The nurse is assessing postpartum patients. Which patient is at risk for postpartum haemorrhage?
Vaginal delivery after 12 hours of Labor
Primiparity delivered at 10 cm dilation
Manual extraction of the placenta
The Correct Answer is C
Choice A reason: Vaginal delivery after 12 hours of Labor, while potentially exhausting for the mother, does not inherently place her at a higher risk for postpartum haemorrhage compared to other factors. Prolonged Labor can be associated with certain complications, but it is not the most direct indicator of increased haemorrhage risk in the postpartum period.
Choice B reason: Primiparity, or being a first-time mother, delivered at full dilation of 10 cm is a normal part of the childbirth process. While first-time mothers might experience longer Labor durations, this alone does not signify a higher risk for postpartum haemorrhage. Risk factors for haemorrhage typically involve conditions or interventions that impact the uterus's ability to contract effectively after birth.
Choice C reason: Manual extraction of the placenta is a significant risk factor for postpartum haemorrhage. When the placenta does not detach and deliver on its own, manual removal is necessary, which can cause trauma to the uterus and interfere with its ability to contract properly after delivery. The lack of effective uterine contraction can lead to increased bleeding, making this a higher risk scenario for postpartum haemorrhage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: While a child with asthma exacerbation needs monitoring, they used their rescue inhaler 16 hours ago and are currently stable. This patient is not the highest priority.
Choice B reason: A 3-year-old who continues to cough with an oxygen saturation of 91% is at risk of respiratory distress or obstruction due to the swallowed sunflower seeds. The low oxygen saturation indicates impaired gas exchange and requires immediate attention.
Choice C reason: A 15-year-old recovering from a laparoscopic appendectomy who is stable and preparing for discharge can wait to be seen after more urgent cases.
Choice D reason: An 18-month-old admitted for dehydration who is producing a normal number of wet diapers and eating well indicates improved hydration status and can be seen after addressing the more critical situation.
Correct Answer is A
Explanation
Choice A reason: Discussing screening for diabetes is appropriate as pre-diabetes in a newly pregnant patient requires careful monitoring and management to prevent the development of gestational diabetes. Early detection and intervention can improve outcomes for both the mother and the baby.
Choice B reason: A one-hour glucose test is typically part of the gestational diabetes screening process, but it is not necessary to fast overnight specifically for the initial discussion and planning. The timing and preparation for specific tests will be guided by the healthcare provider.
Choice C reason: Eliminating sugar from the diet can be part of managing pre-diabetes, but it is not the immediate response to finding pre-diabetes in a newly pregnant patient. A more comprehensive approach will be discussed with the primary care provider.
Choice D reason: A three-hour glucose tolerance test is a diagnostic test for gestational diabetes, which may be recommended later if initial screening results warrant it. It is not typically performed immediately without prior discussion and planning with the healthcare provider.
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