Choice A rationale

Intramuscular ceftriaxone is effective in preventing ophthalmia neonatorum, caused by Neisseria gonorrhoeae. This bacterial prophylaxis inhibits cell wall synthesis, reducing infection transmission from mother to newborn.

Choice B rationale

While ceftriaxone treats bacterial infections broadly, this choice lacks specificity to neonatal risk factors like gonococcal transmission. It’s insufficient for targeted preventative care against ophthalmia neonatorum.

Choice C rationale

Ceftriaxone effectively treats gonorrhea by targeting penicillin-binding proteins. However, this option overlooks preventive measures crucial for neonates, focusing instead on therapeutic intervention for active infections.

Choice D rationale

Postpartum infection prophylaxis might use ceftriaxone, but it fails to address neonatal ophthalmic concerns. The focus here is misplaced, diverging from the stated preventive objective for the newborn.

Choice A rationale

No acute distress indicates the client's physiological stability. It reflects an absence of acute systemic responses like tachycardia or labored breathing, suggesting normal homeostasis during examination.

Choice B rationale

No cardiovascular murmurs or rubs imply normal valve function and an absence of pericardial inflammation. This finding indicates no pathological blood flow changes or cardiac friction sounds.

Choice C rationale

Clear bilateral breath sounds suggest open airways and proper ventilation, excluding lower respiratory tract issues like pneumonia. Normal respiratory examination confirms adequate pulmonary function.

Choice D rationale

Fundal height at 38 cm corresponds to late-third trimester pregnancy. It reflects uterine enlargement due to fetal growth, indicating gestational progression but unrelated to cervical discharge.

Choice E rationale

Purulent cervical discharge suggests an ongoing infection, likely bacterial cervicitis. It reflects leukocyte accumulation due to pathogenic invasion, requiring clinical intervention to prevent complications.

Choice A rationale

Occipital bruising typically results from birth trauma due to compressive forces during delivery. While notable, it isn’t necessarily pathological in the context of common neonatal findings.

Choice B rationale

Yellowish sclera and blanching skin indicate neonatal jaundice from elevated bilirubin levels. Hyperbilirubinemia arises due to immature hepatic conjugation processes, necessitating close monitoring for kernicterus risk.

Choice C rationale

A transcutaneous bilirubin level of 12.5 mg/dL exceeds normal (<12 mg/dL) for newborns, indicating hyperbilirubinemia. It reflects excessive hemolysis or liver immaturity requiring therapeutic interventions like phototherapy.

Choice D rationale

Phototherapy at 08: targets bilirubin breakdown into water-soluble forms for excretion. Blue light exposure facilitates reduced serum bilirubin levels, mitigating neonatal jaundice complications promptly. .

Choice A rationale

Molar pregnancy often manifests as intermittent dark brown vaginal discharge due to trophoblastic tissue expulsion. It warrants assessment as it correlates with hCG elevation and abnormal placental development.

Choice B rationale

Although significant blood loss could occur, dark brown discharge is not indicative of active hemorrhage. Hypovolemic shock typically results from acute red blood loss, not the chronic nature of this presentation.

Choice C rationale

Choriocarcinoma is a concern in cases following molar pregnancies, yet dark brown discharge alone does not confirm malignancy. Laboratory testing may be indicated, but it is not the immediate priority here.

Choice D rationale

Suction and curettage are treatment options for molar pregnancy but are contingent upon confirmed diagnosis. This intervention is premature without comprehensive assessment findings suggesting molar pregnancy.

Choice A rationale

Hypothyroidism is associated with certain conditions like iodine deficiency, but it is not a primary risk in the described situation. It does not specifically link to the immediate complications presented here.

Choice B rationale

Fallopian tube rupture is a critical complication of conditions like ectopic pregnancy, emphasizing the importance of timely diagnosis and intervention to prevent life-threatening internal bleeding and sepsis.

Choice C rationale

Hypovolemic shock, while life-threatening, is a secondary complication arising from severe conditions like abrupt rupture or hemorrhage. It is crucial but not as directly relevant as addressing fallopian tube rupture.

Choice D rationale

An invasive mole is a concern in certain pregnancies, especially following molar pregnancies, but the scenario here does not predominantly highlight invasive mole development.

Choice A rationale: Low uterine tone with mild vaginal bleeding is more indicative of placenta previa rather than abruptio placenta. Placenta previa involves the placenta covering the cervix, leading to painless bleeding. Uterine tone remains soft as there is no detachment of the placenta from the uterine wall. Abruptio placenta, however, is characterized by uterine rigidity due to blood accumulation between the placenta and uterine wall.

Choice B rationale: Rigid uterine tone with dark vaginal bleeding is a hallmark of abruptio placenta. The rigidity arises from blood pooling behind the placenta, causing uterine muscle contraction. Dark vaginal bleeding occurs as the blood is often concealed and clotted before expulsion. This condition is a medical emergency due to the risk of maternal hemorrhage and fetal hypoxia. Prompt diagnosis and intervention are critical to prevent severe complications.

Choice C rationale: Soft uterine tone with painless vaginal bleeding is characteristic of placenta previa, not abruptio placenta. Placenta previa involves the placenta partially or completely covering the cervix, leading to painless bleeding as the placenta detaches from the lower uterine segment. The uterine tone remains soft because there is no significant blood accumulation or uterine muscle contraction, unlike in abruptio placenta.

Choice D rationale: Low uterine tone with absence of vaginal bleeding does not align with abruptio placenta. While concealed abruptio placenta can occur without visible bleeding, the uterine tone is typically rigid due to blood accumulation. Low uterine tone suggests a lack of uterine contraction or detachment, which is inconsistent with the pathophysiology of abruptio placenta. This finding may indicate other obstetric conditions rather than abruptio placenta.

Choice A rationale

Checking the newborn’s temperature every 8 hours is insufficient during phototherapy. Frequent monitoring every 2-4 hours ensures proper thermoregulation, essential to preventing hypothermia or hyperthermia risks.

Choice B rationale

Moisturizing lotions can interfere with phototherapy by altering light penetration. Additionally, these products might increase the risk of skin irritation or chemical burns under light exposure.

Choice C rationale

Repositioning every 2-3 hours evenly exposes all skin areas to light, optimizing bilirubin breakdown and preventing pressure ulcers, ensuring effective phototherapy outcomes and skin integrity.

Choice D rationale

Glucose water is not recommended for hyperbilirubinemia management. Adequate hydration through breastfeeding or formula feeding ensures bilirubin excretion without interfering with feeding schedules or therapy effectiveness. .

Choice A rationale

Ampicillin is a first-line antibiotic effective against group B streptococcus B-hemolytic bacteria, preventing neonatal infection during labor. It targets the bacterial cell wall synthesis and is safe in pregnancy.

Choice B rationale

Azithromycin is a macrolide antibiotic, mainly used for atypical pathogens like Mycoplasma or Chlamydia. It is not the standard treatment for group B streptococcus infections during labor.

Choice C rationale

Ceftriaxone is a broad-spectrum cephalosporin. Though effective for various bacterial infections, it is not the preferred treatment for intrapartum group B streptococcus prevention.

Choice D rationale

Acyclovir is an antiviral medication targeting herpes simplex virus replication. It has no efficacy against bacterial infections like group B streptococcus.