A client is undergoing a non-stress test (NST) at 41 weeks. The nurse finds no FHR accelerations. What should the nurse do next?

When a non-stress test (NST) yields no fetal heart rate (FHR) accelerations, the immediate priority is to assess fetal well-being further. Asking the client if she has felt any fetal movement directly addresses the situation by gathering important information regarding fetal activity. Fetal movement perception can provide insight into the fetus's condition, and if the mother reports decreased movements, further evaluation is warranted.

Engaging with the client about fetal movements can also be a simple yet effective way to stimulate movement, as maternal activity or repositioning can sometimes encourage the fetus to move, which may lead to FHR accelerations during the test. Thus, confirming the presence or absence of fetal movements becomes essential before escalating interventions or notifying healthcare providers about the NST results.

The approach of checking for urinary bladder distension or notifying the healthcare provider would typically come after gathering a complete understanding of the situation with the client's input. While stimulating the fetus may also seem appropriate, ensuring the mother is aware of any fetal movements is foundational to further management.