The nurse is caring for a client at 39 weeks' gestation in active labor. The fetal monitor shows late decelerations. What is the priority nursing action?

Correct Answer: A

Rationale: In this scenario, the priority nursing action is to reposition the client to her left side (Option A). Late decelerations on the fetal monitor indicate uteroplacental insufficiency, which can lead to fetal hypoxia. Repositioning the client to her left side helps improve placental perfusion by relieving pressure on the vena cava, enhancing blood flow to the placenta, and subsequently improving fetal oxygenation. Increasing the oxytocin infusion rate (Option B) would be contraindicated as it can further stress the fetus by increasing the frequency and intensity of contractions, potentially worsening the late decelerations. Encouraging the client to push harder (Option C) would not address the underlying cause of the late decelerations and could potentially lead to fetal distress. Notifying the healthcare provider immediately (Option D) is important but not the most immediate action in this situation. Repositioning the client is the priority to address the fetal well-being promptly. In an educational context, understanding fetal monitoring and the significance of different deceleration patterns is crucial for nurses caring for laboring women. It also highlights the importance of quick and appropriate interventions to optimize maternal and fetal outcomes during labor and delivery.

Correct Answer: B

Rationale: The patient should be instructed to check the strings of the IUD regularly to ensure it remains in place. Choice A is not accurate because while cramping is common, rest is not necessarily required for several days. Choice C is not required; there is no need to avoid sexual activity unless there is an infection or other complication. Choice D is incorrect as Mirena typically reduces bleeding or makes periods lighter.

Correct Answer: B

Rationale: Option B is the statement made by the patient that indicates the need for further teaching. In the basal body temperature method of contraception, a sustained temperature rise typically indicates ovulation has already occurred, making it unsafe to have condomless sex. It is the drop in temperature just before ovulation that is used to predict a fertile window. Therefore, a rise in temperature would not indicate that it is safe to have condomless sex. The patient should be educated that the temperature shift indicates the end of the fertile window and that it is safest to avoid unprotected sex during the fertile window.

Correct Answer: D

Rationale: The education the nurse should provide to a person taking Ella for emergency contraception is to restart their COCs the next day and use a backup method, such as condoms, for 7 days. This is important to ensure continued protection against pregnancy, as Ella may potentially reduce the effectiveness of the COCs. Using a backup method during this time is essential to prevent unintended pregnancy.

Correct Answer: D

Rationale: When a nurse is assessing a newborn upon admission to the nursery, it is expected that the chest circumference will be smaller than the head circumference. This is a normal finding in a newborn, where the head circumference is slightly larger than the chest circumference due to the proportionate sizes of the newborn's head and chest. This difference helps accommodate the vital organs within the chest cavity while allowing for the growth and development of the brain. Therefore, a chest circumference that is 2 cm smaller than the head circumference is a typical and expected finding in a newborn assessment.