At 6-weeks gestation, the rubella titer of a client indicates she is nonimmune. When is the best time to administer a rubella vaccine to this client?
Immediately, at 6-weeks gestation, to protect this fetus.
After the client reaches 20-weeks gestation.
After the client stops breastfeeding.
Early postpartum, within 72 hours of delivery.
The Correct Answer is D
Rationale:
A. Immediately, at 6-weeks gestation: Rubella vaccine is a live attenuated vaccine and is contraindicated during pregnancy because it can potentially cause fetal harm.
B. After the client reaches 20-weeks gestation: Administering rubella during pregnancy at any gestational age is unsafe due to the live virus, so waiting until mid-pregnancy does not prevent fetal risk.
C. After the client stops breastfeeding: Rubella vaccination can be given while not pregnant, including postpartum, and is not strictly contraindicated by breastfeeding. Timing postpartum is more critical than waiting until breastfeeding ends.
D. Early postpartum, within 72 hours of delivery: The optimal time to vaccinate a nonimmune mother is immediately after delivery, ideally within 72 hours, to provide immunity for future pregnancies and prevent congenital rubella syndrome in subsequent pregnancies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Ibuprofen should be used prophylactically to prevent febrile seizures: Antipyretics like ibuprofen or acetaminophen help reduce fever-related discomfort but do not prevent febrile seizures. Prophylactic use for seizure prevention is not recommended.
B. Reassure the parents that febrile seizures decrease as the child grows older: Febrile seizures are typically benign, occur between 6 months and 5 years of age, and most children outgrow them. Conveying this information reduces parental anxiety and provides reassurance
C. Avoid excessive visual stimuli because it can precipitate seizure activity: While some seizures (e.g., photosensitive epilepsy) can be triggered by visual stimuli, febrile seizures are triggered by fever, not light exposure.
D. Provide the child with a sponge bath for temperatures over 100.6°F (38.1°C): Sponge baths may help reduce discomfort from fever but do not prevent febrile seizures. This intervention is supportive rather than preventive or prognostic.
Correct Answer is B
Explanation
Rationale:
A. Respiratory acidosis: Respiratory acidosis occurs when hypoventilation leads to CO₂ retention and carbonic acid buildup in the blood. It is associated with conditions like pneumonia, asthma, or neuromuscular weakness rather than gastrointestinal losses.
B. Metabolic alkalosis: Metabolic alkalosis occurs when prolonged vomiting leads to the loss of gastric hydrochloric acid, reducing hydrogen ion concentration in the blood. This loss of acid causes a relative excess of bicarbonate, making it the most likely imbalance for a child vomiting for 3 days.
C. Metabolic acidosis: Metabolic acidosis occurs when there is either excessive acid production or loss of bicarbonate, as in diarrhea or diabetic ketoacidosis. Because vomiting removes stomach acid instead of bicarbonate, this imbalance would not be expected here.
D. Respiratory alkalosis: Respiratory alkalosis occurs when hyperventilation causes excessive exhalation of CO₂, leading to elevated blood pH. Since vomiting does not impact ventilation directly, respiratory alkalosis is not the likely disturbance in this scenario.
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