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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The vaginal contraceptive ring is designed for cyclic use, specifically to be left inserted for 3 consecutive weeks, followed by a 1-week ring-free interval. This regimen allows for a withdrawal bleed during the ring-free week, mimicking a natural menstrual cycle while maintaining contraceptive efficacy by providing continuous hormone release for 21 days.
Choice B rationale
Body weight fluctuations of 4.5 kg (10 lb) do not significantly impact the effectiveness of the vaginal contraceptive ring. The ring delivers a localized and consistent dose of hormones that is not dependent on systemic absorption influenced by minor weight changes. Therefore, contacting a provider for a new ring due to this weight change is unnecessary.
Choice C rationale
The vaginal contraceptive ring should not be washed with soap and water after each use. The ring is a single-use, disposable device designed to be inserted and remain in place for the full 3-week duration. Washing it could potentially degrade the material or interfere with the controlled release of hormones, compromising its efficacy.
Choice D rationale
The vaginal contraceptive ring does not need to be inserted immediately before sexual intercourse. It provides continuous contraceptive protection as long as it is inserted and used correctly according to the 3-week in, 1-week out schedule. Its efficacy is not tied to the timing of individual sexual acts.
Correct Answer is D
Explanation
Choice A rationale
Hydrocodone is an opioid analgesic, but it is typically used for moderate to severe pain and is not commonly administered as a primary agent for severe active labor pain due to its slower onset and potential for more pronounced maternal and neonatal respiratory depression compared to other rapid-acting opioids.
Choice B rationale
Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) primarily used for mild to moderate pain and inflammation. It is generally not effective enough for severe labor pain and is contraindicated in late pregnancy due to potential adverse effects on fetal circulation, such as premature closure of the ductus arteriosus.
Choice C rationale
Naloxone hydrochloride is an opioid antagonist used to reverse opioid-induced respiratory depression. Administering naloxone during active labor would reverse the effects of any pain medication given, exacerbating the client's pain and potentially precipitating opioid withdrawal symptoms, thus it is not an appropriate pain management strategy.
Choice D rationale
Fentanyl citrate is a potent, rapid-acting synthetic opioid analgesic commonly used for severe pain during active labor. Its quick onset and short duration of action make it suitable for intermittent administration, allowing for effective pain relief with a lower risk of prolonged neonatal respiratory depression compared to longer-acting opioids.
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