A nurse on the labor and delivery unit is assessing four clients.
Which of the following clients is a candidate for an induction of labor with Misoprostol?
A client who has placenta previa.
A client who has active genital herpes.
A client who has a previous uterine incision due to multiple myomectomy.
A client who has gestational hypertension.
The Correct Answer is D
Choice A rationale
Misoprostol is a prostaglandin analog that stimulates uterine contractions. It is contraindicated in clients with placenta previa due to the risk of severe hemorrhage from placental separation if contractions are induced.
Choice B rationale
Active genital herpes is a contraindication for vaginal delivery and therefore also a contraindication for induction of labor with Misoprostol, as it could potentially lead to vertical transmission of the herpes simplex virus to the newborn during passage through the birth canal.
Choice C rationale
A previous uterine incision due to multiple myomectomy can be a contraindication for labor induction with Misoprostol, depending on the type and location of the incisions. The increased risk of uterine rupture with strong contractions stimulated by Misoprostol is a significant concern in such cases.
Choice D rationale
Gestational hypertension, in the absence of other contraindications, can be an indication for induction of labor if the benefits of delivering the baby outweigh the risks of continuing the pregnancy. Misoprostol can be used cautiously in this situation to ripen the cervix and induce labor.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
This notation indicates three pregnancies (G3), one term birth (T1), two preterm births (P2), one abortion (A1), and three living children (L3). While the number of living children is correct, the total number of pregnancies is underestimated by excluding the current pregnancy.
Choice B rationale
This notation accurately reflects four pregnancies (G4: the elective abortion, the daughter, the twins, and the current pregnancy), one term birth (T1: the daughter born at 40 weeks), two preterm births (P2: the twin boys born at 34 weeks), one abortion (A1: the elective abortion), and three living children (L3: the daughter and the twin boys).
Choice C rationale
This notation indicates three pregnancies (G3), one term birth (T1), one preterm birth (P1), one abortion (A1), and three living children (L3). The number of preterm births is incorrect, as there were two preterm births (the twins).
Choice D rationale
This notation indicates four pregnancies (G4), one term birth (T1), one preterm birth (P1), one abortion (A1), and three living children (L3). The number of preterm births is incorrect, as there were two preterm births (the twins).
Correct Answer is B
Explanation
Choice A rationale
A glucose reading of 58 mg/dL in a newborn is below the normal range (typically 40-60 mg/dL in the first hours of life, rising to 50-90 mg/dL). While this requires intervention to prevent hypoglycemia, other parameters might indicate a more immediate threat to the newborn's well-being.
Choice B rationale
A temperature of 97.4°F (36.3°C) is below the normal range for a newborn (typically 97.7°F to 99.5°F or 36.5°C to 37.5°C). Hypothermia in a newborn can lead to cold stress, increasing oxygen and glucose consumption, potentially leading to respiratory distress and hypoglycemia. Therefore, a low temperature requires immediate assessment and intervention to warm the newborn.
Choice C rationale
A respiratory rate of 48 breaths/minute is within the normal range for a newborn (typically 30-60 breaths/minute). While the respiratory rate should be monitored, it does not indicate an immediate critical issue in this case.
Choice D rationale
A pulse of 134 beats/minute is within the normal range for a newborn (typically 110-160 beats/minute). While the heart rate should be monitored, it does not indicate an immediate critical issue in this case. .
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