Which of the following patients is at highest risk for umbilical cord prolapse?
A patient who is 41 weeks pregnant with a cephalic presentation and intact membranes.
A patient who is 38 weeks pregnant with twins and ruptured membranes.
A patient who is 36 weeks pregnant with a transverse lie and intact membranes.
A patient who is 34 weeks pregnant with a breech presentation and ruptured membranes.
The Correct Answer is D
The correct answer is choice D. A patient who is 34 weeks pregnant with a breech presentation and ruptured membranes. This is because breech presentation and ruptured membranes are both risk factors for umbilical cord prolapse, which is where the umbilical cord descends through the cervix and is alongside or below the presenting part of the fetus. This can cause fetal hypoxia and distress.
Choice A is wrong because a cephalic presentation and intact membranes are not risk factors for umbilical cord prolapse.
Choice B is wrong because although twins and ruptured membranes are risk factors for umbilical cord prolapse, the risk is lower than in choice D. Choice C is wrong because although a transverse lie is a risk factor for umbilical cord prolapse, the risk is lower than in choice D if the membranes are intact.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A. “I will avoid squatting or sitting on the toilet after my water breaks.” This statement indicates that the patient understands how to prevent umbilical cord prolapse, which is a rare but serious complication that occurs when the umbilical cord slips out of the cervix before the baby during labor.This can cut off the baby’s blood and oxygen supply and require immediate delivery.
Choice B is wrong because drinking plenty of fluids does not affect the amniotic fluid level, which is determined by the placenta and the baby’s kidneys.Excessive amniotic fluid (polyhydramnios) can actually increase the risk of umbilical cord prolapse.
Choice C is wrong because monitoring the baby’s movements does not prevent umbilical cord prolapse, although it can help detect fetal distress if the cord is compressed.Decreased fetal movements can have other causes besides cord prolapse, such as fetal sleep cycle, maternal medication, or placental insufficiency.
Choice D is wrong because sleeping on the left side does not prevent umbilical cord prolapse, although it can improve blood flow to the baby and reduce the risk of supine hypotension syndrome.Umbilical cord prolapse can occur regardless of the maternal position.
Normal ranges for amniotic fluid index (AFI) are 5 to 25 cm.Normal ranges for fetal heart rate (FHR) are 110 to 160 beats per minute (bpm).
Correct Answer is B
Explanation
The correct answer is choice B. Umbilical cord compression.Variable decelerations are the most common type of fetal deceleration and they are caused by compression of the umbilical cord.They vary in shape, duration, and intensity and may not have a constant relationship with uterine contractions.
Choice A is wrong because uteroplacental insufficiency is the cause of late decelerations, not variable decelerations.Uteroplacental insufficiency is a decrease in the blood flow to the placenta that reduces the amount of oxygen and nutrients transferred to the fetus.
Choice C is wrong because maternal hypotension is one of the possible causes of late decelerations, not variable decelerations.Maternal hypotension can reduce the uteroplacental blood flow and cause fetal hypoxia.
Choice D is wrong because fetal head compression is the cause of early decelerations, not variable decelerations.Early decelerations are benign and uniform in shape and they occur when the fetal head is pressed against the cervix during a uterine contraction.
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