A nurse is reviewing charts for clients who have a diagnosis of placental abruption. Which of the following clients needs an emergent cesarean section?
Client who is at 32 weeks of gestation, has a blood pressure of 138/86 mm Hg, and a heart rate of 71/min with a category I fetal heart tracing.
Client who is at 39 weeks of gestation, has a blood pressure of 122/88 mm Hg, and a pulse of 88/min with a fetal demise.
Client who is at 38 weeks of gestation, has a fetal demise and is hemorrhaging, and has a cervix dilated at 4 cm.
Client who is at 37 weeks of gestation, has a blood pressure of 116/68 mm Hg, a pulse of 72/min, and has a category I fetal heart tracing with cervical dilation at 3 cm.
The Correct Answer is C
Choice A rationale
This client's vital signs are within normal ranges for 32 weeks of gestation. A category I fetal heart tracing indicates normality, suggesting no immediate need for an emergent cesarean section.
Choice B rationale
A fetal demise at 39 weeks of gestation does not necessitate an emergent cesarean section, as the fetus is no longer viable, and other delivery methods can be considered based on the mother's condition.
Choice C rationale
Hemorrhaging at 38 weeks with a fetal demise and cervix dilated at 4 cm indicates a medical emergency. Rapid intervention, including a cesarean section, is necessary to control bleeding and protect the mother’s life.
Choice D rationale
Normal vital signs and a category I fetal heart tracing with cervical dilation at 3 cm at 37 weeks indicate no immediate need for an emergent cesarean section, as labor can proceed naturally under observation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale
CBC will detect abnormalities such as anemia or infection, which may correlate with preeclampsia or HELLP syndrome.
Choice B rationale
Elevated AST and ALT levels indicate liver damage, a potential sign of severe preeclampsia or HELLP syndrome.
Choice C rationale
Serum creatinine helps assess kidney function, as preeclampsia can impair renal perfusion leading to elevated levels.
Choice D rationale
Fetal ultrasound assesses fetal growth, amniotic fluid volume, and placental function, critical in monitoring preeclampsia.
Correct Answer is B
Explanation
Choice A rationale
Breastfeeding a newborn 6-8 times a day is insufficient. Newborns typically need more frequent feedings to ensure adequate nutrition and growth, generally more than 8 times.
Choice B rationale
Newborns should be breastfed 8-12 times in a 24-hour period. This frequent feeding ensures they receive enough nutrients, helps establish milk supply, and supports healthy growth.
Choice C rationale
Feeding 10-14 times a day can be appropriate for some newborns but may not be necessary for all. The standard recommendation is 8-12 times, balancing nourishment and mother's comfort.
Choice D rationale
Breastfeeding 12-16 times a day is excessive and may cause maternal fatigue and discomfort. The general guideline of 8-12 times is sufficient to meet a newborn's nutritional needs.
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