Which method of intrapartum fetal monitoring is the most appropriate when a woman has a history of hypertension during pregnancy?

Correct Answer: B

Rationale: The correct answer is B: Continuous electronic fetal monitoring. This method is most appropriate for a woman with a history of hypertension during pregnancy because it allows continuous monitoring of fetal heart rate patterns and uterine contractions, providing real-time data to detect any signs of fetal distress promptly. Continuous monitoring is crucial in high-risk pregnancies to ensure timely intervention if any issues arise. A: Continuous auscultation with a fetoscope is not ideal for a woman with a history of hypertension as it does not provide continuous monitoring and may miss subtle changes in fetal well-being. C: Intermittent assessment with a Doppler transducer does not offer continuous monitoring, which is essential in high-risk pregnancies like hypertension. D: Intermittent electronic fetal monitoring for 15 minutes each hour is not as effective as continuous monitoring in detecting changes in fetal well-being promptly, which is crucial in cases of hypertension during pregnancy.

Correct Answer: B

Rationale: The correct answer is B because it aligns with the nurse's responsibility to educate and provide information to the patient and their support person. Teaching about the monitoring equipment and addressing any questions ensures that the patient and their support person are informed and empowered. This promotes patient understanding and involvement in their care, leading to better outcomes. Choice A is incorrect because the nurse should initiate corrective actions promptly for abnormal findings without waiting for physician input. Choice C is incorrect as it focuses solely on documentation rather than patient education. Choice D is incorrect as it neglects the importance of involving the support person in the care process.

Correct Answer: B

Rationale: The correct answer is B because +4 meconium-stained amniotic fluid on AROM indicates meconium passage by the fetus, which can lead to meconium aspiration syndrome. Amnioinfusion can help dilute the meconium, reducing the risk of respiratory complications for the newborn. A: Presenting part not engaged is not a direct indication for amnioinfusion. C: Breech position of the fetus does not specifically warrant amnioinfusion. D: Twin gestation alone is not a direct indication for amnioinfusion.

Correct Answer: A

Rationale: The correct answer is A: Administer O at 8 to 10 L/minut. In a left side-lying position, this deceleration indicates possible umbilical cord compression, reducing oxygen supply to the fetus. Administering oxygen at 8 to 10 L/min can help improve fetal oxygenation. Decreasing the IV rate (B) wouldn't directly address the fetal distress. Repositioning the ultrasound transducer (C) is irrelevant to the situation. Performing a vaginal exam (D) could worsen the cord compression if the cord is prolapsed.

Correct Answer: A

Rationale: The correct answer is A: Baseline tachycardia. During labor, it is normal for a preterm fetus to have a higher heart rate due to the stress of the labor process. This is a physiological response to the stress and is considered normal. Baseline bradycardia (choice B) would not be normal as it indicates fetal distress. Fetal anemia (choice C) can affect the oxygen-carrying capacity of the blood and lead to fetal distress. Acidosis (choice D) results from inadequate oxygen supply and accumulation of acid in the blood, indicating fetal distress.