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

Explanation

A boggy uterus that does not respond to massage is an early indicator of postpartum hemorrhage.

A boggy uterus means that the uterus is not contracting properly after delivery, which can lead to excessive bleeding from the site where the placenta was attached.This condition is called uterine atony and it is the most common cause of postpartum hemorrhage.

Massage can help stimulate the uterus to contract and stop the bleeding, but if it does not work, other interventions are needed.

A. Gestational diabetes mellitus B. Polyhydramnios C. Macrosomic fetus D. Breech presentation.

Correct Answer is C

Explanation

A macrosomic fetus is a fetus that is larger than average, usually weighing more than 4 kg or 8.8 lb at birth.A large fetus can cause cephalopelvic disproportion (CPD), which is a condition where the baby’s head does not fit through the mother’s pelvis during labor.CPD can lead to prolonged or obstructed labor, which can endanger both the mother and the baby.

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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 evaluating a client who has prolonged and obstructed labor for signs of postpartum hemorrhage. Which of the following findings is an early indicator of postpartum hemorrhage?

Correct Answer is A

Explanation

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?

Correct Answer is C

Explanation

A nurse is assessing a client who is in labor and has been pushing for 3 hours with no progress. The nurse should identify that this client is at risk for which of the following complications? (Select all that apply.).

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)?

A nurse is caring for a client who is in active labor and experiencing shoulder dystocia. Which of the following actions should the nurse take? (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 gush of blood is noted with the rupture of membranes. On palpation, the uterus is soft (i.e., relaxed) and the patient is not reporting any pain. An FHR deceleration down to 90 bpm is noted. What does the nurse suspect has happened?

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 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?

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)?