Which of the following patients is most at risk for uterine rupture?
A G3P2 whose youngest child is 3 years old.
A G2P1 who has had one prior lower transverse cesarean section.
A CS4 who has had three prior lower transverse cesarean sections.
AG4P3 whose last baby was born at term gestation.
The Correct Answer is C
A CS4 who has had three prior lower transverse cesarean sections is at the highest risk for uterine rupture. The risk of uterine rupture increases with each subsequent cesarean section, and a history of three or more prior lower transverse cesarean sections is considered a significant risk factor for uterine rupture.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Based on the provided information, the probable diagnosis for the spontaneous abortion in this woman would be a threatened abortion, since the cervix is closed and there is no evidence of expulsion of fetal or placental tissue. A threatened abortion is defined as vaginal bleeding occurring before the 20th week of gestation, with a closed cervical os, and no expulsion of fetal or placental tissue.
The other types of spontaneous abortion are defined as follows:
B. Inevitable abortion: vaginal bleeding and cramping with an open cervical os, with or without expulsion of fetal or placental tissue
C. Missed abortion: fetal demise without expulsion of fetal tissue, and may be associated with a closed cervical os and absence of uterine contractions
D. Incomplete abortion: partial expulsion of fetal or placental tissue, with or without vaginal bleeding, and may be associated with an open cervical os and uterine contractions
Correct Answer is A
Explanation
The signs described are consistent with Meconium Aspiration Syndrome (MAS). Meconium aspiration occurs when the fetus has a bowel movement before or during delivery and inhales meconium-stained amniotic fluid into the lungs. This can lead to airway obstruction, chemical pneumonia, and respiratory distress, which may progress to respiratory failure, persistent pulmonary hypertension, and death. The presence of coarse breath sounds, acidosis, and the honeycomb appearance on X-ray are all signs of MAS.
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