A nurse is caring for a client who is at 37 weeks of gestation and received a provider order for group B streptococcus beta-hemolytic culture.
Which of the following statements should the nurse include in the teaching?
Acyclovir will be prescribed if this test result is positive.
This test will be repeated 24 hours after the initial test is done.
Antibiotics will be administered before labor if this test result is positive.
This test will require a blood specimen to be collected from a vein.
The Correct Answer is C
Choice A rationale
Acyclovir is an antiviral medication used primarily to treat herpes simplex virus (HSV) infections to prevent vertical transmission to the neonate. Group B Streptococcus (GBS) is a bacterium and is treated with antibiotics, specifically penicillin or ampicillin, administered intravenously during labor and delivery to prevent neonatal sepsis.
Choice B rationale
The Group B Streptococcus (GBS) culture is typically collected as a single screen between 36 weeks 0 days and 37 weeks 6 days of gestation from the lower vagina and perirectal area. This one-time positive result is sufficient to indicate the need for intrapartum antibiotic prophylaxis (IAP); repeat testing 24 hours later is not standard practice.
Choice C rationale
If the Group B Streptococcus (GBS) culture is positive, the client is considered colonized and requires intrapartum antibiotic prophylaxis (IAP), usually penicillin G, administered intravenously at the onset of labor or rupture of membranes. This reduces the risk of GBS transmission to the newborn, which can cause severe neonatal morbidity like sepsis or pneumonia.
Choice D rationale
The Group B Streptococcus (GBS) culture is a screening test obtained via a swab of the client's lower vagina and perirectal area, not a blood test. The GBS bacteria colonize these areas, and the swab is sent for culture and sensitivity to determine the need for prophylactic antibiotics during labor.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Migraine with aura is considered a Category 4 contraindication (unacceptable health risk) for the use of combined hormonal contraceptives (CHCs), including oral contraceptives. The estrogen component in CHCs increases the risk of ischemic stroke, and this risk is substantially amplified in clients who experience migraine headaches with focal neurological symptoms (aura), necessitating the selection of an alternative birth control method.
Choice B rationale
Hypotension (low blood pressure) is typically not a contraindication for oral contraceptive use. In fact, some studies suggest a potential, though often clinically insignificant, increase in blood pressure with CHC use due to a potential increase in circulating angiotensinogen, the precursor to the vasoconstrictive hormone angiotensin II. The use of CHCs is not restricted based on hypotension.
Choice C rationale
Dysmenorrhea (painful menstruation) is often significantly improved or resolved by the use of combined oral contraceptives (COCs). COCs work by suppressing ovulation and thinning the endometrial lining, which typically reduces prostaglandin production, thus decreasing the cramping and pain associated with the menstrual cycle, making it an indication, not a contraindication.
Choice D rationale
A history of ovarian cysts is generally not a contraindication for combined oral contraceptive use, provided the cysts were non-malignant and resolved or are benign. In fact, COCs can be used to treat or prevent the recurrence of functional ovarian cysts by suppressing the hormonal stimulation of the ovaries that leads to their formation, making it a potential therapeutic benefit.
Correct Answer is C
Explanation
Choice A rationale
A transvaginal fetal Doppler probe is an internal device used early in pregnancy to confirm fetal viability or heart rate in the first trimester, not an appropriate method for continuous intrapartum monitoring in a full-term client with intact membranes.
Choice B rationale
The DeLee-Hillis fetoscope is an external acoustic device used for intermittent auscultation of the fetal heart rate, providing a listening assessment rather than the prescribed continuous electronic tracing required for this client.
Choice C rationale
An external ultrasound transducer monitor (or tocodynamometer for contractions) uses non-invasive Doppler technology placed on the client's abdomen to detect and continuously monitor the fetal heart rate and uterine contractions when membranes are intact, satisfying the continuous monitoring prescription without internal access.
Choice D rationale
An internal fetal scalp electrode (FSE) requires the rupture of membranes and sufficient cervical dilation for placement onto the fetal scalp to provide a precise electrocardiogram of the fetal heart, which is not applicable since the client's membranes are intact.
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