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Practice Question

A nurse is performing a no stress test on a client who is at 35 weeks of gestation and has diabetes mellitus. The test reveals no accelerations of fetal heart rate for 20 min. Which of the following actions should the nurse take?

Answer Choices:

Correct Answer:

Perform vibroacoustic stimulation.

Rationale:

👌A nonstress test (NST) evaluates fetal well-being by monitoring the fetal heart rate (FHR) response to movement, expecting accelerations with fetal activity.

👌 If there are no accelerations within 20 minutes, the nurse should attempt to awaken the fetus using vibroacoustic stimulation (VAS) before determining the test to be nonreactive.

👌 VAS involves placing a sound-generating device on the maternal abdomen to elicit a fetal startle reflex, which may lead to FHR accelerations.

👌 This is a noninvasive and effective method for differentiating between a sleeping fetus and true fetal compromise.

👌Diabetes during pregnancy increases the risk for fetal hypoxia, so prompt evaluation and stimulation are important in detecting fetal distress early.

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This question is from RN ATI Maternal& Newborn ~NGN-2019. which contains 63 questions.

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From Exam
RN ATI Maternal& Newborn ~NGN-2019.

63 Questions

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Question Details
  • Category: RN Nursing Exam(s)
  • Subcategory: ATI Exam(s)
  • Domain: RN ATI Maternal & Newborn Care
  • Answer Choices: 4
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