A nurse in an obstetrics office is reviewing a client’s medical record. The client is a 28-year-old female at 24 weeks gestation.

Exhibits

For each client finding, click to specify if the finding is a biophysical, psychosocial, or environmental risk factor that increases the client’s risk for pregnancy complications. There must be at least 1 selection in every row. There does not need to be a selection in every column.

Ultrasound result

Caffeine intake

Job (cashier)

Pets (cats)

Medical history (anemia)

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B,C"},"D":{"answers":"C"},"E":{"answers":"A"}}

Ultrasound Result
- Biophysical: The ultrasound result indicating normal fetal growth and development provides biophysical information about the fetus's condition.
Caffeine Intake
- Biophysical: Consuming 2 cups of coffee daily affects the biophysical aspect, as excessive caffeine intake can potentially impact fetal development.
Job (Cashier)
- Psychosocial: Prolonged standing and work-related stress can contribute to psychosocial risk factors during pregnancy.
- Environmental: The physical demands and environment of the job can increase the risk for complications.
Pets (Cats)
- Environmental: Having cats at home poses an environmental risk due to the potential exposure to Toxoplasma gondii, a parasite that can cause toxoplasmosis.
Medical History (Anemia)
- Biophysical: A history of mild anemia and current slightly low hemoglobin levels indicate biophysical risk factors that can impact pregnancy.

Nursing Test Bank

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Correct Answer is A

Explanation

Choice A rationale

History of uterine rupture poses a significant risk for a trial of labor after cesarean (TOLAC) due to the potential recurrence of uterine rupture, which can be life-threatening for both mother and fetus.

Choice B rationale

Previous cesarean section for breech presentation is not a contraindication for TOLAC. Patients with prior cesarean deliveries can consider TOLAC if there are no additional risk factors.

Choice C rationale

Previous low transverse cesarean section birth is often considered suitable for TOLAC, as the lower segment incision has a lower risk of rupture compared to vertical or classical incisions.

Choice D rationale

Low-risk pregnancy alone is not a contraindication for TOLAC. It is essential to assess other factors such as uterine scarring, maternal health, and fetal status when considering TOLAC eligibility.

A. Place the mother in the knee-chest position. B. Encourage the mother to push vigorously. C. Apply a warm compress to the umbilical cord. D. Administer oxygen to the mother.

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

Explanation

Choice A rationale

Placing the mother in the knee-chest position helps relieve pressure on the umbilical cord, improving blood flow and oxygen delivery to the fetus.

Choice B rationale

Encouraging vigorous pushing can exacerbate the prolapse, reducing blood flow to the fetus and increasing the risk of complications.

Choice C rationale

Applying a warm compress to the umbilical cord is not effective in managing a prolapsed cord and does not improve fetal outcomes.

Choice D rationale

Administering oxygen to the mother increases the amount of oxygen delivered to the fetus, potentially mitigating the effects of the prolapse.

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Naxlex Comprehensive Predictor Exams

What are the contraindications for a patient wanting to have a TOLAC?

Correct Answer is A

Explanation

Which interventions are appropriate when managing a prolapsed umbilical cord during labor? (Select all that apply)

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

Explanation

Which of the following would lead the nurse to suspect that a laboring client is experiencing Amniotic Fluid Embolism?

A nurse is planning care for a 4-hour-old newborn born to a client who has a prenatal history of substance use disorder. Which of the following interventions should the nurse include in the plan of care?

A nurse is teaching a client at 24 weeks of gestation about special considerations of gestational diabetes mellitus (GDM). Which of the following statements by the client indicates that the teaching was effective? (Select all that apply)

What physical assessment finding is expected in a newborn after a precipitous delivery?

A patient tells the nurse that she knows all about sexually transmitted infections and proceeds to make the following statements. Which one is the only correct statement that the client makes?

Which of the following is a common respiratory anomaly associated with preterm birth?

During a delivery complicated by shoulder dystocia, the baby’s head retracts back against the perineum after it emerges, a phenomenon known as ‘turtling’. Which of the following is the most appropriate immediate action for the healthcare provider to take?