Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
What is the cause of early decelerations in the fetal heart rate (FHR) of a laboring woman?
A. Cerebral compression
Cerebral compression is the cause of early decelerations, as it reflects the fetal head compression during uterine contractions. Early decelerations are decreases in the FHR that begin and end with the onset and end of a contraction, respectively. They are symmetrical and mirror the shape of the contraction. Early decelerations are normal and benign, as they indicate that the fetus is responding to the increased intracranial pressure and maintaining adequate oxygenation.
B. Cord compression
Cord compression is not the cause of early decelerations, but of variable decelerations. Variable decelerations are abrupt and irregular decreases in the FHR that vary in onset, duration, and depth. They are usually caused by the umbilical cord being compressed or occluded by the fetal body, the maternal pelvis, or the uterine contractions. Variable decelerations can indicate fetal distress or hypoxia, especially if they are severe, frequent, or prolonged.
C. Uteroplacental insufficiency
Uteroplacental insufficiency is not the cause of early decelerations, but of late decelerations. Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They are symmetrical and have a gradual onset and recovery. They are usually caused by the reduced blood flow and oxygen delivery to the placenta and the fetus due to maternal or fetal factors. Late decelerations can indicate fetal distress or hypoxia, and require immediate intervention.
D. Spontaneous rupture of membranes
Spontaneous rupture of membranes is not the cause of early decelerations, but it can be a risk factor for cord compression and variable decelerations. Spontaneous rupture of membranes is the breaking of the amniotic sac and the release of the amniotic fluid, which usually occurs during labor or shortly before it. Spontaneous rupture of membranes can cause the umbilical cord to prolapse or slip into the vagina, where it can be compressed or kinked by the fetal head or the contractions.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Maternal Newborn Midterm Proctored Exam 1. Take the full exam now
Full Explanation
Choice A reason: Cerebral compression is the cause of early decelerations, as it reflects the fetal head compression during uterine contractions. Early decelerations are decreases in the FHR that begin and end with the onset and end of a contraction, respectively. They are symmetrical and mirror the shape of the contraction. Early decelerations are normal and benign, as they indicate that the fetus is responding to the increased intracranial pressure and maintaining adequate oxygenation.
Choice B reason: Cord compression is not the cause of early decelerations but of variable decelerations. Variable decelerations are abrupt and irregular decreases in the FHR that vary in onset, duration, and depth. They are usually caused by the umbilical cord being compressed or occluded by the fetal body, the maternal pelvis, or the uterine contractions. Variable decelerations can indicate fetal distress or hypoxia, especially if they are severe, frequent, or prolonged.
Choice C reason: Uteroplacental insufficiency is not the cause of early decelerations, but of late decelerations. Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They are symmetrical and have a gradual onset and recovery. They are usually caused by the reduced blood flow and oxygen delivery to the placenta and the fetus due to maternal or fetal factors. Late decelerations can indicate fetal distress or hypoxia, and require immediate intervention.
Choice D reason: Spontaneous rupture of membranes is not the cause of early decelerations, but it can be a risk factor for cord compression and variable decelerations. Spontaneous rupture of membranes is the breaking of the amniotic sac and the release of the amniotic fluid, which usually occurs during labor or shortly before it. Spontaneous rupture of membranes can cause the umbilical cord to prolapse or slip into the vagina, where it can be compressed or kinked by the fetal head or the contractions.
Similar Questions
Why is glucose metabolism profoundly affected during pregnancy?
A. The pregnant woman uses glucose at a more rapid rate than the nonpregnant woman.
This is not the correct answer, as the pregnant woman does not use glucose at a more rapid rate than the nonpregnant woman. In fact, the pregnant woman has lower fasting glucose levels and higher postprandial glucose levels than the nonpregnant woman. This is because the pregnant woman adapts to the increased fetal demand for glucose by increasing her insulin secretion and decreasing her hepatic glucose production.
B. Placental hormones are antagonistic to insulin, thus resulting in insulin resistance.
This is the correct answer, as placental hormones are antagonistic to insulin, thus resulting in insulin resistance. Insulin resistance is a condition where the cells do not respond well to insulin and require more insulin to maintain normal glucose levels. Placental hormones, such as human placental lactogen, progesterone, and cortisol, increase the insulin resistance of the maternal tissues, especially in the second and third trimesters of pregnancy. This is to ensure that the fetus has enough glucose supply, as the placenta is not insulin resistant and can transport glucose to the fetus².
