A nurse is caring for a newborn whose mother is positive for the hepatitis B surface antigen.Which of the following should the infant receive?
Hepatitis B immune globulin at 1 week followed by hepatitis B vaccine monthly for 6 months.
Hepatitis B immune globulin and hepatitis B vaccine within 12 hr of birth.
Hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigen.
Hepatitis B vaccine at 24 hr followed by hepatitis B immune globulin every 12 hr for 3 days.
The Correct Answer is B
Choice A rationale
Hepatitis B immune globulin at 1 week followed by hepatitis B vaccine monthly for 6 months is incorrect. This schedule delays the immune response and leaves the infant unprotected during the critical early period when the risk of transmission is highest.
Choice B rationale
Hepatitis B immune globulin and hepatitis B vaccine within 12 hr of birth is the correct approach. This combination provides immediate passive immunity through the immune globulin and active immunity through the vaccine, significantly reducing the risk of hepatitis B transmission from mother to child.
Choice C rationale
Hepatitis B vaccine monthly until the newborn tests negative for the hepatitis B surface antigen is incorrect. Monthly administration alone is insufficient without the initial dose of immune globulin, especially since the infant may remain at risk until the negative test result.
Choice D rationale
Hepatitis B vaccine at 24 hr followed by hepatitis B immune globulin every 12 hr for 3 days is incorrect. The delay in the first vaccine dose reduces its efficacy, and the immune globulin schedule does not align with established guidelines for preventing hepatitis B transmission.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Lanugo is a fine hair that covers the fetus but does not primarily protect the skin from amniotic fluid exposure. It mainly helps in thermoregulation and the adherence of the vernix caseosa.
Choice B rationale
While skin care after birth is important, applying cream post-delivery does not explain why the skin is protected during gestation.
Choice C rationale
Vernix caseosa is a protective, cheese-like coating that covers the fetus's skin. It provides a barrier against the amniotic fluid, preventing maceration of the skin during the pregnancy.
Choice D rationale
Although subcutaneous fat develops in the fetus, it is not responsible for protecting the skin from amniotic fluid. The primary protective mechanism is the vernix caseosa.
Correct Answer is C
Explanation
Choice A rationale
Lie on back when counting kicks is incorrect. It is recommended to lie on the side, preferably the left side, as lying on the back can compress major blood vessels and affect circulation to the fetus.
Choice B rationale
You can begin counting fetal movements at 8 weeks gestation is incorrect. Fetal movements are typically felt by the mother starting around 18-20 weeks of gestation, not as early as 8 weeks.
Choice C rationale
Call healthcare provider if at least 3 movements are not felt over an hour. This is an important guideline as decreased fetal movements can indicate potential issues and should be reported to the healthcare provider for further evaluation.
Choice D rationale
Count movements at the same time each day is a good practice but it is not the most critical instruction. While consistency is beneficial, the immediate action for decreased movements is more urgent.
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