A nurse is reinforcing teaching about laboratory testing with a client who is at 6 weeks of gestation.
Which of the following statements should the nurse include?
You will have a screening for gestational diabetes at 12 weeks of gestation.
You will have a group B strep culture at 36 weeks of gestation.
You will have to produce a clean catch urine specimen every 2 months.
You will have a maternal serum alpha-fetoprotein screening at 6 weeks of gestation.
The Correct Answer is B
Choice B rationale
A Group B Streptococcus (GBS) culture is routinely performed between 35 and 37 weeks of gestation. This is a screening test to determine if the client is colonized with the bacteria in the vagina or rectum. Positive status indicates the need for intrapartum antibiotic prophylaxis to prevent transmission of GBS to the newborn, which can cause severe neonatal infection.
Choice C rationale
A clean-catch urine specimen is typically collected at the initial prenatal visit to screen for asymptomatic bacteriuria, which can lead to pyelonephritis if untreated. It is not usually performed every two months. Subsequent urinalysis is often done with every prenatal visit to check for protein, glucose, and ketones, which indicate other potential complications.
Choice D rationale
The maternal serum alpha-fetoprotein (MSAFP) screening is a blood test to check for the risk of neural tube defects and chromosomal abnormalities. This test is typically offered between 15 and 20 weeks of gestation, with the optimal time being 16 to 18 weeks, not at 6 weeks. Fetal protein production is insufficient for reliable screening at 6 weeks.
Choice A rationale
A screening for gestational diabetes mellitus (GDM) is generally performed much later in pregnancy, specifically between 24 and 28 weeks of gestation. An earlier screening (e.g., at 12 weeks) is reserved only for clients identified as having significant risk factors (e.g., obesity, family history, previous GDM). The standard screening is the 1-hour glucose challenge test.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Explanation
Heel warming increases capillary blood flow, improving sample accuracy and reducing hemolysis risk. Capillary glucose testing requires adequate perfusion for reliable results. Breastfeeding provides immediate glucose substrate to correct mild hypoglycemia. Normal neonatal blood glucose is >40–45 mg/dL; this newborn’s initial level of 35 mg/dL is below threshold, but responsive to feeding. Breast milk contains lactose, metabolized to glucose and galactose, supporting cerebral energy demands.
Rationale for incorrect Response 1 options: Administer glucose gel is appropriate only if feeding fails or glucose remains <25 mg/dL in asymptomatic or <40 mg/dL in symptomatic neonates. This newborn improved with feeding. Start IV fluids is reserved for persistent hypoglycemia or symptomatic neonates unresponsive to oral intake. The newborn stabilized post-breastfeeding. Phototherapy treats hyperbilirubinemia, not hypoglycemia. No bilirubin levels or jaundice signs were reported.
Rationale for incorrect Response 2 options: Supplement with formula is secondary to breastfeeding unless maternal milk is unavailable or ineffective. Breastfeeding was successful post-latch correction. Administer insulin is contraindicated; insulin lowers glucose and is used only in hyperglycemia. Monitor for jaundice is unrelated to hypoglycemia management unless bilirubin levels are elevated. No clinical jaundice was noted.
Take-home points:
- Neonatal hypoglycemia is defined as glucose <40–45 mg/dL; early feeding is first-line intervention.
- Macrosomic infants (birth weight >4,000 g) are at risk due to hyperinsulinemia post-placental glucose withdrawal.
- Differentiate hypoglycemia from sepsis, hypothermia, and metabolic disorders—all may present with jitteriness and hypotonia.
- Capillary sampling requires heel warming to ensure perfusion and accurate glucose measurement.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"}}
Explanation
- Cover the newborn's eyes with an eye shield ✅ This is essential to prevent retinal damage from the phototherapy light.
- Reposition the newborn every 2 to 3 hr ✅ Repositioning ensures even exposure to light and prevents pressure injuries.
- Apply lotion to the newborn's skin regularly ❌ Lotion is contraindicated as it may interfere with light absorption and increase the risk of burns.
- Ensure the newborn wears a hat during phototherapy ❌ A hat reduces the surface area exposed to light, decreasing phototherapy effectiveness.
- Move the lights closer to the newborn to increase temperature ❌ Phototherapy lights should be positioned at a safe distance to avoid overheating or burns. Temperature should be monitored, not manipulated this way.
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