C. Pancreatic function in the islets of Langerhans is affected by pregnancy.
This is not the correct answer, as pancreatic function in the islets of Langerhans is not affected by pregnancy. The islets of Langerhans are clusters of cells in the pancreas that produce hormones, such as insulin and glucagon, that regulate glucose metabolism. Pregnancy does not impair the function of the islets of Langerhans, but rather stimulates them to increase their size and number. This is to compensate for the increased insulin resistance and glucose demand of the pregnancy.
D. The pregnant woman increases her dietary intake significantly.
This is not the correct answer, as the pregnant woman does not increase her dietary intake significantly. The pregnant woman needs to consume adequate calories and nutrients to support the fetal growth and development, but not excessively. The recommended weight gain during pregnancy depends on the pre-pregnancy BMI of the woman, but generally ranges from 11 to 16 kg. The recommended calorie intake during pregnancy is about 300 kcal more than the pre-pregnancy intake, which is equivalent to one extra snack per day.
Full Explanation
Choice A reason: This is not the correct answer, as the pregnant woman does not use glucose at a more rapid rate than the nonpregnant woman. In fact, the pregnant woman has lower fasting glucose levels and higher postprandial glucose levels than the nonpregnant woman. This is because the pregnant woman adapts to the increased fetal demand for glucose by increasing her insulin secretion and decreasing her hepatic glucose production.
Choice B reason: This is the correct answer, as placental hormones are antagonistic to insulin, thus resulting in insulin resistance. Insulin resistance is a condition where the cells do not respond well to insulin and require more insulin to maintain normal glucose levels. Placental hormones, such as human placental lactogen, progesterone, and cortisol, increase the insulin resistance of the maternal tissues, especially in the second and third trimesters of pregnancy. This is to ensure that the fetus has enough glucose supply, as the placenta is not insulin resistant and can transport glucose to the fetus².
Choice C reason: This is not the correct answer, as pancreatic function in the islets of Langerhans is not affected by pregnancy. The islets of Langerhans are clusters of cells in the pancreas that produce hormones, such as insulin and glucagon, that regulate glucose metabolism. Pregnancy does not impair the function of the islets of Langerhans, but rather stimulates them to increase their size and number. This is to compensate for the increased insulin resistance and glucose demand of the pregnancy.
Choice D reason: This is not the correct answer, as the pregnant woman does not increase her dietary intake significantly. The pregnant woman needs to consume adequate calories and nutrients to support the fetal growth and development, but not excessively. The recommended weight gain during pregnancy depends on the pre-pregnancy BMI of the woman, but generally ranges from 11 to 16 kg. The recommended calorie intake during pregnancy is about 300 kcal more than the pre-pregnancy intake, which is equivalent to one extra snack per day.
What is the most important factor for successful teaching of the pregnant client by the maternity nurse?
A. The order in which the information is presented
The order in which the information is presented is not the most important factor, as it does not affect the client's motivation or ability to learn. The order of the information should be logical and sequential, but it can vary depending on the client's needs, preferences, and learning style. The nurse should assess the client's prior knowledge and tailor the teaching accordingly.
B. The extent to which the pregnancy was planned
The extent to which the pregnancy was planned is not the most important factor, as it does not determine the client's interest or willingness to learn. The pregnancy may be planned or unplanned, but the client may still have questions, concerns, or goals related to the pregnancy. The nurse should respect the client's feelings and emotions and provide support and guidance.
C. The client's readiness to learn
The client's readiness to learn is the most important factor, as it influences the client's engagement and retention of the information. The client's readiness to learn depends on the client's perception of the relevance, importance, and benefits of the information, as well as the client's physical, psychological, and social readiness. The nurse should assess the client's readiness to learn and use appropriate strategies to enhance it, such as setting realistic and specific objectives, providing positive feedback, and involving the client in the learning process.
D. The client's educational background
The client's educational background is not the most important factor, as it does not reflect the client's learning needs or capabilities. The client's educational background may vary, but the client may still have similar or different learning needs depending on the pregnancy situation. The nurse should not assume the client's level of understanding or knowledge based on the client's educational background, but rather use simple and clear language, avoid medical jargon, and check for comprehension.
