What should the nurse do first if a client reports seeing blood-tinged mucus?

Correct Answer: B

Rationale: If a client reports seeing blood-tinged mucus, the nurse's first priority should be to acknowledge the client's concerns (choice B). This is important because it shows empathy and validates the client's feelings, which can help establish trust and rapport. It also allows the nurse to gather more information from the client about the situation, such as how long it has been happening and if there are any other symptoms present. Assessing for a urinary tract infection (choice A) may be necessary at some point, but it is not the first step. The client's emotional well-being and concerns should be addressed before moving on to a physical assessment. Explaining that it is normal (choice C) may not be accurate and could potentially cause the client further distress. It is important for the nurse to gather more information and assess the situation before making any assumptions. Clarifying that it is not actual bleeding (choice D) may also be necessary, but it should not be the first action taken. The client's concerns should be acknowledged and addressed before providing any information or reassurance.

Correct Answer: C

Rationale: The correct answer is C: Flexed. When a fetus is in a flexed position, it means that the head is bent towards the chest, which is also known as the chin-on-chest position. This position is considered the optimal fetal attitude for vaginal delivery as it allows for easier passage through the birth canal. Choice A: Extended is incorrect because an extended fetal attitude refers to the head being in a position where it is tilted back, away from the chest. This position can make it more difficult for the baby to pass through the birth canal during delivery. Choice B: Neutral is incorrect because a neutral fetal attitude indicates that the baby's head is in a straight, neutral position with neither flexion nor extension. This position is less common and may not be ideal for vaginal delivery. Choice D: Variable is incorrect because a variable fetal attitude means that the baby's head can be in various positions, including flexed, extended, or neutral. This position can make it difficult to predict the optimal position for delivery and may increase the risk of complications during childbirth. In summary, the correct answer is C: Flexed because it represents the chin-on-chest position, which is the ideal fetal attitude for vaginal delivery. Choices A, B, and D are incorrect because they do not describe the specific position of the fetus's head in relation to the chest during childbirth.

Correct Answer: A

Rationale: In a single footling breech position, one leg is extended through the cervix and vagina while the other leg is flexed at the hip and knee. This position is considered more dangerous than a frank breech because the extended leg can easily become trapped during delivery, leading to complications such as umbilical cord prolapse or head entrapment. In a double footling breech position, both legs are extended through the cervix and vagina, making it even more risky than a single footling breech. This position increases the likelihood of cord prolapse and head entrapment, making it a high-risk presentation that often requires a cesarean section for delivery. A frank breech position is when both legs are flexed at the hips and knees, with the feet near the baby's head. This position is considered the safest type of breech presentation for vaginal delivery as the baby's buttocks present first, reducing the risk of cord prolapse and head entrapment. Therefore, the correct answer is A: single footling breech position because it describes a breech presentation where one leg is extended through the cervix and vagina, posing a higher risk during delivery compared to a frank breech position.

Correct Answer: C

Rationale: Fetal heart rate variability is an essential parameter indicating the health and well-being of the fetus. Fetal heart rate variability is influenced by various factors, including fetal sleep cycles. Choice A, hypoxia, would actually result in an increase in fetal heart rate variability as the fetus tries to compensate for the lack of oxygen by increasing its heart rate variability. Choice B, alkalosis, would also lead to an increase in fetal heart rate variability as the body tries to restore the acid-base balance by altering the heart rate variability. Choice D, fetal activity, typically causes an increase in fetal heart rate variability as the fetus moves around, leading to changes in heart rate variability. However, fetal sleep cycles have been shown to decrease fetal heart rate variability. During periods of fetal sleep, the heart rate tends to stabilize, leading to a decrease in variability. This is because the autonomic nervous system activity decreases during sleep, resulting in a more consistent heart rate pattern. Therefore, the correct answer is C: Fetal sleep cycles.

Correct Answer: C

Rationale: Variable decelerations are related to cord compression. Variable decelerations are characterized by abrupt and sharp decreases in fetal heart rate that are not consistent with contractions. This pattern is caused by umbilical cord compression, which can occur when the cord is compressed between the fetal presenting part and the maternal pelvis, leading to decreased blood flow to the fetus. Early decelerations, on the other hand, are caused by head compression during contractions and are considered benign and not related to cord compression. These decelerations mirror the contraction pattern and typically return to baseline once the contraction is over. Late decelerations are associated with uteroplacental insufficiency, where the placenta is not providing enough oxygen to the fetus during contractions. This can lead to fetal hypoxia and acidosis, but it is not directly related to cord compression. A flat baseline is indicative of fetal distress and can be caused by a variety of factors such as fetal hypoxia, drug use, or fetal sleep cycles. It is a non-reassuring finding but is not specific to cord compression. In summary, variable decelerations are the most likely pattern related to cord compression due to the abrupt and variable nature of the decelerations, which are not directly related to contractions. Other deceleration patterns are associated with different causes such as head compression, uteroplacental insufficiency, or fetal distress.