A nurse is caring for a laboring person who is in the second stage of labor. What is the most appropriate nursing intervention during this stage?

Correct Answer: B

Rationale: The correct answer is B because in the second stage of labor, it is appropriate to assist the laboring person with spontaneous pushing to facilitate the descent of the baby through the birth canal. Controlled pushing (choice A) may cause fatigue and unnecessary strain. Deep breathing (choice C) is more suitable for the first stage of labor. Non-pharmacological pain relief (choice D) can be helpful but is not the priority in the second stage when the focus should be on pushing effectively.

Correct Answer: C

Rationale: The correct answer is C: assess for fetal movement. This is the priority intervention before an epidural to ensure the safety and well-being of the fetus. Assessing for fetal movement helps determine the fetal well-being and any potential distress that may require immediate intervention. Ensuring informed consent (A) is important but assessing fetal well-being takes precedence. Checking for allergies to anesthesia (B) is important but not the priority before assessing fetal movement. Administering pain relief (D) can be done after assessing fetal movement to ensure the safety of both the laboring person and the fetus.

Correct Answer: C

Rationale: The correct answer is C because administering IV fluids is crucial during oxytocin infusion to prevent maternal dehydration and maintain fluid balance. This helps prevent complications such as uterine hyperstimulation and fetal distress. Monitoring fetal heart rate continuously (choice A) is important but not the priority. Increasing maternal hydration (choice B) is beneficial but does not address the immediate need for fluid replacement. Assessing uterine tone (choice D) is important but secondary to ensuring adequate hydration.

Correct Answer: A

Rationale: The correct answer is A because administering preoperative medication is crucial to ensure the patient's comfort and safety during the cesarean birth. Preoperative medications help reduce anxiety, prevent infection, and manage pain. Monitoring vital signs (choice B) is important but not the most critical intervention before the procedure. Ensuring proper incision care (choice C) is postoperative, not preoperative. Performing a vaginal exam (choice D) is unnecessary and potentially harmful before a cesarean birth.

Correct Answer: A

Rationale: The correct answer is A: administer oxygen. Fetal bradycardia indicates decreased oxygen supply to the fetus, which can lead to fetal distress. Administering oxygen helps improve oxygen levels in the mother's blood, increasing oxygen delivery to the fetus. This intervention is crucial in preventing further complications and ensuring the well-being of the baby. Administering IV fluids (B) and increasing maternal hydration (C) may be beneficial but do not directly address the immediate need for oxygen. Increasing maternal oxygen (D) is redundant since the primary focus should be on fetal oxygenation.