Full Explanation
Choice A reason: The order in which the information is presented is not the most important factor, as it does not affect the client's motivation or ability to learn. The order of the information should be logical and sequential, but it can vary depending on the client's needs, preferences, and learning style. The nurse should assess the client's prior knowledge and tailor the teaching accordingly.
Choice B reason: The extent to which the pregnancy was planned is not the most important factor, as it does not determine the client's interest or willingness to learn. The pregnancy may be planned or unplanned, but the client may still have questions, concerns, or goals related to the pregnancy. The nurse should respect the client's feelings and emotions and provide support and guidance.
Choice C reason: The client's readiness to learn is the most important factor, as it influences the client's engagement and retention of the information. The client's readiness to learn depends on the client's perception of the relevance, importance, and benefits of the information, as well as the client's physical, psychological, and social readiness. The nurse should assess the client's readiness to learn and use appropriate strategies to enhance it, such as setting realistic and specific objectives, providing positive feedback, and involving the client in the learning process.
Choice D reason: The client's educational background is not the most important factor, as it does not reflect the client's learning needs or capabilities. The client's educational background may vary, but the client may still have similar or different learning needs depending on the pregnancy situation. The nurse should not assume the client's level of understanding or knowledge based on the client's educational background, but rather use simple and clear language, avoid medical jargon, and check for comprehension.
What maternal condition always requires delivery by cesarean section?
A. Partial abruptio placentae
Partial abruptio placentae is not the correct answer, as it does not always require delivery by cesarean section. Partial abruptio placentae is a condition where the placenta partially separates from the uterine wall before the baby is born. This can cause bleeding, pain, and fetal distress. Depending on the severity of the condition, the gestational age, and the fetal status, the delivery may be vaginal or cesarean.
B. Ectopic pregnancy
Ectopic pregnancy is not the correct answer, as it does not require delivery by cesarean section. Ectopic pregnancy is a condition where the fertilized egg implants outside the uterus, usually in the fallopian tube. This can cause bleeding, pain, and rupture of the tube. Ectopic pregnancy is not viable and needs to be removed surgically or treated with medication. It cannot result in a live birth².
C. Eclampsia
Eclampsia is not the correct answer, as it does not always require delivery by cesarean section. Eclampsia is a severe complication of preeclampsia, a condition where the pregnant woman develops high blood pressure and protein in the urine. Eclampsia can cause seizures, coma, and death for the mother and the baby. The only cure for eclampsia is delivery of the baby, which may be vaginal or cesarean depending on the maternal and fetal condition.
D. Total placenta previa
Total placenta previa is the correct answer, as it always requires delivery by cesarean section. Total placenta previa is a condition where the placenta completely covers the cervix, the opening of the uterus. This can cause painless bleeding, preterm labor, and fetal distress. Vaginal delivery is impossible and dangerous, as it can cause severe bleeding and damage to the placenta and the baby. Cesarean section is the only safe way to deliver the baby.
Full Explanation
Choice A reason: Partial abruptio placentae is not the correct answer, as it does not always require delivery by cesarean section. Partial abruptio placentae is a condition where the placenta partially separates from the uterine wall before the baby is born. This can cause bleeding, pain, and fetal distress. Depending on the severity of the condition, the gestational age, and the fetal status, the delivery may be vaginal or cesarean.
Choice B reason: Ectopic pregnancy is not the correct answer, as it does not require delivery by cesarean section. Ectopic pregnancy is a condition where the fertilized egg implants outside the uterus, usually in the fallopian tube. This can cause bleeding, pain, and rupture of the tube. Ectopic pregnancy is not viable and needs to be removed surgically or treated with medication. It cannot result in a live birth².
Choice C reason: Eclampsia is not the correct answer, as it does not always require delivery by cesarean section. Eclampsia is a severe complication of preeclampsia, a condition where the pregnant woman develops high blood pressure and protein in the urine. Eclampsia can cause seizures, coma, and death for the mother and the baby. The only cure for eclampsia is delivery of the baby, which may be vaginal or cesarean depending on the maternal and fetal condition.
Choice D reason: Total placenta previa is the correct answer, as it always requires delivery by cesarean section. Total placenta previa is a condition where the placenta completely covers the cervix, the opening of the uterus. This can cause painless bleeding, preterm labor, and fetal distress. Vaginal delivery is impossible and dangerous, as it can cause severe bleeding and damage to the placenta and the baby. Cesarean section is the only safe way to deliver the baby.