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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Attachment phase is not one of Rubin's phases of role attachment. Rubin's theory of maternal role adaptation describes three stages that the mother goes through during the postpartum period: taking in, taking hold and letting go.
Choice B reason:
Letting go phase is the last stage of Rubin's theory of role attachment. It occurs when the mother accepts her new role and gives up her old roles. She also comes to terms with the reality of the birthing experience and the characteristics of her baby.
Choice C reason:
Taking hold phase is the second stage of Rubin's theory of role attachment. It occurs when the mother becomes interested in caring for the infant and learning about her baby and herself. She may be critical about her care-giving abilities and need positive reinforcement.
Choice D reason:
Taking in phase is the first stage of Rubin's theory of role attachment. It occurs right after the birth of the child, when the mother is passive and focused on her own needs, especially sleeping and eating. She may have limited interactions with her infant and prefer to talk about her experiences during labor, birth, and pregnancy. This matches the description of the new mother in the question, so this is the correct answer.
Correct Answer is B
Explanation
Choice A reason:
Contractions every 3 to 4 min are not a definitive sign of labor, as they can also occur in false labor or Braxton Hicks contractions. These are irregular and do not cause cervical changes.
Choice B reason:
Cervical dilation is the most reliable indicator of true labor, as it shows that the uterus is contracting effectively and preparing for delivery. Cervical dilation is measured in centimeters from 0 to 10, with 10 being fully dilated.
Choice C reason:
Pain just above the navel is not a sign of labor, but rather a possible sign of an abdominal problem such as appendicitis or gallbladder disease. Labor pain usually starts in the lower back and radiates to the abdomen and thighs.
Choice D reason:
Amniotic fluid in the vaginal vault is not a conclusive sign of labor, as it can also result from a premature rupture of membranes (PROM) or a high leak of amniotic fluid. PROM occurs when the amniotic sac breaks before the onset of labor, which can increase the risk of infection and complications for the mother and the baby.
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