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The nurse is discussing birth options with a pregnant client. The client previously had a cesarean birth with a classical incision at 26 weeks' gestation but desires a vaginal birth with this pregnancy. What is the best response by the nurse?

"With a classical incision, there is an increased risk of uterine rupture in labor, so a vaginal birth is not usually recommended."

"This depends on whether your next baby is born at full term; if it is another preterm birth, then a repeat cesarean will be advised."

"There is a decreased risk for complications and easier recovery after a vaginal birth, so a vaginal birth will be recommended for you."

"As long as there is an 18-month interval for scar healing between births, a vaginal birth after cesarean is generally permitted."

Answer and Explanation

The Correct Answer is A

A.   A classical incision increases the risk of uterine rupture during labor, and a vaginal birth is not typically recommended due to this risk.
B.   The type of incision, not the term of the subsequent birth, is the primary consideration for deciding on a mode of delivery.
C.   A classical incision is associated with an increased risk of complications, not a decreased risk.

D. The recommendation for a vaginal birth after cesarean (VBAC) depends on factors such as the type of uterine incision and other clinical considerations, not just the time interval.

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Correct Answer is A

Explanation

A. Changing the client's position, especially if there's a cord compression causing variable decelerations, is a priority intervention to alleviate the decelerations.
B. Informing the primary care provider is important, but immediate action to address the decelerations should be taken first.
C. Vaginal examination is not the immediate priority when variable decelerations are observed; interventions to improve fetal oxygenation are more critical.
D. Continuous monitoring is essential, but addressing the cause of the variable decelerations by changing the client's position is the immediate action.

A. "It will cause your contractions to slow down so we can give you steroids." B. "It will cause an increased blood flow through the placenta." C. "It will cause an increase in urinary output." D. "It will cause your uterus to contract to speed up your labor."

Correct Answer is D

Explanation

A. Oxytocin is administered to enhance contractions, not to slow them down.

B. While increased blood flow through the placenta is important for fetal well-being, oxytocin is primarily used to stimulate uterine contractions.
C. Increased urinary output is not the primary effect of oxytocin; its main action is to stimulate uterine contractions.

D. Oxytocin is commonly used to induce or augment labor by stimulating contractions of the uterus.

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The nurse is discussing birth options with a pregnant client. The client previously had a cesarean birth with a classical incision at 26 weeks' gestation but desires a vaginal birth with this pregnancy. What is the best response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a laboring client. The nurse observes that there are variable decelerations. What is the nurse's priority action?

Correct Answer is A

Explanation

The nurse is caring for a client in labor receiving oxytocin. The client asks the nurse, "What is this medication for?" What is the best response by the nurse?

Correct Answer is D

Explanation

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