It is determined that a client's blood Rh is negative and her partner's is positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time?
24 hours before delivery and 24 hours after delivery
In the first trimester and within 2 hours of delivery
At 28 weeks gestation and again within 72 hours after delivery
At 32 weeks gestation and immediately before discharge
The Correct Answer is C
Choice A Reason: This is incorrect because administering Rho(D) immune globulin 24 hours before delivery is too early and may not provide adequate protection for the fetus. Administering it 24 hours after delivery is too late and may not prevent the mother from developing antibodies against the fetal Rh-positive blood cells.
Choice B Reason: This is incorrect because administering Rho(D) immune globulin in the first trimester is unnecessary and may not be effective, as the risk of Rh isoimmunization is very low before 28 weeks of gestation. Administering it within 2 hours of delivery is appropriate, but not sufficient, as it should be repeated within 72 hours after delivery.
Choice C Reason: This is correct because administering Rho(D) immune globulin at 28 weeks gestation and again within 72 hours after delivery is the recommended schedule for preventing Rh isoimmunization in Rh-negative pregnant women who have Rh-positive partners. This regimen can prevent up to 99% of cases of Rh isoimmunization by blocking the maternal immune response to the fetal Rh-positive blood cells.
Choice D Reason: This is incorrect because administering Rho(D) immune globulin at 32 weeks gestation is too late and may not prevent Rh isoimmunization if there has been any fetal-maternal hemorrhage before that time. Administering it immediately before discharge is also too late and may not prevent the mother from developing antibodies against the fetal Rh-positive blood cells.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason: This is incorrect because mosquitoes do not transmit HIV. HIV is a virus that infects human cells and cannot survive in insects. Mosquitoes do not inject blood from one person to another when they bite, but only saliva that contains anticoagulants and enzymes.
Choice B Reason: This is incorrect because accidental puncture wounds are not a common mode of HIV transmission. HIV can be transmitted through exposure to infected blood or body fluids, such as through needle sharing, blood transfusion, or occupational injury. However, these cases are rare and can be prevented by using sterile equipment, screening blood products, and following universal precautions.
Choice C Reason: This is correct because sexual contact is the most common mode of HIV transmission. HIV can be transmitted through unprotected vaginal, anal, or oral sex with an infected person, as these activities can involve contact with infected blood, semen, vaginal fluid, or pre-ejaculate.
Choice D Reason: This is incorrect because respiratory droplets do not transmit HIV. HIV is not an airborne virus and cannot be spread by coughing, sneezing, or breathing. HIV cannot be transmitted by casual contact, such as hugging, kissing, or sharing utensils.

Correct Answer is B
Explanation
Choice A Reason: This option is incorrect because it underestimates the number of pregnancies (gravida) and overestimates the number of preterm births (preterm). The client has had four pregnancies (twins count as one pregnancy), not three. The client has had one preterm birth (the twins), not two.
Choice B Reason: This option is correct because it accurately reflects the client's obstetric history. GTPAL stands for Gravida, Term, Preterm, Abortions, and Living children. Gravida is the number of pregnancies a woman has had, regardless of outcome. Term is the number of pregnancies that ended at or beyond 37 weeks gestation. Preterm is the number of pregnancies that ended between 20 and 36 weeks gestation. Abortions are the number of pregnancies that ended before 20 weeks gestation, either spontaneously or induced. Living children are the number of children who are alive at present.
The client has had four pregnancies (gravida), one term birth (the son), one preterm birth (the twins), one abortion (the miscarriage), and three living children (the twins and the son).
Choice C Reason: This option is incorrect because it overestimates the number of preterm births (preterm) and underestimates the number of living children (living). The client has had one preterm birth (the twins), not two. The client has three living children (the twins and the son), not one.
Choice D Reason: This option is incorrect because it underestimates the number of pregnancies (gravida) and overestimates the number of abortions (abortions) and preterm births (preterm). The client has had four pregnancies (twins count as one pregnancy), not three. The client has had one abortion (the miscarriage), not two. The client has had one preterm birth (the twins), not two.

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