Group B Streptococcus (GBS) is part of the normal vaginal flora in 20% to 30% of healthy pregnant women. GBS has been associated with poor pregnancy outcomes and is an important factor in neonatal morbidity and mortality. Which finding is not a risk factor for neonatal GBS infection?

Correct Answer: D

Rationale: In this scenario, option D, "Premature rupture of membranes (PROM) 24 hours or longer before the birth," is not a risk factor for neonatal GBS infection. This is the correct answer because GBS transmission to the baby primarily occurs during labor and delivery, especially when the amniotic sac has ruptured for an extended period, increasing the exposure time. Option A, "Positive prenatal culture," is a risk factor because it indicates the presence of GBS in the mother's genital tract, which increases the likelihood of transmission to the newborn during childbirth. Option B, "Preterm birth at 37 weeks or less of gestation," is a risk factor because preterm infants have underdeveloped immune systems, making them more vulnerable to infections like GBS. Option C, "Maternal temperature of 38°C or higher," is a risk factor as maternal fever during labor can be a sign of infection, including GBS, which can increase the risk of neonatal infection. Educationally, understanding these risk factors is crucial for healthcare providers to implement appropriate interventions to prevent neonatal GBS infection, such as intrapartum antibiotic prophylaxis for mothers with known GBS colonization or risk factors. This knowledge can help improve maternal and neonatal outcomes by reducing the incidence of GBS-related morbidity and mortality.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Use another method of contraception for 1 week after starting the pill. Rationale: When a woman starts taking oral contraceptives after a first-trimester abortion, it takes about 7 days for the pill to become fully effective in preventing pregnancy. Therefore, using another form of contraception during this initial week is crucial to ensure protection against unintended pregnancy. Why the other options are incorrect: A) Avoiding sexual contact for 10 days after starting the pill is not necessary if another form of contraception is used during this time. B) While using condoms and foam as a backup method is a good practice in general, it is not specifically required in this situation where oral contraceptives are being used. D) Waiting for vaginal bleeding to end before engaging in sexual relations does not ensure protection against pregnancy. It is important to use another method of contraception during the initial week of starting the pill. Educational context: This question highlights the importance of understanding the timeline for oral contraceptives to become effective and the necessity of using backup contraception during this period to prevent unintended pregnancies. It underscores the need for clear communication and education regarding contraceptive methods to ensure their optimal and safe use.

Correct Answer: B

Rationale: In this scenario, the most important information for the nurse to share is option B: "The risk of pelvic inflammatory disease will be higher with the IUD." This is crucial because the young woman's sexual behavior puts her at increased risk for sexually transmitted infections (STIs), which can lead to pelvic inflammatory disease (PID) if left untreated. Educating her about this risk is essential for her overall health and well-being. Option A is incorrect because while IUDs generally do not interfere with sex, this information is not the most critical in this context where the focus should be on the potential health risks associated with the device. Option C is incorrect because IUDs do not protect against STIs. It's important for the nurse to clarify this misconception to ensure the young woman understands the limitations of contraceptive methods in preventing STIs. Option D is incorrect because IUDs are actually highly effective in preventing pregnancy when used correctly. Pregnancy rates with IUDs are low, making this information less relevant compared to the risk of PID, especially given the young woman's sexual activity and multiple partners. In an educational context, it is vital for healthcare providers to provide comprehensive and accurate information to individuals seeking contraceptive methods, especially in cases where there may be increased risks due to the individual's sexual behavior. By addressing potential health risks associated with specific contraceptive methods, nurses can help individuals make informed decisions that promote their sexual and reproductive health.

Correct Answer: A

Rationale: The correct answer is A) You should always remove your diaphragm 6 to 8 hours after intercourse. Don't use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4°C, hypotension, and a rash. This answer is correct because it provides comprehensive and accurate information on how to reduce the risk of toxic shock syndrome (TSS) when using a diaphragm. Removing the diaphragm after 6 to 8 hours helps prevent the buildup of bacteria that can lead to TSS. Avoiding the use of the diaphragm during menses is essential as the increased moisture and blood can create a breeding ground for bacteria. Additionally, educating the woman on the warning signs of TSS such as fever, hypotension, and rash empowers her to seek prompt medical attention if needed. Option B is incorrect as removing the diaphragm immediately after intercourse does not allow enough time for it to effectively prevent pregnancy, and it does not address TSS prevention adequately. Option C is incorrect as using the diaphragm during menses can increase the risk of TSS due to the factors mentioned earlier, and washing it alone is not sufficient to prevent TSS. Option D is incorrect because leaving the diaphragm in for longer than 24 hours can indeed increase the risk of TSS, but it does not cover other important preventive measures like removing it after intercourse and avoiding use during menses. In an educational context, it is crucial for nurses to provide accurate and detailed information to clients regarding contraceptive methods to ensure their safety and well-being. Understanding the risks associated with different methods and how to mitigate them is essential for clients to make informed decisions about their reproductive health.

Correct Answer: C

Rationale: The correct answer is C) This practice is the only contraceptive method acceptable to the Roman Catholic Church because natural family planning aligns with the Church's teachings on contraception. The Roman Catholic Church promotes natural family planning as it involves understanding a woman's cycle to determine fertile and infertile periods, without the use of artificial contraception methods. Option A is incorrect because natural family planning is distinct from coitus interruptus or pulling out, which involves withdrawing the penis before ejaculation. Option B is incorrect as natural family planning does not align the woman's cycle with the phases of the moon but rather with her menstrual cycle. Option D is incorrect as natural family planning does not involve the use of barrier methods during fertile phases but instead relies on abstinence or other non-contraceptive methods to prevent pregnancy. Educationally, it is important for nurses to understand the nuances of different contraceptive methods to provide accurate information to clients. Knowing the beliefs and values of different religious groups can also help healthcare providers offer appropriate and respectful care to individuals from diverse backgrounds. Understanding natural family planning is crucial for healthcare professionals working in maternal health to support individuals in making informed decisions about their reproductive health.