Which factors should be considered a contraindication for transcervical chorionic villus sampling?

Correct Answer: D

Rationale: Transcervical chorionic villus sampling (CVS) is a prenatal diagnostic procedure used to detect genetic abnormalities in the fetus. The correct answer is D) Positive for group B Streptococcus, as this is a contraindication for CVS due to the risk of ascending infection. Group B Streptococcus can lead to complications such as chorioamnionitis and preterm labor, making it unsafe to perform CVS in these cases. Option A) Rh-negative mother is not a contraindication for CVS as it is not directly related to the procedure or its risks. Option B) Gestation less than 15 weeks is not a contraindication but rather a factor to consider in determining the timing of CVS, as it is typically performed between 10-13 weeks of gestation. Option C) Maternal age younger than 35 years is also not a contraindication for CVS but rather a general demographic factor that may influence the decision to undergo prenatal genetic testing. Educationally, it is crucial for healthcare providers to understand the contraindications and appropriate indications for prenatal diagnostic procedures like CVS to ensure patient safety and optimal outcomes. Understanding the specific risks associated with certain conditions, such as Group B Streptococcus infection in this case, is essential in clinical decision-making and providing quality care to pregnant individuals.

Correct Answer: C

Rationale: Transvaginal ultrasonography during the first trimester is commonly used to assess the presence and location of the pregnancy, making option C the correct answer. This is essential for confirming intrauterine pregnancy and ruling out ectopic pregnancy. Option A, multifetal gestation, is typically not diagnosed solely based on transvaginal ultrasonography in the first trimester, as it may be confirmed later in pregnancy with more clarity. Option B, bicornuate uterus, is a structural uterine anomaly that may not necessarily be detected during routine first-trimester ultrasound. Amniotic fluid volume, option D, is usually assessed in later trimesters and not a primary indication for transvaginal ultrasound in the first trimester. Understanding the indications for specific tests in maternal-fetal monitoring is crucial for healthcare providers managing pregnancy. Knowing when and why certain tests are performed ensures optimal care for both the mother and the developing fetus. The ability to interpret ultrasound findings accurately can lead to timely interventions and improved outcomes.

Correct Answer: B

Rationale: In this scenario, the priority information for the nurse to provide to a 10-week gravid client in the prenatal clinic is "Methods to relieve backaches" (Option B). The rationale behind this is multi-faceted: 1. **Physiological Impact**: Backaches are a common discomfort experienced by pregnant women due to the additional weight and changes in posture. Providing strategies to relieve backaches can significantly improve the client's comfort and quality of life during pregnancy. 2. **Client-Centered Care**: Addressing backaches demonstrates the nurse's commitment to meeting the client's immediate needs. It shows empathy and a personalized approach to care, which is essential in building a trusting nurse-client relationship. 3. **Preventive Care**: By educating the client on methods to relieve backaches early in pregnancy, the nurse can help prevent the exacerbation of this discomfort as the pregnancy progresses, promoting overall well-being and reducing the risk of complications. Now, let's discuss why the other options are not the priority: A) **Pain management during labor**: While pain management during labor is crucial, providing information on this topic at 10 weeks of gestation might be premature and could cause unnecessary anxiety. It is more relevant to discuss this topic in later prenatal visits closer to the due date. C) **Breastfeeding positions**: While breastfeeding is an important topic, discussing breastfeeding positions at 10 weeks of gestation is not as pressing as addressing immediate discomforts like backaches. This information can be appropriately covered in later prenatal education sessions. D) **Characteristics of the newborn**: Understanding the characteristics of the newborn is important, but at 10 weeks of gestation, the focus should be on maternal well-being and prenatal care. Information about the newborn can be addressed in prenatal classes closer to the due date. In an educational context, this rationale highlights the importance of client-centered care, early intervention for discomfort management, and the significance of addressing immediate needs in prenatal education. Providing tailored anticipatory guidance enhances the client's experience, promotes trust in healthcare providers, and supports overall maternal well-being during pregnancy.

Correct Answer: C

Rationale: The most appropriate response by the nurse in this situation is option C: "It sounds like you’re feeling a little overwhelmed right now." This response demonstrates empathy and active listening, acknowledging the client's emotional state without making assumptions or giving false reassurances. Option A ("I’m absolutely positive that everything will turn out all right.") is incorrect because it dismisses the client's concerns and does not address the underlying emotions. Option B ("I suggest that you e-mail your professors to set up an alternate plan.") may be practical advice, but it does not address the client's emotional needs at the moment. Option D ("You and the baby’s father will find a way to get through the pregnancy.") assumes the involvement of the baby's father and may not be applicable in all situations. In an educational context, it is crucial for nurses to prioritize client-centered care, especially in sensitive situations like pregnancy. Active listening, empathy, and non-judgmental responses are essential skills for nurses to support clients effectively during times of stress or uncertainty. It is important to validate the client's feelings and offer support and resources to help them navigate their situation.

Correct Answer: C

Rationale: In the context of maternal fetal monitoring, the correct answer is option C) Hearing the fetal heartbeat. This experience is often a powerful and emotional moment for fathers as it provides a tangible connection to the developing baby. Hearing the fetal heartbeat can evoke a sense of reality and involvement in the pregnancy journey, prompting fathers to feel a stronger bond with the unborn child and a heightened interest in the pregnancy process. Option A) Learning the results of the pregnancy test is an important moment, but it may not necessarily increase the father's interest and involvement in the pregnancy as much as hearing the fetal heartbeat. This initial confirmation may not have the same emotional impact as a direct connection to the developing baby. Option B) Attending childbirth education classes is valuable for both parents to prepare for the birth, but it is a planned educational activity rather than a spontaneous, emotionally impactful moment like hearing the fetal heartbeat. Option D) Meeting the obstetrician or midwife is essential for prenatal care, but it may not inherently increase the father's interest and involvement in the pregnancy to the same extent as a direct experience like hearing the fetal heartbeat. Educationally, understanding the emotional and psychological aspects of pregnancy for both parents is crucial in providing holistic care. Recognizing the significance of moments like hearing the fetal heartbeat can help healthcare providers support fathers in their journey towards active participation in pregnancy and childbirth.