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.

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Correct Answer is D

Explanation

The correct answer is choice D: To prevent her from having convulsions.Magnesium sulfate is a mineral that reduces seizure risks in women with preeclampsia, a condition of high blood pressure and protein in the urine during pregnancy.Magnesium sulfate can lower the cerebral perfusion pressure and prevent convulsions.However, magnesium sulfate does not affect the neonatal outcomes and can cause side effects such as respiratory depression.

Choice A is wrong because magnesium sulfate does not decrease blood pressure.It is used along with medications that help reduce blood pressure.

Choice B is wrong because magnesium sulfate does not decrease tidal volume.It can cause respiratory depression if the serum level is too high.

Choice C is wrong because magnesium sulfate does not prevent dehydration.It can cause fluid retention and pulmonary edema if given in excess.

A. Ask the patient if she has had any alcoholic beverages within the past 24 hours. B. Find out if the patient has had any bloody vaginal discharge today. C. Tell the patient that the fetal heart rate does not appear to indicate that the baby is in distress. D. Explain to the patient the relationship between a woman's anxiety level and her ability to detect movement.

Correct Answer is C

Explanation

This is because a normal fetal heart rate is between 110 and 160 beats per minute, and the range of 136 to 143 indicates that the fetus is well-oxygenated and not experiencing hypoxia or acidosis. The nurse should reassure the patient and explain that fetal movement may decrease during labor due to the pressure of the contractions on the uterus and the fetus.

Choice A is wrong because asking the patient about alcohol consumption is irrelevant and insensitive.

Alcohol can affect fetal development and growth, but it does not directly affect fetal movement or heart rate.

Choice B is wrong because bloody vaginal discharge, or bloody show, is a normal sign of cervical dilation and effacement during labor.

It does not indicate fetal distress or placental abruption.

Choice D is wrong because explaining the relationship between anxiety and fetal movement does not address the patient’s concern or provide any factual information.

Anxiety can affect maternal perception of fetal movement, but it does not cause fetal movement to decrease.

The nurse should validate the patient’s feelings and provide factual reassurance.

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Naxlex Comprehensive Predictor Exams

A patient diagnosed with preeclampsia is admitted to the hospital and prescribed magnesium sulfate therapy. What is the purpose of administering magnesium sulfate to this patient?

Correct Answer is D

Explanation

A patient who is 42 weeks pregnant is admitted to the hospital in active labor.The patient is upset and says to the nurse, "I haven't felt the baby move for about three or four hours." The fetal heart rate is ranging between 136 and 143. Which action should the nurse take?

Correct Answer is C

Explanation

A nurse is caring for a 16-year-old primigravida who is in the last month of an uncomplicated pregnancy. Which measure is most appropriate to include in the patient’s plan of care?

A nurse is caring for a patient who is receiving oxytocin injection intravenously for labor induction.The nurse should monitor this patient for which adverse effect of oxytocin?

A nurse is caring for a client who has gestational diabetes and is scheduled for an amniocentesis at 37 weeks of gestation due to suspected fetal compromise. What is the nurse’s best response to the client’s question as to why the amniocentesis test is being done?

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The nurse at the antepartal clinic reviews four patients’ charts. Which patient is at increased risk for an ectopic pregnancy?

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A patient who is 34 weeks pregnant attends the antepartal clinic and is diagnosed with mild pregnancy-induced hypertension (PIH). The decision is made to treat the patient at home. Which instruction would be most appropriate to give to the patient?