A nurse is providing discharge instructions to parents of a circumcised newborn. To prevent diaper adherence to the penis, what will be recommended to apply during diaper changes?

Petroleum jelly.

Pre-moistened towelettes.

Povidone-iodine.

Silver sulfadiazine.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Petroleum jelly is a common recommendation to apply during diaper changes for circumcised newborns. It acts as a barrier between the diaper and the healing penis, reducing friction and preventing the diaper from sticking to the sensitive area. This can help promote better healing and prevent discomfort for the newborn.

Choice B rationale:

Pre-moistened towelettes are not typically recommended for application on the penis of a circumcised newborn during diaper changes. These towelettes may contain chemicals or irritants that could potentially irritate the delicate skin of the healing area.

Choice C rationale:

Povidone-iodine is an antiseptic solution often used to disinfect the skin before procedures or surgeries. However, it is not recommended for routine use on the penis of a circumcised newborn during diaper changes as it may be too harsh for the healing skin.

Choice D rationale:

Silver sulfadiazine is a topical antimicrobial agent used for treating burns and certain infections. However, it is not indicated for use on a circumcised newborn's penis during diaper changes. The healing process after circumcision does not usually involve infections that require this type of treatment.

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Correct Answer is D

Explanation

Choice A rationale:

This statement is incorrect. The client should receive Rh(D) immune globulin (RhoGAM) if they are Rh-negative and their partner's Rh status is unknown or Rh-positive. This prevents the development of Rh antibodies in the mother's blood, which could be harmful in future pregnancies if the baby is Rh-positive.

Choice B rationale:

This statement is incorrect. Rh(D) immune globulin is administered to an Rh-negative mother within 72 hours after delivery if the baby is Rh-positive. This is done to prevent the mother from developing Rh antibodies that could affect subsequent pregnancies.

Choice C rationale:

This statement is incorrect. There is no restriction on receiving other immunizations after receiving Rh(D) immune globulin. The shot only protects against Rh incompatibility and does not interfere with other immunizations.

Choice D rationale:

This statement is correct. Rh(D) immune globulin can be given after birth to an Rh-negative mother with an Rh-positive baby. This helps protect the mother's future pregnancies from the potential harmful effects of Rh incompatibility.

A. The client's blood does not contain the Rh factor, so she produces anti-Rh antibodies that cross the placental barrier and cause hemolysis of red blood cells in newborns. B. The client's blood contains the Rh factor, and the newborn's does not, and antibodies that destroy red blood cells are formed in the fetus. C. The client has a history of receiving a transfusion with Rh-negative blood. D. The client's anti-A and anti-B antibodies cross the placenta and cause the destruction of the fetal red blood cells.

Correct Answer is A

Explanation

Choice A rationale:

Rh incompatibility occurs when an Rh-negative client is exposed to Rh-positive fetal blood, typically during a prior pregnancy or delivery. The client’s immune system produces anti-Rh antibodies that cross the placenta in subsequent pregnancies, attacking the Rh-positive red blood cells of the fetus. This hemolysis releases bilirubin, leading to hyperbilirubinemia in the newborn.

Choice B rationale:

Rh incompatibility only occurs when the client is Rh-negative and the fetus is Rh-positive. An Rh-positive client will not form antibodies against an Rh-negative fetus, as their immune system recognizes the Rh factor as normal.

Choice C rationale:

This choice is not related to the mechanism of Rh incompatibility. Receiving a transfusion with Rh-negative blood would not cause the mother's immune system to produce anti-Rh antibodies or lead to Rh incompatibility with her newborn.

Choice D rationale:

This choice describes the ABO blood group system, not the Rh factor. ABO incompatibility can occur when a mother with blood type O (producing anti-A and anti-B antibodies) has a newborn with blood type A, B, or AB, leading to hemolysis of the fetal red blood cells. However, the question specifically mentions Rh incompatibility, which involves the Rh factor, not the ABO system.

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A nurse is providing discharge instructions to parents of a circumcised newborn. To prevent diaper adherence to the penis, what will be recommended to apply during diaper changes?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a pregnant client who is Rh-negative about Rh(D) immune globulin. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

A nurse is caring for a client who has just delivered her first newborn. The nurse anticipates hyperbilirubinemia due to Rh incompatibility. The nurse should understand that hyperbilirubinemia occurs with Rh incompatibility for which of the following reasons?

Correct Answer is A

Explanation

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