Maternal Newborn Swift River Exam
Questions And Answers | 2025 Verified
Susie Smith
Ms. Susie Smith, 33 y/o G2P0 at 42 weeks' gestation. She is single with a limited
support system. She has just completed a Non-Stress Test (NST) which was interpreted
as being Non-Reactive. Her obstetrician has now ordered an Oxytocin-Stimulated
Contraction Stress Test (CST). Fetal membranes are intact. Ms. Smith also has a
history of hypertension and a previous pregnancy loss at 18 weeks' gestation. She is
crying and states "I can't lose another baby". External tocodynamometer and fetal
ultrasound transducer remain in place from the NST. CORRECT ANSWERS
Educational Needs - Increased acuity
Fall Risk - Increased acuity
Health change - Increased acuity
Pain level - Normal acuity
Physiological Needs - Increased acuity
Sensorium Needs - Normal acuity
Susie Smith
33 y/o G2P0 at 42 weeks' gestation. She is single with a limited support system. She
has just completed a Non-Stress Test (NST) which was interpreted as being Non-
Reactive. Her obstetrician has now ordered an Oxytocin-Stimulated Contraction Stress
Test (CST). Fetal membranes are intact. Ms. Smith also has a history of hypertension
and a previous pregnancy loss at 18 weeks' gestation. She is crying and states "I can't
lose another baby". External tocodynamometer and fetal ultrasound transducer remain
in place from the NST. CORRECT ANSWERS Physiological:
Acute Pain - False
Anxiety - True
Bleeding - False
Infection, Risk - False
Nausea - False
Risk for Impaired Fetal Gas Exchange - True
Safety:
Deficient Knowledge - True
Disturbed sensory perception - False
Fall, Risk for - True
Impaired Maternal Infant Bonding, Risk for - False
Maternal Injury, Risk for - True
Risk for Ineffective Coping - True
Susie Smith Scenario 1
, You enter the patient's room. After washing and gloving hands, you identify yourself and
the patient, Ms. Susie Smith. Assessment findings: Vital signs: BP 144/90 mmHg, P 88
bpm, R 22 breaths/minute, FHR 134 baseline with moderate variability, no accelerations
noted. No visible contractions on monitor tracing. Ms. Smith is teary and asks if her
baby is going to be alright. SELECT THE FIRST TWO NURSING ACTIONS IN THE
ORDER THAT THEY SHOULD BE IMPLEMENTED: CORRECT ANSWERS 1. Discuss
with woman fears about baby health; offer reassurance.
2. Educate woman on oxytocin contraction stress test (CST) procedure.
3. Have woman empty her bladder.
4. Position woman in Semi-Fowlers position with left lateral tilt.
5. Reassess placement of tocodynamoneter and transducer.
Susie Smith Scenario 2
Ms. Smith verbalizes understanding of purpose and process of the oxytocin Contraction
Stress Test (CST). She appears much calmer and states she is ready to proceed with
initiating the test. You assemble the needed supplies at her bedside; a standard
concentration of 500 ml Lactated Ringer's with 30 units oxytocin is used. After washing
your hands, and donning non-sterile gloves, you are ready to proceed with CST.
SELECT THE FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY
SHOULD BE IMPLEMENTED: CORRECT ANSWERS 1. Assess maternal vital signs.
2. Assess FHR baseline and reactivity.
3. Assess monitor tracing for presence of contractions, palpate uterine fundus for
contractions.
4. Obtain IV access with #18 gauge IV catheter and begin 1000 ml Lactated Ringer's
solution at 125 ml/hour on IV pump.
5. Administer oxytocin intravenously through a secondary line connected to the main
line at the proximal port with an IV pump; begin at 1 mu/min per healthcare provider
prescription.
Susie Smith Scenario 3
30 minutes later, the monitor tracing reveals uterine irritability, but no contractions
present. Per healthcare provider order , it is time to increase the rate of the oxytocin.
SELECT THE FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY
SHOULD BE IMPLEMENTED: CORRECT ANSWERS 1. Assess contraction pattern
and palpate uterine resting tone.
