A nurse is caring for a client who is 6 hr postpartum. The client is Rh-negative and her newborn is Rh-positive. The client asks why an indirect Coombs test was ordered by the provider. Which of the following is an appropriate response by the nurse?

"It determines the presence of maternal antibodies in the newborn's blood."

"It determines if kernicterus will occur in the newborn."

"It detects Rh-positive antibodies in the mother's blood."

"It detects Rh-negative antibodies in the newborn's blood."

Answer and Explanation

The Correct Answer is C

Choice A reason: This statement is incorrect, as it describes the direct Coombs test, not the indirect Coombs test. The direct Coombs test is performed on the newborn's blood, and it detects the presence of maternal antibodies that have attached to the newborn's red blood cells. The direct Coombs test can help diagnose hemolytic disease of the newborn, which is a condition where the maternal antibodies destroy the newborn's red blood cells, causing anemia and jaundice.

Choice B reason: This statement is incorrect, as it is not the purpose of the indirect Coombs test, but rather a possible complication of hemolytic disease of the newborn. Kernicterus is a severe form of jaundice that occurs when the bilirubin level in the blood is very high, and it can cause brain damage, deafness, or death. Kernicterus can be prevented by treating the jaundice with phototherapy or exchange transfusion.

Choice C reason: This statement is correct, as it describes the indirect Coombs test, which is performed on the mother's blood, and it detects the presence of Rh-positive antibodies that have formed in response to the exposure to the Rh-positive blood of the newborn. The indirect Coombs test can help identify the risk of hemolytic disease of the newborn, and guide the administration of Rh immunoglobulin, which is a medication that prevents the formation of Rh-positive antibodies.

Choice D reason: This statement is incorrect, as it is not possible for the newborn to have Rh-negative antibodies, since the newborn has Rh-positive blood. Rh-negative antibodies are produced by Rh-negative individuals who have been exposed to Rh-positive blood, such as Rh-negative mothers who have Rh-positive newborns. Rh-negative antibodies can cross the placenta and attack the Rh-positive red blood cells of the newborn, causing hemolytic disease of the newborn.

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Correct Answer is B

Explanation

Choice A reason: Misoprostol is not the first line medication for postpartum hemorrhage, as it is a prostaglandin E1 analog that causes uterine contractions and cervical ripening. Misoprostol is used for the prevention and treatment of postpartum hemorrhage, but it is less effective and more side effects than oxytocin, which is the first line medication.

Choice B reason: Pitocin is the first line medication for postpartum hemorrhage, as it is a synthetic form of oxytocin, which is a hormone that stimulates uterine contractions and retraction. Pitocin is used for the induction and augmentation of labor, and the prevention and treatment of postpartum hemorrhage, as it reduces blood loss and enhances hemostasis.

Choice C reason: Hemabate is not the first line medication for postpartum hemorrhage, as it is a prostaglandin F2 alpha analog that causes uterine contractions and vasoconstriction. Hemabate is used for the treatment of postpartum hemorrhage, but it is contraindicated in clients with asthma, hypertension, or cardiac disease, as it can cause bronchospasm, hypertension, or cardiac arrhythmias.

Choice D reason: Methergine is not the first line medication for postpartum hemorrhage, as it is an ergot alkaloid that causes sustained uterine contractions and vasoconstriction. Methergine is used for the treatment of postpartum hemorrhage, but it is contraindicated in clients with hypertension, preeclampsia, or cardiac disease, as it can cause severe hypertension, cerebrovascular accidents, or myocardial infarction.

A. Meconium aspiration, hypoglycemia, and dry, cracked skin B. Hyperglycemia, hyperthermia, and an alert, wide-eyed appearance C. Excessive vernix caseosa covering the skin, lethargy, and RDS D. Golden yellow to green-stained skin and nails, absence of scalp hair, and an increased amount of subcutaneous fat

Correct Answer is A

Explanation

Choice A reason: This statement is correct, as these are the common complications of post-term infants, who are born after 42 weeks of gestation. Meconium aspiration can occur when the fetus passes meconium in utero and inhales it into the lungs, causing respiratory distress, inflammation, and infection. Hypoglycemia can occur due to the depletion of glycogen stores and the increased metabolic demands. Dry, cracked skin can occur due to the loss of vernix caseosa and the reduced amniotic fluid.

Choice B reason: This statement is incorrect, as these are the signs of neonatal hypocalcemia, which is a low level of calcium in the blood. Neonatal hypocalcemia can occur due to maternal diabetes, prematurity, or asphyxia, and can cause jitteriness, seizures, or tetany.

Choice C reason: This statement is incorrect, as these are the characteristics of preterm infants, who are born before 37 weeks of gestation. Excessive vernix caseosa covering the skin is a protective coating that prevents heat and water loss. Lethargy and RDS are signs of immaturity and underdevelopment of the central nervous system and the lungs.

Choice D reason: This statement is incorrect, as these are the features of infants with erythroblastosis fetalis, which is a hemolytic disease caused by the incompatibility of the Rh factor or the ABO blood group between the mother and the fetus. Golden yellow to green-stained skin and nails are due to the accumulation of bilirubin, which is a breakdown product of red blood cells. Absence of scalp hair and an increased amount of subcutaneous fat are due to the chronic hypoxia and edema.

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A nurse is caring for a client who is 6 hr postpartum. The client is Rh-negative and her newborn is Rh-positive. The client asks why an indirect Coombs test was ordered by the provider. Which of the following is an appropriate response by the nurse?

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Naxlex Comprehensive Predictor Exams

What is the first line medication for postpartum hemorrhage?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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