A nurse is caring for a client who is in active labor and has a history of two previous cesarean deliveries.

The nurse notes that the client’s fetal heart rate is dropping and the client reports severe abdominal pain.

The nurse suspects that the client has a ruptured uterus.

What is the priority action for the nurse to take?

Notify the provider and prepare for an emergency cesarean delivery

Administer oxygen via face mask and increase IV fluids

Place the client in a knee-chest position and apply a fetal scalp electrode

Perform a vaginal exam and assess for cervical dilation and effacement.

Answer and Explanation

The Correct Answer is A

Notify the provider and prepare for an emergency cesarean delivery. This is because a ruptured uterus is a life-threatening complication that requires immediate surgical intervention to save the mother and the fetus.

The nurse should also monitor the vital signs and fetal heart rate of the client and administer oxygen and IV fluids as needed.

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Correct Answer is C

Explanation

A ruptured uterus can be prevented by avoiding induction or augmentation of labor.This is because induction or augmentation of labor can increase the pressure and stress on the uterine wall, especially if there is a previous C-section scar, and cause it to tear open.

The normal range for uterine rupture is less than 1 percent of pregnant women.It affects about 1 in 300 deliveries for women who have had one C-section delivery, and up to 9 in 300 deliveries for women who have had more than one C-section delivery.

A. Obtain informed consent from the client B. Administer prophylactic antibiotics to the client C. Apply traction to the vacuum cup during contractions D. Release the vacuum cup after every three pulls E. Monitor the fetal heart rate continuously.

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

Explanation

The nurse should obtain informed consent from the client before performing a vacuum extraction, as it is an operative vaginal delivery that carries some risks for the mother and the baby.The nurse should also monitor the fetal heart rate continuously during the procedure, as vacuum extraction can cause fetal distress or scalp injuries.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a prenatal class about the complications of labor and delivery. The nurse explains that a ruptured uterus is a rare but life-threatening condition that can occur during labor. Which of the following statements by a class participant indicates a need for further teaching?

Correct Answer is C

Explanation

A nurse is preparing to perform a vacuum extraction for a client who has an obstructed labor due to a face presentation. Which of the following actions should the nurse take? (Select all that apply.).

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

Explanation

A nurse is teaching a group of pregnant women about the risk factors for prolonged and obstructed labor. Which of the following statements by one of the women indicates a need for further teaching?

A nurse is caring for a client who is in labor and has a history of female genital mutilation (FGM). The nurse should be aware that FGM can increase the risk of which of the following complications?

A nurse is evaluating the outcomes of care for a client who had a ruptured uterus during labor and underwent an emergency hysterectomy. Which of the following outcomes indicates that the nursing care was effective?

A nurse is reviewing the partograph of a client who is in labor. The nurse notes that the fetal head descent is below the alert line but above the action line. What does this indicate?

A nurse is assessing a client who is in labor and has a large baby with a cephalopelvic disproportion (CPD). The nurse should monitor the client for signs of which of the following fetal complications?