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In a prenatal clinic, a nurse is caring for a group of clients.

Which client should the nurse identify as having a contraindication for a contraction stress test?

A.

A client who has gestational diabetes mellitus

B.

A client who had a previous stillbirth

C.

A client who had a nonreactive nonstress test

D.

A client who has a previous classical incision

Answer and Explanation

The Correct Answer is D

Choice A rationale
Gestational diabetes mellitus is not a contraindication for a contraction stress test. This condition affects how the mother’s body uses glucose (sugar) during pregnancy, but it does not interfere with the ability to perform a contraction stress test.
Choice B rationale
A previous stillbirth is not a contraindication for a contraction stress test. A stillbirth refers to the loss of a baby after 20 weeks of pregnancy. While this is a significant event, it does not prevent the mother from undergoing a contraction stress test in a subsequent pregnancy.
Choice C rationale
A nonreactive nonstress test is not a contraindication for a contraction stress test. A nonreactive nonstress test indicates that the baby’s heart rate does not speed up (or “react”) as it should when the baby moves. However, this result does not prevent the mother from undergoing a contraction stress test.
Choice D rationale
A previous classical incision is a contraindication for a contraction stress test. A classical incision refers to a vertical cut in the upper part of the uterus, which is typically used during a cesarean section. This type of incision increases the risk of uterine rupture, which can be life- threatening for both the mother and the baby. Therefore, a contraction stress test, which induces contractions, should not be performed due to the risk of uterine rupture.
 


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Related Questions

Correct Answer is D

Explanation

Choice A rationale
While it’s true that there may not have been any indication of GBS in earlier prenatal testing, this does not explain why the test was not conducted earlier. GBS can come and go in the body, so a negative test earlier in pregnancy does not guarantee that the woman will still be GBS-negative later in pregnancy.
Choice B rationale
Even if previous deliveries were all negative for GBS, this does not mean that the woman will not have GBS in this pregnancy. GBS can come and go in the body, so each pregnancy is considered separately.
Choice C rationale
GBS is usually asymptomatic in adults, so the woman would not typically report any symptoms of GBS during her pregnancy. This does not explain why the test was not conducted earlier.
Choice D rationale
GBS testing is typically done between 35-37 weeks of gestation. This is because GBS can come and go in the body, so testing during this time frame gives the best prediction of whether or not the woman will have GBS at the time of delivery.

Correct Answer is C

Explanation

Choice A rationale
Providing a stimulating environment is not recommended for infants with neonatal abstinence syndrome (NAS). These infants often have a heightened response to stimuli, and a calm, quiet environment is usually more beneficial.
Choice B rationale
While it is important to monitor the infant’s overall health, there is no specific need to monitor blood glucose level every hour in infants with NAS unless there is a separate medical indication.
Choice C rationale
Initiating seizure precautions is an appropriate action for a nurse caring for an infant with signs of NAS5. Infants with NAS are at risk for seizures, so nurses should be prepared to manage this potential complication.
Choice D rationale
Placing the infant on his back with legs extended is not recommended. Infants with NAS often have increased muscle tone and may be uncomfortable in this position.

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