A patient who is 38 weeks pregnant presents to the labor and delivery unit. Upon vaginal examination, it is determined the fetus is engaged. What is the correct interpretation by the nurse?

Correct Answer: D

Rationale: The correct interpretation by the nurse is D: The biparietal diameter of the fetal head is at the level of the ischial spines. At 38 weeks, engagement indicates the fetal head has descended into the pelvis and reached the level of the ischial spines. This is a crucial landmark in labor progress, indicating descent and readiness for birth. Choices A, B, and C are incorrect. Choice A refers to cervical effacement, which is not related to engagement. Choice B refers to fetal lie, which describes the relationship of the fetal spine to the maternal spine. Choice C refers to fetal head flexion, which is important for the mechanism of labor but not specifically related to engagement.

Correct Answer: B

Rationale: The correct answer is B: Start an IV and monitor the fetal heart rate. This is the most appropriate intervention as it allows for assessment of fetal well-being and maternal status. IV access is crucial for potential interventions like administering medications or fluids. Monitoring fetal heart rate helps determine fetal distress. Administering magnesium sulfate (choice A) should be considered for preterm labor, not routine contractions. Performing a cesarean section immediately (choice C) is not indicated without proper evaluation. Encouraging the patient to push (choice D) is premature without assessing cervical dilation.

Correct Answer: B

Rationale: The correct answer is B: Perform a nonstress test (NST) to assess fetal well-being. 1. Decreased fetal movement can be a sign of fetal distress. 2. NST helps monitor fetal heart rate and movement to assess fetal well-being. 3. It is a non-invasive and effective way to determine fetal health. 4. Other choices are incorrect: A: Incorrect because decreased fetal movement is not always normal and should be assessed. C: Incorrect as tocolytic agents are used to stop preterm labor, not for decreased fetal movement. D: Incorrect as sugary drinks do not reliably stimulate fetal movement.

Correct Answer: A

Rationale: The correct answer is A: Administer magnesium sulfate. Magnesium sulfate is commonly used to delay preterm labor by relaxing uterine smooth muscle. It inhibits contractions and delays labor progression. It is a standard treatment to prevent preterm birth and reduce the risk of complications for both the mother and the baby. Choice B: Emergency cesarean section is not indicated for delaying preterm labor unless there are severe complications putting the mother or baby at immediate risk. Choice C: Administering a prostaglandin inhibitor may help in some cases, but magnesium sulfate is the preferred choice for delaying labor in preterm pregnancies. Choice D: Starting a Pitocin infusion would actually stimulate contractions and hasten labor, which is the opposite of what is needed in this scenario.

Correct Answer: C

Rationale: The correct answer is C: Administer tocolytics to delay labor. This intervention helps to delay preterm labor, giving time for corticosteroids to enhance fetal lung maturity and reduce neonatal morbidity. Administering magnesium sulfate (Choice A) is used for neuroprotection in preterm labor but is not the initial intervention. Performing a cesarean section (Choice B) is not recommended unless there are complications. Inducing labor immediately (Choice D) is not appropriate as the goal is to delay labor to improve neonatal outcomes.