The healthcare provider prescribes methylprednisolone 1 mg/kg IM every 12 hours for inflammation for a child who weighs 58 pounds.

The vial is labeled, "40 mg/mL.”. How many mL should the practical nurse (PN) administer with each dose? (Enter the numerical value only. If rounding is required round to the nearest tenth.)

Choice A rationale

Rho immune globulin (RhoGAM) is administered to Rh-negative mothers who have given birth to an Rh-positive baby. This injection prevents the mother's immune system from developing antibodies against Rh-positive red blood cells, which could otherwise harm future Rh-positive fetuses in subsequent pregnancies through hemolytic disease of the newborn.

Choice B rationale

If the mother is Rh positive and the baby is Rh negative, there is no risk of Rh incompatibility. The Rh-positive mother's immune system will not produce antibodies against the Rh-negative fetal red blood cells, as she already possesses the Rh antigen. Therefore, Rho immune globulin is not indicated in this scenario, as there is no sensitization risk.

Choice C rationale

When both the mother and the baby are Rh negative, there is no Rh incompatibility. Since neither the mother nor the baby has the Rh antigen, the mother's immune system will not be stimulated to produce anti-Rh antibodies. Consequently, Rho immune globulin administration is unnecessary in this situation, as no immune response will be triggered.

Choice D rationale

The Rh status of the father is relevant in determining the potential for Rh incompatibility, but it does not directly dictate the need for Rho immune globulin. The critical factor is the Rh status of the mother and the baby. If the mother is Rh positive, regardless of the father's Rh status, she will not produce Rh antibodies, and RhoGAM is not indicated.

Choice A rationale

The Varicella vaccine (chickenpox) is typically recommended for administration to children at 12 to 15 months of age, not at 2 months. Administering it earlier would not provide optimal immune response due to the presence of maternal antibodies, which can interfere with vaccine efficacy, rendering the immunization less effective at stimulating active immunity in the infant.

Choice B rationale

Hepatitis A vaccine is generally recommended for children starting at 12 months of age, with a second dose 6 to 18 months after the first. It is not typically administered to 2-month-old infants. The immunization schedule is designed to optimize the infant's immune system response to the vaccine at specific developmental stages, ensuring effective long-term protection.

Choice C rationale

The Hepatitis B vaccine is routinely administered at birth, followed by doses at 1 to 2 months and 6 to 18 months of age. Therefore, a 2-month-old infant is due for their second dose of the Hepatitis B vaccine as part of the standard childhood immunization schedule. This multi-dose regimen ensures robust and sustained immunity against the hepatitis B virus.

Choice D rationale

The Measles, Mumps, Rubella (MMR) vaccine #1 is typically administered to children at 12 to 15 months of age. Administering it at 2 months would not be appropriate. The timing is crucial for maximizing the immune response and minimizing potential interference from maternal antibodies, which are still present in significant levels at 2 months and can reduce vaccine effectiveness. .