A nurse is assisting with a vaginal delivery. What is the most important nursing intervention when the fetal head begins to crown?

Correct Answer: A

Rationale: The correct answer is A: apply gentle downward pressure. This intervention helps prevent rapid expulsion of the baby, reducing the risk of perineal tears and minimizing maternal discomfort. It also helps control the delivery process, ensuring a safe and controlled birth. Incorrect Choices: B: Perineal massage is not indicated at the crowning stage as it may interfere with the natural birthing process. C: Administering pain relief should have been addressed earlier in labor and is not a priority at this stage. D: Administering IV fluids is important for hydration but is not the most critical intervention when the fetal head is crowning.

Correct Answer: B

Rationale: The correct answer is B: increase fetal monitoring. Monitoring the fetus closely is crucial to detect signs of uterine hyperstimulation, such as non-reassuring fetal heart rate patterns. This allows for timely interventions to prevent fetal distress or hypoxia. Monitoring contractions (choice D) is important but does not directly address fetal well-being. Administering an epidural (choice C) may help manage pain but does not prevent uterine hyperstimulation. While monitoring fetal heart rate (choice A) is important, increasing the frequency of monitoring (choice B) is more specific to detecting complications related to oxytocin-induced uterine hyperstimulation.

Correct Answer: C

Rationale: The correct answer is C: check for allergies to anesthesia. Before administering an epidural, it is crucial to check for any allergies to anesthesia to prevent potential allergic reactions. This step ensures the safety and well-being of the laboring person. Informed consent (choice A) is important but not the most critical step before an epidural. Proper positioning (choice B) is essential during the procedure but not the top priority before it. Educating on wound care (choice D) is not directly relevant to preparing for an epidural.

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.