Maternal Fetal Monitoring -Nurselytic

Correct Answer: C

Rationale: The correct answer is C: Uteroplacental insufficiency. Late FHR decelerations are caused by decreased blood flow and oxygen delivery to the fetus due to impaired uteroplacental circulation. This can result from conditions like placental abruption or placental insufficiency. Altered cerebral blood flow (
A) is more related to early decelerations. Umbilical cord compression (
B) typically causes variable decelerations. Meconium fluid (
D) can lead to fetal distress but is not the primary cause of late decelerations.

Correct Answer: A

Rationale: The correct answer is A: Spinal block. Spinal anesthesia provides rapid onset and reliable anesthesia for cesarean section, making it the preferred method in nonemergent cases. It is safe for both the mother and the baby, as it does not cross the placental barrier. Spinal anesthesia also allows for better pain control postoperatively compared to other methods.


Choice B (Epidural block) may be a suitable option, but spinal anesthesia is preferred due to its faster onset and reliability.


Choice C (General anesthesia) is not the preferred method in nonemergent cases as it carries more risks compared to regional anesthesia and may have adverse effects on the baby.


Choice D (Intravenous sedation) is not appropriate for cesarean section as it does not provide adequate anesthesia for the procedure and may not be safe for the baby.

Correct Answer: A

Rationale: The correct answer is A: Respiratory depression. After receiving an epidural block, the nurse should monitor for respiratory depression in a patient with a history of asthma due to the potential for decreased lung function. This is crucial as the medication from the block can affect respiratory drive, leading to compromised breathing. Tachycardia (choice
B), elevated blood pressure (choice
C), and hyperthermia (choice
D) are not typically associated with epidural blocks and are not the primary concerns for a patient with asthma undergoing this procedure.

Correct Answer: B

Rationale: The correct answer is B: Encourage the patient to bear down with each contraction. This is the most helpful intervention as it helps the patient effectively push during the second stage of labor, facilitating the descent of the baby through the birth canal. Increasing the epidural dose (choice
A) can further impair the patient's ability to push. Performing a cesarean section (choice
C) is not necessary unless there are other complications. Placing the patient in a lithotomy position (choice
D) is a common position for delivery but does not address the issue of difficulty pushing.

Correct Answer: A

Rationale: The correct answer is A: Perform a vaginal examination to assess for cord prolapse. This is the first priority action because cord prolapse is a life-threatening emergency that requires immediate intervention to prevent fetal compromise. By performing a vaginal examination, the healthcare provider can quickly determine if the umbilical cord is presenting before the fetus, allowing for prompt management.


Choice B is incorrect because starting an IV and administering antibiotics is important but not the first priority in this situation.
Choice C is incorrect as monitoring fetal heart rate for decelerations is essential but not as urgent as assessing for cord prolapse.
Choice D is also incorrect as checking for meconium staining is important but does not take precedence over assessing for cord prolapse.