A 14-year-old client who is pregnant has a low result from a rubella serology test.Which notation should be made on this client’s care plan?

Rubella immunization should be given in the early postpartum period.

Gamma globulin should be given when the client is admitted in labor.

Gamma globulin should be given at next visit.

Rubella immunization should be given at next visit.

Answer and Explanation

The Correct Answer is A

Rubella immunization should be given in the early postpartum period. This is because rubella infection during pregnancy can cause serious birth defects or miscarriage, and rubella vaccine is contraindicated during pregnancy. Therefore, the best time to vaccinate a woman who is not immune to rubella is after she delivers her baby.

Choice B is wrong because gamma globulin is not effective for preventing rubella infection or congenital rubella syndrome (CRS). Gamma globulin is a preparation of antibodies that can provide temporary protection against some infections, but it does not induce lasting immunity.

Choice C is wrong because gamma globulin should not be given at the next visit for the same reason as choice B. Moreover, gamma globulin can interfere with the response to live vaccines such as rubella vaccine, so it should not be given within 3 months before or after vaccination.

Choice D is wrong because rubella immunization should not be given at the next visit or during pregnancy, as it can pose a risk to the fetus. Rubella vaccine is a live attenuated virus vaccine that can cross the placenta and infect the fetus. The risk of CRS from vaccination during pregnancy is low, but it cannot be ruled out completely. Therefore, women who receive rubella vaccine should avoid pregnancy for at least 4 weeks after vaccination.

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Correct Answer is D

Explanation

Braxton Hicks contractions are irregular, painless uterine contractions that occur throughout pregnancy, but are more noticeable in the third trimester.They do not indicate labor, but rather help in softening and ripening the cervix.

Choice A is wrong because the patient does not need to time the contractions unless they become regular, painful, and closer together, which are signs of true labor.

Choice B is wrong because documenting fetal activity daily is not related to Braxton Hicks contractions.Fetal activity is monitored to assess fetal well-being and detect any signs of fetal distress.

Choice C is wrong because losing the mucus plug is also not related to Braxton Hicks contractions.The mucus plug is a thick plug of mucus that seals the cervical canal during pregnancy and may be expelled before or during labor.

A. The patient has heart disease, and the antibiotics will decrease the risk to her fetus of developing endocarditis. B. The patient has heart disease, and the antibiotics will decrease her risk of developing pericarditis. C. The patient will deliver post-term, and the antibiotics will help to decrease her risk of developing chorioamnionitis. D. The patient will deliver post-term, and the antibiotics will decrease the risk to her fetus of developing a systemic infection.

Correct Answer is A

Explanation

The correct answer is choice A. The patient has heart disease, and the antibiotics will decrease the risk to her fetus of developing endocarditis.Endocarditis is an infection of the inner lining of the heart and valves, which can be caused by bacteria entering the bloodstream during labor and delivery.Patients with mitral valve prolapse (MVP) are more prone to develop endocarditis because their valve leaflets are floppy and do not close tightly, creating a site for bacterial attachment.Antibiotics can help prevent this complication by killing the bacteria before they reach the heart.

Choice B is wrong because pericarditis is an inflammation of the outer layer of the heart, not the inner lining or valves.It is not related to MVP or bacterial infection.

Choice C is wrong because chorioamnionitis is an infection of the membranes and fluid that surround the fetus, not the heart.It is usually caused by bacteria ascending from the vagina or cervix, not from the bloodstream.

Choice D is wrong because delivering post-term does not increase the risk of systemic infection for the fetus.Systemic infection means infection that affects multiple organs or systems in the body, not just one specific site.

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A 14-year-old client who is pregnant has a low result from a rubella serology test.Which notation should be made on this client’s care plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is A

Explanation

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