PRIORITIZATION DELEGATION AND
ASSIGNMENT COMPREHENSIVE TEST 2026
STUDY GUIDE SOLVED QUESTIONS
◉ The nurse in the labor and delivery unit is caring for a 25-year-old
gravida 3, para 2 patient in active labor. The nurse has identified late
fetal heart decelerations and decreased variability in the fetal heart
rate and notified the health care provider (HCP) on call, who thinks
that the pattern is acceptable. What would be the *priority* action at
this time?
•Advise the patient that a different HCP will be called because the
first HCP's response was not adequate
•Discuss the concerns with another labor and delivery nurse
•Document the conversation with the HCP accurately, including the
HCP's interpretation and recommendation, and continue close
observation of the fetal heart rate
•Go up the chain of command and communicate the assessment of
the fetal heart rate findings clearly to the next appropriate HCP.
Answer: •Go up the chain of command and communicate the
assessment of the fetal heart rate findings clearly to the next
appropriate HCP
•The RN must follow through on the findings of a nonreassuring
fetal heart rate. When patient safety is concerned, the nurse is
,obligated to pursue an appropriate response. Documenting the
conversation with the HCP and discussing it with a colleague are
appropriate, but something must be done to address the immediate
safety concern and possible need for intervention at this time. The
RN must persist until the safety concern has been addressed
appropriately.
◉ What would be the appropriate *first* nursing action when caring
for a 20-year-old gravida 1, para 0 woman at 39 weeks' gestation
who is in active labor and for whom an assessment reveals mild
variable fetal heart rate decelerations?
•Change the maternal position
•Notify the provider
•Prepare for delivery
•Readjust the fetal monitor. Answer: •Change the maternal position
•The cause of variable fetal heart decelerations is compression of
the umbilical cord, which can often be corrected by a change in
maternal position.
◉ A 24-year-old gravida 1, para 0 patient, who is receiving oxytocin,
is in labor at 41 weeks gestation. Which are appropriate nursing
actions in the presence of late fetal heart rate decelerations? *Select
all that apply.*
,•Discontinue the oxytocin
•Decrease the maintenance IV fluid rate
•Administer oxygen to the mother by mask
•Place the woman in high Fowler position
•Notify the health care provider. Answer: •Discontinue the oxytocin
•Administer oxygen to the mother by mask
•Notify the health care provider
•Late fetal heart rate decelerations can be an ominous sign of fetal
hypoxemia, especially if repetitive and accompanied by decreased
variability. Notification of the health care provider is indicated.
Turning off the oxytocin and administering oxygen to the mother are
recommended nursing interventions to improve fetal oxygenation.
An increase in the IV rate can improve hydration, correct
hypovolemia, and increase blood flow to the uterus. Putting the
woman in a lateral position can increase blood flow to the uterus
and increase oxygenation to the fetus. Promptly addressing fetal
heart rate changes may allow intrauterine resuscitation and may
decrease the need for cesarean section if those measures are
effective. This supports the Perinatal Core Measure of reducing of
cesarean section rates.
, ◉ A pregnant woman at 12 weeks' gestation tells the nurse that she
is a vegetarian. What would be the *first* appropriate nursing
action?
•Recommend vitamin B12 and iron supplementation
•Recommend consumption of protein drinks daily
•Obtain a 24-hour diet recall history
•Determine the reason for her vegetarian diet. Answer: •Obtain a
24-hour diet recall history
•The care of a vegetarian woman who is pregnant should begin with
assessment of her diet, because vegetarian practices vary widely.
The RN must first assess exactly what the woman's diet consists of
and then determine any deficiencies. The reason for the diet is less
important than what the diet actually contains. It is probable that
the woman will need a vitamin B12 supplement, but the assessment
comes first. Vegetarian diets can be completely adequate in protein,
and therefore protein supplementation is not routinely
recommended.
◉ A 26-year-old gravida 1, para 1 patient who underwent cesarean
section 24 hours ago tells the nurse that she is having some trouble
breast feeding. Which tasks could be appropriately delegated to the
unlicensed assistive personnel (UAP) on the postpartum floor?
