A client whose first child was delivered by cesarean section is 20 weeks pregnant with her second child and wishes to have a vaginal birth after cesarean (VBAC). What information is most important for the practical nurse (PN) to obtain?

Client's intent regarding breastfeeding of the newborn.

The type of uterine incision used for previous birth.

History of contracting Herpes simplex virus.

Religious preference of the client's family.

Answer and Explanation

The Correct Answer is B

Knowing the type of uterine incision from the previous cesarean section is crucial when considering the option of vaginal birth after cesarean (VBAC). The type of incision can provide important insights into the potential risks and complications associated with a trial of labor.
Specifically, a low transverse uterine incision is considered the most favorable for VBAC, as it has a lower risk of uterine rupture compared to other types of incisions, such as a classical or vertical incision.
A. While information about the client's intent regarding breastfeeding of the newborn is important for providing appropriate support and education, it does not have a direct impact on the decision-making process for VBAC.
C. A history of contracting Herpes simplex virus is relevant to the client's overall health and may have implications for the management of the pregnancy, but it is not directly related to the decision regarding VBAC.
D. The religious preference of the client's family, while important for respecting cultural and spiritual beliefs, does not have a direct impact on the decision-making process for VBAC.

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Correct Answer is B

Explanation

Antiplatelet medications, such as aspirin or clopidogrel, are prescribed to prevent the formation of blood clots by inhibiting platelet aggregation. These medications can increase the risk of bleeding or prolonged bleeding time. Therefore, when removing the saline lock, applying pressure over the site for several minutes helps to minimize the risk of bleeding and promote hemostasis.
A. Leaving the saline lock in place and notifying the charge nurse may not be necessary unless there are specific concerns or complications related to the client's condition.
C. Encouraging the client to drink additional oral fluids is not directly related to the discontinuation of the saline lock and the potential risk of bleeding associated with antiplatelet medication.
D. Preparing a warm pack to apply after removing the lock is not necessary for this situation. Warm packs are typically used for comfort or to promote circulation, but they are not directly related to the risk of bleeding associated with antiplatelet medication.

A. Minimize the number of refined grains in the diet B. Eliminate sugary beverages and juices from the diet C. Increase the amount of dietary fiber D. Double the usual amount of protein in the diet E. Only select feed items with no fat F. Take a cinnamon supplement

Correct Answer is ["A","B","C"]

Explanation

Minimize the number of refined grains in the diet: Refined grains, such as white bread, white rice, and pasta, have had their bran and germ removed, resulting in a loss of fiber and nutrients. Including more whole grains in the diet, such as whole wheat bread, brown rice, and whole grain pasta, can help maintain stable blood sugar levels and reduce the risk of type 2 diabetes.
Eliminate sugary beverages and juices from the diet: Sugary beverages, including soda, fruit juices, and sweetened teas, can contribute to weight gain and an increased risk of type 2 diabetes. Encouraging the client to choose water, unsweetened tea, or other sugar-free beverages can help reduce the intake of added sugars.
Increase the amount of dietary fiber: Fiber-rich foods, such as fruits, vegetables, whole grains, legumes, and nuts, can help regulate blood sugar levels and improve insulin sensitivity. Encouraging the client to include these foods in their diet can be beneficial in reducing the risk of type 2 diabetes.

Incorrect:

D- Double the usual amount of protein in the diet: While protein is an essential nutrient, doubling the usual amount of protein in the diet may not be necessary or appropriate for everyone. It is important to follow individualized dietary recommendations and consult with a healthcare provider or registered dietitian for specific protein needs.

E- Only select food items with no fat: It is not necessary or advisable to eliminate all fat from the diet. Healthy fats, such as those found in avocados, nuts, seeds, and olive oil, are important for overall health. Choosing foods with healthier fats and moderating intake of saturated and trans fats is a more balanced approach to nutrition.

F- Take a cinnamon supplement: While cinnamon has been studied for its potential effects on blood sugar control, it is not a proven or recommended treatment for reducing the risk of type 2 diabetes. It's important to focus on overall dietary patterns and lifestyle factors rather than relying solely on supplements

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A client whose first child was delivered by cesarean section is 20 weeks pregnant with her second child and wishes to have a vaginal birth after cesarean (VBAC). What information is most important for the practical nurse (PN) to obtain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In preparing to discontinue a client's saline lock, the practical nurse (PN) notes that the client is receiving an antiplatelet medication. Which action should the PN implement?

Correct Answer is B

Explanation

Discussed the DASH diet with the client and gave examples of appropriate portion sizes. Review H and P, nurse's note, and laboratory results. What other nutritional recommendations would be helpful for this client in reducing the risk for type 2 diabetes? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

The practical nurse (PN) is assisting with the plan of care for a client who is experiencing torticollis from a traumatic injury sustained during a football game. The client received a prescription for tramadol. Which intervention should the PN include in the client's plan of care?

The practical nurse (PN) is feeding a 2-month-old male infant with heart failure due to a ventricular septal defect (VSD). Which intervention should the PN implement?

An adult female client with type 1 diabetes mellitus is receiving NPH insulin 35 units each morning. Which finding should the practical nurse (PN) document as evidence that the amount of insulin is inadequate?

The practical nurse (PN) applies and then releases pressure to a client's fingernail as seen in the photo. Normal nail color returns in 2 seconds. Which action should the PN take?

A client with diabetic ketoacidosis (DKA) is receiving regular insulin. Which action should the practical nurse (PN) implement to evaluate the effectiveness of the insulin dosage?

The practical nurse (PN) is completing a focused assessment on a client who is prescribed oxygen at 3 liters per minute by nasal cannula. Which assessment finding by the PN requires immediate action?