Nokea
An antepartal client is Rh negative and understands that she will receive a RhoGAM injection during her pregnancy. The client asks the nurse if she will also receive a RhoGAM injection after the birth of her baby. The client will receive RhoGAM after the birth if blood tests are:
- A. Mother Rh positive; baby Rh negative
- B. Mother Rh negative; Coombs positive; baby Rh negative
- C. Mother Rh positive; Coombs negative; baby Rh positive
- D. Mother Rh negative; Coombs negative; baby Rh positive
Correct Answer: D
Rationale: If the baby is Rh positive and the mother is Rh negative, the mother may develop antibodies against the baby's blood. RhoGAM is administered to prevent the mother's immune system from becoming sensitized to Rh-positive blood.
You may also like to solve these questions
A nurse is caring for a client who is 28 weeks pregnant and has preeclampsia. Which of the following is the priority assessment?
- A. Level of consciousness
- B. Deep tendon reflexes
- C. Blood pressure
- D. Urinary output
Correct Answer: C
Rationale: Blood pressure is the priority assessment in clients with preeclampsia because hypertension is the primary symptom of the condition. Elevated blood pressure increases the risk of complications such as eclampsia and placental abruption.
A nurse is developing a plan of care for a newborn who has hyperbilirubinemia and a prescription for phototherapy. Which of the following interventions should the nurse include?
- A. Check the newborn's temperature every 8 hr
- B. Apply moisturizing lotion to the newborn's skin every 4 hr
- C. Give the newborn 1 oz of glucose water every 4 hr
- D. Reposition the newborn every 2 to 3 hr
Correct Answer: D
Rationale: Repositioning the newborn every 2 to 3 hours during phototherapy is important to expose all areas of the skin to light and facilitate the breakdown of bilirubin.
A nurse is caring for a client who is receiving oxytocin to augment labor. The nurse notes recurrent variable decelerations of the FHR. Which of the following actions should the nurse take first?
- A. Prepare the equipment necessary to initiate an amnioinfusion
- B. Administer oxygen at 10 L/min via nonrebreather face mask
- C. Discontinue the infusion of oxytocin
- D. Place the client in a left lateral position
Correct Answer: C
Rationale: The first action should be to discontinue the infusion of oxytocin, as it can contribute to uterine hyperstimulation and fetal distress. This allows for immediate assessment and management of the fetal heart rate.
A nurse is teaching the parents of a newborn how to care for their child's uncircumcised penis. Which of the following instructions should the nurse include?
- A. Retract the foreskin until you feel resistance.
- B. Use a cotton swab to clean under the foreskin.
- C. Apply petroleum jelly to the foreskin.
- D. Wash the penis once per day with soap and water.
Correct Answer: D
Rationale: The nurse should instruct the parents to wash the penis gently with soap and water daily, but to avoid retracting the foreskin forcefully as it can cause pain and injury.
A nurse is caring for a client who is in labor and has an epidural for pain control. Which of the following clinical manifestations is an adverse effect of epidural anesthesia?
- A. Polyuria
- B. Hypertension
- C. Pruritus
- D. Dry mouth
Correct Answer: C
Rationale: Pruritus is a common adverse effect of epidural anesthesia, often due to the opioids administered with the epidural. This can cause significant discomfort and may require treatment.