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.".

Answer and Explanation

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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Correct Answer is C

Explanation

Choice A reason:

Transferring the newborn to the NICU is not the best action to take next, because it does not address the immediate problem of low blood sugar. The newborn may need to be transferred to the NICU later, depending on the cause and severity of the hypoglycemia, but the first priority is to raise the blood glucose level.

Choice B reason:

Calling the lab for a STAT blood glucose level is not the best action to take next, because it will delay the treatment of hypoglycemia. The glucometer reading is a reliable indicator of low blood sugar, and waiting for a lab confirmation will waste valuable time. The nurse should act on the glucometer reading and initiate treatment as soon as possible.

Choice C reason:

Initiating breastfeeding is the best action to take next, because it will provide the newborn with a source of glucose that can raise the blood sugar level quickly. Breastfeeding also has other benefits for the newborn, such as promoting bonding, providing antibodies, and reducing the risk of infection. Breastfeeding should be initiated within the first hour of life for all newborns, unless contraindicated.

Choice D reason:

Recognizing this as a normal reading and documenting it is not the best action to take next, because it is not a normal reading for a 2 hour old newborn. The normal range of blood glucose for a newborn is 40 to 150 mg/dL. A reading of 32 mg/dL indicates hypoglycemia, which can have serious consequences for the newborn's brain development and function. Hypoglycemia should be treated promptly and documented accordingly.

A. Using illicit drugs B. Unknown C. Being in nursing school D. Drinking too much.

Correct Answer is B

Explanation

Choice A reason:

Using illicit drugs is not a known cause of congenital hip dysplasia. Illicit drugs may have other harmful effects on the baby, but they do not affect the formation of the hip joint.

Choice B reason:

Unknown. The exact cause of congenital hip dysplasia is not clear. Both genetic and environmental factors seem to play a role in the development of the disorder. Some risk factors include being female, firstborn, breech position, family history, and tight swaddling.

Choice C reason:

Being in nursing school is not a cause of congenital hip dysplasia. This is an irrelevant and incorrect choice.

Choice D reason:

Drinking too much is not a cause of congenital hip dysplasia. Alcohol consumption during pregnancy may increase the risk of fetal alcohol syndrome and other complications, but it does not affect the formation of the hip joint.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse checks the blood sugar of a 2 hour old newborn, and the glucometer reading is 32 mg/dl. Which action should the nurse take next?

Correct Answer is C

Explanation

What causes congenital hip dysplasia?

Correct Answer is B

Explanation

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