A nurse is assisting the nurse manager with an educational session about ways to prevent TORCH infection during pregnancy with a group of newly licensed nurses. Which of the following statements by one of the session participants indicates understanding?

"A client should avoid consuming undercooked meat while pregnant

"Obtain an immunization against rubella early in pregnancy

“Seek prophylactic treatment if cytomegalovirus is detected during pregnancy.”

"A client should avoid crowded places during pregnancy."

Answer and Explanation

The Correct Answer is A

A. "A client should avoid consuming undercooked meat while pregnant." Toxoplasmosis, one of the TORCH infections, can be contracted by eating undercooked or raw meat. Avoiding undercooked meat helps prevent this infection, which can cause severe complications for the fetus.

B. "Obtain an immunization against rubella early in pregnancy." Rubella vaccine (part of MMR) is a live virus vaccine and is contraindicated during pregnancy due to the risk of harm to the fetus. Rubella vaccination should be administered before conception or postpartum.

C. "Seek prophylactic treatment if cytomegalovirus is detected during pregnancy." Currently, there is no prophylactic treatment for cytomegalovirus (CMV) during pregnancy. Prevention focuses on hygiene practices, such as frequent handwashing, especially after handling bodily fluids, to reduce the risk of transmission.

D. "A client should avoid crowded places during pregnancy." While avoiding crowded places may reduce exposure to certain infections, it is not a specific strategy for preventing TORCH infections. Other preventative measures, like avoiding raw meat and practicing good hygiene, are more effective.

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Correct Answer is C

Explanation

A. Assist the client into a side-lying position. There is no indication that the client needs repositioning based on the biophysical profile score. A score of 10 is normal, indicating the fetus is healthy.

B. Offer the client orange juice and repeat the assessment in 1 hr. This would be indicated if the score was low or if fetal movement was not detected, which is not the case here.

C. Assure the client that the score is within the expected range. A biophysical profile score of 10 is considered normal, indicating the fetus is well-oxygenated and not experiencing distress. The nurse should reassure the client that the score is normal.

D. Administer oxygen and notify the provider. There is no indication of fetal distress requiring oxygen administration based on a score of 10.

A. Apply an external fetal monitor. B. Complete a vaginal exam. C. Perform a rectal exam. D. Apply ice to the perineal area.

Correct Answer is A

Explanation

A. Apply an external fetal monitor. Applying an external fetal monitor is the appropriate action because it allows continuous monitoring of the fetal heart rate and uterine activity without disturbing the placenta, which is important in cases of placenta previa.

B. Complete a vaginal exam. Performing a vaginal exam is contraindicated in cases of suspected placenta previa because it could lead to placental disruption and severe bleeding. The cervix should not be manipulated when placenta previa is suspected.

C. Perform a rectal exam. A rectal exam is not indicated for placenta previa and offers no benefit in this context. This action could also increase discomfort and possibly exacerbate bleeding.

D. Apply ice to the perineal area. Ice to the perineal area is not relevant for placenta previa. Ice is typically used for perineal trauma or swelling, which is not related to this condition.

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A nurse is assisting the nurse manager with an educational session about ways to prevent TORCH infection during pregnancy with a group of newly licensed nurses. Which of the following statements by one of the session participants indicates understanding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is at 38 weeks of gestation and has a score of 10 on her biophysical profile. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is caring for a client who is at 34 weeks of gestation and has a suspected placenta previa. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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