A pregnant patient at 36 weeks gestation reports difficulty breathing when lying flat. What should the nurse do first?

Correct Answer: A

Rationale: The correct answer is A because positioning the patient in a semi-reclined or left side position can alleviate pressure on the diaphragm and improve breathing. This position helps optimize blood flow to the uterus and placenta. Encouraging rest in this position can improve oxygenation for both the mother and fetus. Administering oxygen (Choice B) may help with oxygenation but does not address the underlying issue of positional discomfort. Monitoring fetal heart rate (Choice C) is important but not the first action to address the mother's breathing difficulty. Instructing the patient to take shallow breaths and stay in bed (Choice D) does not address the positional component of the issue.

Correct Answer: C

Rationale: The correct answer is C: every 5-15 minutes. During the second stage of labor, frequent assessment of the fetal heart rate is crucial to monitor fetal well-being and detect any signs of distress promptly. Assessing every 5-15 minutes allows the nurse to closely monitor the fetal heart rate pattern and response to uterine contractions, ensuring timely interventions if needed. Option A (every 5 minutes with contractions) may be too frequent and unnecessary, causing patient discomfort. Option B (at least every 30 minutes) is too infrequent and may miss important changes in fetal status. Option D (only when the physician orders assessment) is incorrect as nurses should proactively monitor fetal well-being without waiting for physician orders.

Correct Answer: A

Rationale: The correct answer is A: oxytocin (Pitocin). Oxytocin is commonly used postpartum to prevent hemorrhage and promote uterine contractions due to its ability to stimulate uterine muscle contractions. Oxytocin plays a crucial role in the physiological process of labor and delivery by helping the uterus contract and reduce bleeding. Fentanyl (B), epinephrine (C), and lorazepam (D) are not uterotonic medications and do not have the same effects on the uterus as oxytocin. Fentanyl is an opioid analgesic, epinephrine is a vasoconstrictor, and lorazepam is a sedative, none of which are indicated for preventing postpartum hemorrhage or promoting uterine contractions.

Correct Answer: A

Rationale: The purpose of Leopold's maneuver in labor and delivery is to assess fetal presentation and position. Step 1 evaluates the fundal grip to determine the fetal part. Step 2 assesses the sides of the abdomen to identify the fetal back. Step 3 determines the presenting part and position. Step 4 confirms the presenting part and its mobility. This systematic approach helps determine the position of the fetus in the uterus. Choices B, C, and D are incorrect as they do not align with the specific purpose of Leopold's maneuver, which is primarily focused on assessing fetal presentation and position.

Correct Answer: B

Rationale: The correct answer is B because the primary purpose of performing a vaginal examination during labor is to assess fetal well-being and progress of labor. By conducting a vaginal exam, healthcare providers can monitor the fetal heart rate, position, and stage of labor. This information helps determine if the labor is progressing normally and if any interventions are needed. Choice A is incorrect because cervical dilation and effacement can be assessed but are not the primary purpose. Choice C is incorrect as fetal distress is typically identified through other methods such as continuous fetal monitoring. Choice D is incorrect as assessing fetal descent and station can be done through vaginal examination but is not the primary purpose.