A patient with a history of mitral valve prolapse is admitted at 41 weeks gestation for induction of labor.The doctor prescribes intravenous antibiotic therapy for the patient to be given during labor.Based on this information, what is the primary reason for administering antibiotics to this patient at this time?

The patient has heart disease, and the antibiotics will decrease the risk to her fetus of developing endocarditis.

The patient has heart disease, and the antibiotics will decrease her risk of developing pericarditis.

The patient will deliver post-term, and the antibiotics will help to decrease her risk of developing chorioamnionitis.

The patient will deliver post-term, and the antibiotics will decrease the risk to her fetus of developing a systemic infection.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. The patient has heart disease, and the antibiotics will decrease the risk to her fetus of developing endocarditis. Endocarditis is an infection of the inner lining of the heart and valves, which can be caused by bacteria entering the bloodstream during labor and delivery. Patients with mitral valve prolapse (MVP) are more prone to develop endocarditis because their valve leaflets are floppy and do not close tightly, creating a site for bacterial attachment.Antibiotics can help prevent this complication by killing the bacteria before they reach the heart.

Choice B is wrong because pericarditis is an inflammation of the outer layer of the heart, not the inner lining or valves. It is not related to MVP or bacterial infection.

Choice C is wrong because chorioamnionitis is an infection of the membranes and fluid that surround the fetus, not the heart. It is usually caused by bacteria ascending from the vagina or cervix, not from the bloodstream.

Choice D is wrong because delivering post-term does not increase the risk of systemic infection for the fetus. Systemic infection means infection that affects multiple organs or systems in the body, not just one specific site.

Nursing Test Bank

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Correct Answer is A

Explanation

Rubella immunization should be given in the early postpartum period.This is because rubella infection during pregnancy can cause serious birth defects or miscarriage, and rubella vaccine is contraindicated during pregnancy.Therefore, the best time to vaccinate a woman who is not immune to rubella is after she delivers her baby.

Choice B is wrong because gamma globulin is not effective for preventing rubella infection or congenital rubella syndrome (CRS).Gamma globulin is a preparation of antibodies that can provide temporary protection against some infections, but it does not induce lasting immunity.

Choice C is wrong because gamma globulin should not be given at the next visit for the same reason as choice B.Moreover, gamma globulin can interfere with the response to live vaccines such as rubella vaccine, so it should not be given within 3 months before or after vaccination.

Choice D is wrong because rubella immunization should not be given at the next visit or during pregnancy, as it can pose a risk to the fetus.Rubella vaccine is a live attenuated virus vaccine that can cross the placenta and infect the fetus.The risk of CRS from vaccination during pregnancy is low, but it cannot be ruled out completely.Therefore, women who receive rubella vaccine should avoid pregnancy for at least 4 weeks after vaccination.

A. Maintain the newborn in a reverse Trendelenburg position. B. Encourage family members to gently stroke the newborn’s face and head. C. Swaddle the newborn in a flexed position. D. Provide the newborn with visual stimulation.

Correct Answer is C

Explanation

The correct answer is choice C. Swaddle the newborn in a flexed position.This helps to reduce the symptoms of neonatal abstinence syndrome, which is what happens when babies are exposed to drugs in the womb before birth and go through drug withdrawal after birth.Swaddling can provide comfort, warmth, and security to the newborn and decrease their stress response.

Choice A is wrong because maintaining the newborn in a reverse Trendelenburg position does not help with drug withdrawal symptoms and may increase the risk of aspiration or reflux.

Choice B is wrong because gently stroking the newborn’s face and head may overstimulate the newborn and worsen their irritability and tremors.

Choice D is wrong because providing the newborn with visual stimulation may also overstimulate the newborn and increase their discomfort and agitation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 14-year-old client who is pregnant has a low result from a rubella serology test.Which notation should be made on this client’s care plan?

Correct Answer is A

Explanation

The newborn of a patient suspected to have used drugs during the prenatal period is admitted to the nursery.The nurse caring for the newborn notes that the infant is beginning to exhibit signs of drug withdrawal.Which action should the nurse take?

Correct Answer is C

Explanation

The nurse instructs a postpartum patient in the use of a sitz bath. Which action by the patient indicates that the teaching was effective?

A 14-year-old patient is 10 weeks pregnant. In order to plan nutritional counseling for this patient, the nurse should have which understanding about adolescents’ nutritional needs during pregnancy?

When assessing a newborn, which is the best method for the nurse to use to elicit the Moro reflex?

A nurse is caring for a primigravida whose cervix is 2 cm dilated, 75% effaced, and the fetal presenting part is at +2 station. The patient says to the nurse, “I want an epidural now.Why won’t someone give me an epidural?” Which response is most appropriate for the nurse to make?

A nurse is observing the internal fetal monitor readings of a laboring client.The fetal heart rate is between 130 and 138 beats per minute, with moderate beat-to-beat variability. How should the nurse interpret this finding?

The fetal monitor indicates that a patient is having contractions every three to four minutes with late fetal decelerations.Which action should the nurse take first?

A nurse is caring for a newborn of a diabetic mother (IDM). What should the nurse monitor for during care of the newborn?