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 A

Explanation

A. Rho(D) immune globulin (RhoGAM) is indicated when an Rh-negative mother gives birth to an Rh-positive infant. This prevents the mother’s immune system from developing antibodies against Rh-positive blood cells, which could cause hemolytic disease of the newborn (HDN) in future pregnancies.

B. An Rh-positive mother already has the D antigen, so she will not form antibodies against an Rh-negative baby. RhoGAM is not needed.

C. The mother is Rh-positive and cannot develop antibodies against Rh-positive fetal blood cells. No RhoGAM is required.

D. Both mother and baby are Rh-negative, so there is no risk of maternal sensitization. RhoGAM is not indicated.

A. Difficulty swallowing drooling, hoarseness, and sitting in a tripod position B. Rhinorrhea, congestion, mild sore throat, and hoarseness C. Sudden onset of cough, wheezing, rapid breathing and difficulty swallowing D. Hoarseness, stridor, and a barking cough

Correct Answer is A

Explanation

A. These are classic signs of epiglottitis, a potentially life-threatening condition caused by inflammation and swelling of the epiglottis, usually from Haemophilus influenzae type b. The child often presents suddenly, is toxic-appearing, prefers to sit upright leaning forward (tripod position) to ease breathing, has drooling due to inability to swallow, and may have muffled or hoarse voice. Stridor may develop as airway obstruction worsens. This is a medical emergency.

B. These are symptoms of upper respiratory tract infections, such as the common cold, and are not indicative of epiglottitis, which presents more acutely and severely.

C. Wheezing and cough are more typical of lower airway diseases like croup or bronchiolitis, not epiglottitis. Difficulty swallowing alone is not sufficient without drooling and tripod positioning.

D. These are classic for viral croup, which affects the larynx and trachea. Epiglottitis differs because it progresses rapidly, causes drooling, and children often refuse to lie down.

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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?

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Naxlex Comprehensive Predictor Exams

Rho immune globulin will be ordered after birth if which situation occurs?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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