A woman has been diagnosed with chlamydia. The nurse would expect the client to complain of which of the following signs/symptoms?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) No signs or symptoms. Chlamydia is a sexually transmitted infection that often presents asymptomatically, especially in women. This is a crucial point to emphasize in high-risk pregnancy assessments because pregnant women with untreated chlamydia are at risk of complications like preterm birth and neonatal infections. Option B) Painful lesions on the labia is more indicative of genital herpes rather than chlamydia. Option C) Foul-smelling discharge is commonly associated with bacterial vaginosis or trichomoniasis, not chlamydia. Option D) Severe lower abdominal pain is a symptom more commonly seen in conditions like pelvic inflammatory disease (PID) rather than chlamydia. Educationally, this question highlights the importance of understanding the varied presentations of different sexually transmitted infections, especially in the context of high-risk pregnancies. It underscores the need for healthcare providers to conduct thorough assessments and testing, even in the absence of symptoms, to ensure the health of both the mother and the developing fetus.

Correct Answer: C

Rationale: The correct answer is option C) 2,900 grams. In assessing a neonate's weight as appropriate-for-gestational age, we consider the expected weight range based on the gestational age. At 34 weeks, a neonate is expected to weigh around 2,900 grams, which falls within the normal range for that gestational age. Option A) 500 grams is too low for a 34-week neonate and would indicate a very low birth weight, which is not appropriate for the gestational age. Option B) 1,700 grams is also below the expected weight range for a 34-week neonate and would be classified as small for gestational age. Option D) 4,100 grams is above the expected weight range for a 34-week neonate and would be considered large for gestational age, not appropriate for the gestational age. Understanding neonatal weight categories is crucial in assessing the overall health and development of the newborn. This knowledge is essential for healthcare providers involved in the care of high-risk pregnancies to monitor and intervene appropriately to ensure optimal outcomes for both the mother and the newborn.

Correct Answer: D

Rationale: In this scenario, the correct question the nurse should ask is D) “When was the last time you fed the baby?” This question is crucial because engorgement is often due to inadequate breastfeeding frequency causing milk buildup. By knowing when the baby was last fed, the nurse can assess if the engorgement is due to infrequent feedings. Option A, asking about a warm shower, is not as pertinent as directly inquiring about the baby's feeding schedule. Option B, asking about an electric breast pump, may not address the immediate concern of engorgement and is not as relevant as feeding frequency. Option C, asking about fluid intake, while important for breastfeeding mothers, is not as directly related to the issue of engorgement as the timing of the last feeding. From an educational perspective, this question highlights the importance of understanding the physiological processes of breastfeeding and how engorgement can occur. It also emphasizes the significance of assessing breastfeeding practices and providing appropriate support and guidance to promote successful breastfeeding outcomes in postpartum care.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Obtain assistance for neonatal resuscitation. A baby with an Apgar score of 3 at one minute after birth indicates severe distress and requires immediate intervention. Neonatal resuscitation is crucial to support the baby's breathing and circulation, potentially saving its life. Option A) Administer ophthalmic prophylaxis is incorrect because at this critical moment, the priority is to address the baby's low Apgar score and potential need for resuscitation, rather than administering ophthalmic prophylaxis. Option B) Placing the baby on the abdomen of the mother is inappropriate in this situation as the baby needs urgent medical attention due to the low Apgar score. Option D) Repeating the Apgar score may lead to a delay in providing necessary care to the distressed newborn. It is crucial to act promptly in situations where immediate intervention is required. Educationally, understanding the significance of Apgar scores and knowing appropriate actions in response to low scores is essential for healthcare professionals working in obstetrics and neonatal care to ensure the best outcomes for both mothers and babies.

Correct Answer: C

Rationale: In the case of an infant of a diabetic mother with macrosomia (birth weight >4,000g), the correct answer to monitor for is C) Respiratory distress. These infants are at higher risk for respiratory distress syndrome due to delayed lung maturity and increased risk of meconium aspiration. Monitoring for signs such as tachypnea, retractions, nasal flaring, and cyanosis is crucial in these babies. Option A) Hyperreflexia is not typically associated with infants of diabetic mothers but may occur in conditions like hypocalcemia or CNS disorders. Option B) Hypoglycemia is a common concern in infants of diabetic mothers due to their exposure to high maternal blood glucose levels. However, it is not the primary concern immediately after birth. Option D) Opisthotonus, a condition characterized by arching of the back, is not a common manifestation in infants of diabetic mothers but may be seen in conditions like meningitis or severe hypoxic-ischemic encephalopathy. Educationally, understanding the specific risks associated with infants of diabetic mothers and how to monitor and manage these risks is essential for healthcare providers working in neonatal care settings. This knowledge ensures prompt recognition of potential complications and appropriate interventions to optimize outcomes for these vulnerable newborns.