Your patient has gestational diabetes and she is currently on insulin 24 units in the morning and at night. She is worried about her baby and what will happen after the baby is born. In your education of the patient, you explain what will occur after the baby is born. Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?

Choice A reason: The HPV vaccine can help prevent cervical cancer, as it protects against the most common types of HPV that cause cervical cancer. HPV is a sexually transmitted infection that can infect the cervix and cause abnormal cell changes that may lead to cancer. The HPV vaccine is recommended for both males and females between the ages of 9 and 26.

Choice B reason: The HPV vaccine will not protect you from all types of the virus, as there are more than 100 types of HPV, and the vaccine only covers 9 of them. However, these 9 types are responsible for about 90% of cervical cancers and 80% of anal cancers. The vaccine also does not protect against other sexually transmitted infections, such as chlamydia, gonorrhea, or HIV.

Choice C reason: You will not need to have a booster vaccination each year, as the HPV vaccine is given in a series of 2 or 3 doses, depending on the age of the person. The vaccine provides long-lasting protection, and no additional doses are needed after completing the series.

Choice D reason: You will still need to get a routine cervical exam, as the HPV vaccine does not eliminate the risk of cervical cancer completely. The vaccine does not protect against all types of HPV, and some people may already be infected with HPV before getting the vaccine. Therefore, regular screening with a Pap test and/or an HPV test is still recommended for women aged 21 to 65 to detect any abnormal cells or HPV infection in the cervix.

Choice A reason: Herpes simplex virus is incorrect because it is not the infection described in the question. It is transmitted through direct contact with the skin or mucous membranes of someone who is infected, usually through oral or genital sex. Symptoms include painful blisters and sores in the mouth or genitals. It does not cause life-threatening infections, but it can increase the risk of other sexually transmitted infections.

Choice B reason: Human papillomavirus is incorrect because it is not the infection described in the question. It is transmitted through direct contact with the skin or mucous membranes of someone who is infected, usually through genital sex. Symptoms include genital warts and cervical cancer. It does not cause life-threatening infections, but it can increase the risk of other cancers.

Choice C reason: Human immunodeficiency virus is correct because it is the infection described in the question. It is transmitted through direct contact with the blood or body fluid of someone who is infected, usually through unprotected sex, sharing needles, or passed from a mother to a baby at birth. Symptoms may take 10 years or more to show. Once they appear, the person is susceptible to life-threatening infections, such as pneumonia, tuberculosis, or cancer. This condition is also known as acquired immunodeficiency syndrome (AIDS).

Choice D reason: Cytomegalovirus is incorrect because it is not the infection described in the question. It is transmitted through direct contact with the saliva, urine, or breast milk of someone who is infected, usually through kissing, sexual contact, or breastfeeding. Symptoms are usually mild or absent in healthy people, but they can be serious in people with weakened immune systems or unborn babies. It does not cause life-threatening infections, but it can cause birth defects, hearing loss, or vision problems.