During a maternal assessment, the nurse determines the fetus to be in a left occipitoanterior (LOA) position. Auscultation of the fetal heart rate should begin in the:
1. Right upper quadrant.
2. Left upper quadrant.
3. Right lower quadrant.
4. Left lower quadrant.
4
Rationale 1: The fetus is head-down, so the heart rate will not be heard in an upper quadrant.
Rationale 2: The fetus is head-down, so the heart rate will not be heard in an upper quadrant.
Rationale 3: Due to the position of the fetus, the heart rate will not be heard on the right side.
Rationale 4: The fetal heart rate is best heard at the fetal back. In a cephalic presentation, the heart rate is heard in the lower quadrants. Because this fetus is on the mother's left side, the heart tones will be heard on the mother's left lower quadrant.
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