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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
During a generalized tonic-clonic seizure, it is important for the practical nurse (PN) to prioritize the safety and well-being of the child. The correct actions to implement immediately are:
A. Observe the progression of the seizure: The PN should closely observe the seizure to gather important information that can be helpful for medical professionals in assessing the seizure's characteristics and duration.
D. Pad the side rails with pillows: Padding the side rails of the bed with pillows helps to prevent the child from injuring themselves by hitting the side rails during the seizure.
E. Loosen clothing around the neck: Loosening any tight clothing around the child's neck helps to ensure adequate breathing and prevent any constriction or discomfort during the seizure.
B. Hold the extremities close to the body: This action is not recommended during a seizure as it may increase the risk of injury to the child or the PN.
C. Insert a tongue blade between the teeth: It is not recommended to insert any object, including a tongue blade, between the teeth of a person experiencing a seizure. This can cause injury to the person's mouth or teeth and is no longer considered an appropriate intervention for seizures.
Correct Answer is D
Explanation
This comment by the practical nurse (PN) is likely to be the most helpful to the client. By offering to sit with the client, the PN shows empathy, support, and a willingness to provide companionship. This approach acknowledges the client's feelings of isolation and offers a listening ear. It provides an opportunity for the client to express his emotions, thoughts, or concerns if he wishes to do so. The presence of a caring and compassionate individual can help alleviate some of the client's feelings of loneliness and may encourage him to open up and engage in conversation or activities when he is ready.
A. "Come into the recreation area. We have your favorite card game and I will play it with you."
This choice assumes that engaging in a specific activity will automatically help the client and solve his current feelings of reclusiveness. While offering an activity may be beneficial in some cases, it is important to first address the client's emotional state and provide support before suggesting specific activities. Pushing the client to participate in an activity without acknowledging his current feelings may further alienate him and not address the underlying issues causing his reclusive behavior.
B. "Why do you want to stay in your room today?"
This choice may come across as confrontational or judgmental. Asking why the client wants to stay in his room implies that there is something wrong with his decision or that he needs to justify his behavior. This approach may make the client defensive or withdraw further. It is essential to create a safe and supportive environment where the client feels understood and validated, rather than questioning his choices.
C. "I know you are sad about not seeing your family as often, but they are visiting as much as they can."
While acknowledging the client's sadness about not seeing his family is important, dismissing his feelings by stating that his family is visiting as much as they can minimize or invalidate his emotions. It is crucial to provide empathy and validate the client's emotions without making assumptions or downplaying his experiences. This approach may not address the client's current state of reclusiveness or provide the support he needs.
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