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 B
Explanation
Choice A reason:
Allowing opportunities for newborn massage is not recommended for preterm newborns, as it can increase their oxygen consumption and energy expenditure. Massage can also cause stress responses, such as increased heart rate, blood pressure, and cortisol levels.
Choice B reason:
Clustering the newborn's care activities is the best way to help the newborn conserve energy, as it minimizes the frequency of handling and stimulation. Clustering care also allows for longer periods of uninterrupted sleep, which is essential for growth and development.
Choice C reason:
Changing the newborn's position every 2 hours is not necessary for preterm newborns, as it can disrupt their sleep and cause them to lose heat. Preterm newborns have limited ability to regulate their body temperature, and frequent position changes can expose them to cold stress.
Choice D reason:
Placing elbow restraints on the newborn is not indicated for preterm newborns, unless they have a specific condition that requires them, such as a cleft lip or palate repair. Elbow restraints can restrict the newborn's movement and cause skin irritation or injury.
Correct Answer is ["A","B","C","E","F"]
Explanation
Choice A reason:
Moro is a newborn reflex that occurs when the baby is startled by a loud sound or movement. The baby will cry, throw back his or her head, and then pull his or her limbs into the body. This reflex lasts until the baby is about 2 months old.
Choice B reason:
Rooting is a newborn reflex that starts when the corner of the baby's mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and root in the direction of the stroking. This helps the baby find the breast or bottle to start feeding. This reflex lasts about 4 months.
Choice C reason:
Gag is a newborn reflex that prevents the baby from choking on foreign objects. The baby will cough, gag or spit out anything that touches the back of the throat or the roof of the mouth. This reflex is present throughout life.
Choice D reason:
Running is not a newborn reflex. It is a voluntary movement that develops later in childhood. Choice E reason:
Babinski is a newborn reflex that occurs when the sole of the foot is stroked from heel to toe. The baby will fan out and curl up the toes and twist the foot inward. This reflex lasts until the baby is about 12 months old.
Choice F reason:
Stepping is a newborn reflex that occurs when the baby is held upright with his or her feet touching a solid surface. The baby will appear to take steps or dance. This reflex lasts about 2 months.
Choice G reason:
The crawling reflex is a developmental milestone observed in infants around 6-8 months of age. It involves the baby moving on their hands and knees, often starting with a belly-crawling motion. Unlike newborn reflexes, this skill is learned and requires muscle coordination and strength.
Choice H reason:
Standing with support is a developmental milestone typically achieved by infants around 9-12 months. In this skill, the baby pulls themselves up to a standing position while holding onto furniture or a caregiver’s hands. It is a learned behavior reflecting increased muscle strength and balance, distinct from newborn reflexes.
Choice I reason:
The pincer grasp is a fine motor skill that usually develops between 8-12 months. It involves the baby using the thumb and index finger to pick up small objects. This ability is not a reflex but a learned skill that demonstrates improved hand-eye coordination and dexterity.
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