CNM Certified Nurse Midwife

Answer: C - The priority action of the nurse midwife is to attach an external electronic fetal monitor. The client’s amnion membranes have ruptured, which require assessment of the fetal heart tone. An L/S ratio is not necessary because it is not a priority action when managing a client who is in labor at 40 weeks’ gestation. An L/S ratio test may be ordered if the labor needs to be augmented. Amniotomy is not necessary because the membranes have ruptured. The frequency of the contractions should be monitored, but it is not a priority action for the nurse midwife.