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. In a non-emergent cesarean section for breech presentation without fetal distress, a spinal block is preferred due to its rapid onset, reliable anesthesia for surgical procedures, and minimal risk to the fetus. Spinal block provides adequate pain relief and muscle relaxation without affecting the mother's ability to breathe and interact with the newborn immediately after delivery. Summary of other choices: B: Epidural block - Epidural block may not provide a dense enough block for a cesarean section and might require more time to administer. C: General anesthesia - General anesthesia poses more risks to both the mother and the fetus compared to regional anesthesia methods. D: Intravenous sedation - Intravenous sedation may not provide sufficient anesthesia for a cesarean section and is not the preferred method for this type of surgery.

Correct Answer: C

Rationale: The correct answer is C: Continue to monitor contractions and fetal heart rate. At 6 cm dilated and 100% effaced, the woman is in active labor, but delivery is not imminent. Monitoring contractions and fetal heart rate is crucial to ensure the progress of labor and fetal well-being. This step allows the nurse to assess for any signs of fetal distress or labor progression. Administering pain relief medications (B) can be considered based on the woman's pain level, but it is not the immediate priority. Preparing for delivery (A) is premature at this stage. Performing a vaginal examination (D) may not be necessary unless there are concerns about fetal descent or progress of labor.

Correct Answer: A

Rationale: The correct answer is A: Deep tendon reflexes. Magnesium sulfate can cause muscle weakness and respiratory depression due to its effect on the central nervous system. Monitoring deep tendon reflexes helps assess for magnesium toxicity. Respiratory rate (B) should also be monitored, but it is not the most critical parameter for magnesium sulfate. Maternal blood pressure (C) is important, but changes are usually gradual and not directly related to magnesium sulfate. Fetal heart rate (D) is crucial, but in this case, the focus should be on the mother's response to the medication.

Correct Answer: B

Rationale: The correct answer is B: Perform a biophysical profile (BPP). A non-reactive NST indicates fetal distress, so a BPP is necessary to assess the overall well-being of the fetus. BPP evaluates fetal breathing movements, fetal movements, fetal tone, amniotic fluid volume, and NST results. Administering a tocolytic agent (A) is not indicated as the issue is fetal distress, not preterm labor. Monitoring the fetal heart rate for 30 minutes (C) may delay necessary intervention if fetal distress is present. Monitoring fetal heart rate (D) alone does not provide a comprehensive assessment of fetal well-being.

Correct Answer: C

Rationale: The correct answer is C: Administer magnesium sulfate to prevent seizures. This is the most important action because preeclampsia can lead to eclampsia, which is characterized by seizures. Magnesium sulfate is the first-line treatment to prevent seizures in preeclamptic patients. Administering antihypertensive medications (A) may be necessary to control blood pressure, but preventing seizures takes precedence. Monitoring blood pressure (B) is important but not the most critical action. Performing an emergency cesarean section (D) may be necessary in severe cases but is not the initial priority.