A nurse is caring for a client who is 39 weeks pregnant and in active labor.

The nurse detects the fetal heart tones above the client’s umbilicus at the midline.

Which of the following positions should the nurse suspect the fetus is in?

Choice A rationale
Preparing the abdominal and perineal areas is not the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. This type of bleeding is suggestive of placenta previa, a condition where the placenta covers part or all of the cervix, preventing normal delivery. While preparing the abdominal and perineal areas may be necessary in preparation for delivery, it is not the immediate priority.
Choice B rationale
Initiating IV access is the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. This type of bleeding is suggestive of placenta previa, a condition where the placenta covers part or all of the cervix, preventing normal delivery. IV access allows for rapid administration of fluids and medications, which may be necessary to stabilize the client’s condition.
Choice C rationale
Inserting an indwelling urinary catheter is not the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. While a urinary catheter may be necessary in preparation for delivery or surgery, it is not the immediate priority.
Choice D rationale
Witnessing the signature for informed consent for surgery is not the priority nursing action for a client who has a large amount of painless, bright red vaginal bleeding at 38 weeks of gestation. While obtaining informed consent may be necessary before performing certain procedures or surgeries, it is not the immediate priority.

Choice A rationale
Repaglinide is an oral medication used to control blood sugar levels in adults with type 2 diabetes. It is not typically used in pregnant women, especially those unable to control their gestational diabetes with diet and exercise.
Choice B rationale
Insulin is the most common medication used to control blood sugar levels in pregnant women, especially those unable to control their gestational diabetes with diet and exercise.
Choice C rationale
Glipizide is an oral medication used to control blood sugar levels in adults with type 2 diabetes. It is not typically used in pregnant women, especially those unable to control their gestational diabetes with diet and exercise.
Choice D rationale
Acarbose is an oral medication used to control blood sugar levels in adults with type 2
diabetes. It is not typically used in pregnant women, especially those unable to control their gestational diabetes with diet and exercise.