Which of the following are contraindications for VBAC? (Select All that Apply.).

A prior vaginal delivery.

Gestation of 42 weeks.

Maternal obesity.

One prior cesarean delivery.

Macrosomic fetus.

Answer and Explanation

Correct Answer : C,E

Choice A reason:

A prior vaginal delivery is not a contraindication for VBAC. In fact, it is a positive predictor of success for VBAC, as it indicates that the woman has a proven pelvis and can tolerate labor.

Choice B reason:

The gestation of 42 weeks is not a contraindication for VBAC. However, it is associated with an increased risk of stillbirth while awaiting spontaneous labor, which should be balanced against the risks of induction of labor or elective repeat cesarean.

Choice C reason:

Maternal obesity is a relative contraindication for VBAC. It is associated with a lower success rate of VBAC, a higher risk of uterine rupture, and a higher risk of maternal and neonatal complications. The decision to attempt VBAC in obese women should be made on a case-by-case basis by a senior obstetrician.

Choice D reason:

One prior cesarean delivery is not a contraindication for VBAC. Most women who have had one prior lower segment cesarean delivery are eligible for VBAC, as the risk of uterine rupture is low (0.5%) and the success rate is high (72-75%).

Choice E reason:

A macrosomic fetus is a relative contraindication for VBAC. It is associated with a lower success rate of VBAC, a higher risk of uterine rupture, and a higher risk of shoulder dystocia and birth trauma. The decision to attempt VBAC in women with suspected macrosomia should be made on a case-by-case basis by a senior obstetrician.

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Correct Answer is C

Explanation

Choice A reason:

Infection is not prevented by vitamin K administration. Vitamin K is needed for blood clotting, not for fighting infections. Newborns are given vitamin K injections to prevent a serious disease called hemorrhagic disease of the newborn (HDN), which is caused by bleeding in the brain or other organs.

Choice B reason:

Hyperbilirubinemia is not prevented by vitamin K administration. Hyperbilirubinemia is a condition in which there is too much bilirubin in the blood, causing jaundice. Bilirubin is a yellow pigment that is produced when red blood cells break down. Vitamin K does not affect the production or breakdown of bilirubin.

Choice C reason:

Bleeding is prevented by vitamin K administration. Vitamin K is needed for the synthesis of several clotting factors that help stop bleeding when there is an injury. Newborns have very low levels of vitamin K in their bodies because they do not get enough from the placenta or breast milk, and they do not have enough bacteria in their intestines to produce it. This puts them at risk for VKDB, which can cause life-threatening bleeding in the brain or other organs.

Choice D reason:

Potassium deficiency is not prevented by vitamin K administration. Potassium is an electrolyte that is important for nerve and muscle function, as well as fluid balance. Vitamin K does not affect the absorption or excretion of potassium.

A. Scant scalp hair B. Copious vernix C. Increased subcutaneous fat D. Dry, cracked skin

Correct Answer is D

Explanation

Choice A reason:

Scant scalp hair is not an expected finding for a newborn who is post-term. Scant scalp hair is more common in preterm infants who have not developed fully.

Choice B reason:

Copious vernix is not an expected finding for a newborn who is post-term. Vernix is a white, cheesy substance that covers the skin of the fetus and protects it from the amniotic fluid. Vernix is usually abundant in preterm infants and decreases as gestation progresses.

Choice C reason:

Increased subcutaneous fat is not an expected finding for a newborn who is post-term. Increased subcutaneous fat is a sign of adequate nutrition and growth, which is more likely in term infants. Post-term infants may have reduced subcutaneous fat due to placental insufficiency and decreased nutrient supply.

Choice D reason:

Dry, cracked skin is an expected finding for a newborn who is post-term. Dry, cracked skin is a result of prolonged exposure to the amniotic fluid, which causes dehydration and desquamation of the skin. Post-term infants may also have meconium staining on their skin due to fetal distress.

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Which of the following are contraindications for VBAC? (Select All that Apply.).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a new mother about the purpose of administering vitamin K to her newborn following delivery. The nurse should explain that the purpose of administering vitamin K is to prevent which of the following complications?

Correct Answer is C

Explanation

A nurse is collecting data from a newborn immediately after delivery by a client who was at 42 weeks of gestation. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

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