min with moderate variability, and mild uterine irritability is noted. The abdomen is soft and nontender upon palpation. Cervical examination reveals dilation of 1 cm, thickness, and no presenting part palpable. An ultrasound shows a footling breech presentation. There are clusters of lesions noted on the vaginal introitus and labia majora.

Exhibit 5: History and Physical

The client is gravida 2 para 1, with a previous vaginal delivery. She has a history of hypothyroidism and Herpes simplex virus type 2. She is currently undergoing labor induction at 39 weeks and 3 days of gestation.

Querry

For which of the following findings should the nurse anticipate a provider's prescription to withhold the dinoprostone? Select all that apply.

Breech presentation

Terbutaline administration

FHR (Fetal Heart Rate)

WBC count

Lesions noted

Question Solution

Correct Answer : A,C,E

Choice A rationale:

Breech presentation is a contraindication for dinoprostone as it increases the risk of complications during labor and delivery. Using dinoprostone to induce labor in a non-vertex presentation can lead to issues such as cord prolapse or obstructed labor, which necessitate a cesarean section for safe delivery.

Choice B rationale:

Terbutaline administration is used to manage preterm labor by relaxing the uterus. While it is relevant in labor management, it does not directly contraindicate the use of dinoprostone. Terbutaline and dinoprostone can be used in conjunction if properly managed.

Choice C rationale:

Fetal heart rate (FHR) monitoring showing abnormalities is a potential reason to withhold dinoprostone. Dinoprostone can increase uterine contractions, potentially stressing the fetus. A stable FHR with moderate variability indicates fetal well-being; however, if there were concerns, the provider might withhold dinoprostone.

Choice D rationale:

A WBC count of 9,500/mm³ is within the normal range and does not indicate an infection or condition that would contraindicate dinoprostone use. Elevated WBC count could raise concerns, but in this case, it is normal and not a contraindication.

Choice E rationale:

Lesions noted on the vaginal introitus and labia majora, likely caused by Herpes simplex virus, are a contraindication for dinoprostone. Active genital herpes lesions increase the risk of neonatal herpes transmission, making vaginal delivery risky. In such cases, cesarean delivery is often preferred to prevent transmission.

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A. "You will be tested again for GBS at about 36 weeks of gestation.”. B. "If you test positive for GBS, the provider will need to perform a cesarean birth.”. C. "You will take an antibiotic during the last 2 weeks of pregnancy to avoid transferring GBS to your baby.”. D. "This infection can cause your baby to experience hearing loss at birth.”.

Correct Answer is A

Explanation

Choice A rationale

Testing for GBS at around 36 weeks of gestation is standard practice to identify carriers and prevent neonatal GBS infections through intrapartum antibiotic prophylaxis if necessary.

Choice B rationale

Cesarean birth is not indicated solely based on a positive GBS status. The primary intervention is intrapartum antibiotic prophylaxis to reduce the risk of neonatal infection.

Choice C rationale

Routine antibiotic administration during the last weeks of pregnancy is not standard practice; antibiotics are given during labor if GBS is present to prevent transmission to the baby.

Choice D rationale

GBS infection does not cause hearing loss in newborns. The primary concern is neonatal sepsis, pneumonia, or meningitis, not hearing loss.

A. Encourage the client to wear a bra that is loose fitting. B. Encourage the client to continue to breastfeed. C. Limit the client's daily fluid intake. D. Prepare the client for an abdominal sonogram.

Correct Answer is B

Explanation

Choice A rationale

Wearing a loose-fitting bra does not help in managing mastitis. Proper breast support and continuing breastfeeding are important to keep the milk flowing and reduce inflammation.

Choice B rationale

Continuing to breastfeed helps to clear the infection and maintain milk supply. It ensures that the ducts are cleared, reducing inflammation and aiding recovery from mastitis.

Choice C rationale

Limiting fluid intake is not recommended. Adequate hydration is crucial to help with milk production and overall recovery, especially during an infection.

Choice D rationale

An abdominal sonogram is not relevant to the management of mastitis. Treatment focuses on antibiotics, pain relief, and continued breastfeeding. .

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Correct Answer is A

Explanation

Correct Answer is B

Explanation

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A nurse is reinforcing teaching with a client who tested positive for group B streptococcus β-hemolytic (GBS) during a prior pregnancy and is at 30 weeks of gestation. Which of the following statements should the nurse make?

Correct Answer is A

Explanation

A nurse is contributing to the plan of care for a client who is postpartum and has mastitis. Which of the following actions should the nurse plan to take?

Correct Answer is B

Explanation

A nurse is reinforcing teaching with a client who tested positive for group B streptococcus β-hemolytic (GBS) during a prior pregnancy and is at 30 weeks of gestation. Which of the following statements should the nurse make?

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A nurse is assisting with the care of a client who is in active labor. The fetal monitor tracing shows late decelerations. Which of the following actions should the nurse take first?

A nurse is reinforcing teaching about crib safety with a group of prenatal clients. Which of the following information should the nurse include in the teaching?

A nurse is collecting data from a newborn who was delivered at 40 weeks of gestation. Which of the following is an expected finding when eliciting reflexes from the newborn?

A nurse on the postpartum unit is caring for a client who delivered vaginally 3 hr ago. Which of the following manifestations is a possible indication of postpartum hemorrhage?

A nurse is reinforcing teaching about risk factors for preeclampsia with a group of clients who are pregnant. Which of the following risk factors should the nurse include in the teaching?

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