A patient is a gravida 1. Rh-negative woman at a 28 weeks gestation. The father of her child is Rh- positive. The mother is asking the nurse about the effect on her unborn child of RhoGAM that has been ordered. What is the nurse's best reply?
"Your child will do well after birth once transfusions are administered.”
"RhoGAM kills antibodies you make, so your kid will be protected."
"Your baby may be Rh positive and cause you to make antibodies. These won't affect this baby, but could affect future children If RhoGAM isn't given."
“If the baby is RH negative at birth, he or she will need Rho GAM also”
The Correct Answer is C
A. "Your child will do well after birth once transfusions are administered": This statement focuses on postnatal intervention rather than preventing maternal sensitization during pregnancy, which is the primary purpose of RhoGAM.
B. "RhoGAM kills antibodies you make, so your kid will be protected": RhoGAM does not destroy existing antibodies; it prevents the formation of maternal antibodies against Rh-positive fetal cells. This explanation could mislead the patient.
C. "Your baby may be Rh positive and cause you to make antibodies. These won't affect this baby, but could affect future children if RhoGAM isn't given": RhoGAM prevents maternal sensitization by neutralizing fetal Rh-positive red blood cells before the immune system responds. This explanation clearly communicates the purpose of the medication and the relevance for future pregnancies.
D. "If the baby is Rh negative at birth, he or she will need RhoGAM also": RhoGAM is administered to the mother, not the baby, and is only necessary if the mother is Rh-negative and the fetus is Rh-positive.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Postpartum infection: While all postpartum clients are at some risk for infection, this typically develops later and is not immediately associated with a large infant or the first few hours after birth.
B. Retained placental fragments: Retained placental tissue can cause bleeding and infection, but careful inspection of the placenta after delivery usually rules this out. There is no indication in the scenario that fragments remain.
C. Thrombophlebitis: Thromboembolic risk increases postpartum, especially with immobility, obesity, or a history of thrombosis. Although this client may have some risk factors, immediate concern in the first hours postpartum is more directly related to uterine tone.
D. Uterine atony: Delivery of a macrosomic infant (9 lb 6 oz) increases the risk of uterine overdistention, which can lead to poor uterine contraction and uterine atony. Uterine atony is the most common cause of early postpartum hemorrhage and requires close monitoring and intervention.
Correct Answer is B
Explanation
A. "I have an IUD and have had the same boyfriend for 3 years.": Being in a mutually monogamous relationship reduces the risk of acquiring STDs, and the presence of an IUD primarily prevents pregnancy rather than influencing STD risk. This statement indicates lower concern for immediate STD education.
B. “I have never been tested for syphilis or chlamydia.": Lack of screening for common STDs places the patient at increased risk of undiagnosed infections. Chlamydia and syphilis can be asymptomatic but cause long-term complications, highlighting the critical need for patient teaching about routine testing and early detection.
C. "I make an appointment every year for a pelvic exam.": Annual pelvic exams are important for reproductive health and early detection of abnormalities, but they do not guarantee protection against STDs. The patient demonstrates proactive preventive care in this context.
D. "I use the birth control pill because I am not ready to settle down yet.": Using oral contraceptives addresses pregnancy prevention but does not prevent STDs. While additional teaching on barrier protection may be warranted, this statement primarily reflects awareness of contraceptive needs rather than immediate high-risk behavior.
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