A nurse is caring for a client who wants to know if it is possible to have a vaginal birth after a cesarean birth (VBAC). Which of the following statements by the nurse is appropriate?
"There are so many variables that you'll have to ask your provider.".
"A repeat cesarean section would be safer for both you and your baby.".
"The primary consideration is what type of incision you had.".
"It's too soon for you to be worrying about that now.".
The Correct Answer is C
Choice A reason:
This statement is not appropriate because it does not provide any information or education to the client who wants to know about VBAC. It also implies that the nurse does not have any knowledge or expertise on the topic, which may undermine the client's trust and confidence in the nurse.
Choice B reason:
This statement is not appropriate because it is not evidence-based and may discourage the client from considering VBAC as a possible option. According to research, VBAC is associated with fewer complications than an elective repeat C-section for many women who had prior
cesarean deliveries. A repeat C-section also carries risks such as infection, bleeding, injury to organs, and placental problems in future pregnancies.
Choice C reason:
This statement is appropriate because it is accurate and informative. The type of uterine incision used for the prior C-section is one of the most important factors that determine the eligibility and success of VBAC. A low transverse or low vertical incision is usually compatible with VBAC, while a high vertical (classical) incision is not recommended due to the risk of uterine rupture.
Choice D reason:
This statement is not appropriate because it dismisses the client's concern and does not address their question. It also implies that the nurse does not respect the client's autonomy and right to make informed decisions about their care. The client may benefit from learning about VBAC early in their pregnancy so that they can weigh the pros and cons and discuss their preferences with their provider.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Drying the newborn's skin thoroughly is the nurse's priority after assuring a patent airway because it reduces evaporative heat loss by the newborn and prevents cold stress. Cold stress can lead to hypoxia, hypoglycemia, acidosis, and increased bilirubin levels. Drying the newborn also stimulates breathing and crying, which are signs of a healthy newborn.
Choice B reason:
Administering phytonadione IM is not the nurse's priority because it is not an immediate life-saving intervention. Phytonadione is given to prevent hemorrhagic disease of the newborn, which is caused by vitamin K deficiency. However, this condition usually occurs after the first day of life, so administering phytonadione can be delayed until after the initial assessment and stabilization of the newborn.
Choice C reason:
Documenting the Apgar score is not the nurse's priority because it is not an action that directly affects the newborn's well-being. The Apgar score is a tool to assess the newborn's condition at 1 and 5 minutes after birth based on five criteria: heart rate, respiratory effort, muscle tone, reflex irritability, and color. The Apgar score can help guide the nurse's interventions, but it is not more important than providing care to the newborn.
Choice D reason:
Applying identification bands is not the nurse's priority because it is not an urgent or essential action. Identification bands are used to ensure the safety and security of the newborn and prevent errors or mix-ups. However, applying identification bands can be done after the newborn is dried, warmed, and assessed for any problems.
Correct Answer is D
Explanation
Choice A:
Two arteries and two veins. This is incorrect because the umbilical cord normally has only three blood vessels: one vein and two arteries. Having four blood vessels is a rare anomaly that can be associated with congenital defects. •
Choice B:
Two veins and one artery. This is incorrect because the umbilical cord normally has only one vein and two arteries. Having two veins and one artery is another rare anomaly that can also be associated with congenital defects. •
Choice C:
One artery and one vein. This is incorrect because the umbilical cord normally has two arteries and one vein. Having only one artery and one vein is a common anomaly that occurs in about 1% of singleton pregnancies and 5% of twin pregnancies. It can be associated with intrauterine growth restriction, congenital anomalies, and perinatal mortality. •
Choice D:
Two arteries and one vein. This is correct because the umbilical cord normally has two arteries and one vein. The vein carries oxygenated blood from the placenta to the fetus, while the arteries carry deoxygenated blood from the fetus to the placenta. The umbilical cord also contains Wharton's jelly, which is a gelatinous substance that protects the blood vessels from compression.
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