A nurse is caring for a client who is receiving prenatal care and is at her 24-week appointment.
Which of the following laboratory tests should the nurse plan to conduct?
1-hour glucose tolerance test.
Rubella titer.
Sexually transmitted disease test (STI test).
Group B strep culture.
The Correct Answer is A
Choice A rationale
The 1-hour glucose tolerance test is typically performed between 24 and 28 weeks of gestation to screen for gestational diabetes. This screening involves measuring the client's blood glucose level one hour after consuming a 50-gram glucose load. A normal result is generally considered to be a blood glucose level below 130-140 mg/dL.
Choice B rationale
Rubella titer is usually assessed early in pregnancy, ideally during the first prenatal visit, to determine the woman's immunity to rubella. If the woman is not immune, vaccination is typically offered postpartum to prevent infection in subsequent pregnancies, as rubella infection during pregnancy can cause serious congenital defects.
Choice C rationale
Sexually transmitted disease testing is ideally conducted at the initial prenatal visit to identify and treat any infections early in pregnancy, reducing the risk of transmission to the fetus and other complications. While repeat testing may be indicated based on risk factors, it is not a routine test specifically scheduled for the 24-week appointment for all clients.
Choice D rationale
Group B Streptococcus (GBS) culture is typically performed later in pregnancy, usually between 35 and 37 weeks of gestation, to determine if the woman is colonized with GBS. This is important for intrapartum management to prevent neonatal GBS infection.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Absent early decelerations of the fetal heart rate are generally considered a reassuring sign. Early decelerations are a gradual decrease and return of the fetal heart rate associated with uterine contractions, thought to be caused by fetal head compression. Their absence does not typically warrant immediate reporting.
Choice B rationale
A fetal heart rate of 140 beats per minute falls within the normal range for a term fetus, which is typically between 110 and 160 beats per minute. This finding is reassuring and does not require immediate reporting to the provider.
Choice C rationale
Contraction frequency of 2 to 3 minutes apart indicates that the labor is progressing. While the overall pattern of contractions needs to be evaluated in conjunction with other factors like duration and intensity, a frequency within this range is not necessarily a concerning finding that requires immediate reporting on its own.
Choice D rationale
Contraction durations of 95 to 100 seconds are considered prolonged. Normal contraction duration in the active phase of labor typically ranges from 45 to 60 seconds. Prolonged contractions can reduce uterine blood flow and potentially lead to fetal hypoxia, making this a concerning finding that should be promptly reported to the provider for further evaluation.
Correct Answer is B
Explanation
Choice A rationale
Placenta previa is a condition where the placenta implants in the lower part of the uterus, potentially covering the cervix. It typically presents with painless vaginal bleeding, especially in the later trimesters, and is not directly associated with sudden, intense abdominal pain and cessation of contractions during labor.
Choice B rationale
Uterine rupture is a serious complication of vaginal birth after cesarean (VBAC), especially with strong, frequent contractions. The sudden onset of intense abdominal pain and the cessation of contractions, along with fetal distress indicated by the absent fetal heart rate tracing, are classic signs of uterine rupture. The prior cesarean scar weakens the uterine wall, making it susceptible to tearing under the stress of labor.
Choice C rationale
A prolapsed umbilical cord occurs when the cord descends into the vagina ahead of the presenting part, potentially compressing the fetal blood vessels and causing fetal distress. While fetal heart rate abnormalities would be present, it is not typically associated with sudden, intense maternal abdominal pain and cessation of contractions.
Choice D rationale
Abruptio placentae is the premature separation of the placenta from the uterine wall. It can cause sudden abdominal pain, vaginal bleeding (though not always), and fetal distress. However, the cessation of uterine contractions is not a typical finding in abruptio placentae. Contractions may continue, although they might be accompanied by increased uterine tone.
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