A nurse is providing instruction to a client about diagnostic tests during their first prenatal visit at 12 weeks of gestation.
Which of the following diagnostic tests should the nurse include in the teaching?
Group B streptococcus (GBS).
Human immunodeficiency virus (HIV).
Chorionic villus sampling.
Cervical cone biopsy.
The Correct Answer is B
Choice A rationale
Group B Streptococcus (GBS) screening is typically performed much later in pregnancy, usually between 35 and 37 weeks of gestation. This screening is crucial for identifying carriers and administering prophylactic antibiotics during labor to prevent vertical transmission to the newborn, which can cause severe infections like sepsis or meningitis.
Choice B rationale
Human immunodeficiency virus (HIV) screening is a standard diagnostic test offered to all pregnant clients during their first prenatal visit, typically around 12 weeks of gestation. Early detection allows for timely interventions, such as antiretroviral therapy, to reduce the risk of mother-to-child transmission and improve maternal health outcomes.
Choice C rationale
Chorionic villus sampling (CVS) is an invasive diagnostic procedure performed earlier in pregnancy, usually between 10 and 13 weeks of gestation, but it is not a routine screening test. It is typically offered to clients at high risk for genetic disorders due to family history, advanced maternal age, or abnormal prenatal screening results.
Choice D rationale
Cervical cone biopsy is a diagnostic and therapeutic procedure used to remove a cone-shaped piece of tissue from the cervix, typically to evaluate or treat abnormal cervical cells. It is not a routine diagnostic test during a normal prenatal visit and is usually performed prior to pregnancy or if there are specific gynecological concerns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A hematocrit of 37% falls within the normal physiological range for a pregnant individual, which typically expands due to increased plasma volume. This hemodilution is a normal adaptive response to pregnancy, ensuring adequate perfusion to the placenta and fetal unit. This finding does not warrant reporting as it reflects a healthy maternal circulatory adjustment.
Choice B rationale
A creatinine level of 0.9 mg/dL is within the normal reference range for renal function in pregnant individuals. Glomerular filtration rate (GFR) increases during pregnancy, leading to a slight decrease in serum creatinine. This value indicates appropriate renal clearance and is not a cause for concern.
Choice C rationale
A WBC count of 11,000/mm³ is generally considered within the physiological elevation often seen during pregnancy, particularly in the second and third trimesters. This mild leukocytosis is an immunological adaptation, supporting the maternal immune response without indicating an infectious process or pathology that requires immediate reporting.
Choice D rationale
A fasting blood glucose of 180 mg/dL is significantly elevated above the normal range (74 to 106 mg/dL) and indicates hyperglycemia. This finding is highly suggestive of gestational diabetes mellitus, which can lead to adverse maternal and fetal outcomes if not managed. Therefore, it requires immediate reporting to the provider for further evaluation and intervention.
Correct Answer is ["A","B"]
Explanation
Choice A rationale
Diphtheria-acellular pertussis (Tdap) vaccine is recommended for pregnant clients during the third trimester, specifically between 27 and 36 weeks of gestation. This timing optimizes the transfer of maternal antibodies to the fetus, providing passive immunity against pertussis (whooping cough) in the newborn during their vulnerable early months, before they are old enough to receive their own vaccinations.
Choice B rationale
Inactivated influenza vaccine is highly recommended for pregnant clients during any trimester of pregnancy. Pregnancy alters the immune system, making pregnant individuals more susceptible to severe complications from influenza. Vaccination protects both the mother and, through passive antibody transfer, the newborn from influenza infection.
Choice C rationale
Varicella vaccine is a live attenuated vaccine and is contraindicated during pregnancy due to the theoretical risk of fetal infection. While the actual risk is very low, it is generally deferred until the postpartum period. Women of childbearing age should be screened for immunity and vaccinated if non-immune prior to conception or postpartum.
Choice D rationale
Measles, mumps, and rubella (MMR) vaccine is a live attenuated vaccine and is contraindicated during pregnancy due to the theoretical risk of fetal infection, particularly with rubella. Rubella infection during pregnancy can lead to congenital rubella syndrome, causing severe birth defects. Vaccination should occur before conception or postpartum.
Choice E rationale
Human papillomavirus (HPV) vaccine is not routinely recommended during pregnancy. While current data do not suggest harm, the vaccine has not been extensively studied in pregnant individuals. Vaccination should be completed before pregnancy or deferred until the postpartum period.
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