Under which circumstance would it be unnecessary for the nurse to perform a vaginal examination?
a. An admission to the hospital at the start of labor
b. When accelerations of the fetal heart rate (FHR) are noted
c. On maternal perception of perineal pressure or the urge to bear down
d. When membranes rupture
ANS: B
An accelerated FHR is a positive sign; however, variable decelerations merit a vaginal examination. Vaginal examinations should be performed when the woman is admitted, when she perceives perineal pressure or the urge to bear down, when her membranes rupture, when a significant change in her uterine activity has occurred, or when variable decelerations of the FHR are noted.
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