Nokea
The nurse practicing in a labor setting knows the woman most at risk for a uterine rupture is:
- A. G4 who had all 4 c/s birth
- B. G5 who had 2 vaginal birth and 2 c/s births
- C. G2 low segment vertical incision for delivery of 10lb infant
- D. G3 who had 2 lower segment transverse c/s birth
Correct Answer: C
Rationale: The correct answer is C because a low segment vertical incision for delivery of a large infant (10lb) puts the woman at the highest risk for uterine rupture. This type of incision weakens the uterine wall, increasing the likelihood of rupture during subsequent pregnancies or labor. Choices A, B, and D involve lower segment transverse c-section births, which are less likely to result in uterine rupture compared to a vertical incision. Additionally, the number of previous births or the mode of delivery does not increase the risk of uterine rupture as much as the type of uterine incision.
You may also like to solve these questions
A nurse is monitoring a client who has preeclampsia and is receiving magnesium sulfate by continuous IV infusion. Which of the following findings should the nurse reports to the provider?
- A. Blood pressure 148/94mm Hg
- B. Respiratory rate 14mm
- C. Urinary output 20 mL/hr
- D. 2+deep tendon reflexes
Correct Answer: A
Rationale: The correct answer is A: Blood pressure 148/94mm Hg. High blood pressure in a client with preeclampsia indicates worsening condition and potential for eclampsia. Magnesium sulfate is given to prevent seizures, so high blood pressure needs immediate provider attention.
Incorrect Choices:
B: Respiratory rate 14mm - This respiratory rate is within normal range.
C: Urinary output 20 mL/hr - Low urinary output should be monitored but is not the priority in this situation.
D: 2+deep tendon reflexes - Normal deep tendon reflexes are expected with magnesium sulfate therapy.
What is the most critical sign of fetal distress during labor?
- A. Accelerations in fetal heart rate
- B. Decreased variability in fetal heart rate
- C. Early decelerations in fetal heart rate
- D. Late decelerations in fetal heart rate
Correct Answer: D
Rationale: The correct answer is D: Late decelerations in fetal heart rate. Late decelerations indicate uteroplacental insufficiency, where the fetus is not receiving enough oxygen during contractions. This is critical as it can lead to fetal hypoxia and acidosis, posing a risk to the baby's well-being. Early decelerations (C) are generally benign and result from head compression during contractions. Accelerations (A) are a reassuring sign indicating fetal well-being. Decreased variability (B) can be concerning but is not as critical as late decelerations in indicating fetal distress.
The nurse is monitoring a client in labor with an epidural. What finding requires immediate intervention?
- A. Blood pressure of 100/60 mmHg.
- B. Fetal heart rate of 90 beats/minute.
- C. Client reports warmth in the lower extremities.
- D. Contractions every 5 minutes.
Correct Answer: B
Rationale: The correct answer is B: Fetal heart rate of 90 beats/minute. A fetal heart rate of 90 bpm indicates fetal distress and requires immediate intervention to prevent potential complications. Decreased fetal heart rate can be a sign of fetal hypoxia or distress. The other choices are not as concerning in this context. A blood pressure of 100/60 mmHg is within normal range. The client reporting warmth in the lower extremities is a common side effect of epidural anesthesia. Contractions every 5 minutes may indicate progress in labor but do not require immediate intervention unless associated with fetal distress.
What is the term for nonmedical factors that influence health outcomes, including conditions in which people are born, grow, work, live, and age, and the wider sets of forces and systems shaping the conditions of daily life?
- A. environmental influences
- B. life circumstances
- C. situational occurrences
- D. social determinants of health
Correct Answer: D
Rationale: The correct answer is D: social determinants of health. Social determinants of health refer to the external factors that impact health outcomes. These factors include socioeconomic status, education, employment, social support networks, access to healthcare, and the physical environment. The term encompasses a broad range of influences beyond individual behaviors or genetics.
A: Environmental influences focus more on physical factors like pollution or climate, rather than the broader societal factors.
B: Life circumstances may include individual factors like personal choices or experiences, but do not encompass the societal influences.
C: Situational occurrences imply random events or temporary situations, rather than the persistent societal factors that shape health outcomes.
The nurse would classify a newborn delivered at 39 weeks' gestation, weighing 2400 g ( 5.0 lbs) as being:
- A. Preterm and immature
- B. Small-for-gestational age
- C. Average-for-gestational age
- D. Average-for-gestational age but pre-term
Correct Answer: B
Rationale: The correct answer is B: Small-for-gestational age. A newborn delivered at 39 weeks' gestation and weighing 2400g is considered small-for-gestational age because the weight is below the 10th percentile for the gestational age. This indicates intrauterine growth restriction. Preterm and immature (choice A) would not apply as the baby was delivered at term. Average-for-gestational age (choice C) would not be accurate as the baby's weight is below the normal range for that gestational age. Choice D is also incorrect as the baby is not within the average weight range for the gestational age.