A nurse is providing instruction to a client about diagnostic tests during their first prenatal visit at 12 weeks of gestation.
Which of the following diagnostic tests should the nurse include in the teaching?

Group B streptococcus (GBS).

Human immunodeficiency virus (HIV).

Chorionic villus sampling.

Cervical cone biopsy.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Group B Streptococcus (GBS) screening is typically performed much later in pregnancy, usually between 35 and 37 weeks of gestation. This screening is crucial for identifying carriers and administering prophylactic antibiotics during labor to prevent vertical transmission to the newborn, which can cause severe infections like sepsis or meningitis.

Choice B rationale

Human immunodeficiency virus (HIV) screening is a standard diagnostic test offered to all pregnant clients during their first prenatal visit, typically around 12 weeks of gestation. Early detection allows for timely interventions, such as antiretroviral therapy, to reduce the risk of mother-to-child transmission and improve maternal health outcomes.

Choice C rationale

Chorionic villus sampling (CVS) is an invasive diagnostic procedure performed earlier in pregnancy, usually between 10 and 13 weeks of gestation, but it is not a routine screening test. It is typically offered to clients at high risk for genetic disorders due to family history, advanced maternal age, or abnormal prenatal screening results.

Choice D rationale

Cervical cone biopsy is a diagnostic and therapeutic procedure used to remove a cone-shaped piece of tissue from the cervix, typically to evaluate or treat abnormal cervical cells. It is not a routine diagnostic test during a normal prenatal visit and is usually performed prior to pregnancy or if there are specific gynecological concerns.

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Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}

Explanation

The client is at risk for developing Intraamniotic infection as evidenced by White blood cell count.

Rationale for correct answers:
Intraamniotic infection (chorioamnionitis) is a bacterial infection of the amniotic sac often associated with prolonged rupture of membranes and labor. This client has spontaneous rupture of membranes (SROM) 1 hour ago with positive nitrazine test confirming amniotic fluid presence. The elevated white blood cell count (19,800/mm³; normal 5,000–15,000/mm³) is an early marker of infection or inflammation. The presence of group B streptococcus further increases infection risk. The amniotic fluid is moderate and clear, which is normal, so fluid characteristics alone do not indicate infection. Early identification and management of intraamniotic infection are critical to prevent maternal and fetal morbidity.

Rationale for incorrect Response 1 options:
Fetal hypoxia typically manifests as abnormal fetal heart rate patterns such as late decelerations or decreased variability, which are not present here (FHR 150/min, moderate variability). Labor dystocia refers to abnormal or slow labor progress; with 2 cm dilation and regular contractions, no evidence suggests dystocia yet. Gestational hypertension is a maternal hypertensive disorder unrelated to current rupture or WBC findings.

Rationale for incorrect Response 2 options:
Amniotic fluid characteristics (clear, moderate) are normal and not indicative of infection. Uterine tone is moderate and normal on palpation, not suggesting infection or abnormal labor. Cervical exam findings (2 cm dilation, 10% effacement) are early labor signs but do not indicate infection risk.

Take home points:

Elevated WBC after rupture of membranes signals increased risk of intraamniotic infection.
Clear amniotic fluid with positive nitrazine confirms membrane rupture but does not confirm infection.
Early labor signs should be monitored for infection risk, especially with group B strep positive status.
Differentiating infection from other labor complications like dystocia or fetal hypoxia relies on clinical signs and fetal monitoring.

Correct Answer is ["8"]

Explanation

Step 1 is to convert grams to milligrams. 2 g × (1000 mg ÷ 1 g) = 2000 mg.

Step 2 is to divide the total milligrams needed by the milligrams per tablet. 2000 mg ÷ 250 mg = 8 tablets. The nurse should administer 8 tablets.

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A nurse is providing instruction to a client about diagnostic tests during their first prenatal visit at 12 weeks of gestation. Which of the following diagnostic tests should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a female client, age 29, at 39 weeks of gestation in the intrapartum unit following spontaneous rupture of membranes. Complete the following sentence by using the lists of options. The client is at risk for developing _________ as evidenced by __________.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}

Explanation

A nurse is preparing to administer metronidazole 2 g PO to a client who has trichomoniasis. Available is metronidazole 250 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["8"]

Explanation

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A nurse is providing instruction to a client about diagnostic tests during their first prenatal visit at 12 weeks of gestation.
Which of the following diagnostic tests should the nurse include in the teaching?