A multiparous woman has been in labor for 8 hours. Her membranes have just ruptured spontaneously. The nurse's priority must be to:
Select one:
Prepare the woman for imminent birth
Assess the fetal heart rate and pattern
Notify the woman's primary health care provider
Document the characteristics of the fluid.
The Correct Answer is B
a. This may be necessary once fetal heart rate and pattern have been assessed, but it is not the initial priority.
b. This is the priority as it will help determine the next steps in the management of labor.
c. This may be necessary once fetal heart rate and pattern have been assessed, but it is not the initial priority.
d. This may be done after assessing the fetal heart rate and pattern, but it is not the initial priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
a. Braxton Hicks contractions are normal and do not require admission to the labor and delivery unit.
b. Braxton Hicks contractions are normal and do not require bed rest.
c. This is the most appropriate action as Braxton Hicks contractions are normal and may occur throughout the pregnancy.
d. Braxton Hicks contractions are normal and do not require contact with the health care provider.
Correct Answer is B
Explanation
a. Suctioning the mouth during a seizure can increase the risk of injury and is not recommended.
b. The primary duty of the nurse during a seizure is to ensure the safety of the client by staying with them and calling for assistance.
c. Inserting an oral airway during a seizure is not appropriate and can increase the risk of injury.
d. Administering oxygen may be necessary after the seizure has ended, but the primary duty during the seizure is to ensure safety.
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