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 D
Explanation
The correct answer is choice D. Chronic alcohol use.
Choice A rationale:
Active herpes simplex infection during pregnancy can lead to neonatal herpes, which is a serious condition, but it does not cause the symptoms described.
Choice B rationale:
Chronic cocaine use during pregnancy can lead to premature birth and low birth weight, but it does not typically result in the specific symptoms described.
Choice C rationale:
Folic acid deficiency during pregnancy can lead to neural tube defects, which can cause a range of symptoms, but not the specific ones described.
Choice D rationale:
Chronic alcohol use during pregnancy can lead to Fetal Alcohol Syndrome, which includes slow growth, cognitive and intellectual deficits, and the facial abnormalities described.
Correct Answer is A
Explanation
The correct answer is choice A.
Choice A rationale:
The GTPAL system stands for Gravida, Term, Preterm, Abortions, and Living children. In this case, the woman has been pregnant 4 times (Gravida 4), has had one term birth (Term 1), one preterm birth (Preterm 1), one abortion/miscarriage (Abortions 1), and one living child (Living 1). Therefore, the correct classification is 4, 1, 1, 1, 1.
Choice B rationale:
This choice incorrectly classifies the number of pregnancies (Gravida should be 4, not 3) and does not account for the preterm birth or the number of living children.
Choice C rationale:
This choice overcounts the number of term births and living children.
Choice D rationale:
This choice incorrectly classifies the number of pregnancies (Gravida should be 4, not 3) and overcounts the number of living children.
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