Which occurrence is related to cervical dilation and effacement?

Choice A rationale
Umbilical cord compression typically causes variable decelerations in fetal heart rate, not accelerations. Accelerations are not related to cord compression but rather to other factors.
Choice B rationale
Placental uterine insufficiency leads to late decelerations rather than accelerations in fetal heart rate. Accelerations indicate adequate oxygenation, whereas insufficiency impairs fetal oxygenation.
Choice C rationale
Accelerations with fetal movement are a positive sign, indicating the fetus's well-being and appropriate response to stimuli. Normal accelerations last for at least 15 seconds and rise by 15 beats per minute.
Choice D rationale
Ominous signs in fetal monitoring include persistent late decelerations, severe bradycardia, and prolonged decelerations. Accelerations, however, are reassuring and do not warrant concern.

Choice A rationale
Notifying the provider is important but does not address the immediate need to assess the patient's progress and readiness for delivery. A direct intervention is required to determine the next steps.
Choice B rationale
Performing a sterile vaginal exam allows the nurse to assess cervical dilation and effacement, fetal station, and presentation, which are crucial to determine if the patient is ready to push and proceed with delivery.
Choice C rationale
Supportive words and care are essential for patient comfort, but they do not provide the necessary assessment to determine the patient's progress in labor or readiness for pushing.
Choice D rationale
Monitoring the fetal heart rate tracing is important for assessing fetal well-being but does not specifically address the patient's readiness to push or her labor progress.