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A 32 year-old G3P2 client is returning for her prenatal visit at 28 weeks.Her prenatal labs on record thus far are as follows: Type & Rh =A negative.
Antibody screen normal.
RPR = negative.
HIV = negative.
Rubella titer 1:16. Cervical smears negative for Gonorrhea & Chlamydia.
Hemoglobin/hematocrit = 11.0 mg/dl and 35%. Gestational diabetes glucose challenge test (GCT) Screen 26 wks = 120.
Urine analysis positive for leukocytes.
Today her plan of care should include which of the following: (Select all that apply)

Administer Rubella vaccine IM.

Instruct client on signs and symptoms of preterm labor.

Administer Rhogam IM.

Obtain a clean catch urine culture.

Order a 3-hour diagnostic glucose tolerance test.

Administer a blood transfusion.

Answer and Explanation

Correct Answer : B,C,D,E

Choice A rationale

Rubella vaccination is contraindicated during pregnancy due to the risk of congenital rubella syndrome in the fetus. It should be administered postpartum if the client is non-immune.

Choice B rationale

Preterm labor is a concern at 28 weeks' gestation. Educating the client on signs and symptoms can help in early detection and management, potentially improving outcomes for both mother and baby.

Choice C rationale

Rh-negative mothers with a negative antibody screen should receive Rhogam at 28 weeks to prevent Rh sensitization. This is crucial to avoid hemolytic disease of the newborn in future pregnancies.

Choice D rationale

A positive urine analysis for leukocytes indicates a possible urinary tract infection. A clean catch urine culture is needed to identify the causative organism and guide appropriate antibiotic therapy.

Choice E rationale

The glucose challenge test result of 120 at 26 weeks is within normal limits, but a 3-hour diagnostic glucose tolerance test may be ordered if there's a high index of suspicion for gestational diabetes or other risk factors.

Choice F rationale

A blood transfusion is not indicated as the hemoglobin/hematocrit levels (11.0 mg/dl and 35%) are within acceptable limits for pregnancy.

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Correct Answer is B

Explanation

Choice A rationale

Zidovudine (ZVD) is given intravenously during labor to reduce the risk of mother-to-child transmission of HIV.

Choice B rationale

HIV-positive mothers are advised not to breastfeed as HIV can be transmitted through breast milk. This statement indicates the need for further teaching.

Choice C rationale

Administering Zidovudine (ZVD) orally to the baby immediately after birth for 6 weeks is standard practice to prevent HIV transmission.

Choice D rationale

Adherence to taking Zidovudine (ZVD) at the same time every day during pregnancy is crucial for maintaining effective drug levels and reducing the risk of mother-to-child transmission.

Correct Answer is ["July 27"]

Explanation

Step 1 is to identify the first day of the last menstrual period (LMP), which is October 20.

Step 2 is to count back 3 months from October 20, resulting in July 20.

Step 3 is to add 1 year to July 20, resulting in July 20 of the following year.

Step 4 is to add 7 days to July 20, resulting in July 27.

Final calculated answer: July 27 of the following year.

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client that is HIV positive about HIV treatment.The client is 16 weeks pregnant.Which statement made by the client indicates that she needs more teaching?

Correct Answer is B

Explanation

A pregnant client tells the nurse that her LMP was 3 months ago and began on October 20. Using Naegele's rule, calculate the client's estimated date of delivery. Answer format: "October 20"

Correct Answer is ["July 27"]

Explanation

A pregnant client, at 16 weeks' gestation, has a hematocrit of 34%. Her pre-pregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change?

A nurse is caring for a client who is in preterm labor with a current L/S ratio of 1:1. Which of the following actions should the nurse take?

A client is 10 weeks pregnant and is experiencing nausea each day.Which strategy would the nurse NOT recommend to the client?

The nurse who is assessing a G2 P1 client palpates the fundal height at the location noted on the picture below (near the umbilicus). The nurse concludes that the fetus is equal to which of the following gestational ages?

A pregnant client tells the nurse that her LMP was 3 months ago and began on October 20. Using Naegele's rule, calculate the client's estimated date of delivery. Answer format E.g. "October 20"

After having an ultrasound, the fetus' heart shows that "normal fetal circulation is occurring.”. The RN is teaching a pregnant client about normal fetal circulation.Which of the following statements is consistent with the finding?

A nurse is caring for a client during an initial prenatal visit.The client's last menstrual period was 18 weeks ago.Which of the following actions should the nurse plan to take?

A nurse in a prenatal clinic is completing a skin assessment of a client who is in the third trimester.Which of the following findings should the nurse expect?