A nurse is admitting a client who is in active labor and has had two prior cesarean births. The nurse should identify that the client is at an increased risk for which of the following complications?

Failure to progress

Abruptio placentae

Precipitous labor

Uterine rupture

Answer and Explanation

The Correct Answer is D

Uterine rupture. When a client has had two prior cesarean births, she is at an increased risk for uterine rupture. Uterine rupture is a serious complication that can occur during labor, where there is a tear in the wall of the uterus. It can lead to significant blood loss for the mother and oxygen deprivation for the fetus. Other risk factors for uterine rupture include a previous uterine surgery, the use of labor-inducing drugs, and multiple gestations.

Failure to progress (choice A) refers to a labor that is not progressing as it should, and can be caused by a variety of factors, including fetal malposition or inadequate contractions. Abruptio placentae (choice B) refers to the separation of the placenta from the uterine wall before delivery, which can cause fetal distress and maternal hemorrhage. Precipitous labor (choice C) refers to a labor that progresses extremely quickly, with contractions lasting less than 3 hours from the onset of active labor. While precipitous labor can be associated with increased risk for perineal lacerations and postpartum hemorrhage, it is not typically associated with prior cesarean births.

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Correct Answer is B

Explanation

Newborns born to mothers with gestational diabetes mellitus are at risk for hypoglycemia, which is a condition characterized by low blood sugar levels. Jitteriness is a common sign of hypoglycemia in newborns. Other signs of hypoglycemia include poor feeding, lethargy, seizures, and apnea.

Choice A, petechiae, refers to small, pinpoint, red or purple spots on the skin caused by bleeding under the skin. It is not a common manifestation of hypoglycemia. Choice C, increased muscle tone, is not a common manifestation of hypoglycemia and may indicate other conditions such as cerebral palsy. Choice D, abdominal distention, may indicate other conditions such as intestinal obstruction or infection, but is not a common manifestation of hypoglycemia.

A. Monitor the rectal temperature every 4 hr. B. Administer broad-spectrum antibiotics. C. Cleanse the site with povidone-iodine. D. Prepare for surgical closure after 72 hr

Correct Answer is B

Explanation

A. Monitor the rectal temperature every 4 hr: Rectal temperature measurement is contraindicated in this newborn due to the risk of trauma to the spinal cord or irritation of the leaking sac. Axillary temperature monitoring is a safer alternative.

B. Administer broad-spectrum antibiotics: Broad-spectrum antibiotics help prevent infection from organisms entering through the exposed or leaking sac. This is a priority intervention to ensure the safety of the newborn.

C. Cleanse the site with povidone-iodine: Povidone-iodine is not recommended for cleansing the sac, as it can cause irritation or toxicity. Instead, the sac should be kept clean and moist with a sterile, saline-soaked dressing.

D. Prepare for surgical closure after 72 hr: Surgical closure of the defect is typically performed within 24 to 48 hours after birth to minimize infection risk and prevent further damage to neural tissue. Waiting beyond this window is not standard practice for a leaking myelomeningocele.

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A nurse is admitting a client who is in active labor and has had two prior cesarean births. The nurse should identify that the client is at an increased risk for which of the following complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a newborn whose mother had gestational diabetes mellitus. The nurse should monitor for which of the following findings as a manifestation of hypoglycemia?

Correct Answer is B

Explanation

A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?

Correct Answer is B

Explanation

A nurse is assessing a client who has preeclampsia during a prenatal visit. Which of the following findings should the nurse report to the provider?

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