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 C

Explanation

When a client reports experiencing numbness and tingling in the extremities, it is crucial for the practical nurse (PN) to prioritize reporting the client's electrolyte levels to the healthcare provider. Electrolytes are essential minerals that help maintain the balance of ﬂuids in the body and enable proper nerve and muscle function. Imbalances in electrolyte levels can lead to neurological symptoms, including numbness and tingling.

Options a, b, and d are not the correct priorities to report in this situation:

A. Insert an indwelling catheter to empty the bladder and contract the fundus. B. Check fundal consistency and continue to monitor the lochial ﬂow amount. C. Return the client to bed and maintain bedrest until the lochial ﬂow slows. D. Massage the fundus and avoid direct pressure on the cesarean incision.

Correct Answer is D

Explanation

This is the best action to take for a client who experiences a sudden gush of vaginal blood and clots after a cesarean section. Massaging the fundus helps to stimulate uterine contractions and reduce bleeding. Avoiding direct pressure on the incision prevents pain and wound dehiscence.

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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

A client reports experiencing numbness and tingling in the extremities. Which of the client's serum laboratory values should the practical nurse (PN) prioritize reporting to the healthcare provider?

Correct Answer is C

Explanation

On the first day after a cesarean section, a client who is a primipara is being assisted to the bathroom for the first time. The client experiences a sudden gush of vaginal blood and notices that several blood clots are in the toilet. Which action should the practical nurse (PN) take?

Correct Answer is D

Explanation

The practical nurse (PN) is assessing an older client with left-sided heart failure (HF). What intervention is most important for the PN to implement?

The practical nurse (PN) palpates a client's radial pulse and notes that the pulse disappears when light pressure is applied. How should the PN document this finding?

At the first dressing change, the practical nurse (PN) tells the client that her mastectomy incision is healing well, but the client refuses to look at the incision and refuses to talk about it. Which response by the PN to the client's silence is best?

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