The nurse is calculating the estimated date of confinement (EDC) using Nagele's rule for a client whose last menstrual period started on December 1. Which date is most accurate?

Choice A rationale:

Breastfeeding mothers can receive the live attenuated rubella virus. Rubella vaccination is part of routine postpartum care for non-immune women. Breastfeeding does not interfere with the effectiveness of the rubella vaccine.

Choice B rationale:

Rubella vaccination is indeed teratogenic and can cause congenital rubella syndrome if a woman becomes pregnant within 28 days of vaccination. It is crucial for healthcare providers to educate women about the importance of avoiding pregnancy for this period after receiving the rubella vaccine to prevent potential harm to the fetus.

Choice C rationale:

Rh immune globulin (RhIg) is given to Rh-negative mothers to prevent Rh isoimmunization. It is administered intramuscularly, not intravenously. Intravenous administration of RhIg can lead to adverse reactions and is not considered a safe route for this medication. RhIg does not have any impact on the infant's immune system.

Choice D rationale:

Rh immune globulin does not boost the immune system or enhance the effectiveness of vaccinations. Its primary function is to prevent the development of antibodies in Rh-negative individuals who have been exposed to Rh-positive blood, such as during pregnancy or delivery.

Choice A rationale:

Do not administer pancreatic enzymes if the child is receiving antibiotics. Rationale: There is no specific contraindication to administering pancreatic enzymes while the child is receiving antibiotics. Pancreatic enzymes are essential for the digestion and absorption of nutrients in children with cystic fibrosis, and they should be continued even if the child is on antibiotics.

Choice B rationale:

Decrease dose of pancreatic enzymes if the child is having frequent, bulky stools. Rationale: Bulky, foul-smelling stools are common in cystic fibrosis due to malabsorption of nutrients. Pancreatic enzyme replacement therapy is crucial to aid in the digestion of fats and proteins. If the child is experiencing frequent, bulky stools, it may indicate inadequate enzyme dosage, and the healthcare provider should be consulted to adjust the dosage or formulation of pancreatic enzymes. Choice