The nurse explains to a client that the purpose of a cerclage is to
stop premature labor contractions
control active vaginal bleeding
prevent dilation of the cervix
prevent spontaneous rupture of membranes
The Correct Answer is C
A. stop premature labor contractions: Cerclage is a surgical procedure involving the placement of a non-absorbable suture around the cervical os. It provides mechanical support to a weakened cervix but does not possess tocolytic properties. Pharmacological agents are required to inhibit active uterine myometrial activity.
B. control active vaginal bleeding: This procedure is contraindicated in the presence of active hemorrhage or placental abruption. Placing a stitch in a bleeding cervix could mask a serious underlying pathology or exacerbate maternal trauma. It is an elective or emergent structural intervention, not a hemostatic one.
C. prevent dilation of the cervix: Cerclage is specifically indicated for cervical insufficiency to provide structural reinforcement during the second trimester. It prevents the passive, painless dilation and effacement that lead to mid-trimester pregnancy loss. This maintains the pregnancy by keeping the internal os closed.
D. prevent spontaneous rupture of membranes: While a cerclage helps maintain cervical length, it cannot biologically prevent the biochemical processes that lead to membrane rupture. In fact, bulging membranes are a risk factor that complicates the procedure. The primary goal is cervical stability rather than membrane protection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Latent: The latent phase of the first stage of labor involves cervical dilation from 0 to 6 centimeters. Contractions are typically mild and less frequent than every 3 minutes. At 10 centimeters, the client has moved far beyond the initial phase of cervical preparation.
B. Active: The active phase is characterized by rapid cervical dilation, traditionally occurring between 6 and 8 centimeters. While contractions are frequent, the cervix is not yet fully dilated. The transition to the second stage occurs only after the cervix reaches the 10-centimeter mark.
C. Second: The second stage of labor begins when the cervix is completely dilated at 10 centimeters and ends with the birth of the infant. The frequent, long-lasting contractions described are typical of the expulsive efforts needed in this stage. The patient is now ready for active pushing.
D. Transition: Transition is the final part of the first stage, occurring between 8 and 10 centimeters of dilation. It is the most intense phase, often accompanied by a strong urge to push. Once 10 centimeters is achieved, the patient has officially concluded transition and entered the second stage.
Correct Answer is C
Explanation
A. adolescents with a breech presentation: Breech presentation in a singleton pregnancy is typically managed via external version or cesarean section. Internal version is an invasive procedure with high risks of uterine rupture and hemorrhage. It is not indicated for routine singleton malpresentations regardless of maternal age.
B. response to fetal distress: Acute fetal distress requires the most rapid and least traumatic delivery method available. Internal version is technically difficult and can worsen fetal trauma or cause placental abruption. It is not an appropriate emergency response for a distressed singleton fetus.
C. multiple gestation, for the birth of the second twin: This maneuver is reserved for delivering a non-vertex second twin after the first twin is born. The clinician reaches into the uterus to pull the fetus into a footling breech for delivery. It is possible due to the dilated cervix.
D. obstetric intensive care unit for delivery of baby in fetal distress: The setting of the delivery does not change the indications for this high-risk maneuver. Internal version is not standard for fetal distress in a singleton pregnancy. It is specifically a tool for managing the delivery of the second twin.
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