A nurse is caring for a client who had a vacuum-assisted delivery due to prolonged labor and is at risk for developing a hematoma in the perineal area.

Which of the following manifestations should alert the nurse to this complication?

Severe perineal pain

Bright red vaginal bleeding

Decreased hemoglobin level

Elevated white blood cell count

Answer and Explanation

The Correct Answer is A

Severe perineal pain is a manifestation of a hematoma in the perineal area, which can result from vacuum-assisted delivery. A hematoma is a collection of blood under the skin or in the tissues that can cause pressure and pain.

Normal ranges for hemoglobin are 12 to 16 g/dL for women and 14 to 18 g/dL for men. Normal ranges for white blood cell count are 4,000 to 11,000 cells per microliter of blood.

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Correct Answer is D

Explanation

All of the above factors should be considered when discussing the possibility of vaginal birth after cesarean (VBAC).

Here’s why:

• The type of uterine incision used in the previous cesarean delivery affects the risk of uterine rupture during VBAC.A low transverse incision is associated with the lowest risk, while a high vertical incision is associated with the highest risk.

• The gestational age of the current pregnancy affects the success rate of VBAC.The optimal time for VBAC is between 39 and 40 weeks of gestation.Attempting VBAC before 37 weeks or after 41 weeks may increase the risk of complications.

• The presentation and position of the fetus affects the feasibility and safety of VBAC.A breech presentation, a transverse lie, or a posterior position may make vaginal delivery difficult or impossible.A cephalic presentation and an anterior position are more favorable for VBAC.

A. Caput succedaneum B. Erb’s palsy C. Respiratory distress syndrome D. Hypoglycemia

Correct Answer is A

Explanation

Caput succedaneum is a swelling of the scalp that can occur after vacuum extraction delivery.It is caused by the pressure of the suction cup on the baby’s head and usually resolves within a few days.

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A nurse is caring for a client who had a vacuum-assisted delivery due to prolonged labor and is at risk for developing a hematoma in the perineal area. Which of the following manifestations should alert the nurse to this complication?

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Naxlex Comprehensive Predictor Exams

A nurse is counseling a client who has a small pelvis and wants to have a vaginal delivery. Which of the following factors should the nurse consider when discussing the possibility of vaginal birth after cesarean (VBAC)?

Correct Answer is D

Explanation

A nurse is assisting a client who has prolonged and obstructed labor to deliver by vacuum extraction. Which of the following complications should the nurse monitor for in the newborn?

Correct Answer is A

Explanation

A nurse is preparing to assist with an emergency cesarean delivery for a client who has a ruptured uterus. Which of the following equipment should the nurse have readily available? (Select all that apply.)

A nurse is assessing a client who had a prolonged labor and is at risk for uterine atony. Which of the following findings should indicate to the nurse that the client has this condition? Select all that apply.

A nurse is reviewing the partograph of a client in labor. The nurse notes that the cervical dilation curve is above the alert line and below the action line. What does this indicate?

A nurse is providing emotional support to a client who had a prolonged labor and delivered a stillborn baby by cesarean section. Which of the following actions should the nurse take?

A nurse is reviewing the medical record of a client who is in labor and has cephalopelvic disproportion (CPD). Which of the following findings should the nurse expect to see in the record?

A nurse is caring for a client who has prolonged and obstructed labor and develops a vesicovaginal fistula. Which of the following interventions should the nurse include in the plan of care?

A nurse is assessing a client who is in labor and notes that the fetal head is visible at the vaginal opening but does not advance with pushing. The nurse should identify this finding as which of the following?

A nurse is caring for a client who had a vacuum-assisted delivery due to prolonged labor and is at risk for developing a hematoma in the perineal area.

Which of the following manifestations should alert the nurse to this complication?