A pregnant woman initiated prenatal care at 12 weeks’ gestation.
At that time, her hemoglobin and hematocrit were 13 gm/dL and 36%, respectively.
Review her following prenatal labs at 28 weeks’ gestation: Hgb: 10.5 gm/dL Hct: 32% Blood type: B GBS: Positive Based on this data, what is the appropriate nursing action?
Administer a Rhogam injection.
Teach about iron-rich foods in her diet.
Notify the midwife to start PO antibiotics to treat the GBS.
Teach about avoiding exposure to rubella.
The Correct Answer is B
Choice A rationale
Administering a Rhogam injection is not indicated because the patient is Rh-positive (blood type B) and Rhogam is for Rh-negative individuals to prevent sensitization.
Choice B rationale
Teaching about iron-rich foods is appropriate, given her hemoglobin level of 10.5 gm/dL and hematocrit of 32%, indicating mild anemia; iron-rich foods help increase hemoglobin.
Choice C rationale
Starting PO antibiotics for GBS is unnecessary at this stage; antibiotics are administered during labor to prevent neonatal infection, not during prenatal care.
Choice D rationale
Avoiding exposure to rubella is important, but there is no indication in her current prenatal labs that she needs immediate teaching about this infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Uterine contractions (powers) are essential for cervical dilation and fetal descent. They are involuntary smooth muscle contractions regulated by oxytocin and prostaglandins.
Choice B rationale
The fetus (passenger) significantly influences labor progression. Fetal size, position, and presentation affect the ease of passage through the birth canal.
Choice C rationale
Pressure is not considered one of the five Ps affecting labor and birth. The five Ps are powers, passenger, passageway, position, and psychological response.
Choice D rationale
The birth canal (passageway) includes the bony pelvis and soft tissues, which must adapt to allow the fetus to pass through during labor.
Correct Answer is A
Explanation
Choice A rationale
Mild contractions and minimal cervical dilation suggest false labor. Administering a sedative helps the patient rest and wait for true labor onset. Sedatives can include sleep-inducing medications.
Choice B rationale
Cesarean birth is not indicated for a primigravida with mild contractions and minimal cervical dilation. This intervention is reserved for more serious obstetric complications.
Choice C rationale
Extended observation is unnecessary for mild contractions and unchanged cervical status. It is more appropriate for patients showing signs of true labor or complications.
Choice D rationale
True labor onset requires regular, increasing intensity contractions and cervical changes. Discharging the patient allows her to await true labor onset at home comfortably.
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