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","D","E"]
Explanation
Explanation
Choice A Reason:
Newborn weight 2.948 kg (6 lb. 8 oz) is incorrect. Newborn weight is not a direct risk factor for postpartum hemorrhage. While larger babies may lead to increased uterine distention, which could potentially contribute to uterine atony, this alone does not significantly increase the risk of PPH.
Choice B Reason:
History of human papillomavirus is incorrect. A history of human papillomavirus (HPV) infection is not directly associated with an increased risk of postpartum hemorrhage. HPV infection primarily affects the cervix and is not typically associated with uterine atony or other factors contributing to PPH.
Choice C Reason:
Labor induction with oxytocin is correct. Labor induction with oxytocin increases the risk of postpartum hemorrhage due to uterine hyperstimulation, which can lead to uterine atony, the most common cause of PPH.
Choice D Reason:
History of uterine atony is correct. Uterine atony is the failure of the uterus to contract adequately after childbirth. It is a significant risk factor for postpartum hemorrhage because effective uterine contractions are necessary to prevent excessive bleeding by compressing the blood vessels at the placental site.
Choice E Reason:
Vacuum-assisted delivery is correct. Vacuum-assisted delivery is associated with an increased risk of postpartum hemorrhage due to potential trauma to the birth canal, including lacerations and hematoma formation. Additionally, vacuum extraction may increase the risk of uterine atony by interfering with the normal process of uterine contractions.
Correct Answer is B
Explanation
Explanation
Choice A Reason:
"Place triple antibiotic ointment on your baby's umbilical cord twice daily." Applying triple antibiotic ointment to the umbilical cord stump is not recommended as it can interfere with the natural drying and healing process. Instead, keeping the umbilical cord stump clean and dry is the preferred method of care to prevent infection.
Choice B Reason:
"Offer your baby a pacifier during naps if desired. “This is an appropriate statement to make during discharge teaching for postpartum clients. Pacifiers can help satisfy a baby's natural sucking reflex and may offer comfort, especially during naps or when they are fussy. However, it's important to note that breastfeeding should be well-established before introducing a pacifier to prevent nipple confusion.
Choice C Reason:
"Give your baby an immersion bath daily "Immersion baths, where the baby is submerged in water, are not recommended until the umbilical cord stump has fallen off and the area has completely healed. Until then, sponge baths should be given to keep the baby clean while avoiding submerging the umbilical cord stump in water, which could increase the risk of infection.
Choice D Reason:
"Swaddle your baby with their legs in an extended position." When swaddling a newborn, it's important to keep their legs in a flexed or "froggy" position to allow for healthy hip development. Swaddling with the legs extended can increase the risk of hip dysplasia. Therefore, swaddling should be done with care to ensure the baby's legs are in a safe and comfortable position.
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