A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors places the client at risk for an infection?

Midline episiotomy

Meconium-stained ﬂuid

Gestational hypertension

Placenta previa

Answer and Explanation

The Correct Answer is A

A. A midline episiotomy is a surgical incision made in the perineal area during childbirth. It is recognized as a risk factor for postpartum infection due to the possibility of bacterial contamination during and after delivery. Proper care and monitoring are essential to prevent infection in the site of the incision.

B. meconium-stained fluid, is not typically a risk factor for maternal infection; it is more a concern for the infant's health if aspirated.

C. gestational hypertension, affects blood pressure during pregnancy but does not directly increase the risk of postpartum infection.

D. placenta previa, is a condition where the placenta covers the cervix, which can lead to bleeding but not infection. Therefore, among the given options, a midline episiotomy is the factor that most significantly places the postpartum client at risk for an infection.

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Correct Answer is C

Explanation

Pregnant clients with HIV require comprehensive care during pregnancy, delivery, and postpartum periods to prevent transmission of HIV to the newborn. Bathing the newborn before initiating skin-to-skin contact is a recommended action to reduce the risk of HIV transmission from mother to child. This practice helps to remove any maternal blood or other bodily ﬂuids from the newborn's skin, which may contain the virus. Therefore, the nurse should instruct the client to bathe the newborn before initiating skin-to-skin contact.

Antiretroviral medications are usually continued throughout pregnancy and during labor and delivery to decrease the risk of transmission to the newborn. Therefore, the nurse should not instruct the client to stop taking antiretroviral medications at 32 weeks of gestation, as mentioned in option a.

Fetal scalp electrode is a device that ataches to the baby's scalp to monitor the fetal heart rate. This device can cause small cuts or abrasions on the baby's scalp, which may increase the risk of HIV transmission.

Therefore, its use should be avoided in clients with HIV. Therefore, option b is not a recommended action.

Administering pneumococcal immunization to the newborn within 4 hours following birth is not a recommended action in the plan of care for a client who is pregnant and has HIV. Pneumococcal immunization is not indicated for newborns immediately after birth. Therefore, option d is not a recommended action.

A. Eversion of the great toe B. Flexion of the forearm C. Downward curl of the toes D. Extension of the leg

Correct Answer is A

Explanation

The Babinski reﬂex is a normal reﬂex present in newborns and infants up to about 2 years old. It is elicited by stroking the lateral aspect of the sole of the foot from the heel towards the toes. A positive Babinski reﬂex is characterized by dorsiﬂexion (upward movement) of the big toe and fanning out of the other toes. This is also known as an extensor response.

Therefore, option a, eversion of the great toe, is the expected finding for a positive Babinski reﬂex. Options b, c, and d are not consistent with a positive Babinski reﬂex.

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A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors places the client at risk for an infection?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions should the nurse include in the plan of care?

Correct Answer is C

Explanation

A nurse is performing an assessment of a newborn’s Babinski reﬂex. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

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A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following factors places the client at risk for an infection?