Try Naxlex NCLEX-RN (Free-Trial)

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.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A rationale

The sex of the fetus can be determined earlier through ultrasound or blood tests, making amniocentesis at 36 weeks unnecessary for this purpose.

Choice B rationale

Detection of metabolic disorders can also be done earlier in the pregnancy through other tests. Amniocentesis at 36 weeks is not typically used for this purpose.

Choice C rationale

Determining fetal lung maturity is a primary reason for performing an amniocentesis at 36 weeks gestation. This test assesses whether the fetus's lungs are developed enough for the baby to breathe independently after birth.

Choice D rationale

Identification of abnormal fetal cells can be done earlier in pregnancy through amniocentesis or other genetic tests. It is not the primary reason for amniocentesis at 36 weeks.

A. Intrauterine growth restriction. B. Gestational diabetes. C. Congenital heart defects. D. Vision loss.

Correct Answer is A

Explanation

Choice A rationale

Intrauterine growth restriction (IUGR) is a significant risk for newborns of mothers who smoke. Smoking affects placental blood flow, reducing the supply of oxygen and nutrients to the fetus, leading to poor growth.

Choice B rationale

Smoking is not a direct cause of gestational diabetes. Gestational diabetes is primarily related to hormonal changes in pregnancy that affect insulin regulation.

Choice C rationale

Congenital heart defects are not directly linked to smoking. They are usually caused by genetic and environmental factors during early fetal development, not smoking specifically.

Choice D rationale

Vision loss is not directly associated with maternal smoking. Smoking affects fetal growth and development, but vision loss is not a common outcome.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse instructs a pregnant client that the purpose of an amniocentesis at 36 weeks gestation is for:

Correct Answer is C

Explanation

A nurse is speaking with a client who is 6 weeks' gestation.The client tells the nurse that she smokes one pack per day, but is trying to quit.The nurse should explain that newborns born to women who smoke are at risk for:

Correct Answer is A

Explanation

A nurse is reviewing the electronic medical record of a pregnant client who reports regular use of alcohol. Which of the following findings should the nurse identify as an indication the client may be at risk for polysubstance use disorder? (Select All that Apply)

Each of the following pregnant women is scheduled for a 14-week antepartal visit.In planning care, the nurse would give priority teaching on Quad screening to which client?

For each potential prescription from the provider, specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

A nurse is providing education to a client during her first prenatal visit.Which of the following should the nurse include in the teaching to decrease the risk of preterm labor?

A pregnant client asks about the functions of the placenta.Which of the following items should the nurse NOT include in the teaching plan?

A newborn who weighs 3900 grams is to receive 25mg/kg of Augmentin (Amoxicillin Clavulanate Potassium) q 24 hours. The supply on hand is 125mg/5mL. How many ml will the newborn receive in 24 hours? (Write in your answer).