The nurse is caring for a laboring client. The nurse observes that there are variable decelerations. What is the nurse's priority action?

Assist the client to change positions

Promptly inform the primary care provider

Advocate for the client to have a vaginal examination

Continue to monitor the client and the fetal heart rate

Answer and Explanation

The Correct Answer is A

A.   Changing the client's position, especially if there's a cord compression causing variable decelerations, is a priority intervention to alleviate the decelerations.
B.   Informing the primary care provider is important, but immediate action to address the decelerations should be taken first.
C.   Vaginal examination is not the immediate priority when variable decelerations are observed; interventions to improve fetal oxygenation are more critical.
D.   Continuous monitoring is essential, but addressing the cause of the variable decelerations by changing the client's position is the immediate action.

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Correct Answer is B

Explanation

A. Late decelerations typically start after the contraction has reached its peak and return to baseline after the contraction ends, not during the contraction.
B. Early decelerations coincide with the contraction and return to baseline by the end of the contraction. They are typically considered benign and related to head compression.
C. Accelerations are brief increases in the FHR above the baseline and are usually associated with fetal movement.
D. Variable decelerations are abrupt decreases in the FHR, often unrelated to contractions, and have an erratic pattern.

A. "With a classical incision, there is an increased risk of uterine rupture in labor, so a vaginal birth is not usually recommended." B. "This depends on whether your next baby is born at full term; if it is another preterm birth, then a repeat cesarean will be advised." C. "There is a decreased risk for complications and easier recovery after a vaginal birth, so a vaginal birth will be recommended for you." D. "As long as there is an 18-month interval for scar healing between births, a vaginal birth after cesarean is generally permitted."

Correct Answer is A

Explanation

A. A classical incision increases the risk of uterine rupture during labor, and a vaginal birth is not typically recommended due to this risk.
B. The type of incision, not the term of the subsequent birth, is the primary consideration for deciding on a mode of delivery.
C. A classical incision is associated with an increased risk of complications, not a decreased risk.

D. The recommendation for a vaginal birth after cesarean (VBAC) depends on factors such as the type of uterine incision and other clinical considerations, not just the time interval.

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The nurse is caring for a laboring client. The nurse observes that there are variable decelerations. What is the nurse's priority action?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse is discussing birth options with a pregnant client. The client previously had a cesarean birth with a classical incision at 26 weeks' gestation but desires a vaginal birth with this pregnancy. What is the best response by the nurse?

Correct Answer is A

Explanation

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