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)?

The type of uterine incision used in the previous cesarean delivery

The gestational age of the current pregnancy

The presentation and position of the fetus

All of the above.

Answer and Explanation

The Correct Answer is D

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.

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

Explanation

Oxygen mask and tubing and blood products and IV fluids should be readily available for a client who has a ruptured uterus.This is because a ruptured uterus can cause severe hemorrhage, hypovolemia, and fetal distress.The client and the fetus may need oxygen therapy and blood transfusion to prevent hypoxia and shock.

A. A boggy uterus B. A firm fundus at the umbilicus C. Excessive lochia rubra D. Clots larger than a quarter E. A pulse rate of 110/min

Correct Answer is ["A"]

Explanation

A boggy uterus is a sign of uterine atony, which is the failure of the uterus to contract sufficiently after childbirth.

This can lead to excessive bleeding and postpartum hemorrhage.

A firm fundus at the umbilicus is a normal finding after delivery and indicates that the uterus is contracting well.

Excessive lochia rubra is also a sign of uterine atony and postpartum hemorrhage.Lochia rubra is the vaginal discharge composed of blood, mucus, and tissue from the placenta and the uterus lining that occurs after childbirth.

It is normal for the first 3 to 4 days, but it should gradually decrease in amount and change in color.

Clots larger than a quarter are abnormal and indicate excessive bleeding.

A pulse rate of 110/min is a sign of tachycardia, which can be caused by blood loss, infection, or pain.

A normal pulse rate for an adult is between 60 and 100 beats per minute.

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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)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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.)

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

Explanation

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.

Correct Answer is ["A"]

Explanation

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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)?