A woman who underwent a primary cesarean birth for a breech presentation states that her neonate seems to have so much more mucus than her first baby. Concerned, she asks why this has happened.
What is the best response by the nurse?

There is no scientific reason for this occurrence; your baby will be fine in a few hours.

All babies are different so it is unwise to make comparisons between your first baby and your new baby.

Babies born by cesarean section do not have the benefit of having the mucus in their lungs removed by the pressure experienced in the birth canal.

The pain medication given during the surgery may have contributed to the mucus build up in the neonate after birth.

Answer and Explanation

The Correct Answer is C

Choice A rationale

This is an unscientific and dismissive response. There is a clear physiological reason for increased neonatal mucus following a cesarean birth. During a normal vaginal delivery, the thoracic squeeze exerted by the birth canal helps physically expel lung fluid and mucus, aiding the transition to extrauterine respiration.

Choice B rationale

While individual differences exist, this response fails to address the specific pathophysiology associated with the increased mucus observed in cesarean-born neonates. The lack of vaginal compression is a known factor that significantly impacts the clearance of fetal lung fluid and mucus, leading to transient tachypnea.

Choice C rationale

The lack of the "thoracic squeeze" during a cesarean birth means less fetal lung fluid and mucus are mechanically cleared compared to a vaginal birth. This remaining fluid can manifest as increased mucus-like secretions and often leads to conditions like Transient Tachypnea of the Newborn (TTN) as the lungs absorb the remaining fluid.

Choice D rationale

Pain medications like opioids, which may cross the placenta, primarily cause neonatal respiratory depression by acting on the central nervous system's respiratory centers, not by directly causing a physical build-up or inadequate clearance of mucus in the respiratory tract. Mucus clearance is a mechanical process.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is ["100"]

Explanation

Step 1 is: Calculate the volume of the magnesium sulfate solution that contains the ordered dose. 500 mL÷30 g = 16.666. mL/g. 6 g/hr×16.666. mL/g = 100 mL/hr. The final calculated answer is 100 mL/hr.

A. A client who had rupture of membranes 26 hours ago. B. A client with a current separation of symphysis pubis. C. A client who had a cesarean section because of placenta previa. D. A client who had a cesarean section because of a breech presentation. E. A client who was positive for Group B streptococcal infection. F. A client who has a gynecoid shaped pelvis. G. A client with a traditional cesarean incision.

Correct Answer is ["C","D","E","F"]

Explanation

Choice A rationale

Rupture of membranes for 26 hours constitutes prolonged rupture, raising the risk of intrauterine infection (chorioamnionitis). An active infection or high suspicion is a strong contraindication to a trial of labor after cesarean (TOLAC) due to the physiological stress on the mother and fetus, increasing the risk of uterine rupture and septic complications, thus requiring delivery.

Choice B rationale

A current separation of the symphysis pubis causes pelvic instability and severe pain. The biomechanical stress of labor and pushing could seriously worsen this condition, leading to severe chronic pain or functional disability for the mother. This significant maternal orthopedic risk factor contraindicates a trial of labor after cesarean (TOLAC) and favors a planned repeat cesarean section.

Choice C rationale

A prior cesarean for placenta previa, where the placenta covered the cervix, is considered a non-recurrent indication in a subsequent pregnancy, provided the current placenta is normally implanted. The previous surgery was for a transient placental issue, not a permanent structural maternal or fetal condition, making the client a candidate for a trial of labor after cesarean (TOLAC).

Choice D rationale

A previous cesarean due to breech presentation, a fetal positioning issue, is generally a non-recurrent indication if the current fetus is cephalic (head-down). This transient fetal factor does not inherently compromise the safety of the maternal pelvis or the integrity of the prior uterine scar, thus favoring an attempt at a trial of labor after cesarean (TOLAC).

Choice E rationale

Group B streptococcal (GBS) colonization is a routine finding requiring intrapartum antibiotic prophylaxis (IAP) to prevent neonatal GBS disease. GBS positivity itself is not a contraindication to a trial of labor after cesarean (TOLAC) because the infection risk is managed with standard antibiotic protocols that can be administered during labor.

Choice F rationale

The gynecoid pelvis is anatomically the most suitable shape for vaginal birth, characterized by a rounded inlet and favorable dimensions that facilitate the cardinal movements of labor. This optimal maternal anatomy significantly improves the probability of a successful trial of labor after cesarean (TOLAC) and supports the attempt.

Choice G rationale

A traditional (classical or vertical) cesarean incision extends through the thick contractile upper segment of the uterus, which heals less robustly than a low transverse incision. This incision type carries a significantly higher risk of uterine rupture during labor (approximately 4-9.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A woman who underwent a primary cesarean birth for a breech presentation states that her neonate seems to have so much more mucus than her first baby. Concerned, she asks why this has happened. What is the best response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["100"]

Explanation

The nurse and student are discussing clients who are laboring on the unit. Which clients would the nurse encourage to attempt a vaginal birth after having a cesarean section? Select all that apply.

Correct Answer is ["C","D","E","F"]

Explanation

A woman who underwent a primary cesarean birth for a breech presentation states that her neonate seems to have so much more mucus than her first baby. Concerned, she asks why this has happened. What is the best response by the nurse?

The nurse is caring for a client in labor whose fetus is in an occiput posterior position. Which intervention would the nurse use to reduce this client's discomfort?

A postpartum client is being treated with subcutaneous heparin for deep vein thrombosis of the left calf. Which client assessment is of most concern to the nurse?

A pregnant client late in the second trimester comes to the emergency department with a report of painless, bright red vaginal bleeding. The client states, "It started all of a sudden and now it seems to have stopped.”. What action is the priority for this client on admission?

A pregnant client presents with painless bleeding caused by placenta previa at 37 weeks' gestation. Which assessment is the most important for the nurse to perform?

A client with a history of three spontaneous abortions is now at 16 weeks' gestation and expresses a concern about remaining at home during pregnancy. Which query will elicit a response most helpful to the nurse developing the client's plan of care?

The nurse is concerned that a pregnant client is developing polyhydramnios in the second trimester. What assessment findings confirm this concern? Select all that apply.

A woman who underwent a primary cesarean birth for a breech presentation states that her neonate seems to have so much more mucus than her first baby. Concerned, she asks why this has happened.
What is the best response by the nurse?