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 A: “The discharge that you are describing is normal at this time.” This is because the client is experiencing lochia serosa, which is a brownish discharge that occurs from about day 4 to day 10 postpartum.
Lochia serosa is composed of old blood, serum, leukocytes, and tissue debris.
It indicates that the placental site is healing and the uterus is involuting.
Choice B is wrong because fever is a sign of infection, not normal lochia.
Choice C is wrong because ovulation usually does not resume until 6 weeks postpartum for nonbreastfeeding women and later for breastfeeding women.
Choice D is wrong because iron supplements do not affect lochia color or amount.
Correct Answer is A
Explanation
This means that the uterus is constantly contracted and does not relax between contractions.This can cause the placenta to separate from the uterine wall, which is called placental abruption or abruptio placentae.Placental abruption can deprive the baby of oxygen and nutrients and cause heavy bleeding in the mother.
Choice B is wrong because strong uterine contractions every 3-4 minutes are normal during labor and do not indicate placental abruption.
Choice C is wrong because bile-colored vomitus is not a sign of placental abruption, but rather a sign of hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy.
Choice D is wrong because fetal heart rate acceleration with fetal activity is a normal finding and indicates a healthy baby.Placental abruption can cause fetal distress and a decrease in fetal heart rate.
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