A nurse is caring for a client at 38 weeks gestation who arrived to the triage with complaints of decreased fetal movement. The nurse contacts the provider and reports the findings. The nurse anticipates an order for which of the following?
Non-stress test.
Biophysical profile.
Ultrasound.
Amniocentesis.
The Correct Answer is A
Choice A rationale
A non-stress test (NST) is a common initial assessment for decreased fetal movement. It evaluates fetal heart rate patterns in response to fetal movements, providing information about fetal well-being and oxygenation.
Choice B rationale
A biophysical profile (BPP) is a more comprehensive assessment that includes an NST and ultrasound evaluation of fetal movements, tone, breathing, and amniotic fluid volume. It may be ordered if the NST results are non-reassuring or if there are other concerns.
Choice C rationale
An ultrasound can provide valuable information about fetal growth, amniotic fluid volume, and placental function. It may be used in conjunction with other tests but is not the first-line assessment for decreased fetal movement.
Choice D rationale
Amniocentesis is an invasive procedure used for specific indications, such as genetic testing or assessing fetal lung maturity. It is not typically used for initial assessment of decreased fetal movement.
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Correct Answer is A
Explanation
Choice A rationale
A reactive non-stress test (NST) indicates that the fetal heart rate increases appropriately with fetal movements, suggesting good fetal oxygenation and neurological function. This is the desired outcome for an NST4.
Choice B rationale
A non-reactive NST means the fetal heart rate did not increase with movements, which could indicate fetal hypoxia or other issues. Further testing would be needed to assess fetal well-being.
Choice C rationale
An inconclusive NST means the test did not provide enough information to determine fetal well-being, possibly due to fetal sleep cycles or maternal factors. Additional testing would be required.
Choice D rationale
A positive NST is not a standard term used in fetal monitoring. The correct terms are reactive or non-reactive.
Correct Answer is A
Explanation
Choice A rationale
The occiput anterior (OA) position is considered the optimal fetal position for vaginal birth. In this position, the baby’s head is down, and the back of the head (occiput) is facing the mother’s front. This position allows for the most efficient passage through the birth canal.
Choice B rationale
The occiput posterior (OP) position, where the baby’s head is down but facing the mother’s back, can lead to a longer and more painful labor. It is not considered optimal for vaginal birth.
Choice C rationale
Breech positions, where the baby’s buttocks or feet are positioned to come out first, are not optimal for vaginal birth and often require a cesarean section due to the increased risk of complications.
Choice D rationale
The transverse position, where the baby is lying sideways across the uterus, is not suitable for vaginal birth. This position typically requires a cesarean section to safely deliver the baby.