A nurse is preparing to administer hepatitis B vaccine to a newborn whose mother is hepatitis B surface antigen negative (HBsAg-).

Which of the following actions should the nurse take?

Obtain informed consent from the mother before giving the vaccine

Give the vaccine intramuscularly in the anterolateral thigh

Administer hepatitis B immune globulin (HBIG) along with the vaccine

Delay giving the vaccine until after breastfeeding is established

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Give the vaccine intramuscularly in the anterolateral thigh.

This is because the anterolateral thigh is the recommended site for intramuscular injections in infants less than 12 months of age.

It has a large muscle mass and minimal risk of injury to nerves or blood vessels.

Choice A is wrong because informed consent is not required for routine immunizations, unless the parent or guardian requests more information or declines the vaccine.

Choice C is wrong because hepatitis B immune globulin (HBIG) is only indicated for newborns whose mothers are hepatitis B surface antigen positive (HBsAg+), as they have a high risk of acquiring the infection from their mothers.

Choice D is wrong because there is no need to delay giving the vaccine until after breastfeeding is established.

Breastfeeding does not interfere with the vaccine’s effectiveness or safety, and it does not increase the risk of adverse reactions.

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Correct Answer is B

Explanation

The correct answer is choice B. Lactic acidosis.

Lamivudine (Epivir) is a nucleoside reverse transcriptase inhibitor (NRTI) used to treat chronic hepatitis B infection and HIV infection.

One of the rare but serious adverse effects of lamivudine is lactic acidosis, which is a condition where the blood becomes too acidic due to the accumulation of lactate.Lactic acidosis can cause symptoms such as nausea, vomiting, abdominal pain, muscle weakness, rapid breathing, and low blood pressure.

Choice A is wrong because pancreatitis is not a common side effect of lamivudine.

Pancreatitis is an inflammation of the pancreas that can cause severe abdominal pain, nausea, vomiting, and fever.Pancreatitis is more likely to occur with other NRTIs such as didanosine (Videx) or stavudine (Zerit).

Choice C is wrong because hypothyroidism is not a common side effect of lamivudine.

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy levels of the body.

Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, and depression.

Hypothyroidism is more likely to occur with other drugs that interfere with thyroid function such as amiodarone (Cordarone) or lithium

A. Irregular respirations B. Cyanosis C. Apnea D. Eye-rolling E. Lethargy

Correct Answer is ["A","C","D","E"]

Explanation

The correct answer is choice A, C, D, and E.Hypoglycemia due to perinatal asphyxia can cause various neurological signs in the newborn, such as irregular respirations, apnea, eye-rolling, and lethargy.

These signs indicate inadequate oxygenation and glucose delivery to the brain.Cyanosis is not a specific sign of hypoglycemia, but rather a sign of poor oxygenation that can occur due to other causes.

Therefore, choice B is wrong.

Choice A is correct because irregular respirations can result from hypoglycemia due to perinatal asphyxia.Hypoglycemia can impair the respiratory center in the brainstem and cause irregular breathing patterns.

Choice C is correct because apnea can result from hypoglycemia due to perinatal asphyxia.

Apnea is defined as a pause in breathing

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A nurse is preparing to administer hepatitis B vaccine to a newborn whose mother is hepatitis B surface antigen negative (HBsAg-). Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has chronic hepatitis B infection and is taking lamivudine (Epivir). The nurse should monitor the client for which of the following adverse effects?

Correct Answer is B

Explanation

A nurse is assessing a newborn who has hypoglycemia due to perinatal asphyxia. Which of the following findings should the nurse expect? (Select all that apply.)

Correct Answer is ["A","C","D","E"]

Explanation

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The nurse is caring for a newborn who was circumcised using a Gomco clamp 12 hours ago and notes that there is a small amount of blood on his diaper where his penis rests against it. The most appropriate nursing action would be to:

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A nurse is preparing to administer hepatitis B vaccine to a newborn whose mother is hepatitis B surface antigen negative (HBsAg-).

Which of the following actions should the nurse take?