A multiparous client with active herpes lesions is admitted to the unit with spontaneous rupture of membranes. Which action should the nurse take?

Obtain blood cultures.

Administer penicillin.

Prepare for a cesarean section.

Cover the lesion with a dressing.

Answer and Explanation

The Correct Answer is C

A. Obtain blood cultures. Blood cultures are not required for diagnosing or managing herpes simplex virus (HSV) in pregnancy. While neonatal herpes can lead to systemic infection, cultures are typically performed on the newborn only if infection is suspected after birth. The priority is preventing vertical transmission.
B. Administer penicillin. Penicillin is used for bacterial infections, such as Group B Streptococcus (GBS) or syphilis, but it is ineffective against HSV, which is a viral infection. Antiviral medications like acyclovir are used to suppress HSV outbreaks during pregnancy, but once active lesions are present at term, cesarean delivery is required.
C. Prepare for a cesarean section. Active genital herpes at the time of delivery poses a significant risk of neonatal herpes, which can cause severe complications such as encephalitis, sepsis, or death. To prevent direct contact with the virus, cesarean section is recommended if there are active lesions or prodromal symptoms at the time of labor or rupture of membranes.
D. Cover the lesion with a dressing. Covering herpes lesions does not prevent transmission during vaginal birth, as the virus can still be present in vaginal secretions. The most effective way to prevent neonatal herpes is to avoid exposure through cesarean delivery.

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Correct Answer is A

Explanation

A. Folic acid. Folic acid is essential for neural tube development and significantly reduces the risk of neural tube defects (NTDs) such as anencephaly and spina bifida. Women planning to conceive should take at least 400–800 mcg of folic acid daily, beginning before conception and continuing during early pregnancy, to support proper neural tube closure.
B. Iron. Iron is important for preventing maternal anemia and supporting fetal growth, but it does not play a direct role in neural tube development. While iron supplementation is recommended during pregnancy, it does not prevent neural tube defects such as anencephaly.
C. Vitamin D. Vitamin D is crucial for calcium absorption and fetal bone development but does not impact neural tube formation. Deficiency can lead to rickets in newborns, but it is not associated with neural tube defects.
D. Calcium. Calcium supports maternal bone health and fetal skeletal development but does not influence neural tube formation. While necessary for overall pregnancy health, calcium supplementation does not prevent anencephaly or other NTDs.

A. Weight gain. B. Reduction of edema. C. Improved caloric intake. D. Reduction of fever.

Correct Answer is B

Explanation

A. Weight gain. While albumin administration increases intravascular volume, leading to temporary fluid retention, the goal in nephrotic syndrome is to shift fluid from the interstitial spaces back into circulation. The expected outcome is a reduction in edema, not an overall weight gain. A persistent increase in weight could indicate continued fluid retention rather than treatment effectiveness.
B. Reduction of edema. Nephrotic syndrome is characterized by hypoalbuminemia, which causes fluid to leak from the blood vessels into the tissues, leading to generalized edema. Albumin 25% IV works by increasing oncotic pressure, drawing fluid back into the bloodstream. Once in circulation, excess fluid is excreted by the kidneys, resulting in decreased swelling, especially in the face, abdomen, and lower extremities.
C. Improved caloric intake. Nephrotic syndrome affects fluid balance but does not typically lead to reduced appetite unless complications arise. While improved well-being may lead to better nutritional intake, this is not the primary expected outcome of albumin therapy.
D. Reduction of fever. Fever is not a direct symptom of nephrotic syndrome, though it may occur with infections due to immunosuppression from protein loss. Albumin therapy does not have antipyretic properties, so a reduction in fever would not indicate the medication’s effectiveness in managing nephrotic syndrome.

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A multiparous client with active herpes lesions is admitted to the unit with spontaneous rupture of membranes. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing preconception counseling. Which supplement should the nurse recommend to help prevent the occurrence of anencephaly?

Correct Answer is A

Explanation

Albumin 25% IV is prescribed for a child with nephrotic syndrome. Which assessment finding indicates to the nurse that the medication is having the desired effect?

Correct Answer is B

Explanation

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