A nurse is caring for a client who is at 37 weeks of gestation and is being tested for group B streptococcus B-hemolytic (GBS). The client is multigravida and multipara with no history of GBS. She asks the nurse why the test was not conducted earlier in her pregnancy. Which of the following is an appropriate response by the nurse?
"You didn't report any symptoms of GBS during your pregnancy."
"Your previous deliveries were all negative for GBS."
"There was no indication of GBS in your earlier prenatal testing."
"We need to know if you are positive for GBS at the time of delivery."
The Correct Answer is D
Explanation
Choice A Reason:
"You didn't report any symptoms of GBS during your pregnancy." This response is incorrect because GBS infection in pregnant women often does not present with noticeable symptoms. Additionally, GBS screening is not based on symptoms but rather on the presence of the bacteria in the genital or gastrointestinal tract.
Choice B Reason:
"Your previous deliveries were all negative for GBS." This response is incorrect because GBS status can change between pregnancies. A negative result in previous pregnancies does not guarantee a negative result in subsequent pregnancies. Screening closer to the delivery date is necessary to determine the current GBS status.
Choice C Reason:
"There was no indication of GBS in your earlier prenatal testing." This response is incorrect because routine prenatal testing typically does not include GBS screening unless there are specific risk factors or symptoms present. GBS screening is specifically done closer to delivery to determine colonization status at that time.
Choice D Reason:
"We need to know if you are positive for GBS at the time of delivery." This response is appropriate. Group B streptococcus (GBS) screening is typically performed around the 35th to 37th week of pregnancy because colonization status can change over time. A negative result earlier in the pregnancy does not necessarily mean that the client will remain negative at the time of delivery. Therefore, it is essential to screen closer to delivery to determine if the client is colonized with GBS and if prophylactic measures are needed to reduce the risk of transmission to the newborn during labor and delivery.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. A client who is at 24 weeks of gestation and reports periodic tingling of the fingers:While tingling may indicate issues such as carpal tunnel syndrome, it is not immediately life-threatening or indicative of a serious condition compared to severe vomiting.
B. A client who is at 36 weeks of gestation and reports back pain following intercourse:Back pain can be a common complaint in late pregnancy and, while uncomfortable, it typically does not require urgent assessment unless accompanied by other concerning symptoms.
C. A client who is at 8 weeks of gestation and reports severe vomiting:Severe vomiting in early pregnancy may indicate hyperemesis gravidarum, a serious condition that can lead to dehydration, electrolyte imbalances, and nutritional deficiencies. This client requires immediate assessment to evaluate the severity of symptoms and to ensure the safety of both the client and the fetus.
D. A client who is at 10 weeks of gestation and reports frequent urination:Frequent urination is common in early pregnancy due to hormonal changes and bladder pressure. This is not an urgent concern compared to severe vomiting.
Correct Answer is D
Explanation
Explanation
Choice A Reason:
Placing the infant on his back with legs extended is a recommended sleeping position for infants to reduce the risk of sudden infant death syndrome (SIDS). However, it is not directly related to managing neonatal abstinence syndrome.
Choice B Reason:
Providing a stimulating environment would not be appropriate for an infant with NAS, as excessive stimulation can exacerbate symptoms such as irritability and tremors. A calm and quiet environment is preferable.
Choice C Reason:
Monitoring blood glucose levels every hour is not a routine practice for managing neonatal abstinence syndrome. While NAS can cause feeding difficulties, hypoglycemia is not typically a primary concern unless the infant is exhibiting specific symptoms.
Choice D Reason:
Initiating seizure precautions is important when caring for an infant with NAS because seizures can be a complication of withdrawal. Seizure precautions may include padding the crib, ensuring a safe environment, and being vigilant for signs of seizure activity.
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