A client at 41 weeks gestation is admitted to the labor and delivery unit for induction.

The nurse notes that the patient is a 36-year-old primigravida with a history of gestational hypertension.

Which risk factor in this client's history is considered a maternal factor for birth trauma?

Primigravida.

Macrosomia.

Vacuum-assisted birth.

Hydrocephalus.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Primigravida, or being pregnant for the first time, is a recognized maternal risk factor for birth trauma. First-time mothers often have tighter, less distensible pelvic tissues and birth canals, which can lead to more difficult or prolonged second stages of labor. This increased resistance during the descent of the fetus can necessitate the use of assistive devices or result in higher mechanical pressure on the fetal head and shoulders, increasing the statistical likelihood of birth-related injuries.

Choice B rationale

Macrosomia, defined as a birth weight greater than 4000 to 4500 grams, is a significant risk factor for birth trauma, but it is classified as a fetal factor rather than a maternal factor. While maternal conditions like gestational diabetes can lead to macrosomia, the weight and size of the fetus itself are what physically impede delivery and cause trauma such as shoulder dystocia or brachial plexus injuries. The question specifically asks for a maternal factor identified in the history.

Choice C rationale

Vacuum-assisted birth is a mechanical intervention used during delivery that significantly increases the risk of birth trauma, such as cephalohematoma or subgaleal hemorrhage. However, it is classified as an intrapartum or procedural factor rather than a maternal history factor. While maternal exhaustion or ineffective pushing might lead to the need for a vacuum, the procedure itself is the direct mechanism of the potential trauma and is categorized separately from the mother's baseline obstetric history.

Choice D rationale

Hydrocephalus is a condition characterized by an accumulation of cerebrospinal fluid in the brain, leading to an enlarged fetal head circumference. Like macrosomia, this is classified as a fetal factor for birth trauma. An enlarged head can cause cephalopelvic disproportion, making a vaginal delivery difficult or impossible and increasing the risk of mechanical injury during labor. Because it is a condition of the fetus, it does not meet the criteria for a maternal risk factor. .

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A rationale

Advising a new mother to stay home and avoid outside activities is counterproductive and can worsen symptoms of depression. Isolation is a significant risk factor for mental health decline. Encouraging moderate activity and social interaction helps improve mood and provides a sense of normalcy. While rest is important, complete social withdrawal prevents the mother from receiving the environmental stimulation and community support necessary for psychological well-being during the challenging transition to parenthood.

Choice B rationale

Suggesting that the mother should be the only caregiver is incorrect and potentially harmful. Relying on a single caregiver increases the risk of exhaustion and burnout, which are major triggers for postpartum mood disorders. Encouraging the involvement of partners and family members facilitates a shared caregiving model that allows the mother time for self-care and sleep. Infant attachment is not hindered by others helping; rather, a well-rested and supported mother is better able to bond.

Choice C rationale

Telling a mother to keep feelings of sadness to herself is dangerous and reinforces the stigma surrounding mental health. Open communication is essential for the early detection and treatment of postpartum depression. Bottling up emotions can lead to a worsening of symptoms and may prevent the mother from seeking life-saving professional help. Education should emphasize that these feelings are common and that there is no shame in requiring clinical support or therapy during this time.

Choice D rationale

The most appropriate statement is to encourage the mother to talk about her feelings and seek help if needed. This promotes open communication and early intervention. "Baby blues" are common and usually resolve within 10 to 14 days, but persistent sadness, hopelessness, or inability to care for the infant are signs of postpartum depression. Normalizing the discussion of mental health allows the mother to recognize when her experience has transitioned from normal adjustment to a clinical condition. .

A. Infertility treatments. B. History of depression. C. Strong social support. D. Low socioeconomic status.

Correct Answer is ["A","B","D"]

Explanation

Choice A rationale

Infertility treatments are recognized as a pre-existing factor that increases the risk for postpartum mood disorders. The emotional stress of the treatments, coupled with the high expectations for the pregnancy and parenthood, can lead to significant psychological strain. The hormonal fluctuations associated with assisted reproductive technologies may also play a role in altering a woman's vulnerability to mood shifts once the pregnancy concludes, making early screening during the first trimester very important for care.

Choice B rationale

A personal or family history of depression is one of the strongest predictors for developing postpartum depression or other mood disorders. The biological and psychological vulnerabilities that contribute to clinical depression are often exacerbated by the massive hormonal shifts and sleep deprivation occurring after childbirth. Women with a pre-existing history of mental health struggles require proactive monitoring and a clear plan for support to manage the transition into the postpartum period safely and effectively.

Choice C rationale

Strong social support is actually a protective factor rather than a risk factor. Having a reliable network of family and friends who provide emotional and practical assistance reduces the stress of new motherhood. This support system can help mitigate the impact of other risk factors and provides a safety net that helps the mother cope with the challenges of infant care. Lack of social support, conversely, would be identified as a significant risk factor during assessment.

Choice D rationale

Low socioeconomic status is a known risk factor for postpartum mood disorders due to the associated stressors of financial instability, food insecurity, and limited access to healthcare. These external pressures compound the normal stresses of caring for a newborn. Chronic stress can affect the endocrine system and brain chemistry, making these individuals more susceptible to depression. Identifying this factor early allows the nurse to connect the client with social services and community resources.

Choice E rationale

Being 20 years old at the time of conception is generally not considered a high-risk factor for postpartum mood disorders. While very young maternal age, such as being an adolescent or teenager, is associated with higher risks due to developmental transitions and potential lack of resources, a 20-year-old is typically viewed as an adult. Unless there are other compounding factors present, age alone in the early twenties does not serve as a primary indicator for increased psychiatric risk.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client at 41 weeks gestation is admitted to the labor and delivery unit for induction. The nurse notes that the patient is a 36-year-old primigravida with a history of gestational hypertension. Which risk factor in this client's history is considered a maternal factor for birth trauma?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a new mother. Which statement by the nurse regarding "baby blues" and postpartum depression is most appropriate?

Correct Answer is D

Explanation

The nurse is conducting a prenatal assessment on a client in the first trimester. Which pre-existing factors should the nurse identify as increasing the client's risk for developing postpartum mood disorders? Select all that apply.

Correct Answer is ["A","B","D"]

Explanation

A parent reports concern that her preschool child is not as coordinated at sports as other children. Which statement by the nurse is most appropriate to address this concern?

The student nurse caring for a 10-year-old child addresses the parents as mom and dad during the admission interview. Which is the best response by the preceptor to the student nurse?

The parents of a child with a neurologic disorder and severe intellectual disability are concerned about the child's frequent emotional changes and anger. How might the nurse interpret these changes in emotion?

A nurse is caring for a client immediately following the birth of the newborn. Which nursing action is the priority to prevent postpartum hemorrhage?

Which nursing intervention is most appropriate when caring for a pregnant client experiencing mild morning sickness?

A nurse is taking a pregnant woman's blood pressure during her prenatal visit. Which practice below will result in an inaccurate reading?

A young child explains to the nurse that her uncle often hits her on the bottom when she misbehaves. Which information is the most important for the nurse to obtain from the child before any action is taken?

The nurse is caring for a 3-month-old in respiratory arrest. Upon assessment, the nurse notes the child is apneic and pulseless. Which is the appropriate next action to take?

A client at 41 weeks gestation is admitted to the labor and delivery unit for induction.

The nurse notes that the patient is a 36-year-old primigravida with a history of gestational hypertension.

Which risk factor in this client's history is considered a maternal factor for birth trauma?