A nurse is caring for a client in the first trimester of pregnancy and discovers that the client lacks immunity to rubella based on her blood work. When is the recommended time for administering rubella immunization?

During the next attempt to get pregnant

Immediately after delivery

During the third trimester of pregnancy

During the first trimester of pregnancy

Answer and Explanation

The Correct Answer is B

A. During the next attempt to get pregnant
This is incorrect because waiting until the next pregnancy increases the risk of congenital rubella syndrome in future pregnancies. The vaccine should be given immediately postpartum to provide immunity.

B. Immediately after delivery
This is correct because the rubella vaccine (MMR) is a live vaccine and is contraindicated during pregnancy due to teratogenic effects. It should be given postpartum before hospital discharge to prevent future rubella infections.

C. During the third trimester of pregnancy
This is incorrect because live vaccines are contraindicated in pregnancy due to the risk of fetal infection.

D. During the first trimester of pregnancy
This is incorrect because administering a live vaccine early in pregnancy is dangerous and could cause fetal harm or congenital anomalies.

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Correct Answer is B

Explanation

A. Advise the client to seek help from family members to reduce stress and manage the baby's care – While social support is helpful, it does not directly address potential postpartum mood disorders, which require further evaluation.

B. Assess the client for further signs of postpartum mood disorders – These symptoms may indicate postpartum depression, which requires further assessment and potential intervention. Early identification is crucial to ensuring the client's safety and well-being.

C. Reassure the client that these feelings are normal and will subside in a few days – While some mood changes are common postpartum ("baby blues"), the intensity of these symptoms may indicate postpartum depression, which requires assessment.

D. Encourage the client to rest whenever the baby is sleeping to alleviate fatigue – While rest is important, it does not address the client's concerns about anxiety, irritability, and feelings of inadequacy, which may signal a mood disorder.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"C"}

Explanation

Correct answers: The nurse's greatest concern is the client's risk of developing HELLP syndrome and related to thrombocytopenia and elevated liver enzymes.

Rationale:

I. HELLP syndrome (Hemolysis, Elevated Liver Enzymes, and Low Platelets) is a severe form of preeclampsia that can lead to life-threatening complications.

Ii. Thrombocytopenia (low platelets) (120,000) increases the risk of bleeding.

Iii. Elevated liver enzymes (ALT 75, AST 78, Alkaline Phosphatase 184) suggest liver involvement, which is a hallmark of HELLP syndrome.

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A nurse is caring for a client in the first trimester of pregnancy and discovers that the client lacks immunity to rubella based on her blood work. When is the recommended time for administering rubella immunization?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a postpartum client who reports feeling anxious, irritable, and unable to sleep despite extreme fatigue. The client also expresses feelings of inadequacy as a mother. Which of the following nursing interventions is the most appropriate?

Correct Answer is B

Explanation

G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST) Complete the following sentence using the drop-down options. The nurse's greatest concern is the client's risk of developing __i_____ and related to __ii____ and ___iii____.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B","dropdown-group-3":"C"}

Explanation

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G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST) As the nurse, you can identify whether the following findings are indicative of preeclampsia, preeclampsia with severe features, or neither. Select at least one answer in each row.