A newborn tests positive for the hepatitis B surface antigen. Which of the following should the nurse administer?
Hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigen.
Hepatitis B immune globulin and hepatitis B vaccine within 12 hours of birth.
Hepatitis B immune globulin at 1 week followed by hepatitis B vaccine monthly for 6 months.
Hepatitis B vaccine at 24 hours followed by hepatitis B immune globulin every 12 hours for 3 days.
The Correct Answer is B
Choice A rationale
While the hepatitis B vaccine is an important part of preventing hepatitis B infection, it is not typically given on a monthly basis until the newborn tests negative for the hepatitis B surface antigen. Instead, the vaccine is usually given in a series of three to four doses over a six-month period.
Choice B rationale
For newborns who test positive for the hepatitis B surface antigen, the current recommendation is to administer both the hepatitis B immune globulin (HBIG) and the
hepatitis B vaccine within 12 hours of birth. The HBIG provides immediate, short-term protection against the virus, while the vaccine stimulates the newborn’s immune system to provide long-term protection.
Choice C rationale
While the hepatitis B immune globulin (HBIG) and the hepatitis B vaccine are both important for preventing hepatitis B infection in newborns, they are not typically administered in the manner described in this choice. The HBIG is usually given once, within 12 hours of birth, while the vaccine is given in a series of three to four doses over a six-month period.
Choice D rationale
The hepatitis B vaccine is typically given within 24 hours of birth, but it is not followed by doses of the hepatitis B immune globulin (HBIG) every 12 hours for three days. Instead, a single dose of HBIG is usually given within 12 hours of birth, along with the first dose of the vaccine.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
At the level of the umbilicus. After a vaginal delivery, the nurse should expect to find the uterine fundus at the level of the umbilicus.
Correct Answer is ["A","B","D","G"]
Explanation
Choice A rationale: A headache that lasts for 2 days and is not relieved by Tylenol is a concerning symptom in a pregnant client. This could be a sign of preeclampsia, a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the liver and kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal. Left untreated, preeclampsia can lead to serious — even fatal — complications for both mother and baby. Severe headaches are a common symptom of preeclampsia and should be reported to the healthcare provider immediately.
Choice B rationale: Blurred vision and dizziness are also symptoms of preeclampsia. These symptoms occur as a result of changes in the blood vessels in the brain due to high blood pressure. The brain relies on a healthy blood supply to function properly, and any disruption to this can lead to symptoms such as blurred vision and dizziness. These symptoms should be reported to the healthcare provider immediately as they may indicate a need for immediate treatment or monitoring.
Choice C rationale: While swelling of the feet is common in pregnancy due to fluid retention and increased blood flow, it is not typically a symptom that needs to be reported to the healthcare provider unless it is accompanied by other symptoms of preeclampsia or other complications. Swelling in the face and hands is more concerning than swelling in the feet.
Choice D rationale: 2+ pitting edema of the lower extremities is a sign of fluid overload in the body, which can be a symptom of preeclampsia. This should be reported to the healthcare provider as it may indicate a need for treatment or closer monitoring.
Choice E rationale: Deep tendon reflexes of 3+ and absent clonus are within normal limits for a pregnant client. Hyperreflexia (reflexes rated as 4+) and the presence of clonus could indicate neurological irritability associated with preeclampsia, but these findings are not present in this client.
Choice F rationale: Fetal heart tones of 150/min are within the normal range of 110-160 beats per minute. This is a reassuring sign and does not need to be reported to the healthcare provider.
Choice G rationale: A blood pressure of 180/99 mm Hg is significantly elevated and is a hallmark sign of preeclampsia. This should be reported to the healthcare provider immediately as it indicates severe preeclampsia, which requires immediate treatment to prevent complications such as eclampsia, placental abruption, and organ damage.
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