A nurse is caring for a laboring person and is monitoring for signs of fetal distress. Which finding is the most concerning in this situation?

Correct Answer: A

Rationale: The correct answer is A: Late decelerations. Late decelerations indicate uteroplacental insufficiency, which can lead to fetal hypoxia and distress. This is the most concerning finding as it indicates a problem with oxygen delivery to the fetus. Bradycardia (B) and Tachycardia (C) can also be concerning, but late decelerations are more specific to fetal distress. Variable decelerations (D) are caused by cord compression and are concerning but not as indicative of fetal distress as late decelerations.

Correct Answer: B

Rationale: The correct answer is B: administer uterotonic medications. Administering uterotonic medications helps prevent postpartum hemorrhage by promoting uterine contractions, which helps to control bleeding. The step-by-step rationale for this answer is as follows: 1. Uterotonic medications, such as oxytocin or misoprostol, are recommended as a prophylactic measure to prevent postpartum hemorrhage. 2. These medications help the uterus to contract, which compresses blood vessels and reduces the risk of excessive bleeding. 3. Administering uterotonic medications is a proactive approach to managing postpartum hemorrhage in high-risk individuals. Summary: Monitoring vital signs (choice A) is important but does not directly prevent hemorrhage. Assessing uterine tone (choice C) is helpful but may not be sufficient in preventing hemorrhage. Performing fundal massage (choice D) can help manage hemorrhage but is not as effective as administering ut

Correct Answer: D

Rationale: The correct answer is D: administer an epidural. Uterine hyperstimulation during labor can lead to fetal distress and complications. Administering an epidural can help manage pain and relax the uterus, reducing the risk of hyperstimulation. Stopping the oxytocin infusion (choice A) is also important, but managing the uterine contractions with an epidural takes priority. Increasing the oxytocin infusion (choice B) would exacerbate the hyperstimulation. Administering IV fluids (choice C) may be helpful, but it does not directly address the uterine hyperstimulation.

Correct Answer: C

Rationale: The correct answer is C: administer IV fluids. Before a cesarean birth, IV fluids are crucial to maintain hydration and prevent hypotension due to anesthesia. Administering IV fluids helps stabilize the person's blood pressure during the procedure, reducing the risk of complications. A is incorrect because informed consent should be obtained earlier in the process. B is incorrect as preoperative medication is typically given closer to the procedure start time. D is incorrect as administering a sedative may affect the person's ability to participate in decision-making and care during the procedure. Administering IV fluids is the priority to ensure the person's safety and well-being during the cesarean birth.

Correct Answer: B

Rationale: The correct answer is B: perform fundal massage. Fundal massage helps stimulate uterine contractions and prevents uterine atony by promoting uterine firmness and reducing the risk of excessive bleeding. It is a non-invasive intervention that can be done immediately after delivery to prevent postpartum hemorrhage. Administering uterotonic medications (Choice A) may be necessary in severe cases but fundal massage is the initial intervention. Performing a vaginal exam (Choice C) is not indicated unless there are specific concerns or indications. Monitoring vital signs (Choice D) is important but addressing uterine atony requires more direct intervention like fundal massage.