A nurse is caring for a client in the first trimester of pregnancy and discovers that the client lacks immunity to rubella based on her blood work. When is the recommended time for administering rubella immunization?

During the next attempt to get pregnant

Immediately after delivery

During the third trimester of pregnancy

During the first trimester of pregnancy

Answer and Explanation

The Correct Answer is B

A. During the next attempt to get pregnant
This is incorrect because waiting until the next pregnancy increases the risk of congenital rubella syndrome in future pregnancies. The vaccine should be given immediately postpartum to provide immunity.

B. Immediately after delivery
This is correct because the rubella vaccine (MMR) is a live vaccine and is contraindicated during pregnancy due to teratogenic effects. It should be given postpartum before hospital discharge to prevent future rubella infections.

C. During the third trimester of pregnancy
This is incorrect because live vaccines are contraindicated in pregnancy due to the risk of fetal infection.

D. During the first trimester of pregnancy
This is incorrect because administering a live vaccine early in pregnancy is dangerous and could cause fetal harm or congenital anomalies.

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Correct Answer is D

Explanation

A. "Depo-Provera."
Depo-Provera (medroxyprogesterone injection) is effective for contraception, but it may worsen menstrual irregularities and cause bone density loss with long-term use, making it less ideal.

B. "Contraceptive implant."
While progestin-only implants (e.g., Nexplanon) are effective, they do not protect against STIs. Additionally, irregular bleeding is a common side effect, which may not be ideal for someone with menorrhagia and irregular cycles.

C. "Combination oral contraceptives."
Estrogen-containing contraceptives (e.g., combined oral contraceptive pills) are contraindicated in women who smoke and are ≥35 years old due to the increased risk of venous thromboembolism (VTE). While this client is 22 years old, smoking still makes this option less preferable.

D. "Barrier methods such as female condoms."
Barrier methods reduce the risk of sexually transmitted infections (STIs), which is crucial for this client with multiple sexual partners. Additionally, they do not contain hormones, making them safer for smokers.

A. Unexplained weight gain B. Pain during menstrual period C. Pain during intercourse D. Infertility

Correct Answer is ["B","C","D"]

Explanation

A. Unexplained weight gain
This is incorrect because weight gain is not a characteristic symptom of endometriosis. Endometriosis primarily affects the reproductive organs and is associated with pain and infertility rather than metabolic or weight-related changes.

B. Pain during menstrual period
This is correct because dysmenorrhea (painful menstruation) is a hallmark symptom of endometriosis due to the presence of ectopic endometrial tissue responding to hormonal changes.

C. Pain during intercourse
This is correct because dyspareunia (pain during intercourse) is a common symptom of endometriosis due to the inflammatory and fibrotic changes caused by ectopic endometrial tissue.

D. Infertility
This is correct because endometriosis can lead to infertility due to scarring, adhesions, and inflammation affecting the fallopian tubes and ovaries. Many clients with endometriosis seek medical attention due to difficulty conceiving.

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A nurse is caring for a client in the first trimester of pregnancy and discovers that the client lacks immunity to rubella based on her blood work. When is the recommended time for administering rubella immunization?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Which assessment findings might raise the nurse's suspicion of endometriosis in the client they are evaluating?

Correct Answer is ["B","C","D"]

Explanation

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A nurse is caring for a client in the first trimester of pregnancy and discovers that the client lacks immunity to rubella based on her blood work. When is the recommended time for administering rubella immunization?

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