RN Comprehensive Predictor 2026 Proctored Exam V2
A nurse is caring for a client who is at 38 weeks of gestation, is in active labor, and has ruptured membranes. Which of the following actions should the nurse take?
Explanation & Rationale
Continuous electronic fetal monitoring is indicated in active labor with ruptured membranes to detect fetal distress, variable decelerations (cord compression risk), and ensure fetal well-being. Fundal massage is performed after delivery to prevent postpartum hemorrhage. An indwelling catheter is not routinely inserted in active labor. Oxytocin augmentation may be considered if labor is not progressing but is not the initial action after membrane rupture.
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