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 B
Explanation
Choice A rationale
Soft bumper pads in a crib are generally discouraged due to the risk of suffocation or strangulation for newborns. The American Academy of Pediatrics recommends a bare crib environment to reduce the risk of sudden infant death syndrome (SIDS). Airflow around the infant is paramount.
Choice B rationale
Setting the water heater temperature to 48.8° C (120° F) is a recommended safety precaution to prevent accidental scalding in infants and young children. Water temperatures higher than this can cause full-thickness burns very rapidly, as a newborn's skin is much more delicate and thinner than an adult's.
Choice C rationale
Washing a newborn's face with a warm, soapy washcloth is generally not recommended for daily care. Plain warm water is usually sufficient for cleansing a newborn's delicate skin. Soaps, especially perfumed ones, can be drying and irritating, potentially disrupting the natural skin barrier and leading to dermatitis.
Choice D rationale
Placing a pillow under a newborn's head during naps increases the risk of suffocation and SIDS. Pillows can obstruct the airway and pose a rebreathing hazard. The safest sleep environment for an infant is on their back on a firm, flat surface without pillows, blankets, or toys.
Correct Answer is A
Explanation
Choice A rationale
During long trips, remaining stationary for extended periods can increase the risk of venous stasis and deep vein thrombosis (DVT) in pregnant individuals due to hypercoagulability and venous compression. Taking breaks and walking every hour promotes circulation, reducing the likelihood of clot formation and improving overall comfort and blood flow.
Choice B rationale
Positioning the lap belt across the navel is incorrect and can pose a significant risk to the fetus in the event of a sudden stop or collision. The lap belt should be positioned low across the bony pelvis, under the pregnant abdomen, to distribute forces safely across the mother's strong pelvic bones, protecting the uterus and fetus.
Choice C rationale
Moving the car seat forward, close to the steering wheel, is unsafe for a pregnant client. There should be adequate space, ideally at least 10 inches, between the sternum and the steering wheel to allow for airbag deployment without direct impact to the abdomen. This prevents potential injury to the pregnant uterus.
Choice D rationale
Wearing the shoulder harness snug across the stomach is incorrect and potentially harmful. The shoulder harness should be positioned snugly across the clavicle and between the breasts, extending across the center of the chest. It should never cross directly over the pregnant abdomen, as this could cause fetal injury during impact.
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