A patient who is about to undergo a cesarean section for breech presentation without fetal distress asks her nurse what kind of anesthesia would be best for her. The nurse explains that which of the following is the preferred method of anesthesia in this nonemergent case?

Correct Answer: A

Rationale: The correct answer is A: Spinal block. Spinal anesthesia provides rapid onset and reliable anesthesia for cesarean section, making it the preferred method in nonemergent cases. It is safe for both the mother and the baby, as it does not cross the placental barrier. Spinal anesthesia also allows for better pain control postoperatively compared to other methods. Choice B (Epidural block) may be a suitable option, but spinal anesthesia is preferred due to its faster onset and reliability. Choice C (General anesthesia) is not the preferred method in nonemergent cases as it carries more risks compared to regional anesthesia and may have adverse effects on the baby. Choice D (Intravenous sedation) is not appropriate for cesarean section as it does not provide adequate anesthesia for the procedure and may not be safe for the baby.

Correct Answer: B

Rationale: The correct answer is B: Encourage the patient to bear down with each contraction. This is the most helpful intervention as it helps the patient effectively push during the second stage of labor, facilitating the descent of the baby through the birth canal. Increasing the epidural dose (choice A) can further impair the patient's ability to push. Performing a cesarean section (choice C) is not necessary unless there are other complications. Placing the patient in a lithotomy position (choice D) is a common position for delivery but does not address the issue of difficulty pushing.

Correct Answer: A

Rationale: The correct answer is A: Perform a vaginal examination to assess for cord prolapse. This is the first priority action because cord prolapse is a life-threatening emergency that requires immediate intervention to prevent fetal compromise. By performing a vaginal examination, the healthcare provider can quickly determine if the umbilical cord is presenting before the fetus, allowing for prompt management. Choice B is incorrect because starting an IV and administering antibiotics is important but not the first priority in this situation. Choice C is incorrect as monitoring fetal heart rate for decelerations is essential but not as urgent as assessing for cord prolapse. Choice D is also incorrect as checking for meconium staining is important but does not take precedence over assessing for cord prolapse.

Correct Answer: B

Rationale: The correct answer is B: Check for cord prolapse. This is the first priority action because a prolapsed cord is a life-threatening emergency that requires immediate intervention to prevent fetal hypoxia and distress. The nurse should quickly assess for cord presentation by performing a vaginal exam and relieving pressure on the cord if present. Incorrect choices: A: Assess for signs of infection - While infection is a concern with ruptured membranes, it is not the immediate priority over checking for cord prolapse. C: Perform a vaginal exam to assess cervical dilation - Assessing cervical dilation can wait until after ruling out cord prolapse. D: Perform a vaginal examination to check for fetal descent - Fetal descent assessment is not urgent compared to checking for cord prolapse in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Blood pressure. In a patient with gestational hypertension, monitoring blood pressure is crucial to assess for worsening hypertension, which can lead to complications such as preeclampsia and eclampsia. Elevated blood pressure can affect both maternal and fetal well-being. Assessing fetal heart rate (A) is important but not the most critical factor in this scenario. Uterine contractions (C) are important but secondary to monitoring blood pressure. Fetal malpresentation (D) can impact delivery but is not the most vital factor to assess in a patient with gestational hypertension.