A nurse is performing a physical examination of a mother and the fetus who are suspected to have a ruptured uterus.

What are some of the signs and symptoms that the nurse should look for? (Select all that apply.).

Abdominal pain, tenderness, and rigidity

Fetal parts palpable through the abdominal wall or under the pubic bone

Vaginal bleeding and signs of shock

Fetal heart rate above 160 beats per minute

Absent or decreased fetal movements.

Answer and Explanation

Correct Answer : A,C,E

A ruptured uterus is a serious complication where the uterus tears or breaks open, usually along the scar line of a previous cesarean delivery.

It can cause severe bleeding and fetal distress. Some of the signs and symptoms of a ruptured uterus are:

• Abdominal pain, tenderness, and rigidity: This is caused by the internal bleeding and the loss of uterine muscle tone.

• Vaginal bleeding and signs of shock: This is due to the hemorrhage from the rupture site and the hypovolemia (low blood volume) in the mother.

• Absent or decreased fetal movements: This is because the fetus may slip into the mother’s abdomen or lose oxygen due to the rupture.

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Correct Answer is D

Explanation

A client who has a ruptured uterus is at risk of severe hemorrhage and shock, so the following tests are necessary to assess the blood loss and prepare for possible transfusion:

• A complete blood count (CBC) can show the level of hemoglobin, hematocrit, red blood cells, white blood cells, and platelets.

A low hemoglobin and hematocrit indicates anemia due to blood loss.

A high white blood cell count indicates infection or inflammation.

A low platelet count indicates impaired clotting ability.

• A blood type and cross-match can determine the client’s blood group and Rh factor, and identify compatible blood units for transfusion if needed.

• A coagulation profile can measure the time it takes for the blood to clot and the activity of clotting factors.

A prolonged prothrombin time (PT), activated partial thromboplastin time (aPTT), or international normalized ratio (INR) indicates a bleeding disorder or anticoagulant use.

A low fibrinogen level indicates excessive bleeding or consumption of clotting factors.

A. Previous cesarean section. B. Uterine fibroids. C. Multiparity. D. Gestational diabetes. E. Induced labor.

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

Explanation

Previous cesarean section.

Uterine fibroids.

Multiparity.

Induced labor.

These are some of the risk factors that can weaken the uterine wall and increase the risk of rupture during labor or delivery.

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A nurse is performing a physical examination of a mother and the fetus who are suspected to have a ruptured uterus. What are some of the signs and symptoms that the nurse should look for? (Select all that apply.).

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory tests of a client who has a ruptured uterus. What are some of the tests that the nurse should expect to be ordered for this client?

Correct Answer is D

Explanation

A nurse is caring for a client who has a history of risk factors for ruptured uterus. What are some of the risk factors that the nurse should assess? (Select all that apply.).

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

Explanation

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A nurse is performing a physical examination of a mother and the fetus who are suspected to have a ruptured uterus.

What are some of the signs and symptoms that the nurse should look for? (Select all that apply.).