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 D

Explanation

Taking oral prednisone with food helps to minimize gastrointestinal side effects such as stomach irritation and upset. Food acts as a protective barrier for the stomach lining, reducing the risk of irritation caused by the medication. Additionally, taking prednisone with food can help improve its absorption and distribution in the body.

The other options mentioned are incorrect:

A- "Take on an empty stomach": This is incorrect because taking prednisone on an empty stomach can increase the risk of gastrointestinal side effects. It is generally recommended to take prednisone with food to minimize these side effects.

B- "Take before bedtime": This is incorrect as there is no specific timing requirement for taking prednisone before bedtime. The timing of prednisone administration should be based on the individual's needs and the instructions provided by the healthcare provider.

C- "Take only as needed": This is incorrect because prednisone is typically prescribed with specific dosing instructions. It is important for the client to follow the prescribed dosing schedule and not take it "as needed" unless instructed otherwise by the healthcare provider.

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

The practical nurse (PN) is preparing a client for discharge who receives a prescription for oral prednisone to treat a severe allergic reaction. Which teaching about medication administration should the PN reinforce?

Correct Answer is D

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

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