A nurse is teaching a client who is 26 weeks pregnant and will be receiving an injection of Rh(D) immunoglobulin.Which of the following should be included in the teaching?
It prevents the formation of Rh antibodies.
It prevents the formation of Rh antibodies in newborns who are Rh positive.
It destroys Rh antibodies in mothers who are Rh negative.
It destroys Rh antibodies in newborns who are Rh positive.
The Correct Answer is A
Choice A rationale
Rh(D) immunoglobulin prevents the formation of Rh antibodies in Rh-negative mothers. This is crucial to prevent Rh sensitization, which can lead to hemolytic disease of the newborn in current and future pregnancies.
Choice B rationale
Rh(D) immunoglobulin does not prevent the formation of Rh antibodies in newborns who are Rh positive. Instead, it works by preventing the mother's immune system from recognizing Rh-positive fetal cells.
Choice C rationale
Rh(D) immunoglobulin does not destroy Rh antibodies in Rh-negative mothers. Its purpose is to prevent the formation of these antibodies in the first place.
Choice D rationale
Rh(D) immunoglobulin does not destroy Rh antibodies in newborns who are Rh positive. The newborn's immune system is not targeted by this immunoglobulin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
The fetal heartbeat can be heard with a Doppler at the fourth week of gestation is incorrect. At this early stage, the embryonic heart has only just begun to form, and its activity cannot be detected by Doppler.
Choice B rationale
The fetal heartbeat can be heard with a Doppler at the sixth week of gestation is incorrect. Although the heart begins to beat around this time, it is usually too faint to be detected by Doppler.
Choice C rationale
The fetal heartbeat can be heard with a Doppler at the seventh week of gestation is incorrect. It remains challenging to detect the fetal heartbeat this early with standard Doppler equipment.
Choice D rationale
The fetal heartbeat can be heard with a Doppler at the twelfth week of gestation is correct. By the end of the first trimester, the fetal heart is sufficiently developed and strong enough to be detected using Doppler ultrasound, allowing healthcare providers to monitor fetal well-being.
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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