What is the most common cause of placenta accreta?

Correct Answer: C

Rationale: Placenta accreta is a serious pregnancy complication where the placenta attaches too deeply into the uterine wall. The most common cause of placenta accreta is a previous cesarean birth (Choice C). This is because during a cesarean section, the placenta can grow into the scar tissue from the previous surgery, making it difficult to detach during delivery. This increases the risk of placenta accreta in subsequent pregnancies. Choice A, malnutrition, is not a common cause of placenta accreta. While a poor diet can impact pregnancy outcomes, it is not directly linked to the development of placenta accreta. Choice B, smoking, is also not a common cause of placenta accreta. Smoking during pregnancy can lead to a variety of complications, but it is not a known risk factor for placenta accreta specifically. Choice D, obesity, is not the most common cause of placenta accreta, although it can be a risk factor. Obesity can lead to various pregnancy complications, but it is not as directly linked to placenta accreta as a previous cesarean birth. In conclusion, the most common cause of placenta accreta is a previous cesarean birth. It is important for healthcare providers to be aware of this risk factor in order to properly monitor and manage pregnancies at risk for placenta accreta.

Correct Answer: A

Rationale: Complications from cocaine and methamphetamine use can be severe and potentially life-threatening. A common complication of using these drugs is seizures. Stimulant drugs like cocaine and methamphetamine can disrupt the normal electrical activity in the brain, leading to seizures. Seizures can range from mild to severe and can have serious consequences if not treated promptly. Hypotonic contractions (choice B) are not typically associated with cocaine and methamphetamine use. These drugs are more likely to cause hypertonic contractions, which can lead to complications during labor and delivery. Prolonged second stage labor (choice C) is not a common complication of cocaine and methamphetamine use. However, stimulant drugs can increase the risk of preterm labor and delivery, as well as other complications during pregnancy. Prolonged first stage labor (choice D) is also not a typical complication of cocaine and methamphetamine use. These drugs can cause vasoconstriction, which may affect the progression of labor, but it is not typically associated with prolonging the first stage of labor. In conclusion, seizures are a common and serious complication of cocaine and methamphetamine use due to their effects on brain function. Choices B, C, and D are incorrect because they do not accurately reflect the potential complications associated with these drugs.

Correct Answer: C

Rationale: The correct answer is C: Contraction stress test. When assessing a client's status during labor, it is essential for the nurse to perform a contraction stress test. This test involves monitoring the client's contractions to assess their frequency, duration, and strength. By analyzing the contraction pattern, the nurse can determine the progress of labor and the well-being of the fetus. This information is crucial in identifying any potential complications that may arise during labor and delivery. Option A, Fetal heart rate, is also an important assessment to perform during labor. Monitoring the fetal heart rate provides valuable information about the baby's well-being and can help identify signs of distress. However, this assessment alone may not provide a comprehensive picture of the client's status, which is why option C is the better choice. Option B, Contraction pattern, is closely related to the correct answer. While monitoring the contraction pattern is important, it is not enough on its own to fully assess the client's status. The contraction stress test provides a more detailed assessment of the contractions and their impact on the fetus. Option D, Vital signs, is also an essential assessment to perform during labor. Monitoring the client's vital signs, such as blood pressure and temperature, can help identify any signs of infection or other complications. However, vital signs alone may not provide enough information to accurately assess the client's status during labor, making option C the most appropriate choice for this question.

Correct Answer: D

Rationale: Leopold's maneuvers are a series of four movements used to determine the position of the fetus in utero. The first maneuver involves palpating the fundus to determine the fetal part. The second maneuver involves locating the back of the fetus. The third maneuver involves determining which fetal part is presenting at the pelvic inlet. The fourth maneuver involves determining the position of the fetal head in relation to the maternal pelvis. In Leopold's maneuvers, if the fetal back is on the right side of the mother (as determined in the second maneuver), the fetus is likely in a right occiput anterior (ROA) position. This means that the back of the fetus is on the right side and the head is down with the occiput (back of the head) anterior (facing the mother's front). Therefore, the correct answer is D: Right sacral posterior (RSP), as this position is consistent with the findings from Leopold's maneuvers. Now let's look at the incorrect choices: A: Left occipital anterior (LOA) - This choice is incorrect because Leopold's maneuvers indicate that the back of the fetus is on the right side, not the left side. B: Left sacral posterior (LSP) - This choice is incorrect because Leopold's maneuvers suggest that the fetus is in a right occiput anterior (ROA) position, not a left sacral posterior position. C: Right mentum anterior (RMA) - This choice is incorrect because Leopold's maneuvers focus on the position of the fetal back, not the fetal chin (mentum). In conclusion, understanding Leopold's maneuvers and how they relate to fetal positioning is essential for healthcare providers to assess the position of the fetus accurately during pregnancy. A correct interpretation of the maneuvers can provide valuable information for labor and delivery management.

Correct Answer: C

Rationale: When determining the fetal position, the nurse should place the fetoscope in the left lower quadrant (LLQ) to hear the fetal heartbeat for LOA positioning. This is because the fetal back is typically located on the left side of the mother's abdomen in the LOA (Left Occiput Anterior) position. Placing the fetoscope in the LLQ allows the nurse to listen directly over the fetal back, where the heartbeat is most easily heard. Option A: Placing the fetoscope in the left upper quadrant (LUQ) would not be the correct choice for LOA positioning. This area is farther away from the fetal back and may result in difficulty hearing the fetal heartbeat clearly. Option B: Placing the fetoscope in the right upper quadrant (RUQ) would also not be the correct choice for LOA positioning. In the LOA position, the fetal back is located on the left side of the mother's abdomen, so placing the fetoscope on the right side would not be effective in capturing the fetal heartbeat. Option D: Placing the fetoscope in the right lower quadrant (RLQ) is not the correct choice for LOA positioning. The fetal back is typically located on the left side of the mother's abdomen in the LOA position, so placing the fetoscope on the right side would not be ideal for hearing the fetal heartbeat clearly. In conclusion, placing the fetoscope in the left lower quadrant is the correct choice for hearing the fetal heartbeat in LOA positioning as it allows the nurse to listen directly over the fetal back where the heartbeat is most easily heard.