OB exam II

During an epidural insertion, the client’s BP drops from 120/70 to 82/48. The nurse’s priority action is:

• Call the anesthesia provider

• Place the client supine

• Administer oxygen and increase IV fluids

• Reassess BP in 15 minutes

A client in active labor has variable decelerations on FHR tracing. Which intervention is appropriate?

• Check for crowning

• Turn client to side and apply O₂

• Prepare for immediate delivery

• Administer oxytocin

The nurse caring for a client on oxytocin infusion observes contractions every 1.5 minutes lasting 90 seconds. What is the priority?

• Obtain BP

• Increase IV fluids

• Stop oxytocin infusion

• Encourage pushing

A client at 33 weeks has contractions every 8 minutes. The cervix is 2 cm dilated, 50% effaced. Which medication does the nurse anticipate?

• Methylergonovine

• Terbutaline

• Oxytocin

• Carboprost

The nurse notes a FHR baseline of 140 bpm with late decelerations. Which action takes priority?

• Document finding as normal

• Reposition to left side and give O₂

• Prepare for C-section immediately

• Encourage deep breathing

The nurse evaluates a client after epidural anesthesia. Which finding is most concerning?

• Pain score 0/10

• FHR 90 bpm

• BP 90/60

• Client reports tingling in feet

A client at 38 weeks reports a sudden gush of fluid. The nurse’s first action is to:

• Perform vaginal exam

• Call provider

• Check FHR

• Test fluid with nitrazine paper

A laboring client reports severe back pain; fetus is occiput posterior. What nonpharmacologic measure helps most?

• Aromatherapy

• Firm counterpressure on the sacrum

• Deep chest breathing

• Ambulation in hallway

A nurse notes that after birth, the umbilical cord is hanging from the vagina. What is the first action?

• Document findings

• Apply oxygen

• Place client in knee-chest position

• Reinsert cord gently

Which client finding contraindicates vaginal birth after cesarean (VBAC)?

• Prior low-transverse incision

• Fetal weight 7 lb

• History of uterine rupture

• Prior preterm delivery