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 A

Explanation

The correct answer is choice A and it indicates fetal distress because it is a sign oflate deceleration.Late decelerations are due touteroplacental insufficiencyas the result of decreased blood flow and oxygen to the fetus during the uterine contractions.This causeshypoxemiaand can lead to fetal acidosis and neurological damage.

Choice B is wrong because it indicates anormal variabilityin the fetal heart rate, which reflects a healthy autonomic nervous system.A normal fetal heart rate is 120-160 beats per minute.

Choice C is wrong because it indicates anearly accelerationin the fetal heart rate, which is a benign finding that may occur with fetal movement or stimulation.

Choice D is wrong because it indicates anearly decelerationin the fetal heart rate, which is a normal response to fetal head compression during contractions.

It does not indicate fetal distress.

Normal ranges for fetal heart rate patterns are:

• Baseline: 120-160 beats per minute

• Variability: 6-25 beats per minute

• Accelerations: at least 15 beats per minute above baseline for at least 15 seconds

• Decelerations: none or early (mirror contractions)

A. Forceps-assisted second stage of labor. B. Precipitous delivery. C. Prolonged first phase of labor. D. Cesarean delivery.

Correct Answer is D

Explanation

The correct answer is choice D. Cesarean delivery.A pregnant patient with genital herpes is at higher risk of transmitting the infection to the baby during vaginal delivery, especially if there is an active outbreak near the time of birth.This can cause serious complications for the baby, such as brain damage, eye problems, or even death.Therefore, a cesarean delivery is recommended to avoid contact between the baby and the genital lesions.

Choice A is wrong because forceps-assisted second stage of labor is not a complication of genital herpes.

It is a method of assisted delivery that may be used for various reasons, such as fetal distress, maternal exhaustion, or abnormal presentation.

Choice B is wrong because precipitous delivery, which means a very fast labor and delivery, is not a complication of genital herpes.

It may be caused by factors such as multiparity, strong contractions, or previous rapid deliveries.

Choice C is wrong because prolonged first phase of labor, which means a slow dilation of the cervix, is not a complication of genital herpes.

It may be caused by factors such as ineffective contractions, large fetal size, or malposition.

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Naxlex Comprehensive Predictor Exams

A nurse caring for a patient in labor is evaluating the fetal heart monitor.Which finding would indicate fetal distress?

Correct Answer is A

Explanation

When a pregnant patient has genital herpes, for which complication is the patient at higher risk than the general population?

Correct Answer is D

Explanation

A patient had a cesarean delivery due to placenta previa.Which statement by the patient would indicate that she understands why she had the cesarean delivery?

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?

A patient with no prenatal care is admitted to the labor and delivery unit.She is placed on an external fetal monitor, and an intravenous infusion is begun. A tentative diagnosis of abruptio placentae is made.Which finding would support this diagnosis?

In planning the postpartum care of a multipara who had a normal pregnancy, labor, and delivery, which factor should be considered? The client needs to have:

A client is to receive ferrous sulfate tablets. Which drink item will enhance the absorption of the medication?

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 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?

A patient who is 37 weeks pregnant and has gestational diabetes is admitted to the labor and delivery unit for induction. The patient is placed on an external fetal monitor and receives an epidural anesthesia.Which action should the nurse take to identify a potential side effect of the epidural?