The nurse is providing anticipatory guidance for an African-American client who is at 24-weeks gestation. Which prenatal laboratory assessment, prescribed at 28-weeks, should the nurse include in client teaching?

One-hour glucose screen.

Repeat HIV test.

Multiple marker screening.

Direct Coombs' test.

Answer and Explanation

The Correct Answer is A

A. One-hour glucose screen: The one-hour glucose screen is typically performed at 24-28 weeks gestation to screen for gestational diabetes. This is a standard test for all pregnant women during this time frame, regardless of ethnicity, and should be included in the client teaching.
B. Repeat HIV test: While HIV screening is important during pregnancy, a repeat HIV test at 28 weeks is not typically recommended for all women unless they are at high risk or have specific risk factors.
C. Multiple marker screening: This screening is usually done earlier in pregnancy, typically between 15-20 weeks, to assess the risk of certain fetal conditions like Down syndrome and neural tube defects. It is not performed at 28 weeks.
D. Direct Coombs' test: The Direct Coombs' test is typically performed on newborns, not on pregnant women, to check for hemolytic disease. However, Rh-negative women are often screened with the indirect Coombs' test at 28 weeks to check for antibodies, not the direct Coombs' test.

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Correct Answer is B

Explanation

A. Re-evaluate the need for medication: While it's important to reassess the client's pain management preferences, the primary focus for an unmedicated delivery is to provide support and help the client cope with labor without the use of medications.
B. Assisting her to maintain control: The primary focus during the active phase of labor for an unmedicated delivery is helping the client maintain control over her body and manage the pain through non-pharmacological methods. This could include breathing techniques, relaxation, and positioning.
C. Assessing the strength of uterine contractions: While monitoring contractions is essential for assessing labor progress, the focus should be more on providing emotional support and ensuring the client is empowered to manage the pain without medication.
D. Remind her to push three times with each contraction: Pushing instructions are typically given in the second stage of labor, not the active phase. During the active phase, the client is usually focusing on coping with the contractions.

A. Obtain a baseline complete blood count. B. Review maternal Rh factor status. C. Provide family support. D. Initiate a saline lock.

Correct Answer is D

Explanation

A. Obtain a baseline complete blood count: While a complete blood count (CBC) may be important for some procedures, it is not a priority for amniocentesis unless there are signs of infection or complications.

B. Review maternal Rh factor status: Rh factor status is not the highest priority in preparation for an amniocentesis. The most immediate concern is ensuring that the client has access to intravenous (IV) access if necessary during the procedure.

C. Provide family support: While providing emotional support is important, the immediate priority is ensuring that the client is medically prepared for the amniocentesis, including having an IV line in place for possible medication administration or fluid needs.

D. Initiate a saline lock: The highest priority is ensuring that the client has a saline lock in place, as this provides access for medication administration or fluids, should complications arise. This ensures the client is medically prepared for any immediate needs during the amniocentesis.

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The nurse is providing anticipatory guidance for an African-American client who is at 24-weeks gestation. Which prenatal laboratory assessment, prescribed at 28-weeks, should the nurse include in client teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which should be the primary focus of nursing care in the active phase of labor for a client who anticipates an unmedicated delivery?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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The nurse is providing anticipatory guidance for an African-American client who is at 24-weeks gestation. Which prenatal laboratory assessment, prescribed at 28-weeks, should the nurse include in client teaching?