2. Assess fetal status.
3. Reassess maternal vital signs.
4. Increase oxytocin to 2 mu/minute per healthcare provider order.
5. Educate and reassure the client.
Susie Smith Scenario 4
Questions And Answers | 2025 Verified
Susie Smith
Ms. Susie Smith, 33 y/o G2P0 at 42 weeks' gestation. She is single with a limited
support system. She has just completed a Non-Stress Test (NST) which was interpreted
as being Non-Reactive. Her obstetrician has now ordered an Oxytocin-Stimulated
Contraction Stress Test (CST). Fetal membranes are intact. Ms. Smith also has a
history of hypertension and a previous pregnancy loss at 18 weeks' gestation. She is
crying and states "I can't lose another baby". External tocodynamometer and fetal
ultrasound transducer remain in place from the NST. CORRECT ANSWERS
Educational Needs - Increased acuity
Fall Risk - Increased acuity
Health change - Increased acuity
Pain level - Normal acuity
Physiological Needs - Increased acuity
Sensorium Needs - Normal acuity
Susie Smith
33 y/o G2P0 at 42 weeks' gestation. She is single with a limited support system. She
has just completed a Non-Stress Test (NST) which was interpreted as being Non-
Reactive. Her obstetrician has now ordered an Oxytocin-Stimulated Contraction Stress
Test (CST). Fetal membranes are intact. Ms. Smith also has a history of hypertension
and a previous pregnancy loss at 18 weeks' gestation. She is crying and states "I can't
lose another baby". External tocodynamometer and fetal ultrasound transducer remain
in place from the NST. CORRECT ANSWERS Physiological:
Acute Pain - False
Anxiety - True
Bleeding - False
Infection, Risk - False
Nausea - False
Risk for Impaired Fetal Gas Exchange - True
Safety:
Deficient Knowledge - True
Disturbed sensory perception - False
Fall, Risk for - True
Impaired Maternal Infant Bonding, Risk for - False
Maternal Injury, Risk for - True
Risk for Ineffective Coping - True
Susie Smith Scenario 1
, You enter the patient's room. After washing and gloving hands, you identify yourself and
the patient, Ms. Susie Smith. Assessment findings: Vital signs: BP 144/90 mmHg, P 88
bpm, R 22 breaths/minute, FHR 134 baseline with moderate variability, no accelerations
noted. No visible contractions on monitor tracing. Ms. Smith is teary and asks if her
baby is going to be alright. SELECT THE FIRST TWO NURSING ACTIONS IN THE
ORDER THAT THEY SHOULD BE IMPLEMENTED: CORRECT ANSWERS 1. Discuss
with woman fears about baby health; offer reassurance.
2. Educate woman on oxytocin contraction stress test (CST) procedure.
3. Have woman empty her bladder.
4. Position woman in Semi-Fowlers position with left lateral tilt.
5. Reassess placement of tocodynamoneter and transducer.
Susie Smith Scenario 2
Ms. Smith verbalizes understanding of purpose and process of the oxytocin Contraction
Stress Test (CST). She appears much calmer and states she is ready to proceed with
initiating the test. You assemble the needed supplies at her bedside; a standard
concentration of 500 ml Lactated Ringer's with 30 units oxytocin is used. After washing
your hands, and donning non-sterile gloves, you are ready to proceed with CST.
SELECT THE FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY
SHOULD BE IMPLEMENTED: CORRECT ANSWERS 1. Assess maternal vital signs.
2. Assess FHR baseline and reactivity.
3. Assess monitor tracing for presence of contractions, palpate uterine fundus for
contractions.
4. Obtain IV access with #18 gauge IV catheter and begin 1000 ml Lactated Ringer's
solution at 125 ml/hour on IV pump.
5. Administer oxytocin intravenously through a secondary line connected to the main
line at the proximal port with an IV pump; begin at 1 mu/min per healthcare provider
prescription.
Susie Smith Scenario 3
30 minutes later, the monitor tracing reveals uterine irritability, but no contractions
present. Per healthcare provider order , it is time to increase the rate of the oxytocin.
SELECT THE FIRST TWO NURSING ACTIONS IN THE ORDER THAT THEY
SHOULD BE IMPLEMENTED: CORRECT ANSWERS 1. Assess contraction pattern
and palpate uterine resting tone.
2. Assess fetal status.
3. Reassess maternal vital signs.
4. Increase oxytocin to 2 mu/minute per healthcare provider order.
5. Educate and reassure the client.
Susie Smith Scenario 4
