In breech delivery, the midwife is advised to keep her hands off the breech as it progressively descends so as to

Correct Answer: D

Rationale: The correct answer is D: Prevent excessive traction being applied. This is because in a breech delivery, excessive traction can lead to complications such as fetal injuries or umbilical cord prolapse. The midwife should avoid pulling on the baby's legs or body to prevent undue stress on the baby. The other choices are incorrect because: A: Ascertain the fetal wellbeing in utero - this is typically done through other means such as fetal monitoring. B: Allow enough room for the fetus to pass - this should be done by ensuring proper positioning and allowing natural descent. C: Allow gravitating descent of the fetus - this is not a recommended practice as it can cause complications.

Correct Answer: C

Rationale: The correct answer is C: Importance of early ambulation. After a cesarean section, early ambulation is crucial to prevent complications like blood clots and promote circulation. It helps prevent post-operative complications. Choice A is important for respiratory health but not the priority right after surgery. Choice B focuses on perineal care which is important but not the immediate priority. Choice D is important, but recognizing signs of infection can wait until the client is more stable. Early ambulation is key to preventing complications and aiding in recovery.

Correct Answer: C

Rationale: The correct answer is C because establishing an intravenous line is essential for immediate access to administer fluids, medications, and blood products during the emergency cesarean section. This step ensures that the patient's vital signs can be supported, and any emergent interventions can be readily delivered. A: While informed consent is important, in an emergency situation, the priority is to ensure the patient's immediate medical needs are met. B: Inserting a Foley's catheter may be necessary during the procedure, but it is not the most critical assessment prior to the cesarean section. D: Shaving the perineal area is not a priority in an emergency situation and may be done during the preparation for surgery.

Correct Answer: D

Rationale: The correct answer is D because additional nursing interventions are necessary to ensure an uncomplicated postpartum period. After an assisted vaginal delivery, the mother may experience increased pain, perineal trauma, and a higher risk of postpartum hemorrhage. Nursing interventions such as pain management, wound care, monitoring for signs of infection, and emotional support are crucial for the mother's recovery. A is incorrect because both vacuum extractors and forceps can cause trauma to the baby and mother's perineum, and the safety of one over the other depends on various factors. B is incorrect as the development of a cephalhematoma is not a normal expected outcome of assisted vaginal delivery and should be monitored and managed appropriately if it occurs. C is incorrect as the use of instruments during childbirth, while not as common as spontaneous vaginal deliveries, is not rare and can be necessary in certain situations to ensure the safety of the mother and baby.

Correct Answer: D

Rationale: The correct answer is D because a client is declared fit for a vaginal birth after cesarean section if their previous delivery was via spontaneous vertex delivery. This indicates that the client has successfully given birth vaginally before, reducing the risk associated with a vaginal birth after cesarean section. A, B, and C are incorrect: A: Cephalopelvic disproportion was the reason for the previous C/S, indicating potential difficulty in vaginal delivery. B: Confirmation of a multiple pregnancy does not impact the client's eligibility for a vaginal birth after cesarean section. C: Previous cesarean section does not necessarily mean the client is fit for a vaginal birth after cesarean section.