A nurse is reviewing a client's rubella titer of 1:8 at her second prenatal visit.
Which of the following statements by the nurse is appropriate?

"You will need a rubella immunization at your next prenatal visit.”.

"Because rubella is a live vaccine, you will not be able to breastfeed your newborn.”.

"Your titer indicates that you are susceptible to rubella.”.

"During your third trimester, you will need to repeat a blood test for the titer.”.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Administering a rubella immunization during pregnancy is contraindicated because the rubella vaccine is a live attenuated virus vaccine. There is a theoretical risk of viral transmission to the fetus, which could lead to congenital rubella syndrome. Vaccination should occur postpartum to protect future pregnancies.

Choice B rationale

Breastfeeding is not contraindicated after receiving the rubella vaccine. Although rubella vaccine virus can be excreted in breast milk, it generally does not cause clinical illness in the infant and passive transfer of antibodies may provide some protection to the infant.

Choice C rationale

A rubella titer of 1: indicates a low level of rubella antibodies, meaning the client is susceptible to rubella infection. A titer of less than 1: or 1: is generally considered non-immune, requiring vaccination to prevent congenital rubella syndrome in future pregnancies.

Choice D rationale

Repeating a rubella titer in the third trimester is not a standard practice for assessing susceptibility. Once susceptibility is determined, the primary intervention is postpartum vaccination. The initial titer result accurately reflects immune status and further testing during pregnancy is unnecessary.

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Correct Answer is A,B,C,D

Explanation

Observe the newborn's respirations. Auscultate the newborn's heart rate. Auscultate newborn's abdomen. Test the newborn's reflexes.

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

Explanation

The client is at greatest risk for developing Endometritis as evidenced by the client’s Lochia characteristics.

Rationale for correct answers:
Endometritis is a postpartum uterine infection commonly occurring after cesarean birth due to ascending bacterial contamination. The client’s foul-smelling lochia is a hallmark sign, indicating infection of the uterine lining. Normally, lochia is odorless and changes from red to serous and then to white over weeks postpartum. The elevated WBC count (18,000/mm³; normal 5,000–15,000/mm³) supports infection but is nonspecific. The firm uterine tone reduces likelihood of postpartum hemorrhage. Urinalysis positive for bacteria suggests UTI but does not explain uterine signs. Hence, lochia changes are the most direct indicator of endometritis.

Rationale for incorrect Response 1 answers:
Postpartum hemorrhage typically involves heavy bleeding, uterine atony, or a rapidly dropping hematocrit, none of which is reported here. Urinary tract infection is suggested by urinalysis but does not account for uterine tenderness or foul lochia. Deep vein thrombosis would present with limb swelling, pain, and possible fever but no uterine or lochia changes.

Rationale for incorrect Response 2 answers:
Urinalysis positive for bacteria points to UTI but not uterine infection. Elevated WBC count indicates infection or inflammation but lacks specificity for endometritis versus other infections. Uterine tone is firm here, making hemorrhage or uterine atony unlikely and less relevant to infection diagnosis.

Take home points:

Endometritis often presents postpartum with foul-smelling lochia and elevated WBC.
Foul-smelling lochia is a critical clinical sign distinguishing endometritis from other postpartum complications.
Positive urinalysis suggests UTI, a separate postpartum infection that requires differentiation.
Uterine tone helps rule out hemorrhage and guides diagnosis of infection versus atony.

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A nurse is reviewing a client's rubella titer of 1:8 at her second prenatal visit. Which of the following statements by the nurse is appropriate?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A,B,C,D

Explanation

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

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A nurse is reviewing a client's rubella titer of 1:8 at her second prenatal visit.
Which of the following statements by the nurse is appropriate?