A nurse is assisting with the care of a newborn whose mother has hepatitis B. Which of the following actions should the nurse plan to take when administering the hepatitis B vaccine?
Insert the needle at a 45° angle
Obtain parental consent
Give the first dose at 24 hr after birth.
Administer the medication into the dorsal gluteal muscle
The Correct Answer is C
A) Incorrect- The angle of insertion for the hepatitis B vaccine is typically 90 degrees.
B) Incorrect- Obtaining parental consent is important for any medical procedure involving a minor, but it is not specific to the administration of the hepatitis B vaccine.
C) Correct - The first dose of the hepatitis B vaccine is usually given within the first 24 hours after birth to newborns whose mothers are hepatitis B positive to prevent vertical transmission.
D) Incorrect- The hepatitis B vaccine is usually administered into the vastus lateralis muscle in the newborn's thigh, not the dorsal gluteal muscle.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Incorrect- An amniocentesis is not typically needed after a molar pregnancy since there is no viable fetus.
B) Correct - A molar pregnancy is a rare condition where abnormal tissue forms in the uterus instead of a normal embryo. It often requires medical follow-up and emotional support. Attending a support group is important for emotional and psychological healing after the experience of a molar pregnancy.
C) Incorrect- Chemotherapy might be necessary in certain cases of molar pregnancy, but immediate chemotherapy is not a general requirement.
D) Incorrect- Home palliative services are not typically needed for molar pregnancy recovery.
Correct Answer is A
Explanation
A) Correct - Monitoring for infection is an appropriate nursing intervention for a client whose membranes have ruptured, as there is an increased risk of infection after the amniotic sac has ruptured for an extended period.
B) Incorrect- Positioning the client supine is not generally recommended for a client in labor, especially if the client's membranes have ruptured.
C) Incorrect- Obtaining consent for a cesarean birth is not indicated solely based on the information provided.
D) Incorrect- Preparing for a forceps delivery is not indicated solely based on the information provided.
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