A charge nurse is teaching a newly licensed nurse about Rh,(D) immune globulin administration. Which of the following should the charge nurse include as an indication for the administration of Rho(D) immune globulin?

Prescription for an amniocentesis

Anemia

Hyperemesis gravidarum

Rh-positive blood test results

Answer and Explanation

The Correct Answer is D

: Rh-positive blood test results. Rho(D) immune globulin is indicated for Rh-negative women who are pregnant and for those who have had a miscarriage, ectopic pregnancy, or induced abortion. It is also indicated for Rh-negative women who give birth to Rh-positive infants. The administration of Rho(D) immune globulin prevents the Rh-negative mother from forming antibodies against Rh-positive fetal cells that may have entered her bloodstream.

Choice A, prescription for an amniocentesis, is not an indication for the administration of Rho(D) immune globulin. Choice B, anemia, and choice C, hyperemesis gravidarum, are also not indications for the administration of Rho(D) immune globulin.

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Correct Answer is B

Explanation

The client who is at 34 weeks of gestation and is experiencing epigastric pain and headache should be assessed first. These symptoms may indicate preeclampsia, which is a serious pregnancy complication characterized by high blood pressure and organ damage. The nurse should monitor the client's blood pressure and assess for signs of organ damage, such as proteinuria, visual disturbances, and epigastric or right upper quadrant pain. The other clients may also require assessment and intervention, but their symptoms are less urgent and may indicate less serious conditions, such as a urinary tract infection (painful urination), early pregnancy symptoms (nausea and vomiting), or early labor (cramping and spotting).

A. "Lesions are visible on the mother's genitalia." B. "Mothers will receive prophylactic treatment with acyclovir prior to delivery." C. "This infection requires that airborne precautions be initiated for the newborn." D. "Transmission can occur via the saliva and urine of the newborn."

Correct Answer is D

Explanation

"Transmission can occur via the saliva and urine of the newborn." Maternal cytomegalovirus (CMV) is a viral infection that can be transmitted to the fetus during pregnancy or to the newborn during delivery or through breast milk. Lesions on the mother's genitalia are associated with herpes simplex virus, not CMV. Mothers with active CMV infection may not show any symptoms, and there is no specific prophylactic treatment with acyclovir for CMV infection. Airborne precautions are not necessary for newborns with CMV infection since the virus is primarily spread through contact with body fluids, such as saliva and urine.

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A charge nurse is teaching a newly licensed nurse about Rh,(D) immune globulin administration. Which of the following should the charge nurse include as an indication for the administration of Rho(D) immune globulin?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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