A client in her third trimester reports abdominal pain. She is restless and has a small amount of dark red vaginal bleeding. Which actions should the nurse implement first?

Rationale: A. Obtain a urine specimen and determine blood type: While obtaining a urine specimen and knowing the blood type are important for baseline assessment, these actions do not immediately address the acute maternal and fetal risks associated with third-trimester bleeding. B. Palpate the fundus and check the fetal heart rate: Assessing the uterine fundus and fetal heart rate is the highest priority because it provides critical information about maternal bleeding, uterine tone, and fetal well-being. These assessments help determine if the client is experiencing placental abruption or another emergent complication. C. Complete a vaginal exam and test for ruptured membranes: A vaginal exam is contraindicated in cases of unknown third-trimester bleeding until placental location is confirmed, as it may worsen bleeding. D. Start IV fluid bolus and obtain a complete blood count: Administering IV fluids and obtaining labs are necessary for stabilizing the client and assessing blood loss, but these interventions follow immediate assessment of maternal and fetal status.