Lowdermilk Chapter 18: Fetal Assessment
During Labor 34Qw/exp
1. What is the most likely cause for early decelerations in the fetal
heart rate (FHR) pattern?
a. Altered fetal cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Spontaneous rupture of membranes - - -
correct answer ✅A
(Early decelerations are the fetus response to fetal head
compression; these are considered benign, and interventions are
not necessary. Variable decelerations are associated with umbilical
cord compression. Late decelerations are associated with
uteroplacental insufficiency. Spontaneous rupture of membranes
has no bearing on the FHR unless the umbilical cord prolapses,
which would result in variable or prolonged bradycardia.)
2. Which clinical finding or intervention might be considered the
rationale for fetal tachycardia to occur?
,Lowdermilk Chapter 18: Fetal Assessment
During Labor 34Qw/exp
a. Maternal fever
b. Umbilical cord prolapse
c. Regional anesthesia
d. Magnesium sulfate administration - - -
correct answer ✅A
(Fetal tachycardia can be considered an early sign of fetal
hypoxemia and may also result from maternal or fetal infection.
Umbilical cord prolapse, regional anesthesia, and the
administration of magnesium sulfate will each more likely result in
fetal bradycardia, not tachycardia.)
3. While evaluating an external monitor tracing of a woman in
active labor, the nurse notes that the FHR for five sequential
contractions begins to decelerate late in the contraction, with the
nadir of the decelerations occurring after the peak of the
contraction. What is the nurses first priority?
,Lowdermilk Chapter 18: Fetal Assessment
During Labor 34Qw/exp
a. Change the womans position.
b. Notify the health care provider.
c. Assist with amnioinfusion
d. Insert a scalp electrode. - - -
correct answer ✅A
(Late FHR decelerations may be caused by maternal supine
hypotension syndrome. These decelerations are usually corrected
when the woman turns onto her side to displace the weight of the
gravid uterus from the vena cava. If the fetus does not respond to
primary nursing interventions for late decelerations, then the nurse
should continue with subsequent intrauterine resuscitation
measures and notify the health care provider. An amnioinfusion
may be used to relieve pressure on an umbilical cord that has not
prolapsed. The FHR pattern associated with this situation most
likely will reveal variable decelerations. Although a fetal scalp
electrode will provide accurate data for evaluating the well-being of
the fetus, it is not a nursing intervention that will alleviate late
decelerations nor is it the nurses first priority.)
, Lowdermilk Chapter 18: Fetal Assessment
During Labor 34Qw/exp
4. What is the most likely cause for variable FHR decelerations?
a. Altered fetal cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Fetal hypoxemia - - -
correct answer ✅B
(Variable FHR decelerations can occur at any time during the
uterine contracting phase and are caused by compression of the
umbilical cord. Altered fetal cerebral blood flow results in early
decelerations in the FHR. Uteroplacental insufficiency results in late
decelerations in the FHR. Fetal hypoxemia initially results in
tachycardia and then bradycardia if hypoxia continues.)
5. The nurse providing care for a high-risk laboring woman is alert
for late FHR decelerations. Which clinical finding might be the cause
for these late decelerations?
During Labor 34Qw/exp
1. What is the most likely cause for early decelerations in the fetal
heart rate (FHR) pattern?
a. Altered fetal cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Spontaneous rupture of membranes - - -
correct answer ✅A
(Early decelerations are the fetus response to fetal head
compression; these are considered benign, and interventions are
not necessary. Variable decelerations are associated with umbilical
cord compression. Late decelerations are associated with
uteroplacental insufficiency. Spontaneous rupture of membranes
has no bearing on the FHR unless the umbilical cord prolapses,
which would result in variable or prolonged bradycardia.)
2. Which clinical finding or intervention might be considered the
rationale for fetal tachycardia to occur?
,Lowdermilk Chapter 18: Fetal Assessment
During Labor 34Qw/exp
a. Maternal fever
b. Umbilical cord prolapse
c. Regional anesthesia
d. Magnesium sulfate administration - - -
correct answer ✅A
(Fetal tachycardia can be considered an early sign of fetal
hypoxemia and may also result from maternal or fetal infection.
Umbilical cord prolapse, regional anesthesia, and the
administration of magnesium sulfate will each more likely result in
fetal bradycardia, not tachycardia.)
3. While evaluating an external monitor tracing of a woman in
active labor, the nurse notes that the FHR for five sequential
contractions begins to decelerate late in the contraction, with the
nadir of the decelerations occurring after the peak of the
contraction. What is the nurses first priority?
,Lowdermilk Chapter 18: Fetal Assessment
During Labor 34Qw/exp
a. Change the womans position.
b. Notify the health care provider.
c. Assist with amnioinfusion
d. Insert a scalp electrode. - - -
correct answer ✅A
(Late FHR decelerations may be caused by maternal supine
hypotension syndrome. These decelerations are usually corrected
when the woman turns onto her side to displace the weight of the
gravid uterus from the vena cava. If the fetus does not respond to
primary nursing interventions for late decelerations, then the nurse
should continue with subsequent intrauterine resuscitation
measures and notify the health care provider. An amnioinfusion
may be used to relieve pressure on an umbilical cord that has not
prolapsed. The FHR pattern associated with this situation most
likely will reveal variable decelerations. Although a fetal scalp
electrode will provide accurate data for evaluating the well-being of
the fetus, it is not a nursing intervention that will alleviate late
decelerations nor is it the nurses first priority.)
, Lowdermilk Chapter 18: Fetal Assessment
During Labor 34Qw/exp
4. What is the most likely cause for variable FHR decelerations?
a. Altered fetal cerebral blood flow
b. Umbilical cord compression
c. Uteroplacental insufficiency
d. Fetal hypoxemia - - -
correct answer ✅B
(Variable FHR decelerations can occur at any time during the
uterine contracting phase and are caused by compression of the
umbilical cord. Altered fetal cerebral blood flow results in early
decelerations in the FHR. Uteroplacental insufficiency results in late
decelerations in the FHR. Fetal hypoxemia initially results in
tachycardia and then bradycardia if hypoxia continues.)
5. The nurse providing care for a high-risk laboring woman is alert
for late FHR decelerations. Which clinical finding might be the cause
for these late decelerations?
