A nurse in a prenatal clinic is caring for a client. Using Leopold's maneuvers, the nurse palpates a round, firm, movable part in the fundus of the uterus and a long smooth surface on the client's right side. In which abdominal quadrant should the nurse expect to auscultate fetal heart tones?

Choice A reason: When a client in active labor presents with hypotension, as indicated by a blood pressure reading of 82/52 mm Hg, the priority nursing intervention is to assist the client to turn onto her side. This position helps to alleviate pressure on the inferior vena cava, which can be compressed by the gravid uterus, thereby improving venous return and increasing blood pressure. It also enhances uteroplacental perfusion, providing better oxygenation to the fetus.

Choice B reason: While preparation for a cesarean birth may be necessary if there are signs of fetal distress or if the hypotension does not resolve, it is not the first-line intervention for isolated hypotension without other indications.

Choice C reason: Preparing for an immediate vaginal delivery is not the priority action in response to hypotension. The focus should be on stabilizing the mother's blood pressure to ensure safe delivery, whether vaginal or cesarean.

Choice D reason: Assisting the client to an upright position is not advisable in the case of hypotension, as this can further decrease venous return to the heart and exacerbate the low blood pressure.

Choice A reason:
A negative rubella titer indicates that the client does not have immunity to the rubella virus. Immunity would be indicated by a positive titer, showing the presence of rubella IgG antibodies in the blood. Therefore, this choice is incorrect.

Choice B reason:
While the client does not have immunity, administering a rubella vaccination during pregnancy is not recommended due to the theoretical risk to the fetus. Vaccinations with live viruses, like the rubella vaccine, are generally avoided during pregnancy.

Choice C reason:
A negative rubella titer does indeed indicate that the client is not currently experiencing a rubella infection, as active infection would be indicated by the presence of rubella IgM antibodies. However, this choice does not address the client's susceptibility to future infection or the need for immunization.

Choice D reason:
The correct interpretation of a negative rubella titer in an antepartum client is that she is not immune to rubella and should receive the rubella immunization after delivery. This is to ensure immunity and prevent the possibility of contracting rubella in future pregnancies, which could be harmful to the fetus.