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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: While colostrum is present in the first few days after delivery, it takes a few more days for breast milk to "come in" and increase in volume.
Choice B rationale: Waiting for 6 to 8 days for breast milk to come in would be too long after childbirth. Breast milk typically "comes in" sooner, around 3 to 5 days after delivery.
Choice C rationale: Colostrum, the first milk, is typically produced in small amounts during the first few days after delivery. Breast milk usually "comes in" or increases in volume around 3 to 5 days after childbirth. This transition from colostrum to mature milk is normal and expected.
Choice D rationale: Waiting for 10 days for breast milk to come in would be too long after childbirth. Breast milk typically "comes in" sooner, around 3 to 5 days after delivery.
Correct Answer is B
Explanation
Choice A rationale: The Mongolian spot is a bluish-gray birthmark that is often seen on the lower back or buttocks of newborns with darker skin tones. It is not related to the swelling described in the scenario.
Choice B rationale: Caput succedaneum is a common condition in newborns delivered by vacuum extraction. It is characterized by swelling of the soft tissues of the scalp that crosses the suture lines. The swelling occurs due to pressure from the vacuum extractor during delivery and is caused by fluid accumulation between the scalp and the skull. Caput succedaneum is typically a benign and self-resolving condition that does not require treatment.
Choice C rationale: Cephalhematoma is a collection of blood between the periosteum and the skull bone. Unlike caput succedaneum, it does not cross the suture lines and can take weeks to months to resolve.
Choice D rationale: Erythema toxicum is a common skin rash in newborns characterized by red or pink spots with a yellow or white bump in the center. It is not related to the swelling described in the scenario.

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