A 35-year-old patient is admitted to the delivery room having contractions 6 minutes apart. Upon palpation of the abdomen, the nurse feels a hard round object in the uterine fundus and a soft object in the pelvis. What should be anticipated?

Correct Answer: A

Rationale: The correct answer is A: Cesarean section. In this scenario, the presence of a hard round object in the uterine fundus and a soft object in the pelvis indicates a situation of breech presentation. Since the baby is presenting in a breech position, it is not safe for a vaginal delivery due to potential complications and risks involved. Therefore, a cesarean section should be anticipated to ensure a safe delivery for both the mother and the baby. Summary of other choices: B: Imminent delivery - Unlikely as the breech presentation may complicate the delivery process. C: Normal progressive labor and delivery - Inconsistent with the breech presentation findings. D: FHR to be heard below the umbilicus - FHR location does not impact the need for a cesarean section in breech presentation.

Correct Answer: C

Rationale: The correct answer is C: Preeclampsia. Preeclampsia is a serious condition characterized by high blood pressure and protein in the urine, which can lead to complications for both the mother and baby during labor. Monitoring for signs of preeclampsia is crucial to ensure timely intervention and prevent adverse outcomes. A: Hypotension is not typically a major concern in a patient with a history of hypertension during labor. B: Precipitous delivery refers to an unusually fast labor, which can be managed but is not the most important issue to monitor for in this case. D: Increased bleeding risk may be a concern, but preeclampsia poses a more immediate threat to the patient's health and requires closer monitoring.

Correct Answer: C

Rationale: The correct answer is C: Continue to monitor contractions and fetal heart rate. At 6 cm dilated and 100% effaced, the woman is in active labor, but delivery is not imminent. Monitoring contractions and fetal heart rate is crucial to ensure the progress of labor and fetal well-being. This step allows the nurse to assess for any signs of fetal distress or labor progression. Administering pain relief medications (B) can be considered based on the woman's pain level, but it is not the immediate priority. Preparing for delivery (A) is premature at this stage. Performing a vaginal examination (D) may not be necessary unless there are concerns about fetal descent or progress of labor.

Correct Answer: A

Rationale: The correct answer is A: Deep tendon reflexes. Magnesium sulfate can cause muscle weakness and respiratory depression due to its effect on the central nervous system. Monitoring deep tendon reflexes helps assess for magnesium toxicity. Respiratory rate (B) should also be monitored, but it is not the most critical parameter for magnesium sulfate. Maternal blood pressure (C) is important, but changes are usually gradual and not directly related to magnesium sulfate. Fetal heart rate (D) is crucial, but in this case, the focus should be on the mother's response to the medication.

Correct Answer: B

Rationale: The correct answer is B: Perform a biophysical profile (BPP). A non-reactive NST indicates fetal distress, so a BPP is necessary to assess the overall well-being of the fetus. BPP evaluates fetal breathing movements, fetal movements, fetal tone, amniotic fluid volume, and NST results. Administering a tocolytic agent (A) is not indicated as the issue is fetal distress, not preterm labor. Monitoring the fetal heart rate for 30 minutes (C) may delay necessary intervention if fetal distress is present. Monitoring fetal heart rate (D) alone does not provide a comprehensive assessment of fetal well-being.