A 30-year-old Rh-negative pregnant woman is at 17 weeks gestation and has an Rh-positive partner. She has had no prior sensitization. She asks the nurse when she will receive Rho(D) immune globulin. Which of the following is the best response?

"Rho(D) immune globulin is only given after delivery, so you don't need it now."

"You only need Rho(D) immune globulin after your second pregnancy"

You will receive Rho(D) immune globulin monthly during pregnancy and then after 72 hours after delivery"

"You will receive Rho(D) immune globulin at 28 weeks of pregnancy and again within 72 hours after delivery if your baby is Rh-positive to prevent your immune system from becoming sensitized."

Answer and Explanation

The Correct Answer is D

A. Rho(D) immune globulin is not given only after delivery. Administering it after delivery alone prevents sensitization for future pregnancies but does not provide prophylaxis during the current pregnancy.

B. The woman does not only receive Rho(D) immune globulin after her second pregnancy. Prophylaxis is necessary during the current pregnancy if she is Rh-negative and the fetus is at risk of being Rh-positive.

C. Rho(D) immune globulin is not given monthly during pregnancy. Standard prophylaxis involves a scheduled dose at 28 weeks gestation, with an additional dose postpartum if the newborn is Rh-positive. More frequent dosing is only indicated if there is a significant risk of fetal-maternal hemorrhage (e.g., miscarriage, trauma, amniocentesis).

D. The recommended schedule for Rh-negative women without prior sensitization is to receive a prophylactic dose of Rho(D) immune globulin at 28 weeks gestation and again within 72 hours after delivery if the newborn is Rh-positive. This prevents the mother’s immune system from producing antibodies against Rh-positive fetal red blood cells, reducing the risk of hemolytic disease in current or future pregnancies. Administration is also indicated after events that increase fetal-maternal blood mixing.

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Correct Answer is C

Explanation

A. A routine abdominal ultrasound is not used to assess bone age or growth delays. While abdominal ultrasounds can detect organ abnormalities, they provide no information about skeletal maturation.

B. A complete blood count (CBC) evaluates blood cell levels and can detect anemia or infection, but it does not provide information about bone growth or skeletal development.

C. A hand-wrist X-ray is the standard diagnostic test to assess bone age and skeletal maturation. By comparing the X-ray of the child’s hand and wrist bones to standardized age-related charts (such as the Greulich and Pyle atlas), providers can determine if the child’s skeletal growth is appropriate for chronological age. This helps identify growth delays, endocrine disorders, or other conditions affecting stature.

D. Anthropometric hand-wrist measurement refers to physical measurements of the hand and wrist, which do not provide sufficient information to determine bone age or detect growth delays. X-ray imaging is required for accurate assessment of skeletal maturity.

A. Apnea and cyanosis during coughing episodes B. Inspiratory stridor with a barking cough C. Wheezing with shortness of breath during activity D. Paroxysmal coughing followed by a high-pitched "whoop" on inspiration E. Dry, hacking cough that worsens at night

Correct Answer is ["A","D","E"]

Explanation

A. Infants, especially those under 6 months, may present with apnea and cyanosis during coughing paroxysms instead of the classic “whoop,” as their respiratory muscles are immature. This is a common severe manifestation in young infants.

B. Inspiratory stridor and a barking cough are characteristic of croup, not pertussis. Croup is usually viral in origin and presents with hoarseness and upper airway obstruction, which differs from pertussis.

C. Wheezing with exertional dyspnea is more typical of asthma or bronchiolitis, not pertussis. While pertussis can cause hypoxia, wheezing is not a defining feature.

D. The paroxysmal stage of pertussis is characterized by repetitive coughing spells followed by a high-pitched inspiratory “whoop”. This is classic for older infants and children, though it may be absent in young infants.

E. In the catarrhal stage, pertussis often begins as a mild, dry cough resembling a common cold, which gradually progresses to severe paroxysms. Nighttime exacerbation is common.

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A 30-year-old Rh-negative pregnant woman is at 17 weeks gestation and has an Rh-positive partner. She has had no prior sensitization. She asks the nurse when she will receive Rho(D) immune globulin. Which of the following is the best response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse in the emergency department is assessing a 4-month-old infant who has suspected pertussis. Which of the following findings should the nurse identify as consistent with this diagnosis? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

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