Nokea
A client who is 38 weeks pregnant is concerned her baby might get a communicable disease before any immunizations are given. Which physiological mechanism should the nurse use when responding to the mother's concerns?
- A. Passive immunity in the first months of life provides protection in newborns.
- B. Infants can receive antiinfectants that have not developed resistance to microbes.
- C. Active immunity in newborns is developed fully in the first month of life.
- D. Neutrophils may be immature in protecting neonates from the risk for infection.
Correct Answer: A
Rationale: Passive immunity from maternal antibodies provides newborns with initial protection against communicable diseases, lasting several months until their immune system matures.
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A newborn is delivered by cesarean section to a mother who is HIV-positive. The mother received antiretroviral therapy during pregnancy. Which intervention should the nurse implement?
- A. Encourage breastfeeding every 2 to 3 hours.
- B. Give zidovudine 6 to 12 hours after birth.
- C. Administer antibiotics for 7 to 10 days.
- D. Delay the initial bath for 1 to 2 days.
Correct Answer: B
Rationale: Zidovudine within 6-12 hours reduces HIV transmission risk in newborns of HIV-positive mothers, unlike breastfeeding, which is contraindicated, or antibiotics and delayed bathing, which are irrelevant.
History and Physical:
Laboratory Results:
The client is a 24-year-old pregnant woman. She is gravida 2, para 1 (G2P1). Her mother has a history of type 2 diabetes mellitus.
Which is likely causing this client's increased blood glucose at 28 weeks? Select all that is apply.
- A. Fetal health problems
- B. Decreased cortisol
- C. Increased insulin needs
- D. Placental infection
- E. Normal weight gain of pregnancy
- F. Fetus with macrosomia
Correct Answer: C,E,F
Rationale: Increased insulin needs, normal weight gain, and macrosomia contribute to insulin resistance and hyperglycemia in pregnancy, unlike fetal health issues, decreased cortisol, or placental infection.
During a routine prenatal visit, a client at 32-weeks gestation reports that urinary frequency has increased during the day as well as at night. The nurse determines the client is having irregular uterine contractions. Which action should the nurse implement?
- A. Collect a urine sample for dipstick analysis.
- B. Ask the client if she had sexual intercourse yesterday.
- C. Obtain a midstream urine specimen for culture.
- D. Determine if she has a change in vaginal discharge.
Correct Answer: C
Rationale: A midstream urine culture diagnoses UTIs, which can cause urinary frequency and uterine irritability, guiding targeted treatment.
After two miscarriages, a client is instructed to increase her daily intake of foods that includes folic acid. The client does not like green leafy vegetables and states she is allergic to soy. Which food should the nurse suggest that the client eat to obtain folic acid?
- A. Yogurt.
- B. Whole milk.
- C. Collard greens.
- D. Strawberries.
Correct Answer: D
Rationale: Strawberries are a good source of folic acid, suitable for the client's dietary restrictions, unlike yogurt, milk, or collard greens, which either lack folic acid or are disliked.
A client who delivered vaginally 18 hours ago develops a slight fever. The client's delivery record shows spontaneous rupture of membranes (SROM) for 36 hours prior to delivery and labor lasting 24 hours. An epidural was placed during labor, and she experienced a third-degree perineal laceration. The nurse should recognize which information poses the greatest risk for developing postpartum endometritis?
- A. SROM for 36 hours.
- B. Labor lasting for 24 hours.
- C. Third-degree perineal laceration.
- D. Epidural anesthesia.
Correct Answer: A
Rationale: Prolonged SROM significantly increases the risk of postpartum endometritis due to extended exposure to pathogens.