For each potential prescription from the provider, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

Choice A rationale

Hepatitis B immune globulin at 1 week followed by hepatitis B vaccine monthly for 6 months is incorrect. This schedule delays the immune response and leaves the infant unprotected during the critical early period when the risk of transmission is highest.

Choice B rationale

Hepatitis B immune globulin and hepatitis B vaccine within 12 hr of birth is the correct approach. This combination provides immediate passive immunity through the immune globulin and active immunity through the vaccine, significantly reducing the risk of hepatitis B transmission from mother to child.

Choice C rationale

Hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigen is incorrect. Monthly administration alone is insufficient without the initial dose of immune globulin, especially since the infant may remain at risk until the negative test result.

Choice D rationale

Hepatitis B vaccine at 24 hr followed by hepatitis B immune globulin every 12 hr for 3 days is incorrect. The delay in the first vaccine dose reduces its efficacy, and the immune globulin schedule does not align with established guidelines for preventing hepatitis B transmission.

Choice A rationale

While a history of rheumatic heart disease is significant, it does not directly correlate with the need for priority teaching on Quad screening. This condition requires careful cardiac monitoring and management during pregnancy.

Choice B rationale

A history of preterm labor is important and may require additional monitoring and interventions, but it is not a direct indication for priority teaching on Quad screening, which assesses risk for certain fetal conditions.

Choice C rationale

Exposure to HIV requires careful management and monitoring to reduce the risk of mother-to-child transmission. However, it is not specifically linked to the need for Quad screening, which is focused on detecting chromosomal abnormalities.

Choice D rationale

A history of having a child with spina bifida places this client at higher risk for having another child with neural tube defects or chromosomal abnormalities. Therefore, priority teaching on Quad screening, which includes markers for such conditions, is essential. .