In a routine prenatal visit, the nurse examining a patient who is 37 weeks pregnant notices that the fetal heart rate (FHR) has dropped to 120 beats/minute from a rate of 160 beats/minute earlier in the pregnancy. What is the nurse's first action?

Choice A rationale Although some sedatives can cross the placenta and potentially depress the fetal central nervous system, leading to a temporary decrease in FHR, this is not the first action. Assuming medication use before assessing the change against established norms is premature. The initial action must be to classify the finding based on physiological expectations at term. Choice B rationale The normal fetal heart rate range generally decreases slightly as pregnancy advances, often settling between 110-160 beats/minute near term. A drop from a baseline of 160 beats/minute to a new rate of 120 beats/minute at 37 weeks gestation is within the normal range. Therefore, the first action is to record the rate as a normal and expected physiological variation at term. Choice C rationale Notifying the physician is unnecessary as the new FHR of 120 beats/minute is considered physiologically reassuring in the late third trimester. FHR changes only warrant immediate medical notification if they fall outside the normal range (e.g., persistent bradycardia <110 beats/minute or non-reassuring patterns) or if accompanied by concerning maternal symptoms. Choice D rationale Turning the patient to her right or left side is performed to correct potential supine hypotension syndrome (aortocaval compression), which can decrease uterine blood flow and cause fetal distress (e.g., late decelerations). Since the FHR is 120 beats/minute and reassuringly within normal limits, there is no immediate indication for repositioning to correct a circulatory compromise.