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
A history of cesarean section for fetal distress is an indication for a repeat cesarean section in subsequent pregnancies, as the risk of recurrence of fetal distress is higher. A trial of labor after cesarean (TOLAC) may be attempted in some cases, but a planned cesarean section is often recommended.
Option B is incorrect because fear of natural childbirth is not a medical indication for a cesarean section.
Option C is incorrect because gestational diabetes does not typically require a cesarean section unless other complications arise, such as fetal macrosomia or failed induction of labor.
Option D is incorrect because a history of cephalopelvic disproportion with the first pregnancy may not necessarily require a cesarean section in subsequent pregnancies. A trial of labor may be attempted, depending on the circumstances.
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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