Inpatient Obstetric Nurse (NCC) Practice Exam

What is the best initial action when abnormal fetal heart rate patterns are noted?

1. Reassess the fetal heart rate after an hour

2. Change the mother's position and re-evaluate

3. Immediately prepare for a cesarean section

4. Increase intravenous fluid administration

The correct answer is: Change the mother's position and re-evaluate

Changing the mother's position and re-evaluating is the best initial action when abnormal fetal heart rate patterns are detected. This approach is grounded in the understanding that fetal heart rate changes can often stem from factors related to maternal positioning, such as cord compression or uterine pressure. Switching the mother's position may relieve these issues, allowing for improved blood flow and oxygen delivery to the fetus. Re-evaluating the fetal heart rate after repositioning provides an opportunity to observe whether the intervention was effective, allowing for timely decision-making based on the fetus's response. This initial action is non-invasive and can be quickly implemented, which is critical in managing potential fetal distress effectively. Other actions, such as reassessing the fetal heart rate after an hour, do not provide immediate intervention. Preparing for a cesarean section or simply increasing intravenous fluids might be necessary later, depending on the situation, but they are not the first steps to address and possibly rectify the abnormal heart rate patterns promptly.