*Select all that apply.*
ASSIGNMENT COMPREHENSIVE TEST 2026
STUDY GUIDE SOLVED QUESTIONS
◉ The nurse in the labor and delivery unit is caring for a 25-year-old
gravida 3, para 2 patient in active labor. The nurse has identified late
fetal heart decelerations and decreased variability in the fetal heart
rate and notified the health care provider (HCP) on call, who thinks
that the pattern is acceptable. What would be the *priority* action at
this time?
•Advise the patient that a different HCP will be called because the
first HCP's response was not adequate
•Discuss the concerns with another labor and delivery nurse
•Document the conversation with the HCP accurately, including the
HCP's interpretation and recommendation, and continue close
observation of the fetal heart rate
•Go up the chain of command and communicate the assessment of
the fetal heart rate findings clearly to the next appropriate HCP.
Answer: •Go up the chain of command and communicate the
assessment of the fetal heart rate findings clearly to the next
appropriate HCP
•The RN must follow through on the findings of a nonreassuring
fetal heart rate. When patient safety is concerned, the nurse is
,obligated to pursue an appropriate response. Documenting the
conversation with the HCP and discussing it with a colleague are
appropriate, but something must be done to address the immediate
safety concern and possible need for intervention at this time. The
RN must persist until the safety concern has been addressed
appropriately.
◉ What would be the appropriate *first* nursing action when caring
for a 20-year-old gravida 1, para 0 woman at 39 weeks' gestation
who is in active labor and for whom an assessment reveals mild
variable fetal heart rate decelerations?
•Change the maternal position
•Notify the provider
•Prepare for delivery
•Readjust the fetal monitor. Answer: •Change the maternal position
•The cause of variable fetal heart decelerations is compression of
the umbilical cord, which can often be corrected by a change in
maternal position.
◉ A 24-year-old gravida 1, para 0 patient, who is receiving oxytocin,
is in labor at 41 weeks gestation. Which are appropriate nursing
actions in the presence of late fetal heart rate decelerations? *Select
all that apply.*
,•Discontinue the oxytocin
•Decrease the maintenance IV fluid rate
•Administer oxygen to the mother by mask
•Place the woman in high Fowler position
•Notify the health care provider. Answer: •Discontinue the oxytocin
•Administer oxygen to the mother by mask
•Notify the health care provider
•Late fetal heart rate decelerations can be an ominous sign of fetal
hypoxemia, especially if repetitive and accompanied by decreased
variability. Notification of the health care provider is indicated.
Turning off the oxytocin and administering oxygen to the mother are
recommended nursing interventions to improve fetal oxygenation.
An increase in the IV rate can improve hydration, correct
hypovolemia, and increase blood flow to the uterus. Putting the
woman in a lateral position can increase blood flow to the uterus
and increase oxygenation to the fetus. Promptly addressing fetal
heart rate changes may allow intrauterine resuscitation and may
decrease the need for cesarean section if those measures are
effective. This supports the Perinatal Core Measure of reducing of
cesarean section rates.
, ◉ A pregnant woman at 12 weeks' gestation tells the nurse that she
is a vegetarian. What would be the *first* appropriate nursing
action?
•Recommend vitamin B12 and iron supplementation
•Recommend consumption of protein drinks daily
•Obtain a 24-hour diet recall history
•Determine the reason for her vegetarian diet. Answer: •Obtain a
24-hour diet recall history
•The care of a vegetarian woman who is pregnant should begin with
assessment of her diet, because vegetarian practices vary widely.
The RN must first assess exactly what the woman's diet consists of
and then determine any deficiencies. The reason for the diet is less
important than what the diet actually contains. It is probable that
the woman will need a vitamin B12 supplement, but the assessment
comes first. Vegetarian diets can be completely adequate in protein,
and therefore protein supplementation is not routinely
recommended.
◉ A 26-year-old gravida 1, para 1 patient who underwent cesarean
section 24 hours ago tells the nurse that she is having some trouble
breast feeding. Which tasks could be appropriately delegated to the
unlicensed assistive personnel (UAP) on the postpartum floor?
*Select all that apply.*
