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Which infant is most likely to express Rh incompatibility?
- A. Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor.
- B. Infant who is Rh negative and a mother who is Rh negative.
- C. Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor.
- D. Infant who is Rh positive and a mother who is Rh positive.
Correct Answer: A
Rationale: Rationale:
1. Rh incompatibility occurs when the mother is Rh-negative and the father is Rh-positive.
2. If the father is homozygous for Rh factor (AA), all offspring will be Rh-positive.
3. The Rh-positive offspring from an Rh-negative mother can lead to Rh incompatibility.
4. Therefore, the infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor is most likely to express Rh incompatibility.
Summary:
- Choice B is incorrect because both mother and infant are Rh-negative.
- Choice C is incorrect because the father being heterozygous for the Rh factor would not result in all offspring being Rh-positive.
- Choice D is incorrect as both mother and infant are Rh-positive, so there is no risk of Rh incompatibility.
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Reduction in congenital rubella is best accomplished by:
- A. Avoiding contact with young children when infections are prevalent
- B. Taking prophylactic antibiotics during the second half of pregnancy
- C. Testing the rubella titer at the first prenatal visit to determine immunity
- D. Immunizing susceptible women at least 28 days before they become pregnant
Correct Answer: D
Rationale: The correct answer is D because immunizing susceptible women at least 28 days before they become pregnant ensures protection against rubella during pregnancy, reducing the risk of congenital rubella syndrome in the fetus. This timing allows for the development of immunity before conception.
Avoiding contact with young children (A) does not directly prevent rubella transmission to pregnant women. Taking prophylactic antibiotics during pregnancy (B) is not recommended for rubella prevention. Testing rubella titer at the first prenatal visit (C) only assesses current immunity status but does not actively prevent congenital rubella.
A 40-year-old woman has just been diagnosed with stage 2 breast cancer. Which of the following are common reactions? Select all that apply.
- A. Anxiety regarding changes in family reactions, body image, disability, and pain
- B. Concern about disruptions related to treatment
- C. Fear of death
- D. Decisional conflict related to controversies about treatment options
Correct Answer: A
Rationale: The correct answer is A. Anxiety is common due to the impact on family, body image, disability, and pain. Concern about treatment disruptions is valid but not as common as anxiety. Fear of death is a general fear but may not be as prominent as anxiety. Decisional conflict can occur but is more specific to treatment options rather than a common reaction.
A client comes to an outpatient clinic for evaluation. What in the client's blood sample reveals that administration of the hepatitis B vaccine has been effective?
- A. Hepatitis B surface antigen (HBsAg)
- B. anti-HBs
- C. anti-HBc IgM
- D. anti-HBc
Correct Answer: B
Rationale: The correct answer is B: anti-HBs. This antibody indicates successful immunity after hepatitis B vaccination. It is produced in response to the vaccine and signifies protection against the virus. Choice A, HBsAg, is present in acute infection. Choices C and D, anti-HBc IgM and anti-HBc, indicate acute or chronic infection, not vaccine response.
When bathing an infant, what sign does the nurse recognize as a sign of developmental hip dysplasia?
- A. Hypotonicity of the leg muscles
- B. One leg is shorter than the other
- C. Broadening and flattening of the buttocks
- D. Two skinfolds on the back of each thigh
Correct Answer: B
Rationale: The correct answer is B: One leg is shorter than the other. This is a key sign of developmental hip dysplasia in infants. It indicates an imbalance in the hip joint, leading to unequal leg lengths. This can be detected during routine physical examinations by the nurse.
Incorrect choices:
A: Hypotonicity of the leg muscles - While muscle tone abnormalities can be associated with hip dysplasia, it is not a specific sign that is easily recognizable during bathing.
C: Broadening and flattening of the buttocks - This may be a sign of hip dysplasia in older children but is not a typical indicator in infants.
D: Two skinfolds on the back of each thigh - Although skinfolds can sometimes be present in infants with hip dysplasia, it is not a reliable or specific sign compared to the leg length discrepancy.
The primary fetal risk when the mother has any type of anemia is for:
- A. Neonatal anemia
- B. Elevated bilirubin level
- C. Limited infection defenses
- D. Reduced oxygen delivery
Correct Answer: D
Rationale: The correct answer is D: Reduced oxygen delivery. Anemia in the mother can lead to decreased oxygen-carrying capacity in the blood, resulting in reduced oxygen delivery to the fetus. This can lead to fetal hypoxia, affecting the baby's growth and development. Neonatal anemia (choice A) is a consequence of the mother's anemia affecting the baby after birth, not the primary risk. Elevated bilirubin level (choice B) is not directly related to maternal anemia but may occur in conditions like Rh incompatibility. Limited infection defenses (choice C) is not the primary fetal risk associated with maternal anemia, although it can be a concern in severe cases due to decreased immune response.