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2/3/24, 11:08 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/51005498 1/17 Exit Performance Week 4 EAQ #3 Due Feb 6, 2024 by 8:30 am Final Score 60% 9 out of 15 questions answered correctly Completed on Feb 1, 2024 12:37 pm Incorrect (6) Report content error Using the paced breathing method, which step would the nurse coach the client to do at the beginning and end of each contraction? Exhale a deep breath.

2/3/24, 11:08 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/51005498 2/17 Rationale The client must remember that all breathing patterns begin with a deep, relaxing, cleansing breath at the beginning of each contraction. The client would then exhale a deep breath. The client would take six to eight breaths per minute when performing slow-paced breathing. As contractions increase in frequency and intensity, the client would take shallow, fast breaths, about 32 to 40 per minute. STUDY TIP: Identify your problem areas that need attention. Do not waste time on restudying information you know. p. 335 Report content error Which statement relates to internal fetal monitoring? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected Take a deep relaxing breath. Take 32 breaths per minute. Take five breaths per minute. Requires secure attachment to the fetal presenting part Can be used during the antepartum period Uses a pressure-sensing device Effectiveness is dependent on suﬃcient cervical dilation Can be used with intact membranes

2/3/24, 11:08 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/51005498 3/17 Rationale A spiral electrode is a method of internally monitoring the fetal heart rate. In this method, an electrode attaches to the fetal presenting part and the attachment must be secure for a good signal. The intrauterine pressure catheter technique as well as the spiral electrode require suﬃcient cervical dilation for effective monitoring. Internal fetal monitoring is only used during the intrapartum period. A pressure-sensing device is used with the tocotransducer technique, which monitors uterine activity and not the fetal heart rate. Internal fetal monitoring requires membranes to have ruptured. p. 360 Report content error Which condition often occurs in a nulliparous client in contrast with a multiparous client during labor? Rationale A nulliparous client may experience a longer labor and therefore more fatigue compared with a multiparous client. This is because her reproductive tract structures are less ﬂexible. The firmer tissues in nulliparous clients, as compared with the ﬂexible tissues in multiparous clients, result in a gradual fetal descent. A nulliparous client has a longer An increase in the speed of fetal descent Less fatigue and pain because of a short labor Greater sensory labor pain during early labor Greater fatigue and pain because of a long labor

2/3/24, 11:08 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/51005498 4/17 labor and therefore experiences greater fatigue. A rapid fetal descent in the second stage of labor occurs in multiparous clients and causes greater sensory pain. STUDY TIP: Study goals should set out exactly what you want to accomplish. Do not simply say, “I will study for the examination.” Specify how many hours, what day and time, and what material you will cover. pp. 331, 332 Report content error Which assessment finding is obtained while performing Leopold maneuvers in a client who is in the first stage of labor? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected Rationale Leopold maneuvers , or abdominal palpation, during the first stage of labor help determine the fetal part present in the fundus, which indicates the fetal lie. The presenting part of the fetus would help determine if the Fetal heart rate Fetal part in the fundus Tone of the uterus Presenting part of the fetus Location of fetal back

2/3/24, 11:08 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/51005498 5/17 client would undergo vaginal birth or require a cesarean delivery. The position and location of the fetal back help determine the best location to listen to the fetal heart rate using an ultrasound transducer. The fetal heart rate can only be auscultated using Doppler ultrasonography. However, using abdominal palpation, the point of maximum intensity of the fetal heart rate can be determined. The nurse may not assess the tone of the fundus during the first stage of labor; this is done after the delivery of the infant to determine the risk of postpartum hemorrhage. Test-Taking Tip: Pace yourself during the testing period, and work as accurately as possible. Do not be pressured into finishing early. Do not rush! Students who achieve higher scores on examinations are typically those who use their time judiciously. p. 384 Report content error When assessing the fetal heart rate (FHR) of a client in labor, which finding would the nurse identify as normal? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected Absent variability Minimal variability Moderate variability Marked variability Sinusoidal

2/3/24, 11:08 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/51005498 6/17 Rationale Moderate variability is highly predictive of a normal fetal acid-base balance. It indicates that FHR regulation is not significantly affected by fetal sleep cycles, tachycardia, prematurity, congenital anomalies, preexisting neurologic injury, or central nervous system (CNS) depressant medications. The significance of marked variability is unclear but likely represents a normal variant. Absent or minimal variability is classified as either abnormal or indeterminate. It can result from fetal hypoxemia and metabolic acidemia. A sinusoidal pattern is considered abnormal. pp. 357, 363-364 Report content error Which condition might be a possible cause of a fetal heart rate (FHR) of 100 beats/min? Rationale An FHR of less than 110 beats/min for 10 minutes or more is referred to as bradycardia . Maternal hypoglycemia is a common cause of bradycardia in the fetus. Chorioamnionitis is an infection that causes fetal tachycardia, in which the heart rate is more than 160 beats/min. Hypoxemia (low fetal oxygen supply) and anemia (decreased hemoglobin) of the fetus also cause fetal tachycardia. Maternal hypoglycemia Chorioamnionitis Low fetal oxygen supply Decreased fetal hemoglobin levels

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