Which complication would the nurse consider for a client with a fetus in a breech presentation?
Stronger contractions, indicating progression of labor.
Nonreassuring fetal signs, indicating prolapse of the cord.
Rapid dilation of the cervix, indicating precipitate labor.
Cessation of contractions, indicating overstretching of the uterus.
The Correct Answer is B
Choice A rationale
Stronger contractions are not a specific complication of breech presentation. Contraction strength is related to uterine action and response to oxytocin, not solely to fetal presentation. Breech presentation primarily poses risks related to the birthing process itself, such as cord prolapse and birth trauma.
Choice B rationale
In a breech presentation, the presenting part (buttocks or feet) is less effective than the head in filling the pelvic inlet, potentially leaving space for the umbilical cord to prolapse, especially upon rupture of membranes. Cord prolapse causes nonreassuring fetal signs such as sudden, severe variable decelerations or prolonged bradycardia due to cord compression and subsequent fetal hypoxia.
Choice C rationale
Precipitate labor is characterized by very rapid cervical dilation and fetal descent, usually occurring within three hours of labor onset. This is not directly caused by a breech presentation. The mechanism of labor in breech is often slower and more complicated due to the less efficient presenting part.
Choice D rationale
Cessation of contractions often indicates uterine fatigue or uterine inertia, which can occur in prolonged labor or with specific uterine conditions, but it is not a direct or common complication of breech presentation. Overstretching of the uterus is typically associated with polyhydramnios or multiple gestation.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice C rationale
Abruptio placentae is the premature separation of the placenta from the uterine wall. The classic signs include dark red vaginal bleeding (due to the pooling of blood behind the placenta), constant and intense abdominal pain, and a rigid, hypertonic uterus that does not relax between contractions. This rigidity is caused by the hemorrhage, clots, and resulting irritation and sustained contraction of the myometrium.
Choice A rationale
Preterm labor is characterized by regular uterine contractions causing cervical changes before 37 weeks' gestation. While contractions cause pain, the uterus typically relaxes completely between them, and the bleeding, if present, is usually bright red and less profuse than that seen with abruptio placentae, and it does not cause sustained uterine firmness.
Choice B rationale
Placenta previa is the implantation of the placenta over or near the cervical os. Its hallmark sign is painless, bright red vaginal bleeding that often occurs late in the second or third trimester. The uterus remains soft and relaxed, unlike the hard, board-like abdomen found with a severe placental abruption.
Choice D rationale
Placenta accreta involves abnormal adherence of the placenta to the uterine wall, typically becoming symptomatic at delivery when the placenta fails to separate. While it can cause bleeding, it does not typically present with the acute, severe abdominal pain and the sustained, board-like uterine rigidity seen before delivery, as it is a pathology of adherence, not separation.
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.
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