A nurse is caring for a patient who is 40 weeks pregnant.
Which finding would indicate the need for a cesarean delivery?
The woman has extremely slender hips.
The woman’s fetus is in a transverse lie.
The woman’s fetus is hyperactive.
The woman has a posterior cervix.
The Correct Answer is B
A transverse lie means that the baby is lying sideways across the uterus, instead of head-down or breech.
This position makes vaginal delivery impossible and increases the risk of umbilical cord prolapse, which can compromise fetal oxygen supply. Therefore, a cesarean delivery is indicated for a fetus in a transverse lie.
Choice A is wrong because having extremely slender hips does not necessarily mean that a woman cannot deliver vaginally.
The size and shape of the pelvis, not the external appearance, determines the adequacy of the birth canal. A trial of labor may be attempted for women with borderline pelvic measurements.
Choice C is wrong because fetal hyperactivity is not a reason for a cesarean delivery.
Fetal movements may vary depending on the time of day, maternal activity, maternal blood sugar level, and other factors. Fetal well-being can be assessed by fetal heart rate monitoring and biophysical profile.
Choice D is wrong because having a posterior cervix does not indicate the need for a cesarean delivery.
A posterior cervix means that the cervix is tilted toward the back of the uterus, which may make cervical dilation slower and more painful. However, with adequate contractions and maternal pushing, the cervix can move to an anterior position and allow vaginal delivery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice B. Test the patient’s vaginal secretions with nitrazine paper.
This is because the patient may be leaking amniotic fluid rather than urine, and nitrazine paper can help differentiate between the two by testing the pH level.Amniotic fluid is alkaline and will turn the paper blue, while urine is acidic and will turn the paper yellow.
Choice A is wrong because checking the patient’s bladder for distention will not help determine if the patient is leaking amniotic fluid or urine.
Choice C is wrong because checking the patient’s urine for glucose content will not help determine if the patient is leaking amniotic fluid or urine.
Glucose content may be elevated in patients with gestational diabetes, but this is not related to the patient’s complaint.
Choice D is wrong because obtaining a specimen of the patient’s vaginal secretions for culture will not help determine if the patient is leaking amniotic fluid or urine.
Culture may be done to check for infections, but this is not the initial action that the nurse should take.
Correct Answer is C
Explanation
This is because the first priority for a pregnant woman with acute abdominal pain is to assess the fetal well-being and rule out any obstetric complications such as placental abruption, uterine rupture, or preterm labor.Fetal heart tones can indicate the presence and viability of the fetus and alert the nurse to any signs of fetal distress or hypoxia.
Choice A: Obtain a full history is wrong because it is not the most urgent action.
A full history can provide valuable information about the possible causes of abdominal pain, but it should not delay the assessment of fetal status and maternal vital signs.
Choice B: Examine the cervix for dilation is wrong because it can be harmful in some cases.A digital cervical examination should be avoided until placenta previa is ruled out by ultrasound, as it can cause bleeding and worsen the condition.
Moreover, cervical dilation alone does not indicate the cause or severity of abdominal pain.
Choice D: Palpate for uterine contraction frequency is wrong because it is not the most reliable method to assess labor.Uterine contractions can be measured by external tocodynamometry or internal intrauterine pressure catheter, which can provide more accurate and objective data than manual palpation.
Furthermore, uterine contractions do not necessarily indicate labor, as they can also be caused by other conditions such as dehydration, infection, or irritable uterus.
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