Nokea
The nurse is discussing with the patient what laboratory tests are performed at the first prenatal visit. What tests for sexually transmitted infections does the nurse include in the discussion? Select all that apply.
- A. GBS
- B. VDRL
- C. chlamydia culture
- D. hepatitis B
Correct Answer: B
Rationale: The correct answer is B: VDRL. At the first prenatal visit, screening for syphilis is essential to prevent adverse outcomes. VDRL is a standard test for syphilis.
GBS (Group B Streptococcus) testing is typically done later in pregnancy to prevent neonatal infection.
Chlamydia culture is important but not typically done at the first visit; it is usually part of routine prenatal care.
Hepatitis B testing is crucial during pregnancy but not specifically for sexually transmitted infections.
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A client who had a vaginal delivery 2 hours earlier has just been transferred to the postpartum unit from labor and delivery. Which of the following nursing care goals is of highest priority?
- A. The client will breastfeed her baby every 2 hours.
- B. The client will consume a nutritious diet.
- C. The client will have a moderate lochial flow.
- D. The client will ambulate in the hallways every shift.
Correct Answer: C
Rationale: Ensuring the client has a moderate lochial flow is a priority to monitor for postpartum hemorrhage.
A client on the obstetric unit is receiving IV medications per physician’s orders. On rounds the nurse notes that the client’s IV has infiltrated. Which of the following actions should the nurse perform first?
- A. Determine whether the infusion is a vesicant.
- B. Stop the infusion and remove the catheter.
- C. Document the occurrence in the medical record.
- D. Elevate the extremity and monitor the site.
Correct Answer: B
Rationale: Stopping the infusion and removing the catheter prevents further tissue damage from the infiltrated medication.
A patient who smokes one pack of cigarettes daily has a positive pregnancy test. The nurse will explain that smoking during pregnancy increases the risk of which condition?
- A. Congenital anomalies
- B. Death before or after birth
- C. Neonatal hypoglycemia
- D. Neonatal withdrawal syndrome
Correct Answer: B
Rationale: The correct answer is B: Death before or after birth. Smoking during pregnancy increases the risk of fetal death, both before and after birth, due to the harmful effects of nicotine and other toxins on the developing fetus. Smoking can lead to complications such as placental abruption, preterm birth, low birth weight, and stillbirth.
A: Congenital anomalies - While smoking during pregnancy can increase the risk of certain birth defects, the primary concern related to smoking is not congenital anomalies.
C: Neonatal hypoglycemia - Smoking during pregnancy is not directly linked to neonatal hypoglycemia, which is usually related to maternal diabetes or other factors.
D: Neonatal withdrawal syndrome - Although smoking during pregnancy can lead to nicotine exposure in the fetus, resulting in withdrawal symptoms after birth, the immediate risk of death is a more critical concern associated with smoking during pregnancy.
The nurse is caring for a client who is scheduled to have an amniocentesis. Which intervention is most important for the nurse to perform after the procedure?
- A. Evaluate need for Rh0D immunoglobulin
- B. Clean site
- C. Administer pain medication
- D. Perform vital signs
Correct Answer: A
Rationale: The correct answer is A: Evaluate need for Rh0D immunoglobulin. After an amniocentesis, it is crucial to assess if the client is Rh-negative and the fetus is Rh-positive. If this is the case, Rh0D immunoglobulin should be administered to prevent Rh incompatibility issues in future pregnancies. This intervention is critical to prevent hemolytic disease in the newborn.
Cleaning the site (B) is important for infection prevention but not the most critical post-procedure intervention. Administering pain medication (C) can be done based on client's discomfort level but not the top priority. Performing vital signs (D) is important but assessing Rh status and administering Rh0D immunoglobulin take precedence.
The nurse has received change of shift report on the following four clients. Which of the clients should the nurse assess first?
- A. G1 P0000, 9 weeks’ gestation, hyperemesis gravidarum, vomited twice during the last shift.
- B. G2 P0101, 24 weeks’ gestation, receiving terbutaline po q 2 h for preterm labor, no complaints of cramping during last shift.
- C. G1 P0000, 1 day postpartum, vacuum extraction, for bilateral tubal ligation during this shift.
- D. G2 P0101, 2 days postpartum, spontaneous delivery, had asthma attack during last shift.
Correct Answer: D
Rationale: The client who had an asthma attack during the last shift should be assessed first due to the potential for respiratory complications.