologic Integrity

3. The nursing student is planning to assess a fetal heart rate. The registered nurse reminds the

student to get gel. Which method of assessing the fetal heart rate is the student planning on
conducting?
a. Fetoscope
b. Tocodynamometer
c. Doppler
d. Scalp electrode

ANS: C
Doppler is the only listed method involving ultrasonic transmission of fetal heart rates; it
requires use of a gel.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 338 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance

4. A nurse manager plans staffing for the Labor and Delivery unit. 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.

ANS: 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. Intermittent auscultation is more staff-intensive.
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/Understanding
REF: p. 336 OBJ: Nursing Process: Planning
MSC: Client Needs: Safe and Effective Care Environment

5. A student nurse is placing a tocotransducer on a woman for electronic fetal monitoring. What

action by the student indicates to the registered nurse that the student understands the
procedure?
a. Places the tocotransducer over the uterine fundus
b. Prepares sterile field for fetal scalp electrode placement
c. Positions the tocotransducer on the woman’s upper arm
d. Attaches the tocotransducer to the woman’s lower abdomen

ANS: A
The tocotransducer monitors uterine activity and should be placed over the fundus, where the
most intensive uterine contractions occur. No sterile field is needed. The tocotransducer is not
placed on the upper arm or lower abdomen.

PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating
REF: p. 338 OBJ: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance