A nurse is calculating the estimated date of delivery for a patient who reports that the first day of her last menstrual period was August 10. Using Nägele’s Rule, what is the patient’s estimated date of delivery?

The correct answer is choice d. Transmission can occur via the saliva and urine of the newborn.

Choice A rationale:

Lesions are not typically visible on the mother’s genitalia with cytomegalovirus (CMV) infection. CMV is often asymptomatic or presents with nonspecific symptoms, and visible lesions are not a characteristic feature.

Choice B rationale:

CMV does not require airborne precautions. It is primarily transmitted through direct contact with bodily fluids such as saliva, urine, blood, and breast milk.

Choice C rationale:

Prophylactic treatment with acyclovir is not standard for CMV. Acyclovir is used for herpes simplex virus infections, not CMV.

Choice D rationale:

CMV can indeed be transmitted via the saliva and urine of the newborn. This is a common mode of transmission, especially in settings like daycare centers where young children are in close contact.

Choice A rationale

While it’s true that symptoms of GBS in pregnant women are often not apparent, the absence of symptoms does not eliminate the risk of transmission to the baby during delivery.
Therefore, this is not the primary reason for the timing of the test.
Choice B rationale
Even though a woman’s previous deliveries were negative for GBS, it doesn’t mean she won’t have GBS in subsequent pregnancies. GBS can come and go in a person’s body without symptoms, so even if previous tests were negative, a woman could still have GBS in her current pregnancy.
Choice C rationale
GBS is not typically part of early prenatal testing. It is usually tested for late in the third trimester because a woman can test negative earlier in pregnancy and be positive by the time of delivery.
Choice D rationale
This is the correct answer. The primary reason for testing for GBS late in pregnancy is to identify women who are GBS positive at the time of delivery, as these women have a risk of transmitting GBS to their newborns during delivery.