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The nurse is working in a prenatal clinic. The first patient is a 21 yo. who is 12 weeks pregnant having her first baby. During the history the nurse discovers that she has a cat at home, and she is not stable relationship. She states she has had multiple partners and is uncertain who is the father of her baby. This is her first prenatal visit and she has lab work done. While all lab results are important the nurse will look closely at which of the following results based upon this history? (Select all that apply. Partial Credit will be given).

Glucose Tolerance Test

HIV

Urine glucose

Rubella Titer

Toxoplasmosis screen

Vaginal cultures for STD's

Maternal Serum Fetal Alphaprotein

Answer and Explanation

Correct Answer : B,E,F

A. The Glucose Tolerance Test is usually performed later in pregnancy (around 24-28 weeks) to screen for gestational diabetes, so it is not a primary concern at 12 weeks.

B. Given the patient's history of multiple partners and uncertainty about the father, HIV screening is important to prevent mother-to-child transmission and provide early treatment.

C. Urine glucose is typically monitored later in pregnancy for gestational diabetes, but it is not immediately prioritized based on this history.

D. The Rubella Titer is important, but it is less immediately critical than HIV, STDs, or toxoplasmosis, given the patient’s risks.

E. Toxoplasmosis screening is necessary because handling cat litter can expose the mother to the risk of toxoplasmosis, which can harm the fetus.

F. Vaginal cultures for STDs are important given the patient’s multiple partners, as untreated STDs can lead to complications like preterm birth or neonatal infections.

G. Maternal Serum Fetal Alphaprotein is typically used for screening for neural tube defects later in pregnancy and is not an immediate concern.

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Correct Answer is B

Explanation

A. Ignoring the mood swings is not an appropriate response because it may be a sign of postpartum mood changes that need to be monitored.

B. Mood swings in the postpartum period are common and often due to hormonal changes. This is normal unless it persists beyond two weeks, at which point it may indicate postpartum depression.

C. Suggesting antidepressants immediately is premature; mood swings are common in the postpartum period, and treatment is not necessary unless they persist or worsen.

D. Advising the husband to leave the wife unattended is unsafe and inappropriate. Ensuring the wife has support during this time is important.

A. A pulse of 132 is high and could be a sign of tachycardia, which is a known side effect of Terbutaline, potentially making the use of this medication unsafe. B. Uterine contractions (UCs) every 10 minutes do not indicate any immediate concern or contraindication for Terbutaline. C. A category 1 FHR is reassuring and would not contraindicate the use of Terbutaline.

Correct Answer is C

Explanation

A. While assessing blood pressure is important, the first priority is to address potential uterine atony, which is the most common cause of postpartum hemorrhage.

B. Bladder distention could be a contributing factor, but uterine massage is the first step to manage uterine tone and control bleeding.

C. Massaging the fundus is the first action to take when the patient is saturating a pad quickly after delivery, as this helps stimulate uterine contractions to control bleeding.

D. Preparing to administer oxytocic medication may be necessary if uterine massage does not effectively control bleeding, but it should come after assessing the uterus.

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Naxlex Comprehensive Predictor Exams

A man calls the nurses’ station stating that his wife, who delivered four days ago, is happy one minute and crying the next. The man says, "She was never like this before the baby was born. What would be the best response by the nurse?

Correct Answer is B

Explanation

A. A blood pressure of 94/60 is low but not typically a contraindication for Terbutaline administration.

Correct Answer is C

Explanation

A patient is HIV+ and wants to know how this will affect her pregnancy and baby. What should be included in the response to this patient? (Select all that apply).

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The nurse is evaluating the effectiveness of breastfeeding of a neonate prior to discharge. Which of the following would be included in the LATCH score? (Select all that apply).

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