A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which findings would lead the nurse to suspect that the woman is developing an infection? Select all that apply.
Cloudy malodorous fluid
Abdominal tenderness
Fetal bradycardia
Elevated maternal pulse rate
Decreased C-reactive protein levels
Correct Answer : A,B,C,D
Choice A Reason: This is correct because cloudy malodorous fluid indicates that the amniotic fluid is contaminated with bacteria or other microorganisms that can cause infection in the woman or the fetus. Normally, amniotic fluid is clear and odorless.
Choice B Reason: This is correct because abdominal tenderness suggests that the woman has inflammation or irritation of the uterus or other pelvic organs due to infection. Abdominal tenderness can also be accompanied by cramping, pain, or fever.
Choice C Reason: This is correct because fetal bradycardia, which is a slow fetal heart rate below 110 beats per minute, indicates that the fetus is experiencing distress or hypoxia due to infection. Fetal bradycardia can be detected by electronic fetal monitoring or Doppler device.
Choice D Reason: This is correct because elevated maternal pulse rate, which is a heart rate above 100 beats per minute, indicates that the woman has an increased metabolic demand or systemic inflammation due to infection. Elevated maternal pulse rate can also be caused by dehydration, anxiety, or pain.
Choice E Reason: This is incorrect because decreased C-reactive protein levels do not indicate infection. C-reactive protein (CRP) is a protein that is produced by the liver in response to inflammation or infection. Increased CRP levels can be a sign of infection, but decreased CRP levels can be normal or indicate other conditions such as liver disease or malnutrition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason: This is the correct answer because it is an empathetic and supportive response that acknowledges the client's loss and grief. This is an empathetic and supportive response that acknowledges the client's loss and grief. The other choices are inappropriate because they are insensitive, dismissive, or inaccurate.
Choice B Reason: This is an inappropriate answer because it implies that the nurse does not understand or care about the client's emotional state. It also suggests that the client has no Reason to cry, which is invalidating and hurtful.
Choice C Reason: This is an inappropriate answer because it focuses on the physical pain rather than the emotional pain of the client. It also implies that the nurse wants to avoid dealing with the client's feelings and just give them a medication to make them stop crying.
Choice D Reason: This is an inappropriate answer because it is inaccurate and misleading. A spontaneous abortion, also known as a miscarriage, occurs when a pregnancy ends before 20 weeks of gestation. At this stage, the baby is already formed and has a heartbeat, organs, and limbs. Saying that a baby still wasn't formed in the womb is false and insensitive to the client's loss.
Correct Answer is D
Explanation
Choice A Reason: This is incorrect because mosquitoes do not transmit HIV. HIV is a virus that infects human cells and cannot survive in insects. Mosquitoes do not inject blood from one person to another when they bite, but only saliva that contains anticoagulants and enzymes.
Choice B Reason: This is incorrect because accidental puncture wounds are not a common mode of HIV transmission. HIV can be transmitted through exposure to infected blood or body fluids, such as through needle sharing, blood transfusion, or occupational injury. However, these cases are rare and can be prevented by using sterile equipment, screening blood products, and following universal precautions.
Choice C Reason: This is incorrect because casual contact is not a mode of HIV transmission. HIV is not an airborne virus and cannot be spread by coughing, sneezing, or breathing. HIV cannot be transmitted by hugging, kissing, or sharing utensils.
Choice D Reason: This is correct because direct contact with infected body fluids is the most common mode of HIV transmission. HIV can be transmitted through unprotected vaginal, anal, or oral sex with an infected person, as these activities can involve contact with infected blood, semen, vaginal fluid, or pre-ejaculate. HIV can also be transmitted through sharing needles or syringes with an infected person, or from mother to child during pregnancy, childbirth, or breastfeeding.

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