A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client with which of the following vaccines? (Select all that apply.)

Human papillomavirus

Varicella

Diphtheria-acellular pertussis

Inactivated influenza

Measles, mumps, and rubella

Answer and Explanation

Correct Answer : C,D

The nurse should plan to immunize the client with the following vaccines: Inactivated influenza: The Centers for Disease Control and Prevention (CDC) recommends that all pregnant women receive the influenza vaccine during any trimester of pregnancy, as pregnant women are at an increased risk of severe illness from the flu.

Diphtheria-acellular pertussis: The CDC recommends that pregnant women receive the Tdap vaccine (which includes protection against tetanus, diphtheria, and acellular pertussis) during each pregnancy, ideally between 27 and 36 weeks of gestation. This is to protect both the mother and the newborn from pertussis (whooping cough).

The following vaccines are not recommended:

Measles, mumps and rubella vaccine should not be given during pregnancy.

The HPV vaccine is not routinely recommended during pregnancy, and if the client becomes pregnant while receiving the HPV vaccine series, vaccination should be delayed until after the pregnancy.

The varicella vaccine (which protects against chickenpox) is not recommended during pregnancy, and if the client is not immune to chickenpox, the vaccine should be given after the pregnancy is over.

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Correct Answer is D

Explanation

The newborn who is 10 hr old and has new onset tachypnea should be assessed first as this could indicate a respiratory distress, which requires immediate intervention. The other options are concerning but not as urgent as respiratory distress.

A newborn with a short frenulum and difficulty breastfeeding can be assessed after the respiratory distress is addressed.

A newborn who is 24 hr old and has not had a meconium stool should be assessed for bowel sounds and abdominal distension, but it is not as urgent as respiratory distress. A newborn who is 30 hr old and has blood-tinged discharge in her diaper can be assessed after the respiratory distress is addressed. The blood-tinged discharge could be due to the infant's mother passing her own vaginal blood to the infant or a minor vaginal laceration during delivery.

A. Three fetal movements perceived by the client in a 20-min testing period B. No late decelerations in the fetal heart rate noted with three uterine contractions of 60 seconds in duration within a 10-min testing period C. An increase in fetal heart rate to 150/min above the baseline 140/min lasting 10 seconds in response to fetal movement within a 40-min testing period D. Irregular contractions of 10 to 20 seconds in duration that are not felt by the client

Correct Answer is D

Explanation

The nonstress test is a screening tool that assesses fetal well-being. It is performed by monitoring the fetal heart rate (FHR) and uterine contractions (UC) while the client is at rest. The test is considered reactive if there are two or more accelerations of the FHR that reach a certain level above the baseline and last for at least 15 seconds over a 20-min period.

The presence of irregular contractions that are not felt by the client is a finding that is concerning because it could be a sign of uterine hyperstimulation, which can lead to fetal distress. Further diagnostic testing may be needed to assess fetal well-being in this situation.

Option A indicates that the client felt fetal movements during the testing period. This is a reassuring finding because fetal movements are a sign of fetal well-being.

Option B indicates that there were no late decelerations in the FHR with uterine contractions. This is a reassuring finding because late decelerations are a sign of fetal compromise.

Option C indicates that there was an acceleration of the FHR in response to fetal movement. This is a reassuring finding because it indicates that the fetus is capable of responding to stimuli.

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A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client with which of the following vaccines? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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