A nurse is reviewing the medical records of four clients who are pregnant and planning to have a vaginal birth after cesarean (VBAC).

Which of the following clients has the highest risk of uterine rupture during labor?

A client who had a low transverse incision for her previous cesarean delivery.

A client who had a vertical incision on her uterus but a low transverse incision on her skin for her previous cesarean delivery.

A client who had two previous cesarean deliveries with low transverse incisions and is now 39 weeks gestation.

A client who had one previous cesarean delivery with a low transverse incision and is now 41 weeks gestation.

Answer and Explanation

The Correct Answer is B

A client who had a vertical incision on her uterus but a low transverse incision on her skin for her previous cesarean delivery has the highest risk of uterine rupture during labor. This is because a vertical incision on the uterus weakens the uterine wall and increases the risk of rupture during contractions.

Normal ranges for uterine rupture during labor are 0.2% to 1.5% for women who have had one previous cesarean delivery with a low transverse incision and 0.9% to 3.7% for women who have had two or more previous cesarean deliveries with low transverse incisions.

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Correct Answer is A

Explanation

The correct answer is choice A.Retained placental fragments are the most common cause of subinvolution.Subinvolution is a condition where the uterus does not return to its normal size after childbirth.Retained placental fragments prevent the uterus from contracting properly and cause prolonged bleeding and infection.

Choice B is wrong because infection is not the most common cause of subinvolution, but it can be an aggravating factor.Infection can cause inflammation and interfere with the healing of the uterine lining.

Choice C is wrong because uterine fibroids are not the most common cause of subinvolution, but they can be a predisposing factor.Uterine fibroids are benign tumors that can distort the shape of the uterus and impair its contraction.

Choice D is wrong because multiparity is not the most common cause of subinvolution, but it can be a predisposing factor.Multiparity means having given birth more than once, which can weaken the uterine muscles and reduce their ability to contract.

Normal ranges for uterine involution are as follows:

• Uterus weight: decreases from about 1000 g at delivery to about 60 g at six weeks postpartum.

• Uterus height: decreases from about 20 cm above the pubic bone at delivery to about 12 cm at one week postpartum, and then descends into the pelvis by six weeks postpartum.

• Uterus size: decreases from about 20 times its normal size at delivery to about its normal size at six weeks postpartum.

A. Encourage the client to verbalize their feelings and fears B. Provide a quiet and calm environment for the client C. . Validate the client’s perception of reality and offer reassurance D. Avoid confronting or challenging the client’s hallucinations.

Correct Answer is A

Explanation

Normal ranges for postpartum psychosis are not applicable, as it is a rare and severe psychiatric disorder that affects 1-2 per 1,000 women.It usually occurs within the first 2 weeks after delivery, but can occur up to 12 months postpartum.

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A nurse is reviewing the medical records of four clients who are pregnant and planning to have a vaginal birth after cesarean (VBAC). Which of the following clients has the highest risk of uterine rupture during labor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the most common cause of subinvolution?

Correct Answer is A

Explanation

A nurse is planning care for a client who has postpartum psychosis and is experiencing hallucinations. Which of the following interventions should the nurse include in the plan?

Correct Answer is A

Explanation

A nurse is caring for a postpartum client who had a difficult labor and delivery. The client expresses frustration and disappointment with her birth experience. Which of the following actions should the nurse take?

The nurse is palpating a patient’s uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis?

A nurse is reviewing the medical records of four clients who are pregnant and planning to have a vaginal birth after cesarean (VBAC). Which of the following clients has the highest risk of uterine rupture during labor?

A client is concerned about the risk factors for pre-term labor. Which of the following factors should the nurse include in the discussion?

A nurse is assessing a postpartum client who received Rho (D) immune globulin (RhoGAM) before discharge. Which statement by the client indicates a need for further teaching?

A nurse is assessing a postpartum client who delivered her second baby 3 days ago. The client says, “I feel sad that my older child will not get as much attention from me as before.” The nurse recognizes that the client is in which phase of maternal role attainment?

A nurse is caring for a postpartum client who has been diagnosed with postpartum depression (PPD). Which of the following interventions should be included in her plan of care?

A nurse is providing discharge teaching to a postpartum client who had a vaginal delivery with an episiotomy. The client asks, “How can I take care of myself at home?” Which of the following responses should the nurse give?

A nurse is reviewing the medical records of four clients who are pregnant and planning to have a vaginal birth after cesarean (VBAC).

Which of the following clients has the highest risk of uterine rupture during labor?