Choice A rationale

Penicillin is the recommended prophylactic treatment for a client at 38 weeks of gestation with a positive group B streptococcus B-hemolytic screening. It is highly effective in preventing the transmission of group B strep from mother to baby during labor and delivery. Administering Penicillin reduces the risk of neonatal sepsis, pneumonia, and meningitis caused by group B strep.

Choice B rationale

Cefazolin is an alternative antibiotic for clients allergic to penicillin. It is less preferred compared to penicillin due to its broader spectrum of activity and potential for resistance. Cefazolin can be used if the client has a non-severe penicillin allergy.

Choice C rationale

Erythromycin is not recommended for group B strep prophylaxis during labor due to its lower efficacy compared to penicillin and cefazolin. It is less effective in preventing neonatal group B strep infections and is used less frequently.

Choice D rationale

Vancomycin is used for clients with a severe penicillin allergy or for those with resistant strains of group B strep. It is a last-resort antibiotic due to its potent effect and potential side effects. It is only used when absolutely necessary.

Choice A rationale

A client whose labor lasted for 6 hours is not necessarily a priority unless other complications are present. Duration of labor alone does not indicate an urgent need for immediate attention postpartum.

Choice B rationale

A client who received magnesium sulfate during labor should be seen first due to the potential for serious side effects such as respiratory depression, hypotonia in the newborn, and maternal complications. Magnesium sulfate is used to prevent seizures in clients with preeclampsia and requires close monitoring.

Choice C rationale

A client with a history of oligohydramnios needs monitoring, but this condition alone does not take precedence over the immediate postpartum risks associated with magnesium sulfate.

Choice D rationale

A client whose newborn is having difficulty latching-on needs support and assistance with breastfeeding. While important, this issue is not as urgent as monitoring the effects of magnesium sulfate in the client described in Choice B.

Choice A rationale

Taking an over-the-counter antacid is not recommended for managing nausea during pregnancy without consulting a healthcare provider. Some antacids contain ingredients that may not be safe during pregnancy.

Choice B rationale

Increasing intake of fresh fruits might help with hydration and nutrition but is not specifically effective in managing morning nausea. Some fruits might even exacerbate nausea due to their acidity.

Choice C rationale

Eating dry, bland foods in the morning can help manage nausea for pregnant clients. Foods like crackers, toast, and cereals are easy on the stomach and can help reduce morning sickness.

Choice D rationale

Restricting fluids to 1,000 mL/day is not advisable. Proper hydration is crucial during pregnancy, and such restriction can lead to dehydration and other complications. Fluids should be encouraged rather than restricted.

Choice A rationale

Carrots, while nutritious and rich in vitamins, are not a significant source of iron. They provide fiber and beta-carotene but do not meet the increased iron needs during pregnancy.

Choice B rationale

Chicken breast is an excellent source of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based foods. Consuming chicken breast helps in meeting the increased iron requirements during pregnancy.

Choice C rationale

Apples are healthy and provide essential nutrients and fiber but are not a significant source of iron. They contribute to overall well-being but do not address the specific need for increased iron intake.

Choice D rationale

Feta cheese is a good source of calcium and protein but not iron. While it contributes to nutritional intake during pregnancy, it does not help in meeting the increased iron needs.

Choice A rationale

Remaining in the sitz bath for only 10 minutes might not provide enough relief for a postpartum client with an episiotomy and hemorrhoids. Extended periods in a sitz bath can help reduce pain and promote healing.

Choice B rationale

Using numbing spray before cleansing is helpful for pain management, but it is not as beneficial as other methods for reducing inflammation and promoting healing.

Choice C rationale

Placing a heat pack to the area several times a day can help with pain but might not be as effective as other options in reducing swelling and promoting healing of hemorrhoids and episiotomy sites.

Choice D rationale

Applying witch hazel pads after urination helps reduce swelling, provides soothing relief, and promotes healing for both hemorrhoids and episiotomy sites. Witch hazel has natural astringent properties that are beneficial for postpartum perineal care.

Choice A rationale

1/2 cup (4 oz) orange juice provides about 55 micrograms of folate. While it is a good source of vitamin C and other nutrients, it does not contain as much folate compared to leafy greens.

Choice B rationale

1 cup cooked spinach contains approximately 263 micrograms of folate, making it one of the richest sources of this essential vitamin. Folate is crucial for DNA synthesis and cell division, especially during pregnancy.

Choice C rationale

1 large egg contains about 24 micrograms of folate. Although eggs offer several nutrients like protein and vitamins, their folate content is relatively low compared to green vegetables.

Choice D rationale

1 cup pasta has around 102 micrograms of folate, assuming it is enriched pasta. While it contributes to daily folate intake, it does not compare to the high levels found in spinach.

Choice A rationale

Wearing an underwire bra is not recommended for clients with inverted nipples as it can cause discomfort and restrict milk flow. Proper support without constriction is essential.

Choice B rationale

Placing breast shells in the client's bra helps to draw out inverted nipples by applying gentle pressure, making breastfeeding easier. They also protect the nipples from friction and irritation.

Choice C rationale

Providing plastic-lined breast pads may prevent leakage, but they do not address the issue of inverted nipples. Proper nipple preparation is essential for effective breastfeeding.

Choice D rationale

Applying breast cream regularly might keep the skin hydrated, but it does not help to correct the inversion of the nipples. Mechanical aids like breast shells are more effective.

Choice A rationale

Mongolian spots are common, benign skin markings that some newborns have, but they are not related to rubella exposure during pregnancy.

Choice B rationale

Jaundice is a common condition in newborns, characterized by a yellowing of the skin and eyes, usually due to an immature liver. It's not specifically linked to maternal rubella exposure.

Choice C rationale

Transient strabismus, or temporary misalignment of the eyes, can occur in newborns but is unrelated to rubella. It usually resolves on its own as the newborn's muscles develop.

Choice D rationale

Deafness is a significant risk associated with congenital rubella syndrome. Rubella can damage the developing auditory system in utero, leading to permanent hearing loss in the newborn.

Choice A rationale

Disabling the driver-side airbags is not advisable as airbags provide crucial protection in the event of a collision. Proper seating position is a safer alternative.

Choice B rationale

Moving the seat as far away as possible from the steering wheel reduces the risk of injury from airbag deployment and allows ample space for the growing abdomen, providing better safety for both mother and baby.

Choice C rationale

Wearing the lap belt high across the abdomen is incorrect and dangerous as it can cause injury to the fetus. The belt should be low across the hips.

Choice D rationale

Placing the shoulder harness across the gravid uterus is incorrect. The harness should go between the breasts and to the side of the belly, not across it, to avoid compression injuries in the event of a crash.

Choice A rationale

Leukorrhea, a normal vaginal discharge, increases during pregnancy due to hormonal changes. It's not indicative of prenatal complications at 41 weeks of gestation.

Choice B rationale

Shortness of breath is common in late pregnancy due to the enlarged uterus pressing against the diaphragm. It is not necessarily a sign of a prenatal complication at this stage.

Choice C rationale

Non-pitting ankle edema is often seen in late pregnancy due to fluid retention and increased pressure on the veins. It is typically benign and not a sign of serious complications.

Choice D rationale

Blurred vision can indicate a serious prenatal complication such as preeclampsia, which is characterized by high blood pressure and can pose significant risks to both mother and baby if not managed properly. .