Choice A reason: Reducing stress level is a good practice for a pregnant client, as it can lower the risk of complications such as preterm labor, hypertension, and low birth weight. Therefore, this statement does not indicate a need for further teaching.

Choice B reason: Using only nonprescription medications while pregnant is a dangerous and incorrect practice, as some over-the-counter drugs can harm the fetus or cause birth defects. The client should always consult with their doctor before taking any medication, whether prescription or nonprescription. Therefore, this statement indicates a need for further teaching.

Choice C reason: Monitoring weight gain during pregnancy is a recommended practice, as it can help the client and the doctor assess the health and growth of the fetus. The client should follow the guidelines for appropriate weight gain based on their pre-pregnancy body mass index (BMI). Therefore, this statement does not indicate a need for further teaching.

Choice D reason: Telling the doctor before using home remedies for nausea is a prudent practice, as some herbal or natural remedies can interact with medications or cause adverse effects on the fetus. The client should also avoid self-medication and seek medical advice for persistent or severe nausea. Therefore, this statement does not indicate a need for further teaching.

Choice A reason: Using male condoms is one of the most effective ways to prevent the transmission of STDs, especially those caused by viruses or bacteria. However, condoms are not 100% foolproof and may not protect against some STDs that can be spread by skin-to-skin contact, such as herpes or HPV.

Choice B reason: Having multiple sex partners increases the risk of getting an STD, as it exposes the person to more potential sources of infection. The more partners a person has, the more likely they are to encounter someone who has an STD or does not know their status.

Choice C reason: Delaying sexual relations as long as possible is another way to lower the risk of getting an STD, as it reduces the number of sexual exposures and the chances of encountering an infected partner. Young people are especially vulnerable to STDs, as they may have less knowledge, experience, or access to preventive measures.

Choice D reason: All of the above choices are valid ways to lower the risk of getting an STD, but none of them are sufficient on their own. The best way to prevent STDs is to practice abstinence or be in a mutually monogamous relationship with a tested and uninfected partner. Additionally, regular testing, screening, and treatment are essential for detecting and curing STDs before they cause serious complications.

Choice A reason: Insulin is the preferred medication for gestational diabetes mellitus, as it does not cross the placenta and has no adverse effects on the fetus. It can be administered subcutaneously or intravenously, depending on the blood glucose level and the type of insulin.

Choice B reason: Glipizide is an oral antidiabetic agent that belongs to the sulfonylurea class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.

Choice C reason: Acarbose is an oral antidiabetic agent that belongs to the alpha-glucosidase inhibitor class. It delays the absorption of carbohydrates from the intestine and reduces the postprandial blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cause gastrointestinal side effects, such as flatulence, diarrhea, or abdominal pain, and may interfere with the absorption of other nutrients.

Choice D reason: Repaglinide is an oral antidiabetic agent that belongs to the meglitinide class. It stimulates the pancreas to secrete more insulin and lowers the blood glucose level. However, it is not recommended for gestational diabetes mellitus, as it can cross the placenta and cause hypoglycemia, macrosomia, or teratogenic effects on the fetus.

Choice A reason: Chlamydia is not the least common of all the major sexually transmitted diseases. In fact, it is the most common bacterial STD in the world, affecting about 131 million people each year. ¹ Therefore, this statement is false and does not need to be emphasized.

Choice B reason: Good handwashing technique is not the best way to prevent chlamydial infections. Chlamydia is spread through sexual contact, not through casual contact or hygiene. The best way to prevent chlamydial infections is to practice safe sex, such as using condoms, limiting the number of partners, and getting tested regularly. Therefore, this statement is misleading and does not need to be emphasized.

Choice C reason: Most people infected with chlamydia are unaware that they are infected. This is because chlamydia often has no symptoms, or the symptoms are mild and easily ignored. This can lead to serious complications, such as pelvic inflammatory disease, infertility, ectopic pregnancy, and increased risk of HIV. Therefore, this statement is true and needs to be emphasized.

Choice D reason: Burning and pain with urination is a frequent symptom of chlamydial infections. However, this symptom is not specific to chlamydia, as it can also occur with other STDs or urinary tract infections. Moreover, not all people with chlamydia experience this symptom, especially women. Therefore, this statement is not very informative and does not need to be emphasized.

Choice A reason: Syphilis is not caused by a virus, but by a bacterium called Treponema pallidum. It can also be spread through unprotected sex, but it has different stages and symptoms than herpes. Syphilis can be cured with antibiotics if detected early.

Choice B reason: HIV/AIDS is caused by a virus, but not one that is related to the virus that causes chickenpox. HIV stands for human immunodeficiency virus, which attacks the immune system and can lead to AIDS (acquired immunodeficiency syndrome). HIV can be spread through unprotected sex, but also through other means such as blood transfusion or sharing needles. HIV cannot be cured, but antiretroviral therapy can help control the infection and prevent AIDS.

Choice C reason: Gonorrhea is not caused by a virus, but by a bacterium called Neisseria gonorrhoeae. It can be spread through unprotected sex, but it usually causes symptoms such as discharge, burning, or pain in the genitals, anus, or throat. Gonorrhea can be cured with antibiotics, but some strains are resistant to treatment.

Choice D reason: Herpes simplex virus is caused by a virus that is related to the virus that causes chickenpox. There are two types of herpes simplex virus: HSV-1 and HSV-2. HSV-1 usually causes oral herpes (cold sores), while HSV-2 usually causes genital herpes. However, both types can infect either area. Herpes can be spread through any form of unprotected sex, and can be transmitted even when there are no visible sores. Herpes has no cure, but antiviral medications can help reduce the frequency and severity of outbreaks.

