A nurse is administering a miconazole vaginal suppository to a client who has vaginal candidiasis. Which of the following actions should the nurse take?
Insert the suppository 5 cm.
Apply petroleum jelly to the suppository.
Assist the client into a prone position.
Insert the suppository along the posterior vaginal wall.
The Correct Answer is D
Choice A rationale
Inserting the suppository 5 cm is generally insufficient for proper placement. The suppository needs to be placed further along the vaginal canal to be effective.
Choice B rationale
Applying petroleum jelly to the suppository is not recommended because it can interfere with the absorption and effectiveness of the medication.
Choice C rationale
Assisting the client into a prone position is not appropriate for inserting a vaginal suppository. The client should be in a lithotomy or supine position with legs bent.
Choice D rationale
Inserting the suppository along the posterior vaginal wall ensures proper placement and maximizes the effectiveness of the medication by allowing it to dissolve and be absorbed where it is needed.
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Correct Answer is A
Explanation
Choice A rationale
"You will be tested again for GBS at about 36 weeks of gestation.”. This is correct because retesting for GBS at 35-37 weeks of gestation is standard practice to identify colonization status before delivery, which helps in planning intrapartum antibiotic prophylaxis.
Choice B rationale
"If you test positive for GBS, the provider will need to perform a cesarean birth.”. This is incorrect because GBS colonization is not an indication for cesarean delivery. The primary intervention is antibiotic administration during labor to prevent neonatal infection.
Choice C rationale
"You will take an antibiotic during the last 2 weeks of pregnancy to avoid transferring GBS to your baby.”. This is incorrect because antibiotics are given intrapartum (during labor) to prevent GBS transmission, not during the last weeks of pregnancy.
Choice D rationale
"This infection can cause your baby to experience hearing loss at birth.”. This is incorrect because GBS infection primarily causes sepsis, pneumonia, and meningitis in neonates, not hearing loss.
Correct Answer is C
Explanation
Choice A rationale
Maternal age of 21 years is not considered a significant risk factor for gestational diabetes. Typically, advanced maternal age (35 years or older) is considered a risk factor due to changes in insulin resistance that occur with age.
Choice B rationale
A fasting blood glucose of 72 mg/dL is within the normal range and does not indicate a risk for gestational diabetes. Gestational diabetes is usually diagnosed with fasting blood glucose levels higher than 95 mg/dL.
Choice C rationale
Previous newborn weighing 4.8 kg is a significant risk factor for gestational diabetes. Having a macrosomic (large) baby in a previous pregnancy is linked with an increased risk of developing gestational diabetes in subsequent pregnancies.
Choice D rationale
A prepregnancy BMI of 23 is within the normal range (18.5-24.9) and does not increase the risk of gestational diabetes. Higher BMI levels, particularly above 25, are associated with an increased risk.