Which of the following are contraindications for VBAC? (Select All that Apply.).
A prior vaginal delivery.
Gestation of 42 weeks.
Maternal obesity.
One prior cesarean delivery.
Macrosomic fetus.
Correct Answer : C,E
Choice A reason:
A prior vaginal delivery is not a contraindication for VBAC. In fact, it is a positive predictor of success for VBAC, as it indicates that the woman has a proven pelvis and can tolerate labor.
Choice B reason:
The gestation of 42 weeks is not a contraindication for VBAC. However, it is associated with an increased risk of stillbirth while awaiting spontaneous labor, which should be balanced against the risks of induction of labor or elective repeat cesarean.
Choice C reason:
Maternal obesity is a relative contraindication for VBAC. It is associated with a lower success rate of VBAC, a higher risk of uterine rupture, and a higher risk of maternal and neonatal complications. The decision to attempt VBAC in obese women should be made on a case-by-case basis by a senior obstetrician.
Choice D reason:
One prior cesarean delivery is not a contraindication for VBAC. Most women who have had one prior lower segment cesarean delivery are eligible for VBAC, as the risk of uterine rupture is low (0.5%) and the success rate is high (72-75%).
Choice E reason:
A macrosomic fetus is a relative contraindication for VBAC. It is associated with a lower success rate of VBAC, a higher risk of uterine rupture, and a higher risk of shoulder dystocia and birth trauma. The decision to attempt VBAC in women with suspected macrosomia should be made on a case-by-case basis by a senior obstetrician.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
FAS is caused by alcohol, and NAS is caused by opioids. This is the correct answer because FAS stands for fetal alcohol syndrome, which is a group of physical and mental defects that can occur in a baby when a woman drinks alcohol during pregnancy. NAS stands for neonatal abstinence syndrome, which is a group of problems that can happen when a baby is exposed to opioid drugs for a length of time while in their mother's womb.
Choice B reason:
FAS and NAS are both incurable. This is incorrect because FAS and NAS have different outcomes. FAS is incurable because the effects of alcohol on the developing brain and body are permanent. NAS, however, can be treated with medication and supportive care to help the baby cope with withdrawal symptoms and prevent complications.
Choice C reason:
FAS and NAS are both curable. This is incorrect because FAS is not curable, as explained above. NAS can be treated, but not cured, because some babies may have long-term problems such as developmental delays, behavioral issues, or learning difficulties.
Choice D reason:
FAS is caused by analgesics and NAS is caused by NSAIDs. This is incorrect because FAS is caused by alcohol, not analgesics, which are painkillers. NAS is caused by opioids, not NSAIDs, which are anti-inflammatory drugs. Analgesics and NSAIDs do not cause the same type of damage to the fetus or the newborn as alcohol and opioids do.
Correct Answer is A
Explanation
Choice A reason:
This is a normal WBC for a newborn. According to MedlinePlus, the normal amount of white blood cells (WBCs) found in the bloodstream of a newborn infant is between 4,500 and 10,000 per microliter of blood. The reference ranges for WBC count established by Mayo Medical Laboratories for infants from birth to 2 years are as follows:.
• Birth: 9.0 to 30.0 x 10 9 /L.
• 1 to 7 days: 9.4 to 34.0 x 10 9 /L.
• 8 to 14 days: 5.0 to 21.0 x 10 9 /L.
• 15 days to 1 month: 5.0 to 20.0 x 10 9 /L.
• 2 to 5 months: 5.0 to 15.0 x 10 9 /L. Therefore, a newborn's WBC of 15,000 is within the normal range and does not indicate any problem.
Choice B reason:
You must call the doctor. This is not a correct answer because there is no need to call the doctor for a normal WBC in a newborn. Calling the doctor unnecessarily may cause anxiety and a waste of time and resources.
Choice C reason:
This indicates a severe infection. This is not a correct answer because a WBC of 15,000 does not necessarily indicate a severe infection in a newborn. A high WBC, also called leukocytosis, may be related to infection, but it can also be caused by other factors such as stress, inflammation, trauma, medication, or blood disorders. Moreover, the type and severity of infection can be better assessed by looking at the differential count of the different types of white blood cells (neutrophils, eosinophils, basophils, monocytes, and lymphocytes) and other signs and symptoms.
Choice D reason:
This is a lab error. This is not a correct answer because a WBC of 15,000 is not likely to be a lab error in a newborn. Lab errors can occur due to improper collection, handling, or analysis of blood samples, but they are rare and usually detected by quality control measures. A WBC of 15,000 is within the normal range for a newborn and does not require repeating the test unless there is a strong suspicion of an error or an inconsistency with other results or clinical findings.
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