Choice A reason: The HPV vaccine can help prevent cervical cancer, as it protects against the most common types of HPV that cause cervical cancer. HPV is a sexually transmitted infection that can infect the cervix and cause abnormal cell changes that may lead to cancer. The HPV vaccine is recommended for both males and females between the ages of 9 and 26.

Choice B reason: The HPV vaccine will not protect you from all types of the virus, as there are more than 100 types of HPV, and the vaccine only covers 9 of them. However, these 9 types are responsible for about 90% of cervical cancers and 80% of anal cancers. The vaccine also does not protect against other sexually transmitted infections, such as chlamydia, gonorrhea, or HIV.

Choice C reason: You will not need to have a booster vaccination each year, as the HPV vaccine is given in a series of 2 or 3 doses, depending on the age of the person. The vaccine provides long-lasting protection, and no additional doses are needed after completing the series.

Choice D reason: You will still need to get a routine cervical exam, as the HPV vaccine does not eliminate the risk of cervical cancer completely. The vaccine does not protect against all types of HPV, and some people may already be infected with HPV before getting the vaccine. Therefore, regular screening with a Pap test and/or an HPV test is still recommended for women aged 21 to 65 to detect any abnormal cells or HPV infection in the cervix.

Choice A reason: This is not an appropriate response by the nurse, as an ultrasound is not a screening tool for spina bifida. Spina bifida is a birth defect that occurs when the spine and spinal cord do not form properly. It can be detected by a blood test that measures the level of alpha-fetoprotein (AFP) or by a detailed ultrasound that shows the spine and the brain.

Choice B reason: This is not an appropriate response by the nurse, as an ultrasound is not necessary to determine if there is more than one fetus. Multiple fetuses can be detected by other methods, such as listening to the fetal heartbeats, measuring the fundal height, or feeling the fetal movements.

Choice C reason: This is an appropriate response by the nurse, as an ultrasound assists in identifying the location of the placenta and fetus. This is important for an amniocentesis, which is a procedure that involves inserting a needle through the abdomen and the uterus to collect a sample of amniotic fluid. The ultrasound helps to guide the needle and avoid injuring the placenta or the fetus.

Choice D reason: This is not an appropriate response by the nurse, as an ultrasound is not useful for estimating fetal age at 36 weeks of gestation. Fetal age can be estimated by an ultrasound in the first trimester, when the fetus is growing at a predictable rate and has distinct features. However, in the third trimester, the fetus grows at different rates and has more variations in size and shape. Therefore, an ultrasound is less accurate and reliable for estimating fetal age at this stage.

Choice A reason: You can receive an influenza vaccination during pregnancy, as it is safe and recommended for pregnant women. The flu vaccine can protect you and your baby from serious complications of influenza, such as pneumonia, preterm labor, and low birth weight. The flu vaccine can also provide some immunity to your baby for the first few months of life. ¹

Choice B reason: You can receive the Tdap vaccine during pregnancy, as it is safe and recommended for pregnant women. The Tdap vaccine can protect you and your baby from tetanus, diphtheria, and pertussis (whooping cough). Pertussis can be very dangerous for newborns, as it can cause severe coughing, breathing problems, and even death. The Tdap vaccine can also provide some immunity to your baby for the first few months of life.

Choice C reason: You should not receive a varicella vaccine before you deliver, as it is not recommended for pregnant women. The varicella vaccine can protect you and your baby from chickenpox, which can cause serious complications such as skin infections, pneumonia, and birth defects. However, the varicella vaccine is a live vaccine, which means it contains a weakened form of the virus that can cause infection in some people. Therefore, it is not safe for pregnant women or their babies.

Choice D reason: You should not receive the rubella vaccine while breastfeeding, as it is not recommended for breastfeeding women. The rubella vaccine can protect you and your baby from rubella, which can cause serious complications such as miscarriage, stillbirth, and birth defects. However, the rubella vaccine is a live vaccine, which means it contains a weakened form of the virus that can cause infection in some people. Therefore, it is not safe for breastfeeding women or their babies.

Choice A reason: None of the above is incorrect because the other choices are not true statements about the overall number of cases of STIs.

Choice B reason: Staying about the same is incorrect because the overall number of cases of STIs is not constant. According to the World Health Organization, more than 1 million STIs are acquired every day worldwide.

Choice C reason: Going down is incorrect because the overall number of cases of STIs is not decreasing. On the contrary, some STIs such as syphilis, gonorrhea, and chlamydia are resurging in many regions due to factors such as antimicrobial resistance, lack of access to prevention and treatment services, and stigma.

Choice D reason: Rising is correct because the overall number of cases of STIs is increasing globally. The World Health Organization estimates that there were 376 million new cases of four curable STIs (chlamydia, gonorrhea, syphilis, and trichomoniasis) in 2016, up from 357 million in 2012. Additionally, there are millions of cases of incurable STIs such as herpes, HPV, and HIV that affect the health and well-being of people worldwide.

Choice A reason: HIV/AIDS is incorrect because it is not a curable infection. It is a chronic condition that requires lifelong antiretroviral therapy to suppress the virus and prevent complications.

Choice B reason: Chlamydia is correct because it is a curable infection. It is caused by a bacterium that can be eliminated with antibiotics. However, it can cause serious complications such as pelvic inflammatory disease, infertility, and ectopic pregnancy if left untreated.

Choice C reason: Human papillomavirus is incorrect because it is not a curable infection. It is a virus that can cause genital warts and cervical cancer. There is no specific treatment for HPV, but the symptoms can be managed and the risk of cancer can be reduced with regular screening and vaccination.

Choice D reason: Herpes simplex virus is incorrect because it is not a curable infection. It is a virus that can cause painful blisters and sores in the genital area. There is no cure for herpes, but antiviral medications can help reduce the frequency and severity of outbreaks.