A woman who has had multiple cesarean sections is in labor. What is the most important complication to monitor for?

Correct Answer: A

Rationale: Correct Answer: A: Uterine rupture Rationale: 1. History of multiple cesarean sections increases the risk of uterine rupture. 2. Uterine rupture is a life-threatening complication for both mother and baby. 3. Signs include sudden severe abdominal pain, fetal distress, and hemodynamic instability. 4. Immediate intervention is crucial to prevent adverse outcomes. Summary: B: Precipitous labor - Quick labor is not specifically associated with multiple cesarean sections. C: Maternal hypotension - Important but not the most critical complication in this scenario. D: Fetal malpresentation - While important, it is not the most immediate concern compared to uterine rupture.

Correct Answer: B

Rationale: The correct answer is B: Healthy People 2020. This is because Healthy People 2020 provides specific objectives related to maternal and child health, including reducing fetal death outcomes during delivery. The goals and targets outlined in Healthy People 2020 are evidence-based and nationally recognized, making it a reliable guide for setting healthcare goals. A: WHO Maternal care guidelines focus more broadly on global maternal health issues and may not provide specific goals related to reducing fetal death outcomes during delivery. C: AWHONN white papers may offer valuable insights and recommendations, but they are not as comprehensive or widely recognized as the goals outlined in Healthy People 2020. D: State Practice Acts govern the scope of practice for healthcare providers in a specific state, but they do not typically include specific goals related to reducing fetal death outcomes during delivery.

Correct Answer: D

Rationale: The correct answer is D, instructing the pregnant woman to get up slowly and avoid standing for long periods. This is because during pregnancy, blood pressure can drop when standing up quickly, leading to dizziness and fainting. Getting up slowly allows the body to adjust gradually, preventing a sudden drop in blood pressure. Standing for long periods can worsen these symptoms, so it is important to avoid prolonged standing. A: Lying down flat on the back immediately can worsen symptoms in this case by reducing blood flow to the brain. B: Standing up quickly can exacerbate dizziness and fainting by causing a sudden drop in blood pressure. C: Drinking a large amount of water may not address the underlying issue of postural hypotension and could potentially worsen symptoms by increasing blood volume without addressing the drop in blood pressure.

Correct Answer: A

Rationale: Step 1: Folic acid is crucial for neural tube development in the fetus. Step 2: Spinal cord defects are a type of neural tube defect. Step 3: Statement A directly links folic acid to preventing spinal cord defects. Therefore, choice A is correct as it demonstrates an understanding of the specific benefit of folic acid during pregnancy. Choices B, C, and D are incorrect as they do not accurately reflect the primary role of folic acid in pregnancy.

Correct Answer: A

Rationale: The correct answer is A: Count fetal movements and report a decrease of more than 10 movements per day. This recommendation is evidence-based and aligns with guidelines for monitoring fetal well-being. Counting fetal movements helps assess fetal health, and a decrease in movements could indicate potential issues like fetal distress. Reporting a decrease of more than 10 movements per day ensures timely intervention if needed. Choice B is incorrect because waiting until after 32 weeks could delay necessary intervention if there are concerns about fetal movements. Choice C is incorrect as it dismisses the importance of monitoring fetal movements altogether. Choice D is incorrect as there is no requirement to always lie down or restrict monitoring to only after meals, which could lead to missed opportunities for detecting potential problems.