What is the expected language skill level for a 2-3 year old toddler?

Choice A rationale

Impetigo is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes. Steroids have immunosuppressive properties and can exacerbate bacterial infections by hindering the body’s ability to fight off the pathogens. Therefore, steroid creams are contraindicated and would not effectively treat the sores, as they would likely worsen the condition and delay healing.

Choice B rationale

The statement indicates an understanding of the importance of completing the full course of antibiotics to eradicate all of the bacteria. Discontinuing the medication prematurely can lead to antibiotic resistance and a recurrence of the infection, as some of the bacteria may survive and proliferate. Finishing the entire prescription ensures complete elimination of the pathogens.

Choice C rationale

Impetigo sores should not be covered with a tight dressing, as this can trap moisture and heat, creating an ideal environment for bacterial growth and proliferation. While the sores should be kept clean and dry, covering them daily with an occlusive dressing is generally not recommended. This can worsen the infection and hinder the drying and healing process.

Choice D rationale

Impetigo is highly contagious, but it is primarily spread through direct contact with the sores. While thumb sucking could potentially transfer bacteria from the hands to the face, it is not the primary route of transmission or a specific treatment concern. The focus should be on proper hand hygiene and avoiding scratching or picking at the lesions, which is the main way the infection spreads.

Choice A rationale

Preparing for a vaginal delivery is not the first action to perform based on a specific fetal monitor pattern. The initial step is to identify the cause of the non-reassuring pattern and attempt to correct it with less invasive measures. Preparing for delivery is a more advanced intervention and is considered only after other interventions, such as changing maternal position, administering oxygen, and providing intravenous fluids, have failed to resolve the fetal distress pattern.

Choice B rationale

Administering oxygen at 3 liters via nasal cannula is a supportive measure to increase fetal oxygenation. However, it is not the first action. The most immediate and effective first step is to improve uterine blood flow and placental perfusion by changing the maternal position. Decreasing pressure on the vena cava and aorta is a more direct way to improve oxygen delivery to the fetus than administering oxygen to the mother.

Choice C rationale

Turning the client or asking them to turn on their side is the first action. This maneuver relieves pressure on the maternal vena cava and aorta, which can be caused by the gravid uterus. By improving venous return and cardiac output, this position change directly increases blood flow to the placenta. This enhanced placental perfusion often corrects non-reassuring fetal heart rate patterns, such as late decelerations, by improving oxygen delivery to the fetus.

Choice D rationale

Performing a vaginal exam to assess for the umbilical cord is an important assessment, but it is not the first action. While a vaginal exam is necessary to rule out a prolapsed cord, especially with sudden changes in the fetal heart rate, it should be done after attempting the less invasive and immediate intervention of changing the client's position. Position change is a quick and non-invasive way to improve fetal oxygenation and is the priority initial step.