The nurse is caring for a pregnant patient at 38 weeks gestation who is experiencing sudden, severe abdominal pain and vaginal bleeding. What should the nurse do first?

Correct Answer: C

Rationale: The correct answer is C: Call the healthcare provider immediately to report the symptoms. This is the first step because sudden, severe abdominal pain and vaginal bleeding in a pregnant patient at 38 weeks gestation could indicate a serious complication such as placental abruption or preterm labor. Notifying the healthcare provider promptly allows for timely intervention and appropriate management. Choice A is incorrect as assessing the fetal heart rate and preparing for delivery should not be the first action without consulting the healthcare provider. Choice B is incorrect as encouraging the patient to rest is not appropriate in this emergent situation. Choice D is incorrect as providing pain relief and monitoring vital signs should not take precedence over notifying the healthcare provider for further evaluation and management.

Correct Answer: A

Rationale: The correct answer is A (30-60 seconds) for delayed cord clamping in an uncomplicated delivery. Delaying cord clamping for 30-60 seconds allows more blood to flow from the placenta to the baby, increasing the baby's hemoglobin levels and improving circulation. This extra blood transfer can provide the baby with essential nutrients and oxygen, reducing the risk of anemia and improving overall health outcomes. Choice B (15-30 seconds) may not provide enough time for sufficient blood transfer compared to the optimal window of 30-60 seconds. Choice C (30 seconds) is within the recommended range, but 30-60 seconds is considered more beneficial for maximizing blood flow to the newborn. Choice D (Delayed cord clamping is not recommended) is incorrect as delayed cord clamping has been shown to have various benefits for newborns when done in uncomplicated deliveries.

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: Respiratory depression. After receiving an epidural block, the nurse should monitor for respiratory depression in a patient with a history of asthma due to the potential for decreased lung function. This is crucial as the medication from the block can affect respiratory drive, leading to compromised breathing. Tachycardia (choice B), elevated blood pressure (choice C), and hyperthermia (choice D) are not typically associated with epidural blocks and are not the primary concerns for a patient with asthma undergoing this procedure.

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.