Maternal / Newborn Question #12

Question

A client 10 weeks pregnant arrives at the clinic for a scheduled prenatal visit. The nurse is unable to locate fetal heart tones and the client becomes concerned. What is the nurse’s priority action?

Answers

  1. Schedule an ultrasound immediately.
    • Rationale:
  2. Have the health provider notified to come into the exam room.
    • Rationale:
  3. Reassure the client that fetal heart tones may not be heard until 12-weeks.
    • Rationale:
  4. Call the hospital and admit the client for pending miscarriage.
    • Rationale:

Overview

Explanation

Fetal heart tones may not be heard until 12-weeks of pregnancy and the client should be reassured. This finding is completely normal. Options A, B, & D are incorrect since there is no need for ultrasound, notifying the health provider, or admitting to the hospital.

Learning Outcomes

Test Taking Tip

Video Rationale