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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Free Nursing Study Resources

Correct Answer is ["B","C","E","F","H","I"]

Explanation

A. Pump breastmilk and feed it to infant instead of nursing: Pumping doesn’t effectively empty the breast like direct nursing, which can worsen milk stasis. Direct breastfeeding helps clear the infection and encourages proper drainage.

B. Start infant on the unaffected side, so there is less pain when infant is the hungriest: Starting on the unaffected breast helps avoid pain when the breast is full and the infant is hungriest. It provides comfort while still allowing effective milk drainage from the affected side.

C. Finish antibiotics even if symptoms improve: Completing the antibiotic course is essential to fully eradicate the infection. Stopping early can lead to a relapse of mastitis or cause antibiotic resistance.

D. Wear an underwire bra around the clock: An underwire bra can restrict milk flow and cause further blockage, worsening mastitis. It's better to wear a non-restrictive, supportive bra for comfort and proper milk drainage.

E. Apply warm compresses to affected area before feeding: Warm compresses help relieve pain and soften the breast tissue, encouraging better milk flow and reducing the inflammation caused by mastitis.

F. Wash hands before handling the breast: Washing hands reduces the risk of introducing bacteria into the breast tissue, preventing further infections and ensuring better hygiene while managing mastitis.

G. Maintain activity due to the risk of blood clots with extra rest: While moderate activity is important, rest is crucial for healing from mastitis. Overexertion can delay recovery; adequate rest supports immune function and recovery from infection.

H. Vary breastfeeding positions at each feeding: Changing positions ensures thorough milk removal from all areas of the breast, reducing the risk of milk stasis and helping to relieve mastitis symptoms.

I. Pump breasts if feeding will be missed, due to absence from the infant: Pumping ensures the breast is emptied if feeding is missed, preventing milk stasis. This is important for reducing the risk of mastitis and maintaining milk flow.

A. Artificial rupture of the membranes. B. Administration of antibiotics. C. Amnioinfusion for the baby. D. Administration of oxytocin.

Correct Answer is B

Explanation

A. Artificial rupture of the membranes: While artificial rupture of membranes may be done in some situations, it is not an immediate treatment for a GBS-positive client. The priority is to reduce the risk of infection, which is best achieved with antibiotics.
B. Administration of antibiotics: The most important and immediate treatment for a GBS-positive laboring client is administration of antibiotics, usually penicillin or ampicillin, to reduce the risk of transmitting the infection to the baby during delivery. This is typically given during labor.
C. Amnioinfusion for the baby: Amnioinfusion is a procedure used to relieve umbilical cord compression or meconium aspiration, but it is not indicated for managing GBS infection. Antibiotics are the primary treatment to prevent neonatal infection.
D. Administration of oxytocin: Oxytocin is used to stimulate labor but is not the immediate priority for a GBS-positive client. The focus should be on preventing infection through antibiotic administration, not on initiating or enhancing labor.

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Body System	Nurses Notes and Flow Sheet
Respiratory	Respirations 16 breaths/minute Oxygen saturation of 89% Several deep breaths
Integumentary	Episiotomy intact with no redness Pad is saturated with blood 18 gauge IV to left forearm
Circulatory	Heart rate 96 beats/minute Blood pressure 90/62 mm Hg IV infusing at 125 mL/hr
Genital/Urinary	Boggy fundus 1 cm above umbilicus Fundus rotated to the right Voided 200 mL of clear yellow urine

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?

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Naxlex Comprehensive Predictor Exams

Exhibits Which education by the nurse will help resolve the issue for the client? Select all that apply.

Correct Answer is ["B","C","E","F","H","I"]

Explanation

The nurse is caring for a laboring client who is group B Streptococcus positive (GBS+). Which immediate treatment is indicated for this client?

Correct Answer is B

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?

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