A nurse is reinforcing teaching about immunizations with a woman in her first trimester of pregnancy whose diagnostic testing indicates she does not have immunity to rubella. The nurse should recommend that the client receive a measles, mumps, rubella (MMR) vaccine at which of the following times?

When she does not desire future pregnancies

Prior to discharge from the hospital after giving birth

Two weeks before attempting pregnancy again

Prior to giving birth

Answer and Explanation

The Correct Answer is B

Choice A rationale: If the woman does not desire future pregnancies, she may not need the MMR vaccine, but the timing of vaccine administration is not appropriate for the current situation.
Choice B rationale: Administering the MMR vaccine prior to discharge from the hospital after giving birth is recommended during the postpartum period, especially if the woman is planning to have more children in the future.
Choice C rationale: The MMR vaccine contains live attenuated viruses and is contraindicated during pregnancy. If a woman is planning to become pregnant and is not immune to rubella, she should receive the MMR vaccine at least one month before attempting pregnancy. This allows time for her body to develop immunity before conception occurs.
Choice D rationale: The current guidelines from the Centers for Disease Control and Prevention (CDC) advise that the measles, mumps, rubella (MMR) vaccine should not be administered during pregnancy due to possible effects on the uterus.

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Correct Answer is C

Explanation

Choice A rationale: RhoGAM is not given solely based on blood loss. It is administered to prevent Rh isoimmunization, which is unrelated to the amount of blood loss.
Choice B rationale: If the client has previously given birth to an Rh-negative infant, she is already sensitized and would not require RhoGAM for this current ectopic pregnancy.
Choice C rationale: Rho(D) Immune globulin (RhoGAM) is given to Rh-negative individuals to prevent the development of Rh isoimmunization, which could occur if the client is exposed to Rh-positive blood. In the case of an ectopic pregnancy, there may be a possibility of fetal blood mixing with the mother's bloodstream, which could lead to sensitization in an Rh-negative individual.
Choice D rationale: The desire to conceive again does not dictate the need for RhoGAM. It is solely based on the client's Rh factor status and the potential for sensitization during the ectopic pregnancy.

A. Craniofacial abnormalities B. Low birth weight C. Hypersensitivity to noise D. Hyperactivity

Correct Answer is B

Explanation

Choice A rationale:
Craniofacial abnormalities are not directly associated with maternal smoking during pregnancy. However, smoking during pregnancy can have other adverse effects on the baby's development.
Choice B rationale:
Maternal smoking during pregnancy is a significant risk factor for delivering a baby with low birth weight. Smoking can lead to restricted blood flow to the placenta, affecting the baby's growth and development.
Choice C rationale:
Hypersensitivity to noise is not a common clinical manifestation associated with maternal smoking during pregnancy.
Choice D rationale:
Hyperactivity is not a common clinical manifestation associated with maternal smoking during pregnancy. However, smoking during pregnancy can have other effects on the child's behavior and development later in life.

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A nurse is reinforcing teaching about immunizations with a woman in her first trimester of pregnancy whose diagnostic testing indicates she does not have immunity to rubella. The nurse should recommend that the client receive a measles, mumps, rubella (MMR) vaccine at which of the following times?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in the immediate postoperative period following the removal of an ectopic pregnancy via salpingostomy. For which of the following indications should the nurse administer Rho(D) Immune globulin?

Correct Answer is C

Explanation

A nurse is reinforcing teaching with a client who is at 6 weeks of gestation. The client tells the nurse that she smokes one pack of cigarettes per day. The nurse should instruct the client that her newborn is at increased risk for which of the following clinical manifestations?

Correct Answer is B

Explanation

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