a nurse in a womans health clinic is obtaining a health history from a client which of the following findings should the nurse identify as increasing
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HESI Maternal Newborn

1. When obtaining a health history from a client, a nurse in a woman’s health clinic should identify which of the following findings as increasing the client’s risk for developing pelvic inflammatory disease (PID)?

Correct answer: D

Rationale: Chlamydia infection is a significant risk factor for developing pelvic inflammatory disease (PID). PID is often caused by untreated sexually transmitted infections (STIs) like Chlamydia and Gonorrhea that ascend from the vagina to the upper reproductive organs. Recurrent cystitis (choice A) is more related to urinary tract infections, frequent alcohol use (choice B) is not directly linked to PID, and the use of oral contraceptives (choice C) does not increase the risk of developing PID.

2. A client who is receiving prenatal care is at her 24-week appointment. Which of the following laboratory tests should the nurse plan to conduct?

Correct answer: B

Rationale: The correct answer is B: 1-hour glucose tolerance test. At around 24-28 weeks of gestation, a pregnant individual is typically screened for gestational diabetes. The 1-hour glucose tolerance test helps in identifying elevated blood sugar levels during pregnancy. Choice A, Group B strep culture, is not typically performed at the 24-week appointment but later in the third trimester to screen for Group B streptococcus colonization. Choice C, Rubella titer, is usually checked early in pregnancy to determine immunity to rubella. Choice D, Blood type and Rh, is important for determining the client's blood type and Rh status, but it is usually done earlier in pregnancy and not specifically at the 24-week appointment.

3. The healthcare provider prescribes 10 units per liter of oxytocin via IV drip to augment a client's labor because she is experiencing a prolonged active phase. Which finding would cause the nurse to immediately discontinue the oxytocin?

Correct answer: A

Rationale: A contraction duration of 100 seconds is too long and can indicate uterine hyperstimulation, which can lead to fetal distress and other complications. This prolonged contraction duration suggests that the uterus is not relaxing adequately between contractions, potentially compromising fetal oxygenation. Choice B, 'Four contractions in 10 minutes,' is a sign of tachysystole, which is concerning but not as immediately critical as the prolonged contraction duration. Choice C, 'Uterus is soft,' is not a reason to discontinue oxytocin; in fact, it is a normal finding. Choice D, 'Early deceleration of fetal heart rate,' while indicating fetal distress, is not a direct result of the oxytocin and may require intervention but not immediate discontinuation of the medication.

4. When should the low-risk patient, who is 16 weeks pregnant, be advised to return to the prenatal clinic?

Correct answer: D

Rationale: The correct answer is D: 4 weeks. Low-risk pregnant patients typically have prenatal visits every 4 weeks until 28 weeks of gestation. This frequency allows for adequate monitoring of the pregnancy without being overly burdensome on the patient. Choices A, B, and C are incorrect as they do not align with the standard prenatal care schedule for low-risk pregnancies. Visits that are too frequent may cause unnecessary anxiety for the patient, while visits that are too infrequent may miss important opportunities for monitoring and intervention.

5. What is the primary role of meiosis in the production of sperm and ova?

Correct answer: A

Rationale: The correct answer is A. Meiosis is a type of cell division that reduces the chromosome number by half, resulting in the formation of sperm and ova. Choice B is incorrect because meiosis does not increase the chromosome number. Choice C is incorrect because meiosis creates genetically diverse gametes, not identical copies of chromosomes. Choice D is incorrect because meiosis does not primarily function to repair damaged chromosomes.

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