A newborn, whose mother is HIV positive, is scheduled for follow-up assessments. The nurse knows that the most likely presenting symptom for a pediatric client with AIDS is:

Correct Answer: C

Rationale: In this scenario, the correct answer is C) A persistent cold. This is because pediatric clients with AIDS often present with recurrent or persistent infections due to their compromised immune system. A persistent cold is a common manifestation in pediatric patients with AIDS due to their inability to fight off infections effectively. Option A) Shortness of breath is less likely to be the most common presenting symptom in a pediatric client with AIDS compared to recurrent infections like a persistent cold. While respiratory issues can occur in AIDS patients, they are not typically the initial presenting symptom. Option B) Joint pain is not a common presenting symptom of AIDS in pediatric clients. Joint pain is more commonly associated with conditions like arthritis or other rheumatologic disorders. Option D) Organomegaly (enlargement of organs) is also not typically the most likely presenting symptom in a pediatric client with AIDS. While organomegaly can occur in some cases of AIDS, it is not as common or as specific a symptom as recurrent infections like a persistent cold. Educationally, understanding the common presenting symptoms of pediatric clients with AIDS is crucial for healthcare providers working in maternal and reproductive health. This knowledge can help in early identification, timely interventions, and appropriate management of pediatric patients with HIV/AIDS, ultimately improving their outcomes and quality of life.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Transition labor with contractions every 2 minutes, lasting 90 seconds each. This pattern indicates very frequent and prolonged contractions, which can lead to uterine hyperstimulation and potential fetal distress. Discontinuing the oxytocin infusion in this situation is crucial to prevent further complications and allow for adequate uterine relaxation. Option B) Early labor with contractions every 5 minutes, lasting 40 seconds each, represents a normal pattern for early labor and does not warrant discontinuation of oxytocin. Option C) Active labor with contractions every 31 minutes, lasting 60 seconds each, indicates inadequate contractions for progression and would not require stopping oxytocin. Option D) Active labor with contractions every 2 to 3 minutes, lasting 70 to 80 seconds each, also represents a pattern of appropriate contractions for active labor and does not necessitate discontinuation of oxytocin. Educationally, understanding the appropriate management of oxytocin infusion in labor is essential for ensuring maternal and fetal well-being. Nurses must be able to recognize patterns of contractions that may indicate uterine hyperstimulation and take prompt action to prevent adverse outcomes. This rationale emphasizes the importance of monitoring labor progression and responding appropriately to deviations from normal patterns.

Correct Answer: A

Rationale: In the context of client teaching for gravid clients, the factor with the greatest influence on successful teaching is the client's readiness to learn (Option A). This is because a client's willingness and ability to engage with the information being presented significantly impact the effectiveness of the teaching process. When a client is motivated and open to learning, they are more likely to retain and apply the information provided by the maternity nurse. Clients who are ready to learn are more likely to ask questions, participate actively in discussions, and follow through with recommended practices, leading to better maternal and reproductive health outcomes. Regarding the other options: - Option B (The client's educational background) is less influential because regardless of a client's educational level, their readiness to learn can still vary. Education does not always correlate with a person's receptiveness to new information. - Option C (The order in which the information is presented) is important but not as critical as the client's readiness. While presentation order can impact comprehension, if the client is not receptive, the sequencing of information becomes less effective. - Option D (The extent to which the pregnancy was planned) may have some impact on the client's mindset and readiness to engage in learning, but it is not as directly related to the teaching process as the client's actual readiness to learn. In educational context, understanding and assessing the client's readiness to learn is fundamental for a maternity nurse to tailor their teaching strategies effectively. By recognizing and responding to the client's readiness, nurses can optimize the teaching process, promote client engagement, and ultimately enhance the client's maternal and reproductive health outcomes.

Correct Answer: B

Rationale: The most common neonatal birth trauma due to vaginal delivery is fracture of the clavicle. Although an infant may be asymptomatic, a fracture clavicle should be suspected is an infant has limited use of the affected arm malposition of the arm, an asymmetric Moro reflex (B), crepitus over the clavicle, focal swelling or tenderness, or cries when the arm is moved.

Correct Answer: D

Rationale: The most important instruction for a woman who had a miscarriage 6 months ago and is now pregnant is to take prescribed multivitamin and mineral supplements (Option D). This instruction is crucial because proper nutrition, including essential vitamins and minerals, is vital for supporting a healthy pregnancy and reducing the risk of complications. Elevating lower legs while resting (Option A) is not directly related to the specific needs of a pregnant woman who previously experienced a miscarriage. Increasing caloric intake by 200 to 300 calories per day (Option B) can be important during pregnancy, but it is not the most critical instruction in this scenario. Increasing water intake to 8 full glasses per day (Option C) is generally good advice for overall health but is not as directly essential as ensuring proper vitamin and mineral intake during pregnancy. In an educational context, it is important for nurses to understand the specific needs of women who have experienced miscarriages and are now pregnant. Providing targeted and evidence-based instructions, such as the importance of taking prescribed multivitamin and mineral supplements, is crucial for promoting the health and well-being of both the mother and the developing fetus. Nurses play a key role in educating and supporting women through their reproductive health journey, and ensuring they have the necessary information to optimize their outcomes.