A patient has a history of drug use and is screened for hepatitis B during the first trimester. Which action is most appropriate?

Correct Answer: B

Rationale: The correct answer is B: Plan for retesting during the third trimester. This is because screening for hepatitis B in the first trimester may not accurately reflect the patient's current status. Retesting in the third trimester ensures an updated result closer to delivery, allowing for appropriate interventions if needed. A: Practice respiratory isolation is incorrect because hepatitis B is transmitted through blood and bodily fluids, not through respiratory droplets. C: Discuss the recommendation to bottle feed her baby is incorrect as breastfeeding is not contraindicated in mothers with hepatitis B. D: Anticipate administering the vaccination for hepatitis B as soon as possible is incorrect as vaccination is not the immediate next step after screening; retesting and further evaluation are necessary before deciding on vaccination.

Correct Answer: A

Rationale: The correct answer is A: Ultrasound. Ultrasound is used to confirm cephalopelvic disproportion by assessing fetal size, position, and the mother's pelvic anatomy. It provides valuable information on fetal head size and position relative to the pelvis, helping to determine if the baby can pass through the birth canal. B: Fetal scalp pH is used to assess fetal well-being and oxygenation during labor, not specifically to confirm cephalopelvic disproportion. C: Amniocentesis is a procedure to obtain amniotic fluid for various tests, not directly related to confirming cephalopelvic disproportion. D: Digital pelvimetry involves manually measuring the dimensions of the maternal pelvis, which is less accurate and reliable compared to ultrasound for confirming cephalopelvic disproportion.

Correct Answer: D

Rationale: The correct answer is D: Active genital herpes. This condition can be transmitted to the baby during a vaginal birth, leading to serious complications. Cesarean birth is recommended to prevent transmission. Gonorrhea (A) and Chlamydia (B) can be treated with antibiotics and do not typically require a cesarean birth. Chronic hepatitis (C) does not necessarily require a cesarean birth unless there are other complicating factors.

Correct Answer: A

Rationale: The correct answer is A: Mastitis. The symptoms described point towards an infection of the breast tissue commonly seen in breast-feeding mothers. The redness, pain, fever, chills, and malaise are indicative of mastitis. It is important to differentiate mastitis from engorgement, which is a common issue in early breastfeeding, characterized by swelling and firmness of the breast. Blocked milk ducts may cause localized pain and tenderness but do not typically present with fever and systemic symptoms. Inadequate milk production is unrelated to the symptoms mentioned and is more related to breastfeeding challenges such as latch issues or insufficient milk removal.

Correct Answer: A

Rationale: The correct answer is A because lying in the left-lateral recumbent position helps maximize uterine and kidney perfusion by improving blood flow to these organs. By lying on the left side, the weight of the uterus is shifted off the major vessels, reducing compression and allowing for better circulation. This position also helps in relieving pressure on the inferior vena cava, promoting venous return and cardiac output. Choices B, C, and D are incorrect because they do not address the specific physiological benefits associated with the left-lateral recumbent position in the context of preeclampsia.