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A delirious client is admitted to the hospital in labor. She has had no prenatal care and vials of crack cocaine are found in her pockets.
The nurse monitors this client carefully for which of the following intrapartum complications?

A.

Prolonged labor.

B.

Prolapsed cord.

C.

Abruptio placentae.

D.

Retained placenta

E.

Retained placenta

Answer and Explanation

The Correct Answer is C

Choice A rationale

Prolonged labor is not directly linked to drug use and does not present as an immediate complication.

 

Choice B rationale

Prolapsed cord is not associated with substance abuse and lacks direct connection to this scenario.

Choice C rationale

Cocaine use heightens the risk of abruptio placentae, a serious condition where the placenta detaches prematurely.

 

Choice D rationale

Retained placenta is a concern but less likely than abruptio placentae in the context of cocaine use.


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Correct Answer is A

Explanation

Choice A rationale

A 37-year-old patient with obesity and pregnancy-induced hypertension presents multiple risk factors. Advanced maternal age, obesity, and hypertension collectively increase the

likelihood of complications such as preeclampsia, gestational diabetes, and cesarean delivery, necessitating close monitoring and management.

Choice B rationale

A patient with preexisting hypertension and twins is indeed high-risk due to the combined strain on the cardiovascular system and potential for preterm labor or other complications

associated with multiple gestations. However, the presence of pregnancy-induced hypertension and obesity in the first patient poses a slightly higher cumulative risk.

Choice C rationale

A 16-year-old patient with newly diagnosed gestational diabetes is at increased risk, particularly because of age and the potential for poorly managed diabetes leading to

complications. However, this scenario presents fewer immediate cumulative risks compared to older age and existing hypertension.

Choice D rationale

A 28-year-old patient who had a premature birth three years prior must be monitored for signs of recurrent preterm labor. Yet, this history alone does not present as high a cumulative

risk as older maternal age, obesity, and pregnancy-induced hypertension. .

Correct Answer is B

Explanation

Choice A rationale

Prior amniotic fluid leakage is not a required criterion for amniotomy. The main concern is cervical readiness and fetal head position, not previous leakage.

Choice B rationale

The fetal head engaged in the maternal pelvis ensures proper pressure and position for safe amniotomy. Engagement reduces the risk of umbilical cord prolapse and injury.

Choice C rationale

Certification of the nurse for amniotomy is not a standard criterion. The procedure is performed by qualified professionals, but certification isn't a prerequisite for the procedure to be scheduled.

Choice D rationale

Ultrasound to check the umbilical cord's position isn't a standard pre-amniotomy criterion. While it can be useful, the primary concern is the fetal head engagement and cervical readiness.

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