The nurse has received shift report for five clients admitted in labor. Which clients will the nurse anticipate delivering by a cesarean section? Select all that apply.

A previous low transverse uterine incision

Placenta previa

A previous classical uterine incision

Prolapsed umbilical cord

Breast cancer

Answer and Explanation

Correct Answer : B

A.   A previous low transverse uterine incision is a factor that may allow for a trial of labor after cesarean (TOLAC) or a vaginal birth after cesarean (VBAC), rather than an automatic cesarean section.
B.   Placenta previa, where the placenta partially or completely covers the cervix, often requires a cesarean section to avoid complications such as bleeding during labor.

C.   A previous classical uterine incision, especially if it extends into the upper part of the uterus, is a contraindication for a trial of labor or vaginal birth, usually requiring a repeat cesarean
section.

D. Prolapsed umbilical cord, where the cord precedes the presenting part, can lead to cord compression during contractions, necessitating a prompt cesarean section.
E. Breast cancer is not a direct indication for a cesarean section; it does not impact the mode of delivery in the absence of other obstetric indications.

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Correct Answer is C

Explanation

A. Early decelerations are generally considered benign and not an indication for a vaginal exam unless other concerning factors are present.
B. Promptly informing the primary care provider may not be necessary for early decelerations, which are often a normal response to head compression.
C. Continuous monitoring and observation of the client and fetal heart rate are appropriate for early decelerations, especially when the baseline is reassuring and there is moderate variability.
D. Repositioning the client to the left side is a general measure for optimizing fetal oxygenation, but it may not be the priority in the case of early decelerations, which are usually benign and
related to head compression.

A. Uteroplacental insufficiency B. Maternal hypotension C. Cord compression D. Head compression

Correct Answer is A

Explanation

A. Late decelerations are associated with uteroplacental insufficiency, indicating that the baby is not getting enough oxygen during contractions.
B. Maternal hypotension can lead to decreased perfusion but is more likely associated with variable decelerations.
C. Cord compression is often associated with variable decelerations, not late decelerations.

D. Head compression typically does not cause late decelerations; it may be associated with early decelerations.

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The nurse has received shift report for five clients admitted in labor. Which clients will the nurse anticipate delivering by a cesarean section? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a laboring client with early decelerations and a fetal heart rate baseline of 130 with moderate variability. What will the nurse do for this client?

Correct Answer is C

Explanation

The nurse is caring for a client in labor and discovers late decelerations of the fetal heart rate. What does the nurse know as the reason for this type of deceleration?

Correct Answer is A

Explanation

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