When reviewing the medical record of a postpartum client, the nurse notes that the client has experienced a fourth-degree laceration.
The nurse understands that the laceration extends to which area?.
Superficial structures above the muscle.
Through the anterior rectal wall.
Through the anal sphincter muscle.
Through the perineal muscles.
The Correct Answer is D
The correct answer is choice D.
Choice A rationale:
Superficial structures above the muscle refer to first-degree lacerations, which only involve the skin of the perineum and vaginal mucosa.
Choice B rationale:
A fourth-degree laceration does not stop at the anterior rectal wall. It extends through the anal sphincter and into the rectal mucosa.
Choice C rationale:
While a fourth-degree laceration does involve the anal sphincter muscle, it also includes the underlying rectal mucosa.
Choice D rationale:
A fourth-degree laceration involves the perineal muscles, the anal sphincter, and the underlying rectal mucosa.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice B.
Choice A rationale:
Massaging the uterus does not increase its boggy nature, but rather helps it contract and become firm, reducing the risk of postpartum hemorrhage.
Choice B rationale:
Massaging the uterus helps constrict the uterine blood vessels, which reduces bleeding after the placenta has been expelled.
Choice C rationale:
Massaging the uterus has no effect on the likelihood of conducting an episiotomy, which is a surgical incision made during childbirth.
Choice D rationale:
Massaging the uterus does not remove pieces left attached to the uterine wall. This would require a manual or surgical procedure.
Correct Answer is D
Explanation
The correct answer is choice D.
Choice A rationale:
This statement describes the second stage of labor, not the third. The second stage begins with full cervical dilation and ends with the delivery of the fetus.
Choice B rationale:
The third stage of labor does not end 48 hours after the delivery of the placenta. This choice is incorrect.
Choice C rationale:
While it’s important to ensure no placental fragments remain, the third stage of labor technically ends with the delivery of the placenta, not at this later point.
Choice D rationale:
This is the correct definition of the third stage of labor. It begins with the delivery of the fetus and ends with the delivery of the placenta.
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