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 group B strep culture at 36 weeks of gestation.”.
"You will have a maternal serum alpha-fetoprotein screening at 6 weeks of gestation.”.
"You will have a screening for gestational diabetes at 12 weeks of gestation.”.
"You will have to produce a clean-catch urine specimen every 2 months.”.
The Correct Answer is A
Choice A rationale
Group B Streptococcus (GBS) is a bacterium that can colonize the genitourinary and gastrointestinal tracts. Screening for GBS is typically performed between 35 and 37 weeks of gestation, not 36 weeks exactly, using a vaginal and rectal swab culture. This timing allows for identification and treatment with intrapartum antibiotics, such as penicillin or ampicillin, to prevent vertical transmission to the newborn during labor and delivery, which can lead to serious neonatal infections like sepsis, pneumonia, or meningitis.
Choice B rationale
Maternal serum alpha-fetoprotein (MSAFP) screening is a blood test typically performed between 15 and 20 weeks of gestation, with optimal timing around 16 to 18 weeks. It is used to screen for potential chromosomal abnormalities and neural tube defects. Performing this screening at 6 weeks of gestation would be too early, as the levels of alpha-fetoprotein would not be sufficiently elevated or stable enough to provide accurate and reliable diagnostic or screening information for fetal anomalies.
Choice C rationale
Screening for gestational diabetes mellitus (GDM) is generally performed between 24 and 28 weeks of gestation using an oral glucose tolerance test (OGTT). This period allows for the detection of glucose intolerance that develops during pregnancy, often due to increasing insulin resistance caused by placental hormones. Screening at 12 weeks of gestation would be too early, as the physiological changes leading to GDM typically manifest later in pregnancy.
Choice D rationale
While regular urine specimens are important throughout pregnancy to screen for conditions like urinary tract infections (UTIs), pre-eclampsia, and gestational diabetes, the frequency of "every 2 months" for a clean-catch urine specimen is not a standard routine. Typically, a urine specimen is collected at each prenatal visit, which is often more frequent than every 2 months, especially as pregnancy progresses. This allows for ongoing monitoring of various parameters.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Multiple gestation, such as twins or triplets, typically results in elevated maternal serum alpha-fetoprotein (MSAFP) levels because there are multiple fetuses producing AFP. AFP is a protein produced by the fetal liver and yolk sac.
Choice B rationale
Neural tube defects, such as spina bifida or anencephaly, are associated with *elevated* levels of MSAFP due to the open defect allowing leakage of AFP into the amniotic fluid and then into the maternal circulation.
Choice C rationale
Intrauterine growth restriction (IUGR) can sometimes be associated with either normal or slightly elevated MSAFP levels, depending on the underlying cause, but it is not typically linked to *low* levels.
Choice D rationale
Low levels of maternal serum alpha-fetoprotein are associated with an increased risk of Down syndrome (Trisomy 21). This is thought to be due to altered placental function or fetal production of AFP in these pregnancies.
Correct Answer is A
Explanation
Choice A rationale
Assisting the client into a knee-chest position, or Trendelenburg, is the priority to alleviate pressure on the prolapsed umbilical cord. This position uses gravity to shift the fetal presenting part off the cord, preventing further compression and preserving umbilical blood flow. Maintaining adequate blood flow is crucial to prevent fetal hypoxia and bradycardia, which can quickly lead to fetal compromise and potential death if uncorrected.
Choice B rationale
Administering oxygen via face mask is a supportive measure for potential fetal hypoxia, but it is secondary to relieving cord compression. While oxygen can improve maternal oxygen saturation and fetal oxygenation, it will not resolve the underlying issue of cord compression. Addressing the mechanical compression of the cord must be the immediate priority to restore adequate blood flow.
Choice C rationale
Applying an external fetal monitor is important for assessing fetal well-being after a cord prolapse. However, it is not the first action. The immediate priority is to relieve pressure on the cord to prevent further fetal compromise. Fetal monitoring provides diagnostic information but does not directly intervene to alleviate the life-threatening compression.
Choice D rationale
Loosely wrapping the cord with a saline-saturated towel is an important step to prevent drying and maintain viability of the exposed cord, but it is not the immediate priority. The primary goal is to relieve pressure on the cord to ensure blood flow to the fetus. Protecting the cord from drying is a subsequent action after addressing the compression.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.